Supported Education (SEd) Trevor J Manthey, MSW, Ph.D. University of Kansas

An intervention model designed to assist individuals with psychiatric disabilities to complete educational goals.

Different SEd Models? Classroom model (closed classes on campus) Onsite model (individual supports on campus) Mobile support model (flexible supports through mental health agency) Free-standing model (located at the organizational setting sponsoring the SEd program)

10 Hallmarks of SEd 1) coordination of SEd with mental health services; 2) use of specialized supported education staff 3) career counseling, vocational counseling and planning; 4) assistance with financial aid; 5) assistance to develop skills needed to cope with a new academic environment; 6) provision of on-campus information about rights and resources; 7) on or off campus mentorship and personal support 8) facilitation of access to courses and within-course assistance; 9) access to tutoring, library assistance and other academic support; 10) access to general support (e.g. referral for mental health services)

What was YOUR experience like attending school?

How did your education relate to your employment?

There are pros and cons Higher education has repeatedly been demonstrated to predict better vocational outcomes in the general population.

Higher Ed is Not for Everyone: However, Individuals with Psychiatric Disabilities: 1)Are Underrepresented at Educational Institutions (Corrigan et al., 2008) 2)Fewer Attempt Education (Corrigan et al., 2008) 3)Leave School Earlier (Waghorn et al., 2004) 4)Have Higher Dropout and Lower Completion Rates (Waghorn et al., 2003) 5)Often First Episodes Occur During School Years (Mowbray et al., 2005) 6) Experience Additional Barriers Such as Stigma (Atkinson et al., 2008) 7) Often Need Additional Supports (Mowbray et al., 2005)

Higher Ed is Not for Everyone: However, Individuals with Psychiatric Disabilities: 8) Unemployment is Extraordinarily High (Mechanic, Bilder, & McAlpine, 2002) 9) Least Likely to Succeed in VR Programs (Andrews et al., 1992). 10) Enormous Social Costs (Cook, 2006; Marcotte & Wilcox-Gök, 2001) 11) Higher Ed. Positively Associated with Emp. (Waghorn et al., 2004) 12) Higher Level Positions and Increased Income (Yelin & Trupin, 2003) 13) Vocational Training May Be Even More Effective (Waghorn et al., 2004).

Meta analyses Preliminary Support for SEd: Obtain educational goals Improve vocational success Increase self-esteem/self- perception Learn to manage symptoms Increase satisfaction (Chandler, 2008; Leonard & Bruer, 2007; Parrish, 2009; Rogers et al., 2009) It is a Promising Practice not an Evidence Based Practice

Gaps in the Research Most studies qualitative or descriptive Lack of consistent measurement or control groups Lack use of a fidelity scale Don’t explore how to integrate SEd into other EBP’s

What Challenges Have You Experienced? There are Challenges with Implementing Supported Education.

Competing EBP Priorities Some SEd Fidelity Scales Burdensome Funding Issues Long Time to Measure Change is Hard Psychiatric Disability Often Cyclical

Research in Kansas National Survey of SE and SEd Programs Qualitative Study of Those who Currently Have Ed Goals and Those Who Don’t Analysis of Possible-Selves Questionnaires Restructuring the KU SEd Scale Quasi-Experimental Effectiveness Study Peer Run SEd

THE UNIVERSITY OF KANSAS SUPPORTED EDUCATION TOOLKIT 3.0

Purposes of the Revised Scale Make it easier to integrate with other models (such as supported employment) Be of use in a variety of models, settings and programs. Used here "fidelity" means concordance with principles Requested from programs in Canada, Australia, Europe and elsewhere in the US.

Fidelity Items 1) Provides all Phases 2) Integration with MH 3) Educational Outcomes 4) Caseload Size 5) Supervisors Duties 6) Range of Services 7) Screening 8) Client Communication 9) Program Awareness 10) Services Begin Quickly 11) Assertive Engagement and Outreach 12) Written Assessment 13) Disclosure 14) Educational Goal Planning 15) Essential Enrollment Supports 16) Supplemental Enrollment Supports 17) Ongoing Supports 18) Financial Assistance 19) Liaison Services 20) Individualization 21) Mobile Supports

The Full KU SEd Toolkit wel.ku.edu/projects/pro mising/supportededucat ion.shtml wel.ku.edu/projects/pro mising/supportededucat ion.shtml SECTION 1: Fidelity Scale and Protocol SECTION 2: Tools for Fidelity Reviewers SECTION 3: Tools for Implementation Sites SECTION 4: Bibliography

How Was It developed? Original KU Supported Education Scale Expert panel of six researchers Review of other fidelity scales Individual interviews (with general consumers, students with psychiatric disabilities, community mental health staff, and community college staff) Three large focus groups, A review of the literature. Through piloting process at community mental health centers in Kansas Revised KU Supported Education Scale (3.0) Review of piloting data Additional literature review A national study of integrated supported education and supported employment programs (Manthey, et al., 2012), An additional focus group of nine SEd provider agencies in Kansas, Use of an additional panel of seven KU researchers.

Integration Efforts Let’s Be Realistic What would it take to adequately integrate Supported Education with Supported Employment?

Stair Stepped Efforts Stair-Stepped Efforts Adequate Disclosure Conversations Peer Support Counselors Augmenting Campus Accommodations

Is it worth it? Was it worth it for you?

Does SEd Matter for Oregon? Reputation for Being on the Cutting Edge Fits in Well With Integrated VR and MH Collaborations Fits with Oregon’s Goal It’s Really Up to You

Next Steps? Future Research More Developed SEd Programs Integrated SE/SEd Peer Run SEd More Experimental Trials

Admitting My Story It’s About Financial Success/ Escaping From Poverty About Opportunity About Reevaluating Your Self Image It’s About Recovery

Questions?