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Work Is Recovery

Work Is Recovery. Mindy Vance Mindy.Vance@mha.ohio.gov Ohio Mental Health and Addiction Services .

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Work Is Recovery

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  1. Work Is Recovery Mindy Vance Mindy.Vance@mha.ohio.gov Ohio Mental Health and Addiction Services

  2. Gainful and meaningful employment can enhance a person's recovery. Not only does meaningful employment help pay the bills, it can also provide a person with a sense of pride and belonging. It offers opportunities to connect with others socially. Unfortunately, the current rate of employment among people with mental illness is very low despite research evidence that strongly supports the critical impact that work plays in promoting recovery. • The Ohio Department of Mental Health and Addiction Services (OhioMHAS) is committed to helping consumers of mental health services locate, obtain, and maintain employment. OhioMHAS supports technical assistance, consultation, and training on employment to mental health provider organizations and consumer operated peer centers.

  3. Value of Work • Financial compensation • Structure • Purpose • Being a part of something greater • Social • Energizing • Follow their passion • Opportunities for growth • Gain Confidence

  4. Barriers • Stigma • Mental illness • Lack of support • Myths about benefits • Medication side effects • Transportation • Child care • Lack of social skills (employment soft skills) • One time benefit analysis • Traditional role of VR

  5. Today’s Question: • How can we best support individuals with a severe and persistent mental illness succeed at work? • Answer: A shift in perspective

  6. IPS Supported Employment • Supported Employment/Individual Placement and Support is an evidence-based practice that helps people with mental illness and other disabilities identify and acquire part-time or full-time jobs of their choice in the community. http://www.centerforebp.case.edu/practices/se

  7. Making the Case for IPS Supported Employment • For most people with a mental illness, employment is part of their recovery. • Most people with severe mental illness want to work. Approximately 2 of every 3 people with mental illness are interested in competitive employment, but less than 15% are employed. http://sites.dartmouth.edu/ips/

  8. Individual Placement and Support (IPS) supported employment is evidence-based. • IPS is cost-effective. • IPS helps people join the competitive labor market. IPS is three times more effective than other vocational approaches in helping people with mental illness to work competitively. • IPS has been found effective for numerous populations in which it has been tried, including people with many different diagnoses, educational levels, and prior work histories; long-term Social Security beneficiaries, young adults, older adults, veterans with post-traumatic stress disorder or spinal cord injury, and people with co-occurring mental illness and substance use disorders. To date, we have not discovered a subgroup for which IPS has not been effective. • http://sites.dartmouth.edu/ips/

  9. Severe mental illness constitutes the largest and fastest growing group of beneficiaries in Social Security disability programs. Once on the disability rolls, less than 1% of beneficiaries per year move off of benefits to return to work. By helping people with mental illness gain employment, especially young adults experiencing early psychosis, IPS can help forestall entry into the disability system and reduce Social Security expenditures.

  10. Over the long term, clients who return to work produce huge long-term savings in mental health treatment costs. A 10-year follow-up study of clients with co-occurring severe mental illness and substance abuse disorder found an average annual savings of over $16,000 per client in mental health treatment costs for steady workers, compared to clients who remained out of the labor market. http://sites.dartmouth.edu/ips/

  11. People who obtain competitive employment through IPS have increased income, improved self-esteem, improved quality of life, and reduced symptoms. Approximately 40% of clients who obtain a job with help from IPS become steady workers and remain competitively employed a decade later • http://sites.dartmouth.edu/ips/

  12. WORK IS RECOVERY • SE is different from traditional vocational rehabilitation (voc rehab). SE emphasizes consumer choice and utilizes rapid job-search and placement services as well as time-unlimited and individualized follow-along services. • http://www.centerforebp.case.edu/practices/se

  13. SE Increases • Employment in competitive jobs • Number of hours worked • Amount of income earned in competitive jobs • http://www.centerforebp.case.edu/practices/se SE Decreases • Unemployment • Dependence upon public systems of care • Symptoms of mental illness • Hospitalizations • Stigma in the community about mental illness • http://www.centerforebp.case.edu/practices/se

  14. Competitive Employment Improves • Self-esteem • Self-management of mental health symptoms • Independent living • Autonomy • http://www.centerforebp.case.edu/practices/se

  15. Opportunities for Ohio with Disabilities: • Leadership has done a great job of recognizing the benefits of IPS Supported Employment • Current collaboration with OMHAS, OOD, and community stakeholders to take a further look at future possibilities

  16. Principles of Supported Employment

  17. Competitive Employment • Employment specialists help clients obtain jobs. Competitive employment is defined as paying at least minimum wage and the wage that others receive doing the same work, based in community settings alongside others without disabilities, and not reserved for people with disabilities. Clients prefer competitive jobs over sheltered work. Working alongside others without psychiatric disabilities helps to reduce stigma and discrimination. http://sites.dartmouth.edu/ips/

  18. IPS Supported Employment team is integrated with the mental health treatment team: • Employment specialists are members of multidisciplinary teams that meet regularly to review client progress. Discussions include clinical and rehabilitation information that is relevant to work, such as medication side effects, persistent symptoms, cognitive difficulties, or other rehabilitation needs. They share information and develop ideas to help clients improve their functional recovery. • http://sites.dartmouth.edu/ips/

  19. Zero Exclusion • Eligibility is based on client choice. Every person with serious mental illness who wants to work is eligible for IPS supported employment regardless of psychiatric diagnosis, symptoms, work history, or other problems, including substance abuse and cognitive impairment. • http://sites.dartmouth.edu/ips/

  20. Attention to client preferences. • Services are based on clients’ preferences and choices, rather than providers’ judgments. Client preferences help determine the type of job that is sought, the nature of support provided by the employment specialist and team, and whether to disclose the aspects of a person’s psychiatric disability to the employer. • http://sites.dartmouth.edu/ips/

  21. Benefits counseling is important • Employment specialists help clients to access ongoing guidance regarding Social Security, Medicaid, and other government entitlements. Fear of losing benefits is a major reason that clients may not want to seek employment. It is vital that clients obtain accurate information to inform and guide the plan for starting work and over time for making decisions about changes in wages and work hours. • http://sites.dartmouth.edu/ips/

  22. Rapid job search • Employment specialists help clients seek jobs directly, rather than providing extensive pre-employment assessment and training, or intermediate work experiences. Beginning the job search process early (within 30 days) demonstrates to clients that their desire to work is taken seriously, and conveys optimism that there are multiple opportunities available in the community for clients to achieve their vocational goals. • http://sites.dartmouth.edu/ips/

  23. Systematic job development • Employment specialists develop relationships with employers, based upon their clients’ work preferences, by meeting face to face over multiple visits. Employment specialists learn about the work environment and the employers’ work needs. They find out about jobs that they may not be aware of at employment sites. They gather information about the nature of job opportunities and assess whether they may be a good fit. Employment specialists continue to make periodic visits because networking is how people find jobs. • http://sites.dartmouth.edu/ips/

  24. Time-unlimited support • Follow-along supports are individualized and continued for as long as the client wants and needs the support. IPS specialists and other members of the treatment team provide work support. In addition the look for natural supports (family member, co-worker) that would be available over time. The goal is to help the client become as independent as possible in his or her vocational role, while providing support and assistance as needed. Once a person has worked steadily (one year) they discuss transitioning from IPS. • http://sites.dartmouth.edu/ips/

  25. References • http://www.centerforebp.case.edu/practices/se • http://sites.dartmouth.edu/ips/

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