Key takeaway
SAMHSA's Individual Placement and Support toolkit says a job search starts soon after a person wants to work, without required readiness classes or vocational testing. Competitive jobs are ordinary jobs anyone can apply for, paying at least the minimum wage. The model is not a job offer. The search is the subject, not the interview script.
Last updated: Mon Oct 05 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Looking for work and returning to a job you already hold are different chores. You may want a paycheck and a reason to leave the house, and still be scared of the application. SAMHSA's Individual Placement and Support toolkit treats employment as a social determinant of health, meaning work is tied to better health, and it lists ordinary benefits: earning money, a structured day, a way to contribute, a place to have friends. It says those benefits hold for the general public and for people with disabilities, including people living with mental health conditions and substance use disorders. The model was built because people with mental health conditions were often told they could not work, or were steered into day treatment, vocational evaluations, and sheltered workshops. Surveys, the toolkit says, have long shown that people with mental health conditions want to work. The returning-to-work guide covers the broader recovery question, including the research that guide summarizes about outcomes. What follows is the search itself, inside one evidence-based model. It is not a job offer, and it is not a placement service.
If withdrawal is the emergency, a seizure, a person who will not wake, or trouble breathing, call 911. For a mental health crisis, call or text 988. A hiring search can wait.
The search is supposed to start soon
IPS is defined by eight principles. Two of them decide the calendar. Eligibility is based on the person's choice, without a test of whether they are ready. The job search starts soon after the person says they want to work. People are supported to look without a requirement of preliminary vocational assessments and evaluations. The practitioner training guide puts the same idea in operational language. A career profile is usually finished in two or three meetings. The specialist, the job seeker, or both have in-person contact with a hiring manager within about 30 days of starting IPS. Nobody is asked to complete job-readiness groups, job tryouts, or other pre-employment services first. Starting quickly, the guide says, is one way of showing that the wish to work is taken seriously.
That is a fidelity rule for programs that claim this model. It is not a federal order that every person in early recovery must be employed in a month, and it is not permission to skip food, housing, or medical care because a clock is running. A program that is not IPS may still ask you to finish a class. Ask the name of the model, and ask what happens if you want to look before the class ends. As of 2024, the toolkit says, 28 states, the District of Columbia, and seven countries were in the IPS Learning Community. That is a footprint. It is not a directory of open slots, and it does not mean a residential program down the street has an employment specialist on staff.
What kind of job the model is aiming at
The glossary's definition of competitive employment is concrete. It means part-time and full-time jobs anyone can apply for, rather than jobs reserved for people with disabilities, except when an employer is following federal rules that call for affirmative action to hire a percentage of qualified people with disabilities. Competitive jobs pay at least the minimum wage. People receive the same pay as others doing the same work. The employees on site are not exclusively people with disabilities. The social-service agency does not put an artificial time limit on the job. Wages are paid by the employer to the worker, not routed as a training stipend from the clinic.
A sheltered or set-aside job can still be someone's choice. It is not what this principle is measuring. Mainstream education and training can sit beside the job when they serve a career path the person wants. The toolkit's point is that education is not a holding pen that replaces the search. Preferences lead. The principles include attention to the kind of job, the hours, and the support the person actually wants, and individualized benefits planning so someone can see how disability payments, health coverage, and other benefits might change if they earn wages. Benefits counseling is a specialist's job. A benefits estimate belongs with that specialist, not in a general summary.
The career profile is the paper that keeps the search honest. The specialist records work preferences, work history, education, strengths, legal history, and other facts that matter to the person's employment and education goals. It is used to build a job-search plan and a job-support plan. A legal history is allowed to be in that file because it changes which employers are realistic. It is not a character score, and it is not something to print on a public resume by default. The resume guide covers the public form. The profile is a tool inside the service.
What the research claim is, and is not
The toolkit says IPS studies have run in cities and rural areas, with younger and older adults, with different racial and ethnic groups, and with people who had co-occurring substance use disorders, with positive results. It says more than 28 randomized controlled trials have been completed, all showing positive competitive-employment outcomes favoring IPS. It calls IPS the best researched employment model it knows, and it says adherence to the model, measured by a fidelity scale, strongly influences outcomes. Read those sentences as findings about programs that follow the practice. They are not a personal success rate. They do not mean a person who wants to work is guaranteed a hire, and they do not mean a person who is not in an IPS program has failed recovery. The model began with mental health conditions. Substance use disorders are inside the population the toolkit says the services should reach, including through studies of co-occurring disorders. A substance use disorder by itself does not enroll you.
Employment specialists in the model visit employers chosen from the job seeker's preferences, to learn what the business needs. That employer contact is the specialist's work. It is not a cold-call quota for tonight. Time-unlimited, individualized support means help can continue as long as the worker wants it, including after the start date. Getting the job is not the last meeting.
Disclosure is a fork, not a step you owe the model
The same glossary defines disclosure as sharing a disability, or other personal information, at work. Some people share so they can ask for an accommodation, such as a quieter workspace or different duties, or because they are proud of having gotten past a barrier. Others do not share, because they are concerned about stigma or because they do not believe the disability is relevant to the job. The toolkit does not pick a side. The interview guide covers which questions an employer may ask before an offer. The coworker guide covers peers after you are hired. The stigma guide covers why the worry exists. None of them is a slogan you have to repeat in a cover letter.
Work can also collide with treatment hours. The IOP guide covers whether an intensive outpatient schedule can sit next to a shift. The finances guide covers money after treatment, which is a wider problem than the first application. If a search is making you stop a medicine or stop alcohol suddenly so a test looks clean, stop and read the drug-test guide. A job is not worth a seizure.
FindTreatment.gov lists care. It does not list competitive jobs. Call or text (800) 653-9376 if you want help looking for treatment that may include employment help.
Additional Resources
Sources cited on this page:
- SAMHSA: IPS Supported Employment Toolkit, Introduction (PEP25-01-002)
- SAMHSA: Training Practitioners About IPS Supported Employment (PEP25-01-002)
- 988 Suicide & Crisis Lifeline
- SAMHSA FindTreatment.gov
Common Questions
Do I have to finish a job-readiness class before I look for work?
Not in the Individual Placement and Support model SAMHSA describes. One of the eight principles is that the job search starts soon after the person says they want to work. People are supported to look without first having to complete vocational assessments and evaluations. The training guide says no one is asked to finish job-readiness groups, job tryouts, or other pre-employment services, and that contact with a hiring manager is expected within about 30 days of starting the service. A clinic that does not offer this model may still use a waiting list. Ask which model you are in.
What does SAMHSA mean by a competitive job?
The toolkit glossary says competitive employment is part-time or full-time work that anyone can apply for, rather than a job set aside for people with disabilities, except where an employer follows federal affirmative-action rules. The job pays at least the minimum wage, and the person is paid the same as others doing the same work. The workplace is not made up only of people with disabilities. The social-service agency does not impose an artificial end date. The employer pays the worker directly.
Is this model only for mental health, not substance use?
The toolkit says IPS was built to help people with mental health conditions get competitive work, and that employment matters for people with disabilities, including mental health conditions and substance use disorders. It says studies over three decades included people with co-occurring substance use disorders and showed positive competitive-employment results. It also says more than 28 randomized trials favored IPS. Those are group findings about programs that follow the model. They do not promise you a job, and they do not mean every treatment program offers an employment specialist.
Does looking for work mean I must tell employers I was in treatment?
The toolkit treats disclosure as a choice. Some people share a disability so they can ask for an accommodation, or because they are proud of having cleared a barrier. Others do not, because they worry about stigma or because they do not think the disability matters to the work. The interview guide is what an employer may ask before an offer. The resume guide is a gap on a form. Disclosure stays your decision.
Where is the page about going back to a job I already had?
The returning-to-work guide covers employment as one piece of purpose in recovery, the research summaries about work and outcomes, and a list of practical barriers. Leave from a current job is the workplace-leave guide. The search for a job, including a first job, under a specific supported-employment model is the subject here. It is not career counseling and it is not a placement service.