Mental Health Disabilities

1. Mental Health Disabilities Accommodations and Supports Debbie Jones, Humanitas Dr. Valerie Cherry, Humanitas Dr. Suzanne Gosden, Job Accommodation Network

2. Interdisciplinary Team Considerations Preparing to accommodate

3. Accommodation Considerations? • How do we know what accommodations an applicant or student needs to access the Job Corps program? • Remember that many applicants/students will not know much about the types of accommodations they previously received in school and they may not specifically know what to ask for in the Job Corps program. So, what do you do?

4. Accommodations Considerations • IEPs • 504 plans • Medical records • Psycho-educational evaluations • Neuro-psychological evaluations • Psychological evaluations • Center staff and clinician recommendations • Interviews and review of history/documentation • Applicant and/or family

5. Sample Scenario • 18 year old applicant has a history of conflict with peers which has resulted in verbal altercations in the past. • No history of physical aggression, but has demonstrated dramatic and impulsive behavior with one hospitalization for suicidal attempt about 2 years ago. • Currently applicant is unemployed, but has worked at two jobs in the past year – Burger King and WalMart.

6. Sample Scenario • Applicant reports that the people at the jobs were not fair and treated employees badly. Applicant quit both jobs after about 3-4 months each. • Has a therapist who reports present behavior as stable on medication. • Medication side effects of morning grogginess, dry mouth • Therapist also indicates that applicant can function in a residential group setting, but needs to continue in outpatient treatment to work on managing anger and improving self-esteem. • Applicant has a diagnosis of borderline personality.

7. What accommodations might you suggest?

8. Definitions and Types Mental Health impairments and Functional Limitations

9. Mental? Mental Illness? Mental Disorder? Mental Disease? Mental Disability? Mental Impairments? 9

10. Mental Health Impairments • Mental health impairments, refer collectively to all diagnosable mental health disorders characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning. 1 1Goldman, H.H., Rye, P., & Sirovatka, P. (Eds.) (1999). Mental health: A report of the surgeon general.

11. Common Mental Health Impairments • ADHD • Anxiety Disorders • Generalized Anxiety • Post Traumatic Stress Disorder • Obsessive Compulsive Disorder • Asperger’s Syndrome • Bipolar Disorder • Depression

12. Common Mental Health Impairments (cont’d) • Personality Disorders • Cluster A: Odd or eccentric behavior • Schizoid Personality Disorder • Paranoid Personality Disorder • Cluster B: Dramatic, emotional or impulsive behavior • Antisocial Personality Disorder • Borderline Personality Disorder • Cluster C: Anxious fearful behavior • Obsessive-Compulsive Personality Disorder • Schizophrenia

13. Functional Limitations Definition: The inability to perform an action or a set of actions, either physical or mental, because of physical or emotional restriction2 • Time Management • Organization and Prioritization • Social Skills • Concentration • Memory • Communication • Stamina • Responding to Change • Screening Out Environmental Stimuli • Managing Stress 2Brodwin, M., Tellez, F., Brodwin, S. (1993). Medical, Psychosocial and Vocational Aspects of Disability. Athens, GA: Elliott and Fitzpatrick, Inc.

14. Mental Health Impairments and Functional Limitations • Screening Out Environmental Stimuli • An applicant with ADHD reports being easily distracted may not be able to work in a large group. • Concentration • An applicant reports having Depression and has trouble focusing on tasks for extended periods. • Stamina • Student with a diagnosis of Schizophrenia reports not having energy to do residential chores in the morning and combating drowsiness in the afternoon due to medications.

15. Mental Health Impairments and Functional Limitations • Change • A student with Anxiety Disorder may take longer to learn new routines, or feel stressed when new students arrive in the dorm. • Managing Stress • An applicant with a personality disorder indicates that when stressed by deadlines and workload has a hard time managing emotions and sometimes gets into verbal conflicts with peers. • Social Skills • A student with Asperger’s does not talk much with other students during down time in the dorm and has trouble reading subtle social cues in a group setting.

16. Accommodations and Supports How Can we help Outside the classroom

17. Accommodations: Screening Out Environmental Stimuli • Help arrange the student's environment • Redesign space • Minimize auditory/visual distractions • Reduce clutter

18. Accommodations: Maintaining Concentration • Help arrange the student’s schedule • Prioritize tasks/activities/assignments • By day, week, month, etc. • Identify student’s patterns in activity • Example: “you do this 3 times each week” • Emphasize due dates on calendars • Develop a color-coded system (each color represents a task, or event, or level of importance) • Ensure accuracy of entries on calendar or I-Phone

19. Accommodations: Maintaining Stamina • Arrange for longer/more frequent breaks between activities • Help student pace their workload and social activities • Develop substitution strategies (for times when a student cannot keep their obligation to the event or activity)

20. Accommodations: Managing Change (Transition) • Recognize that change can be difficult (physically/mentally) • Maintain special channels of communication during transition period (hotline, on-call personnel) • When appropriate, share your own experiences with transition • Re-fresh skills learned in orientation (such as directions through the building, doing laundry, etc.) • Offer peer mentorship

21. Accommodations: Managing Stress • Reinforce time management techniques • Identify support personnel • Teach money management skills • Invite therapy animals organization onto site for visit

22. Accommodations: Exhibiting Appropriate Social Skills • Develop simple and appropriate code of conduct for environment: • Acceptable verbal language or gestures • Engaging in debate or discussion • Acceptable student interaction • Environments might require different codes of conduct: • Classroom/career technical • Lunchroom • Dorms or common areas • Recreation • Out in the community

23. Accommodations: Exhibiting Appropriate Social Skills • Practice appropriate social skills • Role play • Video demonstration • Encourage all students to model appropriate social skills • Use a peer, tutor, and/or mentor to reinforce appropriate social skills • Reward/praise student engaging in appropriate behavior

24. Accommodations: Exhibiting Appropriate Social Skills • Identify the “out” for those times when the student cannot demonstrate appropriate skills • Hand gesture, word, or signal • Where to go to regain composure • How to return/re-engage in environment

25. Accommodations: Communicating with Others • Adjust method of communication • One-on-one • Face-to-face • In the presence of another • Teach/model appropriate communication skills • Addressing person by name or title • Waiting to speak (not interrupting others) • How to enter another group’s conversation

26. What accommodations might you suggest?

27. Accommodation Suggestions • What accommodations might be indicated? • REMEMBER: You must consider accommodation needs throughout the center environment. • Water bottle in class, in testing, and in dorm. • What could you do if refillable water bottles are prohibited for drug/alcohol use concerns? • Schedule adjustments • For therapy appointments, later start to class day, change in time medication is taken so adjustment to dorm schedule • Frequent breaks (for movement and to re-organize self) • Positive Peer Mentor (particularly during meal times) • Chunking assignments - why?

28. Resources Job corps and JAN

29. Contact JAN! (800) 526-7234 (V) (877) 781-9403 (TTY) http://www.jan.wvu.edu jan@jan.wvu.edu Please call, e-mail, or visit us on the Web!

30. Job Corps Disability Website – located at JC Community within the Job Corps Citrix Portal

31. Presenter Bio • Suzanne Gosden Kitchen, Ed.D., Senior Consultant for the Job Accommodation Network (JAN) As a Senior Consultant of JAN, a service of the U.S. Department of Labor's Office of Disability and Employment Policy, Dr. Kitchen handles both ADA and accommodation cases, specializing in providing accommodation solutions for workers with cognitive and neurological impairments. Her areas of expertise include Human Resource Management, EEO, Affirmative Action, diversity in the workplace, and business ethics. Dr. Kitchen graduated from West Virginia University with Bachelor's and Master's degrees in Education and a Doctoral degree in Higher Education Administration. In addition to her duties at JAN, Dr. Kitchen teaches in graduate school for West Virginia University's Industrial Relations department. Currently, Dr. Kitchen designs disability awareness activities to educate the public, and enjoys finding new ways to promote disability etiquette in society.

32. Presenter Bio • Dr. Valerie Cherry, Principle Mental Health Consultant, Humanitas  Dr. Valerie R. Cherry is a licensed clinical psychologist, with over 25 years of clinical and research experience, working with youth and their families. She has served as the Job Corps Principal Mental Health Consultant for the past 15 years and is co-administrator of Humanitas Inc.’s Continuing Education Program approved by the American Psychological Association.  Dr. Cherry has worked extensively with populations who come from environments that place them at risk for mental health and substance abuse issues providing assessments, therapeutic interventions, and strategies for success in the school and the workforce. Over the past four years, Dr. Cherry has worked jointly with the National Office of Job Corps and the Office of Civil Rights in developing disability related policies and processes for Job Corps to ensure equal access for students with disabilities. She is also the President of Cherry and Associates, LLC, a consulting firm that provides employee assistance programs and specializes in assisting organizations to develop community-based prevention programs for adolescents and young adults.

33. Presenter Bio • Debbie Jones, Disability Specialist, Humanitas, Inc. Debbie has spent the majority of her career working to support the achievement of underserved and at-risk youth and young adults. She currently serves as a Disability Specialist for Humanitas and has had involvement with the Job Corps program since 1987. Debbie also serves as the vice-chairman of her home community’s School Board after having been elected to her first term of service in 2007 and is a member of Virginia’s Parent Information Resource Center Board (V-PIRC). She is also the 2005 recipient of the National Alliance of Women Business Owners Owen-Minor Community Service Award and the 2006 Down Syndrome Association of Greater Richmond Service Award for her work within the community on behalf of children. Debbie is married to her husband, Don, and they have three children.