Impact of Substance Use Disorders on Employment for Veterans

Approximately 1.1 million veterans meet criteria for substance use disorders (SUDs) with 1 in 4 struggling with illicit drugs, 4 in 5 struggling with alcohol use, and 1 in 13 struggling with both. The purpose of this study was to examine the impact of SUDs on closure status (exiting with employment, did not exit with employment) for veterans served in a Department of Veterans Affairs' Veterans Health Administration (VHA) vocational rehabilitation (VR) program. Data (N = 2,620) from a VHA VR program in the Veterans Integrated Service Network 12 network were obtained for the purpose of the present study and consisted of veterans enrolled from 2012 to 2018. Findings showed that veterans without SUDs were more likely to exit with employment, and veterans enrolled in transitional work and community-based employment were more likely to exit with employment compared to those within supported employment (SE). Given that SE helps to serve veterans with the most severe psychological or medical conditions (e.g., active psychosis, schizophrenia, bipolar disorder, spinal cord injury, traumatic brain injury), findings suggest veterans are more successful with less serious mental health conditions. Impact Statement Despite Veterans Health Administration (VHA) Policy Directive 1163 indicating that veterans are eligible for VHA vocational rehabilitation (VR) services despite having substance use disorders (SUDs), findings showed that veterans with SUDs are less likely to exit with employment. Veterans with the most severe psychological or medical disabilities (e.g., active psychosis, schizophrenia, bipolar disorder, spinal cord injury, traumatic brain injury) are served in supported employment (SE) and were less likely to secure employment compared to veterans enrolled in other programs (transitional work, community-based employment services). SE mandates the use of the Individual Placement and Support (IPS) model which emphasizes rapid employment, whereas the other programs accentuate knowledge, skills, interests, and functional abilities. However, this intensive program did not yield employment rates to that of the other programs. VHA policy directives should implement a structured measurement-based care initiative that assists programs in identifying social health determinants that impact employment status at closure to better reduce barriers for veterans with SUDs. Since a large portion of veterans have substance/alcohol use disorders, there is an increased need to imp