Supported Employment for Veterans with Traumatic Brain Injury: Patient Perspectives

Publication date: Available online 4 August 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kathleen F. Carlson, Terri K. Pogoda, Tess Gilbert, Sandra G. Resnick, Elizabeth Twamley, Maya E. O'Neil, Nina A. Sayer
ObjectiveTo quantify the need for, and interest in, Supported Employment (SE) among recent military Veterans with traumatic brain injury (TBI), and to examine characteristics associated with Veterans' interest in SE.DesignStratified random sample of Iraq and Afghanistan War Veterans confirmed to have TBI through the Veterans Health Administration (VHA) screening and evaluation system.SettingCommunity-based via mailed survey.ParticipantsWe recruited 1,800 Veterans with clinician-confirmed TBI (1,080 mild TBI; 720 moderate/severe TBI) through multiple mailings. Among 1,451 whose surveys were not returned undeliverable, 616 (42%) responded.InterventionsNot applicable.Main Outcome MeasuresVeterans rated their interest in SE after reading a script describing the program. Additional measures assessed mental health and pain-related comorbidities, employment, financial/housing difficulties, demographics, and military service characteristics. Estimates were weighted to represent the population of Veterans with VHA clinician-confirmed TBI.ResultsUnemployment was reported by 45% (95% confidence interval [CI]: 43, 47) of Veterans with TBI. Although 42% (95% CI: 40, 44) reported they would be interested in using SE if it were offered to them, only 12% had heard of SE (95% CI: 11, 14) and <1% had used it. TBI severity and comorbidities were not associated with Veterans' interest in SE. However, those who were unemployed, looking for work, experiencing financial strain, or at risk for homelessness were more likely to be interested in SE.ConclusionsOur research highlights an important gap between Veterans' vocational needs and interests and their use of SE. Systematically identifying and referring those with employment and financial/housing difficulties may help close this gap.



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