Working with Individuals with Mental Health Issues: An Employment Perspective – Part III

The webinar will begin shortly.

Presented by:

Hosted by:Mariella Bozzer Dr. Sarah-Jane Meachen

BC Centre for Employment Excellence

Agenda5 mins Welcome & Introductions45 mins Presentation10 mins Discussion

We encourage you to ask questions! We will address them during

and after the presentation. To submit a question:

Use the “Questions” tab at the right of your screen (at any time

during the presentation.)

Welcome & Agenda

Working with Individuals

with Mental Health Issues

An Employment Perspective:

Part 3

OVERVIEW

● Recap of Webinar 1 & 2

● Employment Continuum

● Supported Employment in the PSR Context

● Supported Employment Components

– Individual Placement and Support (IPS) Model

● The Role of the Employer

● Bringing it all together

● Where are we headed in vocational rehab?

Recap of Webinar 1

● Mental health conditions increasingly recognized as common

barriers to employment.

● Employment is a key factor in recovery of persons with mental

health conditions.

● Employment benefits individuals with mental health conditions

and society as a whole

● Principles of psychosocial rehabilitation provide framework for

guiding work with this population

Recap of Webinar 2

● Psychosocial Rehabilitation

● The role of the job developer / career practitioner

● Strength-Based Assessment

● Wellness for work

– Wellness Recovery Action Plan (WRAP) for Work

The Employment Continuum

Prevocational

TrainingVolunteer

Placement /

Work

Transitional

Employment

Competitive

Employment

Customized

Employment

Supported

Employment

Employment Continuum:

Pre-Vocational Training● Pre-employment education & support

– Prepare client for volunteer or employment roles

– Examples:

● Resume building, Job search strategies, Interviewing,

work readiness, wellness planning, CBT

● Research suggests of limited value

– ―train and place‖ versus ―place and train‖

● Clinical experience: augments engagement, client

confidence, builds skills

Employment Continuum:

Volunteer Placement / Work

● Support client to choose, obtain, and maintain

volunteer positions or work experience placements

● May be time-limited or unlimited

● Build skills

● Gain experience and confidence

● Obtain reference

● Useful in facilitating recovery and employability

● May lead to competitive / supported employment

Employment Continuum:

Transitional Employment● Often time limited / may involve work crews (job sharing)

● May be competitive or non-competitive

● Provide an ―accessibility ramp‖1

● May be facilitated through...

– Clubhouses1,2

– Social cooperatives3,4,5 (even in remote communities)

– Peer-run initiatives6

Employment Continuum:

Transitional Employment● Potential benefits to both client AND employer

● Limits…

– stress of interviews

– training by strangers

– threat of job loss due to absenteeism

Supported Employment

● Place and Train Approach

● Competitive jobs for pay

● Strength-Based Assessment / Goal Setting

● Client/consumer choice

● Time-unlimited

● Provision of supports on job

● Most effective in terms of employment outcomes and

recovery

Customized Employment

● Individualized support based on relationship

between applicant and specific employer

– Meeting needs of both

– Assumes employers have unmet needs

– Individualized – e.g. Job carving or restructuring

– Result in at least minimum wage

– Similar to supportive employment in emphasis on

strengths

Customized Employment17

● Discovery

● Capturing Discovery Through Profiles

● Customized, person-centred planning

● Portfolio Development

● Job development and negotiation

● Job site analysis, accommodations, support

Customized Employment vs.

Supported Employment17

● Similarities

● Provision of supports

● Emphasis on strengths

● Evidence for enhanced employment outcomes

● Differences

● SE: labour market approach; fill existing jobs; emphasis on

formal assessment, traditional resume, job coaching

● CE: discovery approach; job carving; portfolio vs. resume;

customized

Competitive Employment

● Return-to-work scenario or self-serve job search

supports

● Collaborate with employer and unions to develop

and implement workplace supports (e.g. self-care

resources)

● Stress early identification of problems – proactive

approach

● Harm reduction, stress management

Supported Employment

• An effective approach to vocational

rehabilitation that emphasizes helping

individuals to obtain competitive employment

• Each person has an Individualized training and

support plan to ensure success

• ―Place and train ― approaches

Supported Employment (con’t)

• Evidence: 40-60% of clients in SE programs obtained competitive employment

• Key features of SE model: – ongoing support

– jobs not services

– all persons regardless of diagnosis can benefit

– all those interested in work are included

– variety and flexibility in providing individualized support

Components of Sup Employment:

• Strength-based assessment

• Goal-setting by the client

• Job coaching and job development

• Employer outreach

• Job placement (may include accommodations or modifications)

• Skills training –on the job

• On-going support to maintain employment

Individual Placement and Support

(IPS ) Model

• Most researched and most widely used SE model

• Has well developed Fidelity

• IPS 25 Fidelity Scale and Model - available

at:http://www.dartmouth.edu/~ips/page19

• Fidelity criterion: eg. caseload size

Components of IPS model:

• Focus on competitive employment and

rapid job search from the start

• Eligibility based on client choice—zero

exclusion philosophy

• Attention is focused on clients interests /

preferences and choice

• Integration of IPS programs within mental

health treatment centers

Components of IPS :(con’t)

• Counselling advise on benefits/income

assistance, health care benefits

• Job development: build on employer

networks, develop relationships with

employers

• Follow-along supports are individualized,

continuous and time-unlimited

Supported Education and

Supported Employment

• Research to support the effectiveness of

combining Sup Education with Sup

Employment to assist clients in pursuing

skill trades

• Rudnik and Gover ( 2009)

Case example

• Client –centered approach

• Strength-based assessment

• Goal-setting by the client

• Flexible approach/ accommodations

• Work experience to build confidence

Close follow-up support

• Working closely with employer and client

as partners to problem-solve

Role of the Employer

● Increasing recognition of duty of employers to

provide psychologically safe workplaces7

● Mental health conditions rank in top 3 causes of

long-term disability for 72% of businesses8

– 82% of businesses rank mental health conditions in

top 3 causes of short-term disability

● Recognition of not only absenteeism cost but

―presenteeism‖ costs (may be 1.5x greater)

13 Psychosocial Factors Promoting

Workplace Psychological Health9,10

● Psychological Support

● Organizational Culture

● Clear Leadership /

Expectations

● Civility & Respect

● Psychological

Competencies and

Requirements

● Growth & Development

● Recognition & Reward

● Involvement & Influence

● Workload Management

● Engagement

● Balance

● Psychological Protection

● Protection of Physical

Safety

National Standard of Canada for

Psychological Health & Safety in the

Workplace (―The Standard‖)

● Championed by Mental Health Commission of Canada

● Developed by Canadian Standards Association and

Bureau de normalisation du Quebec

● Voluntary set of guidelines, tools, resources

● Focus is promoting employee psychological health and

preventing psychological harm in the workplace

● Benefit employer through increased: productivity, financial

performance, risk management, organizational

recruitment, employee retention

What can the employer do?

● Sign up for The Standard11

– Monthly webinars, Audit Tool, Action Guide for

Employers and so much more

● Join Guarding Minds @ Work

● Take Mental Health First Aid course

● Be proactive – have conversations!

● Create safe spaces where employees can seek

supports when needed

● Provide regular constructive feedback

What can the employer do?

● Other Resources

– Mental Health Works (CMHA)10

– Great West Life Centre for Mental Health12

– Bell ―Let's Talk‖ Toolkit13

Career Practitioners are KEY

● Uniquely positioned

– Knowledge of PSR and recovery principles

– Knowledge of job market and employers

– Key relationship with clients and their support

systems

Where are we headed?

● Role of technology, internet, social media

– Reaching more remote areas

● Peer-based initiatives / social enterprises

● Recovery Focus / reduced stigma

● PSR Principles as guiding framework

● Mental Health as Important as Physical Health

● Recognition that employment key to recovery –

inability to work is exception, not rule.

References

1. Austin Clubhouse: http://austinclubhouse.org/services/transitional-employment/

2. Pathways Clubhouse: http://richmond.cmha.bc.ca/how-we-can-help/support-

services

3. British Columbia Cooperative Association: http://www.bcca.coop/

4. Canadian Cooperative Association: http://www.coopscanada.coop

5. The Cooperative Learning Centre: http://www.learningcentre.coop/

6. Lived Experience Research Network: www.lernetwork.org

7. Shain Reports on Psychological Safety in the Workplace:

http://www.mentalhealthcommission.ca/English/node/493

8. WatsonWyatt 2007 Survey Report: Staying@Work - Effective Presence At Work:

https://www.easna.org/documents/WatsonWyattStayingatWorkSurvey.pdf

References

9. Leadership Framework for Advancing Mental Health in the Workplace

(Mental Health Commission of Canada): http://www.mhccleadership.ca/

10.Guarding Minds at Work: http://www.guardingmindsatwork.ca

11. National Standard of Canada for Psychological Health and Safety in the

Workplace (―The Standard‖):

http://www.mentalhealthcommission.ca/English/node/5346

12. Great West Life Centre for Mental Health:

http://www.gwlcentreformentalhealth.com/index.asp?

13. Bell Let's Talk Toolkit: http://letstalk.bell.ca/en/toolkit/

14. Best Practices in Supported Employment: www.employmentforall.ca

15. Canadian Association for Supported Employment:

www.supportedemployment.ca

References

16.Customized Employment Demonstration Project – Questions and

Answers: www.communitylivingbc.ca/what_we_do/documents/

CustomizedEmploymentQAs.pdf

17. Customized Employment: A Comprehensive Job Developer's Manual

(BackinMotion & Community Living B.C.): www.bcemploynet.org

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To submit your question:

Please use the “Questions” tab to the right of your screen.

Questions and Discussion

36

Accessibility for Specialized Populations in One-stop Employment Centres: Best Practices from the UK, US and Australia

Presented by: Wendy Bancroft, it’s about us research

In a one-stop employment services model like the Employment Program of British Columbia (EPBC), what can be learned from countries with a longer history of implementing one-stop approaches? What have other jurisdictions found to work best for clients and providers within one-stop frameworks? What are the factors most likely to spell “success,” in terms of supporting specialized populations to find and retain jobs?

Next Webinar – May 21st

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