Statewide Initiative of Intensive Psychiatric Rehabilitation: Outcomes and Relationship to Other Mental Health Service Use t Marsha Langer Ellison University of Massachusetts Medical School E. Sally Rogers, Asya Lyass and Joseph Massaro Boston University Nancy J. Wewiorski Mental Illness Research Education and Clinical Center, Bedford VA Medical Center Bedford, MA Su-Ting Hsu Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan William A. Anthony Boston University Acknowledgements: This study was supported by the National Institute on Disability and Rehabilitation Research (NIDRR) within the Department of Education, and the Center for Mental Health Services (CMHS), a divi- sion of the Substance Abuse and Mental Health Services Administration (Grant # H133B990023). The findings and interpreta- tion of the data expressed in this article do not necessarily represent the views of NIDRR or the CMHS, but are the sole responsibility of the authors. Objective: This study examines the outcomes of a statewide implementation of Intensive Psychiatric Rehabilitation (IPR) for improving residential and employ- ment status and earnings among individuals with severe mental illnesses and also examines its implementation with respect to mental health service utilization and costs. Methods: This study employs a pre-post design with participants act- ing as their own controls for rehabilitation outcomes (residential status, vocation- al outcomes and earnings) comparing those who “completed” or had a sufficient- ly intense dose of IPR (one year) to those who dropped out early (before six months of service) and those who dropped out later in service (6-12 months). A separate analysis was conducted examining the relationship of IPR to other men- tal service use and costs using a quasi-experimental design that contrasted IPR completers with a control group matched via propensity scores. Results: The results suggested significant improvement in residential status, employment sta- tus and gross monthly earnings for IPR completers relative to other groups. IPR completers also tended to use more mental health services or have more shallow decreases in use and cost of services relative to matched controls. Conclusions and Implications for Practice: Gains in rehabilitation outcomes can be expected for those who engage in and complete IPR services, but IPR cannot be expected to result in reduced overall mental health service use and costs. Rather, IPR may improve service access or perhaps ameliorate any containment effect of managed care on service use. Keywords: psychiatric rehabilitation, employment, mental illness, rehabilitation intervention, rehabilitation outcomes, housing, earnings, propensity scores Introduction As the result of a federal mandate, mental health leaders have re-focused their efforts beyond symptom reduc- tion and maintenance to full communi- ty integration and recovery for individuals with mental illness (New Freedom Commission on Mental Health, 2003; Substance Abuse and Mental Health Services Administration, 2007). This systems transformation ef- fort and resulting paradigm shift have pushed programs to evolve to a more comprehensive recovery orientation (Mueser, Torrey, Lynde, Singer, & Drake, 2003; Becker, Bond, McCarthy, Thompson, Xie, McHugo, & Drake, 2001). Increasing numbers of states have attempted to implement psychi- atric rehabilitation programs system- 9 Psychiatric Rehabilitation Journal 2011, Volume 35, No. 1, 9–19 Copyright 2011 Trustees of Boston University DOI: 10.2975/35.1.2011.9.19 Article This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.