Integrating Employment Strategies into Criminal Justice Programs

1. Integrating Employment Strategies into Criminal Justice Programs Steve Fishbein Michelle Robison Moderator: Nancy Fishman Smart Responses in Tough Times: Achieving Better Outcomes for People with Mental Illnesses Involved in the Criminal Justice System July 15-17, 2009

2. Employment Strategies for Justice Involved Individuals with Mental IllnessSteven M Fishbein, MS, CRC, LRCSupervisor of Psychiatric Rehabilitation ServicesEmployment, Education & Justice Involved ServicesOffice of Housing, Policy & Program DevelopmentNew Jersey Division of Mental Health Services Office (609) 777-0655 steve.fishbein@dhs.state.nj.us

3. What is Supported Employment? • An evidence based practice, supported employment facilitates competitive work in integrated work settings for individuals with the most severe disabilities (i.e. psychiatric,) for whom competitive employment has not traditionally occurred, and who, because of the nature and severity of their disability, need ongoing support services in order to perform their job. • Paid Employment - Work performed must be compensated with the same benefits and wages as other workers in similar jobs receive. Employment must be for at least 18 hours per week. • Integrated Work Sites - Individuals with disabilities should have the same opportunities to participate in all activities in which other employees participate and to work alongside other employees who do not have disabilities. • Ongoing Support - A key characteristic which distinguishes supported employment from other employment programs is the provision of ongoing support for individuals with severe disabilities to maintain employment. DOL – ODEP

4. Supported Employment is based on Six Principles 1. Eligibility is based on consumer choice. No one is excluded who wants to participate. 2. Supported employment is integrated with treatment. Employment specialists coordinate plans with the treatment team: the case manager, therapist, psychiatrist, etc. • SE provided by a single entity which provides both the employment and clinical services is more effective then when provided by separate agencies. Bond, et.al, Effectiveness of Psychiatric Rehabilitation Approaches for Employment of People with Severe Mental Illness, Journal of Disability Policy Studies, 1999 SAMSHA SE Toolkit 2003

5. Six Principles (cont.) 3. Competitive employment is the goal. The focus is community jobs anyone can apply for that pay at least minimum wage, including part-time and full-time jobs. 4. Job search starts soon after a consumer expresses interest in working. There are no requirements for completing extensive pre-employment assessment and training, or intermediate work experiences (like prevocational work units, transitional employment, or sheltered workshops). • Prevocational training appears to detract from rather then enhance the effectiveness of SE. Bond, et.al, Effectiveness of Psychiatric Rehabilitation Approaches for Employment of People with Severe Mental Illness, Journal of Disability Policy Studies, 1999

6. Six Principles (cont.) 5. Follow-along supports are continuous. Individualized supports to maintain employment continue as long as consumers want the assistance. • Consumer preferences are important. Choices and decisions about work and support are individualized based on the person’s preferences, strengths, experiences. Only 2.5% of consumers receiving SE out of total estimated SMI Source: 2005 CMHS Uniform Reporting System (URS) Tables 1/9/2007 EBP NJ p.23

7. Justice Involved Consumers in New Jersey Supported Employment Programs - September, 2007

8. Learning from New Jersey’s Experience with Providing Support Employment

9. Helping people with Mental Illness to work is more of a human growth & development issue then a clinical issue. “Readiness” for work is about personal commitment or motivation, not about performing predetermined tasks and tests. When assisting individuals with mental illness to go to work treatment, while important, becomes a support to employment not the primary agenda.

10. The SE Golden Rules: • It’s all about the fit between the individual and the job; greater satisfaction, longer job tenure. • The right support and not just paid support can compensate for a myriad of issues

11. The System

12. Recognize that the “system” rather then the consumer is often the biggest barrier to employment and work to reduce those roadblocks • Government systems may have arbitrary “rules” about providing services to ex-offenders with mental illness or co-occurring disorders • Resource development and coordination is significantly more difficult but can be accomplished

13. Addressing NJ systems barriers: • NJDMHS has made consumers with criminal justice backgrounds a priority group for SE • Contract performance commitments for Justice Involved Services (JIS) include employment • JIS & SE providers are expected to work together • DMHS has facilitated training for its SE providers in adapting SE for consumers with criminal backgrounds

14. The Employment Process

15. Speeding up the matching process • Obtaining preferences, skills & supports in a succinct, targeted fashion. • Expecting less than a perfect match • Job matching is critical in promoting job satisfaction & therefore retention. • SE can tend to strive for an “ideal” match. • Greater compromise may be required to comply with time constraints place on the individual by probation or parole. Shoot for 2/3rds match

16. Apply for entitlements as early as possible • Be aware that this may be a significant barrier to work • Apply early for state One Stop or Voc Rehab services • They may be needed to pay for SE or other employment related services • There may be an increased need to use federal or other bonding programs

17. Generalized marketing may play a more important role • Cold calling and up front inquiries about hiring ex-offenders may be called for then the typical process of individualized job development • Higher rates of disclosure are likely called for. Many consumers do not want to disclose their illness to employers but will need to disclose their convictions.

18. Occupational selection becomes more critical: Identify barred occupations based upon conviction Job location is a more important consideration Focus on transferable skills learned in varied environments including jail and prison More time is needed in developing strategies and practice to explain gaps due to incarceration and or convictions

19. Personnel

20. Staff considerations: • Staff need to believe in the consumer and convey hope. Staff have to be non-judgmental and motivational. This may be particularly difficult as some consumers test limits and staff. • The mental illness may have gone untreated most of the person’s life, expect typical initial treatment issues • Don’t get stuck in the person being an ex-offender, they are often motivated • Trust is not easy to come by; follow through with promises, do what you say!

21. Staff are often intimidated by the thought of working with this group of individuals: • Choose staff who are not only comfortable with this group of consumers but comfortable procuring employment! • Individuals like structure and support but are often very needy • There is a greater need to set clear boundaries

22. Strategies are needed to learn the full truth from the person and requires getting behind the game • A recognition of jail and prison culture is crucial; behaviors and attitudes which are adaptive while inside may be maladaptive when out. Merrill Rotter, MD GAINS National Conference, 2006 • It’s critical to clarify roles when involved with multiple agencies and entities • Conferring & communicating with the courts, probation or parole is crucial; approval may be needed for the job choice

23. Employment specialist (ES) must make allowances for and develop strategies to overcome their own responses: • The individual may be more aggressive and quick tempered • The individual may be offended easily • The individual may be “smart mouthed”, carry a chip on their shoulder or have a know it all attitude

24. There may be many missed appointments which will require aggressive outreach. The ES may have to assist the person in dealing with the losses they have sustained as a result of conviction and incarceration. The ES must be trauma informed and be prepared to address manifestations there of; be aware of the internal chaos jail or prison environments can stir up.

25. Integrating Employment Strategies into Criminal Justice/Mental Health Programs: A Local StoryMichelle R. Robison

26. Cobb County Community Services Board/Douglas County Community Services Board • $29 million organization • 34 sites • 630 employees • 14,000 served in community-based delivery system • 2,500 served in correctional facility • CARF accredited

27. Our Story: Cobb County Detention Center & Cobb/Douglas Community Service Boards

28. Cobb County Community Service Board • 1990’s -The Cobb CSB had a Criminal Justice Liaison who would visit the jail to help insure that inmates with mental health issues received their medication and case management services. The liaison inter-faced with a psychologist and a medical doctor who were on staff inside the jail. • 2001 - A Cobb CSB part time psychiatrist and a small team of full time mental health providers offered services in the jail. • 2009 - A psychiatrist, three full time mental health staff and 4 part time employees are now working in the facility. The approval for adding an additional four positions has recently been given.

29. Medication $$$ • 2003 - 370 in-mates prescribed psychiatric medication at any given time with the average monthly pharmacy cost of $10, 750. • 2009 - 550 in-mates prescribed psychiatric medication at any given time with the average monthly pharmacy cost of $28, 500

30. Recovery & History of Service • SE Services are an important component along the recovery model continuum. • The Cobb-Douglas CSB had been successfully providing Supported Employment Services since the mid 80s.

31. Self-employment Prior to October 2001 almost all of our SE folks were working in traditional/service industry jobs and no one was pursuing self-employment, where now 45 consumers are doing self-employment.

32. Funding $$$ for Supported Employment Services Expansion: Federal Grants • DOE Learn to Earn Pre-Release • 2007 BJA Learn to Earn Post-Release

33. Customized Employment Means: (Federal Register) • individualized employment relationship to meet the needs of the employee and employer via a process of negotiation and customization. • determination of the individualized strengths and interests of the person with a disability; duties negotiated to fit the needs of individuals with a disability • includes: self-employment, entrepreneurial initiatives, restructuring strategies.

34. Resource Ownership • individual purchases a resource that a business needs and brings to the employer • paid a wage or salary • takes equipment with them when the leave • e.g. – dog grooming equipment in a pet salon and paid as an apprentice

35. Business-within-a-business • operate a micro-enterprise inside an existing, larger business • profits shared to off-set person’s space requirements • e.g. – selling manicure products in a salon; computer training in a day care • market analysis, feasibility study, business plan writing

36. Self-employment, also referred to as small business and/or micro-enterprise • person with a disability owns the business • flexibility with schedule, tasks, supports • feasibility study, market analysis, financial projections, business plan

37. Customized Employment Tools & Strategies

38. Tools & Strategies • Creative Assessment: Vocational Profile Process • Individualized Training Account (I.T.A.) • Work Force Planning & Assistance (WIPA) Services • Business Plan Development

39. X.I.J. Consulting and Associates

40. Bradley • Self- Employed • Attended the EDGE Connection for business plan development course work and start-up consultation. • He attended and graduated from the 2nd NxLevel course for micro-entrepreneurs. • Funding: ITA –$1,500 • Relies on ongoing marketing support and client word of mouth.

41. Resource Information • Griffin, C.C., Hammis, D. & Geary, T. (2007). The Job Developer’s Handbook: Practical Tactics for Customized Employment. Baltimore: Brookes Publishing. • Griffin, C.C., Hammis, D. (2003). Making Self-Employment Work: for People with Disabilities.

42. Academic Journals • Journal of Vocational Rehabilitation 23 (2005) 123¡V134 123 IOS Press Supporting consumer directed employment outcomes Nancy Brooks-Lane, Suzanne Hutchesonb and Grant Revell, Developmental Disabilities Services, Cobb and Douglas Counties Community Services Boards, 3830 South Cobb Drive, Smyrna, GA 30080, USA E-mail: nanwal@earthlink.net Helping People Succeed, Inc., P.O. Box 597, Stuart, FL 34995, USA cVCU RRTC, P. O. Box 842011, Richmond, VA 23284, USA Tel.: +1 804 828 6989; E-mail: wgrevell@mail1.vcu.edu • May (2007) A revolution in the employment process of individuals with disabilities: Customized employment as the catalyst for system change Tod Citron, Nancy Brooks-Lane, Doug Crandell, Kate Brady, Cobb-Douglas Counties Community Services Boards, Smyrna Georgia USA

43. Comprehensive Media & Publication List • National Public Radio (NPR) story, 2005 • Making a Difference Magazine, multiple issues • Marietta Daily Journal, multiple issues • Atlanta Journal and Constitution, multiple issues • Real Work, Real Play, edited by Paul Weiman, 2006 • US DOL Fact Sheets, multiple • T-TAP web-casts & fact sheets, multiple • Journal of Vocational Rehabilitation, 2006 issue • Latest book by Griffin-Hammis and Associates, March 2007 • Schizophrenia Digest, 2006 • MOUTH Magazine, 2003 • TV-21 Interview, 2001 & 2005 • Fox-5 TV-News Story, 2001 • Griffin-Hammis and Associates website, www.griffinhammis.org • NCWD Customized Grantee website, www.onestops.info • EDGE Connection website, www.theedgeconnection.org • Bright Side, March 2006

44. Thank you For further information & conference presentations please visit www.consensusproject.org This material was developed by presenters for the July 2009 event: “Smart Responses in Tough Times: Achieving Better Outcomes for People with Mental Illnesses Involved in the Criminal Justice System.” Presentations are not externally reviewed for form or content and as such, the statements within reflect the views of the authors and should not be considered the official position of the Bureau of Justice Assistance, Justice Center, the members of the Council of State Governments, or funding agencies supporting the work.