The DMIE Long-Term Follow Up project will answer questions about the long-term effects of early-intervention services for workers with mental health problems that are designed to help them maintain employment while promoting maximal levels of health and economic independence. The findings will contribute to the knowledge base on how to design interventions for workers with potentially disabling conditions that improve their health and vocational status, thereby enhancing their economic independence and reducing vulnerability to the onset of severe disability. These so-called “early interventions” can be used to prevent unnecessary dependence on public assistance programs and enhance overall self-sufficiency.

The Demonstration to Maintain Independence and Employment (DMIE), authorized under the Ticket to Work and Work Incentives Improvement Act of 1999 awarded funds to states to develop, implement, and evaluate interventions for workers with potentially disabling health conditions that would help to improve their health and vocational status, thereby allowing them to avoid enrolling in public assistance programs. Two states — Texas and Minnesota – conducted randomized controlled trials (RCTs) to test multi-component interventions aimed at providing comprehensive health insurance coverage, healthcare navigators, and vocational supports for large numbers of employed individuals with serious mental illness and co-occurring behavioral and physical health disorders. At 12-month follow-up, participants in both states reported greater access to and utilization of health and mental health services. In Texas, those receiving early intervention were significantly less likely to be receiving SSI/SSDI than controls after one year of service delivery.

This study will extend the original study time period so that all participants will have data for 36-months post enrollment. By following these respondents over a longer period of time than the original evaluation time frame, this study will determine the longer-term impact of early intervention services on at-risk workers and help determine the characteristics of those most likely to benefit from such services.