MEASURING SERVICE SYSTEM IMPLEMENTATION IN A PUBLIC MENTAL-HEALTH SYSTEM THROUGH PROVIDER DESCRIPTIONS OF EMPLOYMENT-SERVICE NEED AND USE

In a provider survey 6654 consumers of mental health services were sampled from a public mental health system. Case managers or other principal clinicians completed forms for sampled consumers, providing data on services ideally needed and used by these consumers during a specified month. Data were analyzed for individual services and service groupings identified by cluster analysis. Field staff judged 47% of all persons in a public mental health service as needing one or more employment related services. According to the perceptions of field staff, only 22% of persons actually received employment services. The congruence between perceptions of amounts of service needed and received across all employment services (art indicator of service appropriateness) was 34%. Four service clusters were identified: skills training; TEP/Clubhouse, supported employment, and minimal services. Data on the congruence between prescribed and provided cluster are also presented. To the degree that the public mental health system studied is representative, these data indicate a need for increasing the amount of employment service received by persons in public mental health systems.