Abstract
Objective: For many years, vocational and clinical services for persons with severe mental illness have been separated (i.e., non-integrated) in the United States. Recent research on supported employment shows, however, that combined vocational and clinical services within the same team (i.e., integrated services) produce higher rates of competitive employment than non-integrated services.
Design: To understand the advantages of integrating vocational and clinical services, the authors examined quantitative process data, ethnographic findings, and qualitative interview data from practitioners in three independent studies of supported employment.
Results: Integrated services offer four consistent advantages over non-integrated services: (1) more effective engagement and retention, (2) better communication, (3) opportunities for clinicians to understand and focus on employment, and (4) incorporation of clinical information into vocational plans and services.
Conclusions: Combining clinical and vocational services within multidisciplinary teams is consistent with the general movement toward developing integrated systems of care. Integrated services are more effective than parallel services because clinicians rather than clients assume the burden of coordination, consistency, and coherence.