A case report of the conversion of sheltered employment to evidence-based supported employment in Canada.

This case report describes the transformation of a sheltered workshop program to a program that provides evidence-based supported employment services in partnership with five community treatment teams. Over a 15-year period, a Canadian nonprofit agency that provides employment services for persons with severe mental illness made a series of programmatic changes to increase the effectiveness of the services. The agency initially modified its facility-based sheltered workshop to include a prevocationally oriented work preparation program, later added brokered supported employment services, and finally completely transformed its organization by relocating its vocational rehabilitation counselors to five community mental health teams, in order to implement an evidence-based supported employment program that is based on the individual placement and support model. During the initial period in which the sheltered employment program was utilized, less than 5 percent of clients who were unemployed when they entered the workshop achieved competitive employment annually. The annual competitive employment rate did not increase during the prevocational phase; it increased during the brokered supported employment phase but did not exceed 25 percent. By contrast, after shifting to evidence-based supported employment, 84 (50 percent) of 168 unemployed clients who received between six and 27 months of individual placement and support services achieved competitive employment. This article also documents the role of agency planning and commitment quality improvement in implementing change.