Primary Sources: Integrated Employment and Mental Health Services -- How Well Do They Work For Homeless Youth?

A diverse group of happy young people.

Using the Social Enterprise Intervention and Individual Placement and Support Models to Improve Employment and Clinical Outcomes of Homeless Youth With Mental Illness” (abstract). Kristin M. Ferguson. Social Work in Mental Health, Vol. 11, No. 5 (2013).

What it’s about: Author Kristin M. Ferguson worked with two social services agencies in Los Angeles that work with homeless youth who also suffer from mental illness. Together, Ferguson and agency staff studied the effect on young people of two programs that combine employment and mental health services.

About three dozen youth participated in each of the two studies. In each case, Ferguson involved staff, clients, community members, board members and others in conducting the research, an approach called community-based participatory research. Both studies had an "intervention group" that took part in the program being studied and a "control group" that got regular support services.

Why read it: Homeless youth face many barriers to employment. Other researchers have estimated that the unemployment rate among homeless young people may be as high as 75 percent. At the same time, Ferguson writes, many homeless youth make money through nontraditional and sometimes through illegal means, like selling blood, dealing drugs, panhandling and survival sex. Programs that empower homeless youth, including those struggling with mental illness, to gain job skills and get and keep jobs may also help them to afford stable housing and stay off the streets.

Biggest takeaways for family and youth workers: One of the two models Ferguson studied is Social Enterprise Intervention, an evidence-informed 20-month program with four stages through which youth gain vocational skills and small-business skills, start their own cooperative business, and get clinical mental health services.

Youth in the intervention group felt better about their lives and about the support they received from family and peers at the end of the program. Their symptoms of depression had decreased, as well. In focus groups, they said the program boosted their self-esteem, motivation and employability.

The second model that Ferguson studied is Individual Placement and Support, an evidence-based program designed to help people with mental illnesses get employed and stay employed. The program uses eight principles, including integrated clinical and vocational services, rapid placement in jobs, and continuing, individualized support for participants.

Youth in the study group had higher employment rates throughout the months of the study than did youth in the control group, who were receiving less intensive employment services separate from mental health services. Between 45-70 percent of youth in the study group were working in any given month, compared to 19-31 percent of control-group youth.

Ferguson also makes a case for the practical effects of the community-based participatory research approach she used for both studies. She argues that using this method of research to pilot a new program can make it easier to integrate services that are typically kept separate, such as mental health and employment.

Additional references: Look for more articles about youth employment and mental health in NCFY’s research library.

Previously, we wrote about research into whether mental health and housing services can help homeless youth hold down a job.

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