employment and recovery robert meyer, ips trainer uw-madison, rpse department april 24, 2015 nami wi...
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Employment and Recovery
Robert Meyer, IPS TrainerUW-Madison, RPSE Department
April 24, 2015NAMI WI State Conference
OverviewWhat is recovery?
Evidence based employment programs.
Outcomes associated with employment
Common factors/take home thoughts
What is recovery“A process of change through which individuals
improve their health and wellness, live self-directed lives, and strive to reach their full potential.” (SAMHSA)
“Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.” (National Consensus Statement,
Four dimensions of recovery
Health – overcoming or managing disease or symptoms
Home* – having a stable and safe place to live
Purpose* – meaningful daily activity
Community* – having relationships and social networks that provide support, friendship, love, and hope
from SAMHSA
*recovery factors that relate to employment
Home – income necessary to live where and with whom you want
Purpose – employment provides many with a purpose to their daily routine
Community – employment provides connections to the community: workmates, social interaction, transportation
Gap between desires and current situation
Although we know that employment leads to good outcomes there is still widespread unemployment for people living with severe and persistent mental illness.
~20% employment rate, 60 – 70% express a desire to work.
Current system of providing health coverage/public assistance has a perceived disincentive to work.
Use best practices to bridge the gap
Evidence based modelsIPS (Individual Placement and Support)
Supported Employment.Developed by Robert Drake and Deborah Becker at
Dartmouth College
Clubhouse InternationalFounded 1948 – Fountain House NY City
IPS Guiding Principles IZero exclusion
Consumer choice
Competitive jobs
Systematic job development
IPS Guiding Principles IIRapid job search
Integration of mental health and vocational teams
Individualized benefits counseling
Time unlimited and individual follow along supports
IPS evidence24 Randomized control trials
Typically twice the level of employment compared to standard employment activities.
Well researched fidelity of the model program
Proven track record in the 17 states in collaborativeRural and urban settings
Expanding throughout WI via CCS programs.20+ sites in 19 counties
Clubhouse InternationalCreated in 1948 in New York.
Based on the principles of sharing work and recovery experiences.
5 locations in Wisconsin (Madison, Milwaukee, Wausau, Manitowoc, Racine)
Clubhouse characteristicsa work-ordered day in which the talents and
abilities of members are recognized and utilized within the Clubhouse;
participation in consensus-based decision making regarding all important matters relating to the running of the Clubhouse;
opportunities to obtain paid employment in the local labor market through a Clubhouse-created Transitional Employment Program. In addition, members participate in Clubhouse-supported and independent programs;
Clubhouse cont’dassistance in accessing community-
based educational resources;
access to crisis intervention services when needed;
evening/weekend social and recreational events; and
assistance in securing and sustaining safe, decent and affordable housing.
Outcomes related to employment – research
(correlation vs causation)Bond & Resnick, 2001
Reduction in psychiatric symptoms
Increase in self-esteem
Satisfaction with services offered
Increased satisfaction with leisure and finances
Long-term outcomes(Saylers, et al. 2004)
10 year follow up study of IPS.
75% had worked beyond the initial study period
33% had worked 5 of the 10 years interim, 32 month average
Improvements in reported diverse areas;Self-esteemHopeRelationshipsSubstance abuse control
Common themes Take away messages
Choice, not availability. Go with strengths.
Competitive
Rapid search when you are ready.
Job development (get to know the people, systems and the place before you ask for a job or accommodation).Three Cups of Tea analogy In person, before on-line
Common themes, con’tTeam approach – make sure everyone is on
board and supportive of workPsychiatrist/therapistCase/care coordinatorDVR counselorFamily/support networkPeer supports
Have a clear follow along and crisis planTriggers/coping mechanismsBoundaries and breaks
ResourcesSAMHSA recovery information
http://www.samhsa.gov/recovery http://store.samhsa.gov/product/SAMHSA-s-Working-De
finition-of-Recovery/PEP12-RECDEF
IPS http://www.dartmouthips.org/ https://www.dhs.wisconsin.gov/mh/ips.html
Clubhouse http://www.clubhouse-intl.org/ http://www.journeymhc.org/services/community/yahara
-house
ReferencesA Ten-Year Follow-Up of a Supported Employment Program Michelle P. Salyers, Deborah R. Becker, Robert E. Drake, William C. Torrey, and Philip F. Wyzik, Psychiatric Services 2004 55:3, 302-308
Does competitive employment improve nonvocational outcomes for people with severe mental illness Bond, Gary R.; Resnick, Sandra G.; Drake, Robert E.; Xie, Haiyi; McHugo, Gregory J.; Bebout, Richard R Journal of Consulting and Clinical Psychology, Vol 69(3), Jun 2001, 489-501.
Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models
Cathaleene Macias, Ph.D., Charles F. Rodican, M.S.W., William A. Hargreaves, Ph.D., Danson R. Jones, Ph.D., Paul J. Barreira, M.D., and Qi Wang, Ph.D. Psychiatric Services 2006 57:10, 1406-1415
