Costs of preparing to implement a virtual reality job interview training programme in a community mental health agency: A budget impact analysis

Matthew J. Smith*, Andrea K. Graham, Rachel Sax, E. Shawn Spencer, Lisa A. Razzano, Justin D. Smith, Neil Jordan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Rational, aims and objectives: Individual Placement and Support (IPS) is an evidence based strategy for facilitating employment among adults with severe mental illness (SMI) where staff may lead mock job interviews to prepare clients for real-world interviews (a method with limited scalability and cost effectiveness). A virtual reality job interview training program (VR-JIT)—delivered via the internet—has demonstrated efficacy for increasing employment among adults with SMI. Now, VR-JIT is being implemented with a community mental health agency (CMHA) and evaluated for its effectiveness within IPS. This study is a budget impact analysis, evaluating the costs of preparing a CMHA to implement VR-JIT. Method: Implementation preparation occurred over 7 months from October 1, 2016 to April 30, 2017. CMHA staff (n = 15) and external research partners (n = 3) tracked their hours completing implementation preparation activities. Salaries plus a 28% fringe benefit rate were used to derive a per-hour salary amount for each individual and applied to each activity. Non-labor equipment costs were obtained from purchase receipts. A budget impact analysis evaluated the expenditures associated with preparing the CMHA to implement VRJIT. Results: The total implementation preparation costs equaled $25,482. Labor costs equaled $22,882 and non-labor costs equaled $2,600. In total, 655 person-hours were spent preparing for VR-JIT implementation (e.g., preparing lab space, training, and supervising operations). Conclusions: This study presents an initial evaluation of the budget impact of preparing to implement VR-JIT in a CMHA. Cost considerations for future implementation preparation will be discussed. Given that the cost to prepare to implement an intervention can hinder its adoption, results provide an important analysis for decision-makers that may enhance uptake. Future work will determine the cost-effectiveness of VR-JIT implemented within IPS. This study is registered at, NCT = 03049813, “Virtual Reality Job Interview Training: An Enhancement to Supported Employment in Severe Mental Illness.”.

Original languageEnglish (US)
Pages (from-to)1188-1195
Number of pages8
JournalJournal of Evaluation in Clinical Practice
Issue number4
StatePublished - Aug 1 2020


  • budget impact analysis
  • community mental health
  • health economics
  • implementation cost
  • virtual reality job interview training

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health Policy


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