Transcript Best Practices in Employment Services -Co

Workforce Retention in Supported
Employment: Promising Practices
Amy Gelb, MS, CAGS, CRC, CPRP- [email protected]
Rick Kugler, M.S., CPRP- [email protected]
The Institute for Community Inclusion-UMass Boston
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Questions…
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Why talk about mental illness and work?
What are the current vocational outcomes for this
group?
What are the issues involved in maintaining (or
finding) employment?
What are some possible strategies to increase
workforce tenure?
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Work and Mental Illness
• The majority of people with mental illness report the
desire to work
• The employment rate is low
• Unemployment is costly for everyone
– Living on $600 - $900 a month?
– SSA distributes over $75 billion a year on disability benefits: 25% - 30%
are beneficiaries with SMI
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Three Myths and a Fact
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Generally, stress from employment make it
more likely for someone to be hospitalized
People who are unemployed have more time
to invest to control their symptoms
People with SMI and a substance abuse
problem are likely to benefit from SE
services
Clinical benefits for people with SMI who
work are rare
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Research and SE
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People with SMI may require more support and have
difficulty with retention than people with chronic
disease/disabilities (non- cognitive)*
Most of the current research is comparative in nature –
one program vs. another
Over a decade of research demonstrates that 40% 60% can obtain employment through SE
interventions**
Hoekstra et al., 2004 & Lerner et al., 2004, ** Bond, 2004
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What Are the Reasons
People Go to Work?
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What Are The Reasons
People Stay At Work?
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Principles for Effective SE:
Evidence - Based Principles
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Consumer Choice
Integration of vocational and clinical
Competitive employment is the goal
Rapid Job search
Individualized job finding
Follow-up supports are continuous
Work Incentives Counseling
Principles based on work done by Becker, Bond, and Drake
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Employment Outcomes
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SE studies (mainly IPS) lasting 18 to 24 months:
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People work 15-30 weeks -job tenure 15-20 weeks
SE participants followed up after 10 years*
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1/3 of worked five or more years
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Average job tenure at <3 years
Retention Rates - Clubhouse –
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Working members averaged 300 days over 3 years**
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10-year span - average tenure of working member <3
years(?)***
* Salyers, Becker, Drake, Torrey & Wyzik, 2004
** Mckay, Johnsen & Stein, 2005
*** Dorio, 2004
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Turnover for Other Populations
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Convenience store workers - 130%
Leisure/Hospitality - 45% *
National Average - 40% **
Low Wage Earners – 4 in 10 jobs
turnover quarterly***
*Employment Policy Foundation, 2005
**Tumulty - Gannett New Service, 2002
***Lane-HHS, 1999
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What Interferes With
Work: Problems
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Reasons for turnover are not prevalent in the
literature
Resignations and terminations are more
common than career advancement & layoffs
The relationship of substance abuse and
work yields inconsistent results*
* Drake, Becker & Bond, 2003
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What Interferes With Work:
Problems
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Studies also identify struggles with:
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psychiatric symptoms & hospitalizations
physical illness
involving interpersonal issues
unattractive, low paying jobs
the same problems that people without
mental illness confront
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Know the Job Seeker
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What skills does the job seeker
bring?
What abilities do they have?
What are their strengths?
What can they do for an employer?
What kind of work culture works
best for them?
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Know the Employer
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What do they do / make?
What jobs do the typically hire for?
What hiring needs do they have?
What tasks are not getting done?
What areas of business do they want to expand?
Are tasks getting done by high paid employees that
someone else could do?
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Now...
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Look for a match between the businesses
needs and the skills and strengths of the
job seeker and…
Identify how the employer will profit
from hiring the job seeker.
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Potential Factors That Help
Perpetuate Employment
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Provision of ongoing support services (needs more
study)
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One FACT study yielded better consistency than IPS*
People who hold on to their job report intrinsic rewards
Job satisfaction through better matches
Attachment to better paying, ‘benefited’ jobs and or
ones with potential
Teach skills, “soft” skills, retention strategies, etc.**
* McFarlane et al., 2000
**Wallace & Tauber, 2004
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Recommendations
 Start: Use EBP principles
 Include: Good job matches, if the pay can’t
be great, the job should at least be “looking
up a stairway”
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SSA Considerations- Make sure people know
what they will earn
 Include: Integrative and Collaborative
services-vocational, clinical and social
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Recommendations
 Include: Provide community based-services,
assertive outreach
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Help develop natural supports
 Explore: Employment support staff need to
encourage consumer participation in
ongoing skills development
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Resources
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Articles on SE @ Dartmouth NH – Psych Research
Center (click publications; vocational)
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www.dartmouth.edu/~psychrc/ …or
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…visit www.naric.com/research/ for information
from research and training centers
Find out more about Work Incentives @
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www.socialsecurity.gov/work/
SAMHSA Workbook on SE
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www.mentalhealth.samhsa.gov/media/ken/pdf/toolkit
s/employment/16.SE_workbook.pdf
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Acronyms
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FACT= Family-aided assertive community treatment
IPS= Individual Placement & Support Model
SE= Supported Employment
SMI= Serious mental illness
SSI= Supplemental Security Income
SSDI= Social Security Disability Insurance
SSA= Social Security Administration
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