Quality Improvement Project to Increasing Employment Support Awareness Among Behavioral Health Staff

Purpose: This quality improvement (QI) project aimed to increase staff understanding of employment’s importance to mental health, comfort with and intention to refer patients to employment support services, and increase patient contact with vocational rehabilitation.Background: The Substance Abuse and Mental Health Service Administration (SAMHSA) has named employment an important step in mental illness recovery. Employment has been linked to social integration, improved mental health, and financial independence. Employment support services are offered in Arizona to those with a debilitating mental illness. However, of the public service mental health patients who report wanting to work, less than 2% are referred to employment support services. Low referral rates have been linked to a lack of knowledge and buy-in among the mental healthcare community. This project included administering a week-long employment support education intervention to staff at a psychiatric care facility. This education utilized approaches described in Adult Learning Theory (ALT) by tailoring the education to meet the learner’s needs and background. Methods: This project was implemented at a 12 bed, adult, inpatient, acute psychiatric care facility located in Prescott Valley, Arizona. A pre/posttest design assessed intervention efficacy on an 11-item numerical scale. The mean, minimum, maximum, and sum of the survey responses were calculated and compared. The project intervention was an educational video, a poster placed on the patient milieu, and information/application pamphlets for staff distribution. Patient contact of vocational support was tracked four weeks pre and post-intervention. The Institutional Review Board (IRB) approved this study. No conflicts of interest were identified. Results: Of the six screener staff volunteers, two submitted pre- and post-questionnaires. Post-intervention responses indicated increased appreciation for the importance of employment on mental health and comfort and intention to refer patients to employment support services. No patients from Pronghorn Psychiatry inpatient contacted vocational support pre- or post-intervention. Conclusion: Education may have increased employment support understanding and comfort with and intention to refer patients to employment support services. Low staff participation may have resulted in a lack of patient referral. Future interventions at Pronghorn Psychiatry may benefit from utilizing a personal approach to solicit medical staff buy-in pre-intervention