TOWARDS ZERO EXCLUSION IN VOCATIONAL OPPORTUNITIES FOR PERSONS WITH PSYCHIATRIC DISABILITIES - PREDICTION OF SERVICE RECEIPT IN A HYBRID VOCATIONAL CASE-MANAGEMENT SERVICE PROGRAM (VOL 18, PG 17, 1995)

Caught in the dilemma of too few vocational rehabilitation slots to se rve all interested consumers, agencies often have been accused of ''cr eaming''-offering vocational opportunities primarily to those with be greatest likelihood of employment success. Project WINS sought to impl ement a cost-effective method of enhancing vocational services to indi viduals with severe mental illness served by mental health agencies, t hrough Be addition of vocational specialists (and other supports) to c ase management teams, The major principles guiding implementation had relevance for the process by which clients should receive vocational i ntervention: 1) toward zero exclusion of individuals from vocational s ervices 2) client self-determination of vocational goals desires, and needs for service; and 3) the choose/get/keep model, tailoring interve ntions to individual clients, whatever their stage of vocational devel opment Clients were referred to WINS primarily through case managers, although self-referrals were accepted, Predictive analyses (logistic r egression and survival analysis) identified variables that differentia ted clients who received services during the first 18 months of WINS o peration from those who did not, Potential predictors came from four d omains: demographic and background characteristics; descriptors of psy chiatric status and community functioning; work history and expectatio ns; and agency setting variables Results indicated that systematic cli ent selection occurred: some elements of selection reflected the inter vention's guiding principles, while other selection factors reflected traditional labor market variables. Discussion includes application of findings to implementation of vocational interventions in mental heal th case management agencies.