Vocational rehabilitation services helps people with traumatic brain injuries get back to work

More than 2 million people in the United States suffer traumatic brain injuries (TBI) each year, costing the nation nearly $1 billion in lost wages, increased government support and lost tax income in the first year alone. However, a University of Missouri-Columbia researcher has found that persons with TBI have a good chance of successfully returning to work if they receive vocational rehabilitation services. Brick Johnstone, a professor of health psychology, also said the vocational rehabilitation is most effective for persons with the most severe neuropsychological impairments.

Working in collaboration with the Missouri Division of Vocational Rehabilitation (DVR), Johnstone followed nearly 200 patients over a period of 10 years. He said that TBI clients who use vocational rehabilitation services such as on-the-job training and career counseling are the most successful at returning to work. He found 24 percent of DVR clients with TBI are able to return to work following their injury.

“We found vocational rehabilitation is most successful for the clients with the most significant TBI’s,” Johnstone said. “Patients with a mild injury might return to work without any kind of rehabilitation, but they may or may not be successful. Those with moderate injuries might try the services but not follow through. Those patients with the most severe injuries know they need the help and stay with their rehabilitation to ensure they get the most out of it.”

Johnstone found major differences in the work success of patients based on gender and location. Males are more likely to return to work after a TBI (24 percent to 4 percent for females), and those living in urban areas are more likely to get a job than their rural counterparts (24 percent to 7 percent). Race is not a major issue in returning to work from a traumatic injury as Johnstone and his colleagues found 23 percent of the African American patients were successful in returning to work with DVR assistance, compared to 18 percent of Caucasians.

“It is important to know that women with TBI may face distinct issues when considering returning to work, including issues related to being primary homemakers and child care providers,” Johnstone said. “People who live in urban areas are more successful returning to work for several reasons. There are not as many jobs or rehabilitation professionals in rural areas and there are fewer transportation opportunities in rural areas. This shows we must find new ways to work together to provide job services to people who live in rural areas.”

In addition to studying the success of vocational rehabilitation, Johnstone, other MU faculty and DVR staff also assessed the usefulness of telehealth services for TBI clients in rural areas. They found that telehealth interviews, which are video interviews done using telephone networks, were as effective as in-person interviews. TBI clients said they were more likely to return for services if they were offered the telehealth interviews.

“Telehealth saved considerable time and money for the persons with TBI, MU neuropsychologists and DVR,” Johnstone said. http://www.missouri.edu/


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