BEYOND THE BASICS: REAL SUPPORTS FOR INDIVIDUALS WITH MENTAL ILLNESS. Debbie Walker-Lass with Alexis Pearce

Transcription

1 BEYOND THE BASICS: REAL SUPPORTS FOR INDIVIDUALS WITH MENTAL ILLNESS Debbie Walker-Lass with Alexis Pearce

2 WORKTEC is A community resource providing employment opportunities to students and adults with disabilities and other barriers to employment for more than 34 years A CARF accredited facility that has been recognized in the top 3% of accredited rehabilitation facilities A part of the CCPS system A comprehensive program that works with individuals with any physical or cognitive disability

3 WORKTEC BHDD SE Began serving individuals with dual diagnoses in a rural county in 1998 Expanded services in % community based for this division Staff retention for direct support 100% for the past eight years Jobs include professional, paraprofessional, reception, customer service, janitorial, mail room services, library aide, and supervisory / management

4 Strategies for individuals diagnosed with MI to face and overcome barriers with the RIGHT supports.

5 What is Supported Employment? Supported Employment (SE) is an evidencebased practice that promotes rehabilitation and return to mainstream employment for people with mental health disabilities. Evidenced-based practices for supported employment are based on the Individual Placement and Support (IPS) Model.

6 Summary Report: IPS Model of SE In 11 of 11 studies, SE had significantly better competitive employment outcomes than controls (other vocational interventions). Mean % across studies of consumers working competitively at some time: 61% for Supported Employment 23% for controls ---Bond, 2008

7 What is Supported Employment? Essential features include: Consumer choice & preferences are honored Access to competitive jobs Benefits counseling Timely & continuous supports ---SAMHSA 2007

8 R Recovery! After an extended period of employment, the job coach and the individual begin to see real changes in the way an individual relates to the work place. Sometimes, a job coach can get stuck : The individual still has goals they want to accomplish, however, the job coach may begin to feel the goals are BIG. This is an opportunity for growth for both this team and the division as a whole. It s time to push the envelope!

9 Time for a Change People that have been working for a year or more may be ready to re-visit goals they weren t able to consider before. For instance, obtaining a driver s license or a personal checking account. Individuals that previously refused group or individual therapy may feel ready for these options after working and gaining self-esteem. Don t forget to revisit goals from the behavioral health center. Medications may require adjustment as an individual gains or loses weight due to job duties.

10 I Individualization is more important than ever! Now that employment milestones have been reached, it s time to step out of the box and help the individual think about options beyond their current job. This may be the time to start planning a promotion or a lateral change in duties to increase flexibility and experience. It may be time to look at opportunities beyond their current employer. It could be time to help the person increase their skills by attending free or low cost community educational events, or returning to college or technical school. Of course, if the person is happy where they are, supports may still need to change.

11 G Greatness isn t for sissies! Don t be afraid to dream bigger. Support for SE participants should not become stagnant over time. Supports that have assisted people in LT placement include: Assisting with completion of applications for trainings, such as CPS and GPSI and finding funding to support these endeavors. Helping individuals to apply for QMB Medicaid and Medicare Part D : This is like getting a raise! -JW Encouraging people to attend community training events: Free basic computer courses at the Library, Free fitness center membership at local church, free financial literacy course at local state college. Encouraging people to apply for freelance job opportunities outside of their usual occupation Encouraging individuals to become part of APSE and run for an office Encouraging a former attorney to become an advocate through training at the GAO: This opportunity led to a job offer!

12 Greatness, continued Encourage people to become leaders. Even people that won t normally speak out will do so if the subject is passionate to them. Example: individuals have spoken at the BH caucus about supported employment. This had a great impact on legislators. It helped individuals to build self-esteem, and prompted one young lady to ask for (and receive!) a raise and promotion. Also, one young man added his presentation before legislators to his resume. Don t forget internal trainingmany employers offer this online. Encouraging people to be a part of something bigger opens up opportunities and raises expectations. SE specialists are encouragers by nature! Encouragement=support!

13 H Help people remain Hopeful: Remain concerned with the individual s life path and how work fits in to their long-term plan. Jessie H. wanted to work, but after a long period of unemployment, and with physical issues, she needed a job that would offer flexibility and independence. She also wanted the ability to connect with others when she felt able to do so. Jessie works in a job she would have never previously thought of until we discussed the way this job could fit her needs. She enjoys her independence, and was also cross-trained to answer the phone. Jessie has made many friends at work. She was motivated to work, and we have found motivation to be the strongest indicator of long-term job success.

14 Jessie H.

15 Jessie H. says Supportive employment has helped me to see mental illness from a different perspective. I realize now that I m not crazy, but I have a chemical imbalance that can be controlled with medication. The WORKTEC team has come to be one of the best things that could have come into my life. Everyone treats me with respect and show that they support me. My job coach has taken the time to really get to know who I am. Even before I have a chance to tell her, she knows when things are not right and will ask me if I want to talk about it. I was at the point of giving up before gaining employment through WORKTEC. But thanks to Supportive Employment, I have not only been helped financially, but now I have something to look forward to, and my self-esteem has been given the boost it needed to get started again.

16 T Trust is built over time and requires the active input of the Employment Specialist. Do what you say you will, and don t over-promise. Trust is a basic building block of support, and it assumes a two-way relationship. Give participants a chance to follow-through, and notice when they do. Remember important personal and employment milestones. It s easier to remember a person s first year on the job than their sixth, but no less important.

17 A Job is Just the Beginning Social factors such as feeling isolated or excluded, fearing others may look at an individual as different, and inability to find a way through the maze of work culture contribute more often than other factors in job loss in our experience. Supports around social inclusion on the job such as contributing to a Friday pizza party or attendance at work-related functions that take place after hours means you assist a person in cracking the code of social norms at work. Finding a work mentor is an important part of this process, are you looking?

18 Natural supports can feel unnatural at first Do you and your staff Do it all? From transportation to MD appointments to picking up meds to job coaching to total exhaustion!! Supported employment attracts nurturing people. Over-nurturing can lead to unnecessary dependence. Don t forget the individual may have other supports : Support can show up when you least expect it. Notice it and nurture it.

19 Simple Support Simple things are easy to overlook! Instead of using your company address for participants on job applications, why not assist that person in obtaining their own? Gmail takes about five minutes to set up. Teach individuals without internet access to use their local library to check their and scan job search sites. Help them choose a professional address. Check employer web sites for employee log-in prompts and help individuals to set up accounts. Help individuals set up professional voic .

20 Simple supports II Check-ins can become more interesting for the participant if you follow-up in ways that are relatable to the individual. For instance, looking for resources on the internet and sending them to a person in relation to a goal works well for some people. For others, changing the meeting time or place (not at work or the SE office) is a good idea. Celebrating work accomplishments can be inexpensive. A card, phone call, or short note can lift spirits and make someone s day. Certificates are almost free. E-cards are free on some sites. Don t forget those people who are doing well! If you do, they may not continue to do so!

21 Details Laservoic Individuals voice mail box with unique number & code. Can receive up to 20 messages, must check at least every seven days. K7.net allows users to have voic messages sent directly to a computer address. Also allows for fax access through . Not all voic services are free. Check out before you recommend by trying it yourself. Gmail and Yahoo are free and reliable services.

22 The Hard Part: Supporting Through Difference When everyone is aligned towards a common goal (getting and keeping a job) the Employment Specialist leads the charge and can even feel like a HERO. What happens when the Rubber hits the road and the HERO needs to advocate and / or support something the individual wants that it is hard for people to support (possibly including the ES!!).

23 The Hard Part, Continued WHAT WOULD YOU DO IF An individual decides to cut back on their medication with the (somewhat reluctant) support of her psychiatrist. A person with depression wants to work on a reception desk After two years of successful employment, an individual wants to quit their current job and go to work with a family member who offers no benefits or job security. A person employed for 6 months wants to move out of residential services and get their own apartment. (Residential does not feel the person is ready, MD and case manager do not support this decision) A young man employed for four years with one employer wants to move out of state and transfer within his company.

24 Supporting Through Differences The individuals case manager feels the ES should Help her to retire because of age, but ES and client disagree. An employed person with a developmental disability and an MH diagnosis wants to move out of the family home because family is moving to a rural community and he would have to quit his job. The individual wants to take a course to advance their employment, but there is no money in your budget to support this endeavor. An attorney comes to you for assistance, and you have to argue your case for slowing down and accepting what is without discouraging future growth and opportunity.

25 Chris moved out and kept his job!

26 Patricia did not retire at age 70! Patricia B., seventy years old, works only one day per week and says, Coming to work gets me out of the house, gives me extra food money, and helps to motivate me. I have friends here, and I NEVER want to quit! I used to be able to work more, but I enjoy it more now. Patricia came to SE at the age of sixty, an age when some people want to retire!

27 Alexis: An Employers Perspective The most important thing an employment specialist can do is show up. I have been a consumer of services and an employer. Because I have served in both roles, I know that support and unconditional love for what you do and who you serve is of paramount importance.

28 Dress On The Job Some people really do not know how to dress for a job once they have one. Pants hanging down in the back and underwear showing is not acceptable on most jobs, including mine. Once someone is placed, employers need help with helping individuals to understand the dress code. Employers really do want to work with individuals, but they also need support. You need to make a phone call and come by to see what is going on. Help us to ensure people understand the dress code, this is a huge issue.

29 The care and feeding of an employer If things are not working out on the job, you should know it. Be proactive if someone is not working out. Don t be afraid to ask questions as this could save not only a job, but your relationship with the employer.

30 Know our Schedule & Rules The employer s schedule and yours may not be the same. My crew works nights. You need to be flexible. Know the policy for call-outs and sick and vacation leave. An employer is more likely to be able to bend the rules if you know what they are. People with mental health issues need to keep their appointments, and the employer has a job to get done. You are the one balancing these issues.

31 Peers Are Important In Georgia, we have the CPS designation (Certified Peer Specialist) however, formal or informal, peers are necessary and provide a listening ear plus lived experience of employment while living with a mental illness. Once one person goes to work from a day treatment or peer center, the impact of employment is magnified. Referrals will come quickly as success on the job is reported to peers and formal or informal mentors. WORKTEC has hired peers in staff positions since For more information on CPS GA program:

32 Overcoming fear: Individual Served to Staff Member I consider myself a Walking Miracle ITE (I am the evidence) I m living a happy and stable life in my own home, with a car AND a motorcycle! ---B. King, CPS, Employment Support Specialist

33 BEYOND THE BASICS: REAL SUPPORTS FOR INDIVIDUALS WITH MENTAL ILLNESS Debbie Walker-Lass with Alexis Pearce