Improving Employment Outcomes for Homeless with Disabilities
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The document discusses evidence-based supported employment (SE) practices for improving employment outcomes for homeless individuals with disabilities. It describes the core features of SE, including integrating employment services with treatment teams, having no employment exclusions, focusing on competitive community jobs based on client preferences, and providing long-term ongoing supports. Research shows SE following these principles leads to significantly higher employment rates than traditional models.
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Improving Employment Outcomes for Homeless with Disabilities
- 1. Improving Employment Outcomes for Homeless Job Seekers with Disabilities Supported Employment John Rio Advocates for Human Potential Mike Donegan Downtown Emergency Services Center
- 2. What is it ?
- 13. “ Recovery may be a journey; but if you never get anywhere, it can easily become a treadmill” Joe Marrone
- 15. Does it work?
- 19. Competitive Employment Rates in 12 RCTs of Supported Employment
- 22. How do you do it?
- 26. Dealing with the Unexpected: Getting beyond the day to day Crisis
- 28. 2. Participation is open to all who want to work “ We don’t seem to do well at predicting who can work and who cannot”
- 31. It’s time for a new paradigm! Can you shift your paradigm?
- 54. How do I pay for it?
- 59. What do you say to people who say they don’t want to work?
- 61. Know what EBP-SE looks like
- 62. "You've got to be very careful if you don't know where you're going, because you might not get there."
Editor's Notes
- What is it? Does it work? How do you do it? How do I pay for it?
- Health —Overcoming or managing one’s disease (s) as well as living in a physically and emotionally healthy way; Home —A stable and safe place to live that supports recovery; Purpose —Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors and the independence, income, and resources to participate in society; and Community —Relationships and social networks that provide support, friendship, love, and hope. #1 – Prevention of Substance Abuse and Mental Illness #2 – Trauma and Justice #3 – Military Families #4 – Recovery Support #5 – Health Reform #6 – Health Information Technology #7 – Data, Outcomes, and Quality #8 – Public Awareness and Support
- Increase the proportion of individuals with mental and/or substance use disorders who are gainfully employed and/or participating in self-directed educational endeavors. Develop employer strategies to address national employment and education disparities among people with and without identified behavioral health problems. Improve the employment and educational outcomes among individuals with mental and/or substance use disorders served by SAMHSA., Implement evidence-based practices related to employment and education for individuals with mental and/or substance use disorders throughout all service systems. To recover, people need meaningful work and the ability to enhance their skills through education . Employment by its very nature helps integrate individuals in society and acknowledges their ability to contribute. In 2009, unemployed adults were classified with substance dependence or abuse at a higher rate (16.6 percent) than were full- or part-time employed adults (9.6 percent and 11.2 percent, respectively).87 The income employment produces enables people to improve their living situation, reducing exposure to violence and other stressors that may adversely affect behavioral health. Conversely, being unemployed is associated with increased rates of mental disorders, especially among men,88 and with relapse to substance use.89,90,91,92 Employment is recognized as a factor in preventing and ending homelessness among people with disabilities; for many individuals, it helps develop motivation and hope for the future. Nevertheless, individuals with mental disabilities have the lowest earning level and household income of any disability group.93 People who are unemployed show higher rates of substance dependence or abuse than those who are employed full or part time.
- Faithful implementation to the practice… leads to desired outcomes
- Supported Employment is regular competitive jobs in the community that anyone can apply for which pay prevailing wage, including part-time and full-time jobs “ intended for people with significant barriers to work”
- There is no correlation between employment outcomes and psychiatric diagnoses 1 , overall psychiatric symptoms 1 , or severity of symptoms 3 Work history is associated with employment outcomes 3 and total earned wages 1 Negative symptoms can adversely impact employment 2 Social support is correlated with employment outcomes 3
- Randomized Controlled Trials of EBSE In all 11 studies, EBSE had significantly better competitive employment outcomes than controls Mean across studies of consumers working competitively at some time: 62% for EBSE 25% for controls Bond, G.R. (2004). Supported employment: Evidence for an evidence-based practice. Psychiatric Rehabilitation Journal, 27 (4), 345-359. Bond, G. R. (2004, December 14). Critical ingredients of supported employment: Research evidence. Paper presented at the UNC/Duke Mental Health Seminar , Durham, NC. Latimer, E., Lecomte, T., Becker, D., Drake, R., Duclos, I., Piat, M., Xie, H. Supported employment for people with severe mental illness: Implications for the first Canadian randomized trial, The Journal of Mental Health Policy and Economics, 8 (1), March 2005. Twamley, E.W., Bartels, S.J., Becker, D., & Jeste, D.V. Individual Placement and Support for Middle-aged and Older Clients with Schizophrenia. International Association of Psychosocial Rehabilitation Services , San Diego, CA, May 2004.
- In 2005, responding to an increasing consumer desire for employment and long waiting lists for the SE services in the county, the board of directors and management team of TripleCsawan opportunity to develop an in-house SE program to meet the needs of its consumers. Furthermore, the management team considered the SE project as a springboard to transform the agency from a traditional residential service provider to a recovery-oriented psychiatric rehabilitationprovider. They recognized that such a paradigm shift demanded a new organizational culture that values employment and promotes recovery.
- Standardized tests, work sample and situational assessments can present a barrier to consumers interested in jobs and can screen out people who do poorly in test situations Does not attend to consumer’s goal.
- I do intend to seek employment, but it will be at a time and place of my own choosing
- to learn the needs of the employer, convey what the SE program offers to the employer, describe client strengths that are a good match for the employer.
- Support throughout the agency from the CEO and board on down; Gowdy-difference between successful programs and those that weren’t was that everyone especially the administration talked positively about the clients potential for success.
- Flat affect changed when describing his childhood in Hawaii when he sailed; aob to DVR meeting; challenged their denial; have started a CD group for clients who want to go to work and have CD issues; attending regularly; using a volunteer job as a reference and assessment…
- Often the lynchpin in coordinating clinical and housing services.. Only way we are going to achieve our goals Housing staff know our clients the best – see them in their own environment 24 hours a day can be there before and after job iterview or work
- What can we do to change your mind? The gentle Art of persuasion
- Consumers and family members must lead and drive the Public Mental Health System to change!
- Be able to identify EBP-SE