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 sam pled from a public mental health system. Case managers or other princi pal clinicians completed forms for sampled consumers, providing data o n services ideally needed and used by these consumers during a specifi ed month. Data were analyzed for individual services and service group ings identified by cluster analysis. Field staff judged 47% of all per sons in a public mental health service as needing one or more employme nt 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 a ll employment services (art indicator of service appropriateness) was 34%. Four service clusters were identified: skills training; TEP/Clubh ouse, supported employment, and minimal services. Data on the congruen ce 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 se rvice received by persons in public mental health systems.