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Serving Jobseekers with Psychiatric Disabilities. DOL/CRC Conference Washington D.C. August 25, 2005. The Value of Work. “ the right to employment is as much a symbol of full citizenship in modern society as is the right to vote” (Fabian, 1999)

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serving jobseekers with psychiatric disabilities

Serving Jobseekers with Psychiatric Disabilities

DOL/CRC Conference

Washington D.C.

August 25, 2005

the value of work
The Value of Work
  • “ the right to employment is as much a symbol of full citizenship in modern society as is the right to vote” (Fabian, 1999)
  • “Our work, our recreational and leisure pursuits, our friendships, our membership in our community, all of these are linked to one another. What happens in one area affects the others. (Hagner, DiLeo, 1993)
the value of work3
The Value of Work

“IT IS NEARLY IMPOSSIBLE TO

MAKE YOUR OWN FUTURE WHEN

YOU ARE NOT PART OF THE

ECONOMIC FABRIC OF THE CULTURE

YOU LIVE IN”

PATRICIA DEEGAN

20th World Congress Rehab International: Oslo, Norway

JUNE 2004

role of work in recovery
Role of Work in Recovery
  • Individuals with severe and persistent mental illness who say that they want to work

60 - 70%

  • Are currently working = less than 15%

(The facts about Mental Illness and Work, Matrix Research Institute, Philadelphia, Pa)

role of work in recovery cont
Role of Work in Recovery (cont)

Mental health consumers spend 14% of the day in productive activity compared to 39% for the general population (Krupa, 2001)

Consumers who work utilize mental health services less and improve their social skills and presentation. It is tied to an increase in self esteem and self confidence

(Bond et al, 2001)

the facts about mental illness and work
THE FACTS ABOUT MENTAL ILLNESS AND WORK
  • There are over 3 million working age adults with psychiatric disabilities of whom 70% to 90% are not employed
  • Psychiatric disability is the largest single diagnostic category among working-age persons receiving Social Security Administration SSDI/SSI disability benefits (27%/36% as of 2001)
the facts about mental illness and work7
THE FACTS ABOUT MENTAL ILLNESS AND WORK
  • Studies have shown that the great majority of people with serious mental illness want to work
  • A diagnosis of serious mental illness is not a reliable indicator that someone can not work

(Bond, 2004)

chicago statistics
CHICAGO STATISTICS
  • Almost 75,000 people in the Chicago area have mental disabilities according to the 2000 census
  • Chicago area unemployment rate is 6.1%, but 77% of people with psychiatric disabilities are not working (2003)
advancing customized employment project ace
Advancing Customized Employment (Project ACE):
  • Funded by the U.S. Department of Labor, Office of Disability Employment Policy (DOL ODEP)
  • Designed to enrich the capacity of local One-Stops to provide customized employment (CE) services to people with psychiatric disabilities who are not regularly targeted for services by the One-Stop Center system
  • A Collaboration of:
    • Chicago Workforce Board/Chicago One-Stop Centers
    • Thresholds, Inc.
    • The Center for Mental Health Services Research & Policy, University of Illinois at Chicago
thresholds the agency s role in community services
Thresholds: The Agency’s Role in Community Services
  • Thresholds has been operating in the Chicagoland area since 1959
  • The agency is committed to helping individuals who want to work find opportunities to do so
  • Strong belief from past experience that individuals with mental illness recover and contribute
the importance of a recovery focused framework
The Importance of a Recovery-Focused Framework
  • Recovery is a process, a way of life, an attitude, and a way of approaching the day’s challenges…The need is to meet the challenge of the disability and to reestablish a new and valued sense of integrity and purpose within and beyond the limits of the disability;…to live, work and love in a community. . . .”

Patricia E. Deegan, National Consumer Leader

the model of vocational programming at thresholds
The Model of Vocational Programming at Thresholds
  • Individualized approach to job development in keeping with customized employment concepts
  • Based on research, retention is enhanced when the job fits an individual’s preferences, interests and abilities
vocational programming cont
Vocational Programming (cont)
  • Review with individuals the barriers to employment and develop plans that address these issues
  • Approach employers as partners
  • Provide follow along supports – something research has demonstrated as a critical need, but also a service to employers
supported employment model
Supported Employment Model
  • Eligibility is based on consumer choice
  • Supported employment is integrated with treatment
  • Competitive employment is the goal
  • Rapid job search is used
  • Job finding is individualized
  • Follow-along supports are continuous

(Drake and Becker, 1993, Bond, 2001)

supported employment concepts marketing strategies
Supported Employment Concepts: Marketing Strategies
  • Employing people with disabilities is not different from employing anyone else
  • Businesses benefit when they exercise ownership and control over the employment process
  • Strategies and techniques available from supported employment programs are useful in working with all employees
supported employment concepts marketing strategies16
Supported Employment Concepts: Marketing Strategies
  • Investment in human resources is the most important investment a business can make
  • Managing a diverse workforce is an increasingly critical business function

(Hanger & DiLeo, 1993)

disclosure
Disclosure

5. Overt professional supports, similar to disclosure itself, have both potential benefits and drawbacks on the worker with mental illness and the relationships with the employer and co-workers

(Marrone,1998)

disclosure18
Pros

Accommodations

Burden lifted

Ability for advocacy by professional staff

More support from supervisor (Rollins,2002)

Cons

Stigma/discrimination

Concern about scrutiny

Relationships with co-workers/supervisors

Advancement fears

Disclosure
disclosure19
Disclosure
  • Issues around disclosure
  • Disability identity
  • Job matching
  • Lark of clarity about psychiatric accommodations
  • Concern about negative responses
  • Assessment process for disclosure

(Dalgin & Gilbride, 2003)

disclosure20
Disclosure

Questions to review with a consumer

  • Personal ethics
  • Is the truth better
  • Is the truth relevant
  • Can the facts be checked
  • Effect on job seeker
  • Consequences

Marrone, 1998

disclosure21
Disclosure

Program needs to review after the previous discussions what it means if the person does not want to disclose in terms of program support in terms of help getting a job and keeping a job

Always good to revisit the consumer decision as time goes on

accommodations
Accommodations
  • What are some accommodations that can be asked for that might help?

Fabian (1993) most frequent:

  • Orientation and training to supervisors
  • Modifying non-physical work environment by providing job coaching
  • Modification of work hours and schedules
accommodations23
Accommodations

Mancuso (1990) listed out functional limitations

  • Screening out environmental stimuli
  • Sustaining concentration
  • Maintaining stamina
  • Handling time pressures and multiple tasks
accommodations24
Accommodations

Mancuso (cont)

5. Interacting with others

6. Responding to negative feedback

7. Responding to change

ace program description
ACE Program Description
  • Population description
ace program description26
ACE Program Description
  • Program offerings
development of interface
Development of Interface
  • Establishing interface between MH providers and One-Stop System partners is essential
  • Points of contact vary by the One Stop
some essential elements
Flexibility of service delivery

development of regular communication

Understanding of partners’ roles and best points for interface

bringing resources to the partnership

Some Essential Elements
a provider s view of barriers to services
A Provider’s View of Barriers to Services
  • Funding Streams
  • Performance Indicators
  • Need for Individualization of Services
  • Supports Available to Customers
goals for improved services for individuals with disabilities
Goals for Improved Services for Individuals with Disabilities
  • Institutionalizing a system of interface between One-Stops and local social service providers
  • A national commitment to provide incentives to working with individuals with hidden disabilities, such as mental illnesses, in the employment area