Public provision of postsecondary education for transition-age youth with mental health conditions.

OBJECTIVE: We examine the role of state vocational rehabilitation (VR) agencies (SVRA) in providing postsecondary education support to transition-age youth with and without mental health conditions (MHC) to provide insights into who receives such supports and the association between the receipt of postsecondary education support and successful VR exits. METHOD: We used data from SVRA administrative records (fiscal years 2002 through 2013) for a secondary analytical approach that relied on descriptive and regression methods, resulting in the identification of 436,883 VR youth clients who applied from 2002 to 2004. Linear regression models examined the relationships between youth demographic and service characteristics and each of 4 binary outcomes derived from the administrative records: (1) receipt of VR services, (2) receipt of college support (conditional on receiving services), (3) receipt of vocational training support (conditional on receiving services), and (4) exiting with employment. RESULTS: SVRAs had a wide range in the provision of postsecondary education support to clients with MHC, from almost none receiving such supports to more than half. VR youth clients with MHC were less likely than those without MHC to have received any VR services or college support. Receipt of postsecondary education support was positively associated with being employed at the time of VR exit, and the associations for those with MHC were not statistically different from those without MHC. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: SVRAs have the potential to play a large role in the provision of postsecondary education support. Although those who received postsecondary education support were more likely to be employed at the time of VR exit, the provision of that support came at a cost-the high financial costs of that type of support relative to other services offered by SVRAs, as well as the opportunity cost of the client's time. (PsycINFO Database Record

Health care in Jamaica: quality, outcomes, and labor supply

This paper investigates the relationship among labor force participation, health outcomes, and the availability and quality of health care in a developing country. We develop an econometric model that addresses the demand for health care in a choice model and then link it to health status outcomes and labor force participation decisions. The econometric model has two parts to it. First, we estimate a discrete choice model to determine how ill people choose among the various providers of health care. Using the parameter estimates from this model, we calculate the expected value of the best available to each individual. In the second stage, health is allowed to affect labor force participation in a simultaneous equations probit model where the potential endogeneity of reported health is controlled for with a set of instruments that includes the constructed health care quality. We report the results of simulating the impact on health outcomes and labor force participation of policy changes such as improving access to and quality of health care as well as reducing the price of health services. We use data from the 1989 Jamaican Survey of Living Conditions, the 1989 Jamaican Labour Force Survey, and a sample (also from 1989) of Jamaican health care facilities. We find that the quality of health facilities has a small improving effect on health but no significant effect on labor force participation (AU)