WWT Technical Assistance Center Survey Findings

1. WWT Technical Assistance Center Survey Findings

2. Table of Contents Pages • Background, Respondents, Survey Method 2-9 • Challenges 10-16 • Challenges by Subgroup 17-26 • Role 19-22 • Ethnicity/Culture 23-26 • Solutions 27-30 • Some Implications 31- 33

3. Background • Survey designed to identify • Ongoing challenges in the area of consumer, family, and parents/caregivers workforce development • Issues where solutions (accomplishments) to these challenges have been identified and implemented • Survey • Web-based • Completed during the Fall of 2008

4. Respondents • Reponses sought from • County: Director; MHSA, WET, FSP Coordinators; Ethnic Services Managers • Consumer and Family Organizations: NAMI, Network, UACF, Empowerment Centers, Wellness Centers, Consumer Employment Summit • Responses received • Survey opened 460 times • Partial completions: 102* • Completed surveys: 175 * There were no significant differences in the demographic characteristics of those completing and partially completing the survey. The results reported here are from the 175 completed surveys.

5. Respondents: Demographic Characteristics Gender Female 73% Male 26% Transgender 1% Sexual Orientation Heterosexual 89% LGBT 8% Other 3%

6. Respondents: Roles Note: Percentages more than 100% because of respondents checking more than one category. The category of “other” was reclassified to produce this table. Subsequent analyses by role do not include these reclassifications.

7. Survey Format • List of 46 statements which represent either • Potential challenges/barriers: • “Stigma within mental health agencies prevents useful identification and descriptions of job roles for clients, families, parents/caregivers staff” or • “Having to interview everyone on an existing hiring list is a pre-existing job description is used for a new position” • Necessary components for effective employment: • “Adequate benefits counseling exists in multiple languages” or • “Preparing co-workers to be welcoming and helpful • Respondent indicates whether the statement is a challenge, if a solution has been found, or if unknown or not applicable

8. Categories of Statements • Recruitment and hiring (12 statements ) • Current workforce attitudes and resistance (7 statements) • Jobs and careers (6 statements ) • Pay and benefits (6 statements ) • Pre and post employment training (7 statements ) • Supervision, support and accommodations (8 statements )

9. Unknown and Not Applicable Responses • Range of unknown and not applicable is relatively high • <20% 18 statements • 20–29% 17 statements • 30%+ 11 statements • This means the percentages of challenges might be even higher than reported, i.e. the percentages would be higher if we excluded the DK/NA

10. CHALLENGES

11. Challenges – Overall Percentages

12. % Rated as Challenges By Issue Area

13. Statements with 60%+ As A Challenge • Career advancement is a major challenge • “Limited career advancement opportunities” the most frequently cited challenge (75%) • “Stigma within mental health agencies prevents development of career ladders that acknowledge and value C-F-P/C experience and expertise (61%) • Historical patterns are seen as important barriers • “Historical mistrust between the MH system and racial, ethnic, and cultural communities including LGBTQ, impacts the organizational environment (64%)” • “Historical policies, practices,, and/or funding patterns are a barrier to creating C-F-P/C job opportunities (64%)” • “Historical disparities within the MH system prevent the development of community partnerships and relationships necessary for effective recruitment of culturally diverse C-F-P/C employees (60%)”

14. Statements with >50% Saying a Challenge • Workforce attitudes and resistance • “Some co-workers would be uncomfortable (fear of job loss, confidentiality issues, etc.) (58%) • Some co-workers and managers do not acknowledge the benefit of employees with C-F-P/C experience (58%) • Some clinicians fear having clients as fellow employees could jeopardize their licensure (e.g. boundary issues, inappropriate contact, etc.) (53%) • “Some people think it is inappropriate to employ individuals with C-F-P/C experience (51%) • Jobs and careers • Stigma within MH agencies prevents useful descriptions of job roles for C-F-P/C staff (55%)

15. Statements with >50% Saying a Challenge (cont) • Pay and benefits • “Ease of hiring into full-time positions” (61%) • “Adequate benefits counseling in multiple languages” (54%) • “Ease of providing health benefits” (50%) • Pre and post employment training • “Orientation and initial training needs are unclear” (57%) • “Peer, family, and parent/caregiver training programs are non-existent or not well developed”(58%) • Recruitment and hiring • “Engagement and outreach to C-F-P/C from racial/ethnic/cultural specific communities” (51%)

16. Summary of Most Cited Challenges • Lack of career opportunities and advancement • Historical attitudes and patterns within the MH system against C-F-R/C and ethnic communities • Co-worker attitudes and system stigma • Clarification of need for and provision of training for C-F-P/C • Specific human resource policies and practices • Lack of effective outreach to ethnic/cultural communities in recruitment of C-F-P/F

17. CHALLENGES BY SUBGROUP

18. Differences Among Subgroups • What differences are there, if any, between the responses of consumers, family members, and employers*? • What differences are there, if any, between respondents of different ethnic background? • Are these differences reliable? • What accounts for the differences? • What implications do the differences have for the WWT agenda? *Note: The persons who answered “other” on the initial identification of role are NOT included in these analyses. See Note on Page 5.

19. Family Members See the Greatest Challenges

20. Items Where Consumers & Family Members See Greater Challenges than Employees Consumer Family Employee “Some people think it is inappropriate to employ individuals with C-F-P/C experience.” 55% 62% 44% “Some co-workers would be uncomfortable (fear of 69% 69% 53% job loss,confidentiality).” “Some co-workers and managers do not acknowledge 63% 70% 53% the benefit of employees with C-F-P/C experience.” “Some managers appear to want a few C-F-P/C 57% 64% 42% employed only to please reviewers, auditors.” “Stigma within MH agencies prevents useful 62% 58% 45% descriptions of job roles for C-F-P/C staff.” “Some managers and co-workers do not acknowledge the potential for reducing disparities as a result of 57% 64% 42% hiring culturally diverse C-F-P/C.” Note: All statements in which the percentage citing as a challenge among employee subgroup at least 10% lower than the lower of the consumer or family member subgroup.

21. Challenges Cited More Often by Family Members than Consumers Consumers Family “Soliciting input from C-F-P/C in creating 24% 48% specifically designated positions.” “Peer, family and P/C training programs are 56% 72% non-existent or not well developed.” “Preparing co-workers by offering education about organizational culture and its impact on stigma and 29% 51% discrimination.” “Providing transitional support and information regarding re-entry to services is needed upon C-F-P/C 39% 54% resignation or termination.” “Traditional degree requirements for non-traditional 36% 57% positions geared towards C-F-P/C positions.” “Hiring as ‘independent contractors.’” 36% 52% Note: All statements in which the percentage rating as a challenge was at least 15% higher for family members than consumers.

22. Summary of Role Subgroup Analysis • Family members appear to see more challenges than the other two groups • An exception is in the the area of recruitment and hiring where the employer group sees more challenges • Consumers and family members have higher ratings than employers for the challenges related to attitudes, stigma, historical tendencies • Family members see more challenges than consumers in • Certain specifics of the job • Lack of training programs • Preparing co-workers

23. Asians and Native Americans See the Biggest Challenges

24. Examples of Items with Major Discrepancies AA Asian White Latino Native “Linking with an educationalprogram designed to prepare 46% 73% 42% 46% 83% C-F-P/C for employment.” “HR communication with applicants during application process 31% 60% 30% 29% 33% regarding job requirements and/or benefits.” “”Having to interview everyone on an existing list.” 36% 70% 38% 32% 33% “Traditional degree requirements for non- traditional positions 38% 80% 45% 48% 33% positions geared towards C-F-P/C positions.” “Preparing co-workers by offering education about organizational 50% 46% 38% 54% 83% culture and its impact on stigma and discrimination.” “Ease of hiring into flexible positions.” 50% 54% 41% 54% 100% “Providing supports required by a person’s work assignments.” 38% 46% 35% 36% 67% “Ongoing training to improve job performance.” 71% 45% 46% 37% 67% “Stigma with MH agencies prevents useful descriptions of job 71% 82% 52% 56% 33% roles for C-F-P/C staff.”

25. Reliability and Meaning of Differences by Ethnicity • Numbers of respondents are small for some groups • African Americans: 14 • Asians: 11 • Native Americans: 6 • Meaning of differences • Why would Asians report more challenges with recruitment and hiring? • Why would Native Americans report more challenges with training and with supervision, support and accommodations? • Why would African Americans report more challenges with jobs and careers? • Why do Latinos generally report a lower level of challenges?

26. Summary of Ethnic Subgroup Analysis • The data show significant differences in perceived challenges among ethnic groups • Asians and Native Americans perceive more challenges followed by African Americans • The type of challenges appear to differ some by ethnic group • More work is necessary to verify the reliability of findings and understand their meaning • WWT agenda would appear to need to be at least somewhat targeted by ethnicity

27. SOLUTIONS

28. Solutions – Overall Percentages

29. Solutions by Types • Solutions were noted by many for some challenges, particularly • The concrete elements of recruitment and hiring – job descriptions, job qualifications, HR communication • Some elements of pre and post employment training • Providing supervision, supports and accommodations • Solutions were noted more rarely for • The workforce attitudes, resistance, sigma • Career advancement • Pay and benefits

30. Where to Look for Solutions • More consumers (than family or employers) report solutions for • Recruitment and hiring issues • Pay and benefits issues • Supervision, support and accommodation issues • Employers report more solutions for current attitudes and resistance challenges

31. SOME IMPLICATIONS

32. For more information about WWT: www.workingwelltogether.org (916) 379-5380

33. Implications for Follow-Up Information Gathering Efforts • As the Project shares this information it should explore the following: • Why there are differences in perceptions and/or experiences among consumers, family members, and employers about certain challenges, e.g. why to family members perceive more challenges? • Why there are differences in perceptions and/or experiences among different ethnic groups about certain challenges, e.g. why do Asians and Native Americans perceive more challenges?

34. Implications for Project Activities • How can information best be gathered from survey respondents (and others) about the perceived solutions (and whether they are effective)? • Information needs to be gathered from stakeholders and from the literature about how to better solve the “softer” challenges related to historical patterns, attitudes, stigma that are challenges for effective C-F-P/C employment. • Solutions will need to be sought for some challenges which appear high on everyone’s list, e.g. how to provide career opportunities for advancement for C-F-P/C employees.