How Working is Promoting Recovery for People with Mental Illness Please stay on the line. The webinar will begin shortly. Download the PPT here: http://soarworks.prainc.com/article/soar-webinar-employment AUDIO: Toll Free Number: (855) 749-4750 Access code: 660 225 125 Contact lguerin@prainc.com if you experience technical difficulties. This webinar is being recorded and will be available for viewing within 1 week of this presentation.

How Working is Promoting Recovery for People with Mental Illness Presented BY: SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc. Under Contract TO: Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services

Welcome! Kristin Lupfer, LmSW, Project Director, SOAR Technical Assistance Center, Policy Research associates, Delmar, New York

Webinar Instructions Muting Recording availability Downloading documents Evaluation http://soarworks.prainc.com/article/soar- webinar-employment

Learning Objectives Define IPS and describe core principals of IPS (Individual Placement and Support) model. Understand how IPS model can support individuals with mental illness who have experienced homelessness seek competitive employment in the community. Provide an example of a SOAR program offering job supports.  

Agenda IPS Model: Dartmouth Psychiatric Research Center (PRC), Lebanon, NH Robert E. Drake, M.D., PhD., Professor of Psychiatry and of Community and Family Medicine Deborah R. Becker, M.Ed., CRC, Director of Supported Employment Programs at the PRC, Associate Research Professor SOAR Program: Columbus House Inc. / Pathways to Independence, New Haven, CT Thomas Fortuna, Pathways to Independence Manager Carl Reynolds, Pathways to Independence Employment Services Coordinator Questions & Answers Facilitated by SOAR TA Center Staff

Poll Question #1 Does your SOAR program connect SSA beneficiaries to employment support services? a. Yes b. No c. Unsure d. Making plans to in the future

Supporting Individuals Experiencing Homelessness with Individual Placement and Support (IPS) Robert Drake, Professor & Deborah Becker, Associate Research Professor Dartmouth Psychiatric Research Center Hanover, New Hampshire

Quotes from Workers “When I am working, the noise in my head gets quieter.” “Working gives me a reason to get up in the morning. And that is the best medicine.” “The money is nice but I feel good telling my son that I have to go to work tomorrow.”

Four Main Points Many people with serious mental illness want to work People with serious mental illness can work IPS Supported Employment Fidelity Scale is a program road map Work is everybody’s business

Recovery and Work Work promotes recovery and wellness- Emotional Financial Social Spiritual Physical Intellectual Environmental M. Swarbrick, Collaborative Support Programs of New Jersey

Competitive Employment Say they want to work: 60-70% Are currently working: <15% Are receiving supported employment: <2%

IPS Principles Open to anyone who wants to work Individualized long-term supports Focus on competitive employment Integrated with treatment Benefits counseling included Rapid job search Systematic job development Client preferences guide

1. Every Person Interested in Work is Eligible Zero exclusion People with justice system involvement People who have experienced homelessness People with co-occurring substance use disorders Encouragement about work and school

Focus on Employment “Have you thought about a job?” “Would you like to know about work incentives (benefits planning)?” “Tell me about your work experience?” “How will you know when you are ready to work?”

Build a Culture of Work Clients share their back to work stories with other clients and staff, for examples: Written stories in waiting rooms, newsletters… Speakers at treatment groups, picnics, agency meetings… Posters and brochures about work

Short Conversations About Work Talk about work over time. Don’t push; help people explore the possible benefits and costs of employment. “I believe you can work. It’s up to you.” Make sure people have good information about benefits, jobs available, etc.

2. Competitive Jobs are the Goal Pays at least minimum wage Integrated community setting “Owned” by the worker Not set aside for people with disabilities Part-time or full-time jobs

Competitive Jobs Landscaper Childcare Worker Machine Operator Data Entry Photographer Deli Meat Cutter Receptionist Grocery Bagger/Carriage Attendant Reporter Housekeeper Sales Clerk Dishwasher Security officer Welder Baker’s assistant

3. Employment Services & Mental Health Services are Integrated Team approach Help team think about work/school for others Connect with Vocational Rehabilitation Connect with families

Team Approach IPS worker assigned to 1-2 teams Participate in weekly team meetings Communicate outside of meetings Share office space Help team think about work/school for others Connect with Vocational Rehabilitation Connect with families Dartmouth Psychiatric Research Center

Work is Everybody’s Business Team members share: Person strengths, experiences, wellness strategies Ideas for job types Job leads Job support

4. Preferences Are Honored

Individual Preferences Job type Job setting Work hours Disclosure Role of employment specialist with employer contact Job support Dartmouth Psychiatric Research Center

5. Benefits Planning Is Offered Offered to all clients seeking work Provided by specially trained staff Impact on Social Security, Medicaid, other government entitlements Offered when making changes in work hours and pay

6. The Job Search Occurs Rapidly Avoid lengthy assessment, training, counseling Face-to-face contact with employers within 30 days Investigate job types and settings Employer contacts based on person’s preferences, strengths

7. Systematic Job Development Develop employer relationships. Employment specialists meet with employers over time to learn about business needs and positions. Specialists make at least 6 contacts with hiring managers each week.

Job Finding Techniques First meeting, schedule a 15-minute appointment. Meet with employer for 15 minutes to learn about the business and hiring preferences. Go back to talk about the strengths of a person who would be a good fit for that business. Ask for an interview.

8. Job Supports are Continuous Ongoing as needed and desired Individualized

Ongoing Job Support Face-to-face before job start Day of job start Weekly contact Transition out of IPS

Individualized Job Support Individualized support Employer support Career development Enhanced team support

IPS Supported Employment Guidelines 8 Practice Principles 25-item Fidelity Scale

Wellness and Recovery Wellness moves the focus from thinking one needs treatment forever to capitalizing on the strengths and abilities of the individual and his/her family and community. M. Swarbrick, CSPNJ  

What People Say “When you are working, you are part of the real world. You feel connected. Having a job gives me stability. I have something to look forward to every day.” “In the past, people might have used labels to describe me such as ‘homeless,’ ‘mentally ill,’ and ‘welfare mother.’ Now my titles are ‘financial administrator,’ ‘college student,’ and ‘working mom.’”

Resources http://www.dartmouthips.org ASK Online courses for practitioners and supervisors IPS Supported Employment: A Practical Guide

A Few Facts 70% of people with mental health issues want to work IPS can help 60% or more to become competitively employed Most people work about half-time, like their jobs, and benefit in many ways from employment

Controlled Trials RCTs are gold standard in medical research 22 Randomized Controlled Trials (RCTs) of Individual Placement and Support (IPS): Best evidence available on effectiveness RCTs are gold standard in medical research

Controlled Trials: Findings

Overall Findings for 22 RCTs Every study showed a significant advantage for IPS Mean competitive employment rates: 56% for IPS 23% for controls

Homelessness Baltimore study Washington, DC study Majority recently homeless 27% vs. 7% employment Washington, DC study 71% vs. 9% employment Combined NH, DC, CT, and IN studies Over 20% recently homeless Employment outcomes unrelated

2 Long-Term IPS Studies

IPS Is Effective for a Wide Variety of Subgroups PTSD diagnosis Homeless Mental illness + substance use Criminal justice history Disability beneficiaries Older adults African American First episode of psychosis Hispanic

Contact Information Dartmouth Psychiatric Research Center Lebanon, NH (603)448-0263 http://www.dartmouthips.org Robert E. Drake, M.D., PhD. Professor of Psychiatry and of Community and Family Medicine Robert.E.Drake@dartmouth.edu Deborah R. Becker, M.Ed., CRC Director of Supported Employment Programs at the PRC, Associate Research Professor Deborah.r.becker@dartmouth.edu  

Poll Question #2 What is one myth our presenters debunked? a. Most people work about half-time, like their jobs, and benefit in many ways from employment b. Most people with mental illness do not wish to work. c. IPS can help 60% or more to become competitively employed

Income=Empowerment: The Pathways to Independence Program Thomas Fortuna, Manager and Carl Reynolds, Employment Services Coordinator Columbus House Inc./Pathways to Independence New Haven, Connecticut

Pathways to Independence Combining SOAR & employment incomes with a holistic approach to recovery, housing and community reintegration. Using holistic, recovery-based incentives to support individuals to engage in employment. Targeted services for individuals experiencing homelessness and a disabling condition.

Our Core Mission and Values Mission Statement To increase housing, income and health security for individuals who are homeless and experiencing a behavioral health and/or substance use disorder.  Values Pathways to Independence promotes Hope, Personal Responsibility, Education, Self-Advocacy and Support, helping to provide opportunities, skills, and the education necessary to become independent and productive.

Program Goals Maximize our client’s access to income Employment and SOAR assistance (dual screening) Employment Network: Ticket to Work WorkFare Provide connection to healthcare providers Facilitate and nurture opportunities for client employment Educational support and assistance for client’s financial stability and improved quality of life Identify and secure housing options in the community

Program Components Housing Services Employment Services Financial Literacy, Employment Training (EEC) Enrollment into Benefit Programs (SOAR) Representative Payee Healthcare Referral **All Individuals Served Participate in EEC**

Employment Enrichment Center PTI Employment Enrichment Center Case Manage-ment Income Housing

Employment and Enrichment Center Funded in part by the United Way of Greater New Haven Through Education, Enrichment and Employment, graduates will discover: Greater Self-Esteem Stronger Recovery from addiction Better control of psychiatric symptoms Greater Confidence Greater Life Satisfaction Enjoy a life worth living Have a life worth saving Instructors are certified Recovery Support Specialists Also facilitated through a relationship with a local community bank: START

Employment and Enrichment Center Curriculum: 90 hours, classes include: Intro to Computers Key Train, ONET training & job identification Math, Reading & Comprehension Wellness & Recovery Action Plan (WRAP) Teambuilding Starting Your Own Business Resume, Cover Letter Writing and Interviewing Skills And More! Housing Education Employment and Search Tools

Extra Curricular Classes Regular Classes: Monday through Friday, 9:00 AM to 12:00 PM Jobs Club: Tuesday and Thursday 1 PM to 3 PM Focus on interviewing skills, online applications, and gaining field work/experience outside of the classroom Computer Lab: Monday and Friday 1 PM to 3 PM Housing Resource Class: Wednesday 1 PM – 3 PM Resources on tenancy, fair housings rights, etc.

Additional Resources Provided Interview clothing including suits and shoes Transportation including bus passes and rides Gift cards for personal necessities Consistent phone and computer access to streamline the job-hunt process

Dress for a Successful Interview!

The End Result=Employment Resume Working Cell Phone Cover Letter Direct Connection to a Local Banking Resource Working Email Account Interview Practice Interview Clothing

Community Partners Career Resources / Connect To Work START Community Bank Social Security Administration New Haven One Stop / CT Labor Office Cornell Scott Hill Health Center (local community health center) STRIVE Veteran’s Affairs Bureau of Rehabilitation Services

Columbus House WORKFARE Want a Job? We Can Help!   Want a Job? We Can Help! WORKFARE trains people facing homelessness for careers in the custodial trades and the food service industry so they can obtain stable full time employment. Learn how to write a résumé and cover letter, attend interviews, develop a personalized Action Plan, and gain basic computer and job-search tools. Free Hands-On training at Columbus House facilities, where you work alongside talented professional staff and volunteers. Great for Ticket to Work program participants!

WorkFare Benefits Certificates: Receive a Certificate valued by employers to show you have successfully completed the training. Job Search: Meet with job search counselors, learn how to fill out applications, go to interviews, use email, and find jobs on the internet and through commercial publications. Graduate Support: Graduates may attend additional sessions for regular ongoing job advice, employment search assistance, and help with a variety of other social service resources. Also includes a guaranteed and extended shelter bed stay for Emergency Shelter occupants

Employment Network (EN) Employment Network designation Generates revenue to support and sustain PTI Direct connection to the SSA = Streamlined communication Ticket to Work program In house, collaborative resources for SSA Beneficiaries Access to Employment & Enrichment Center, Jobs Club, Employment Specialist Services

PTI Program Results: Looking Back SOAR Employment 77 applications approved over 3.5 years Over $1.5 Million in cumulative income 104 Individuals Hired and Retained 3.5 years Over $3.5 Million in Earned Income EEC Results: Last 12 months Over 3.5 years Housed: 205 Individuals Rep Payee: 53 Enrolled 89 Attended Initial Orientation 63 Completed the Program 31 Employment Placements Average Wage: $10.25 67 Referred to External Programs: GED prep, occupational training, local community college enrollment

Supportive Services for Veteran Families (SSVF) Additional Columbus House Programs Homeless Veterans Reintegration Program (HVRP) Employment Services Employment & Enrichment Center Supportive Services for Veteran Families (SSVF) Employment Services SOAR Services Housing Services Case Management Homelessness Prevention Direct Financial Assistance

The Benefits of Working and Providing Support Carl Reynolds, Employment Services Coordinator Columbus House Inc./Pathways to Independence New Haven, CT

Providing Support Peer Experience Employment Spectrum Job Developing Employment and Training EEC Trainings

Thomas Fortuna, Pathways to Independence Manager Contact Information Columbus House, Inc./Pathways to Independence 592 Ella T Grasso Blvd New Haven, CT 06519 Fax 203-772-4097 Thomas Fortuna, Pathways to Independence Manager 203-772-4200  ext. 2139 tfortuna@columbushouse.org & Carl Reynolds, Pathways to Independence Employment Services Coordinator (203)772-4200 ext. 2117 creynolds@columbushouse.org

Questions and Answers Facilitated By: SAMHSA SOAR Technical Assistance Center Policy Research Associates, Inc. Please type your question into the Q&A panel located underneath the participant tab, or To ask a question by phone, please raise your hand by clicking the hand icon in the participant pod. We will unmute you so you can ask your question.

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