Supported Employment for people with mental disabilities in South Africa: cost calculation of service utilisation

Abstract

Introduction: Supported Employment (SE) is a strategy that facilitates positive employment outcomes for people with mental disabilities in open labour market settings. SE's cost-effectiveness has been established internationally, but not in South Africa. This paper reports on the cost and affordability of SE services offered to people with mental disabilities in South Africa.

Method: A longitudinal descriptive study was used to determine the cost of SE service components utilised by people with mental disabilities, from two programmes in the Western Cape. The utilisation of service elements was captured in 15-minute time units. Data collection continued for 12 months, commencing when a job had been identified and preparation for placement had ensued. Time utilisation data were used to calculate cost, using a government sessional salary (R189/hour) and a medical aid reimbursement rate (R367/hour) of occupational therapists acting as job coaches.

Findings: The findings show SE services to be less than 10% of the cost of a monthly disability grant, and 10% - 21% lower than the current subsidy per consumer in a protective workshop.

Conclusion: Evidence from the study thus reflects the cost of SE services to people with mental disability as substantially lower than the current government investment in disability grants and protective workshops subsidies.

 Key words: psychiatric disability; intellectual disability; vocational rehabilitation; reasonable accommodation; return to work