implementing supported employment and helping consumers get and keep jobs: research findings
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Implementing Supported Employment and Helping Consumers Get and Keep Jobs: Research Findings. Gary R. Bond Dartmouth Psychiatric Research Center Oregon SE Statewide Training Breakout Session July 26, 2011. - PowerPoint PPT PresentationTRANSCRIPT
Implementing Supported Implementing Supported Employment and Helping Employment and Helping
Consumers Get and Keep Jobs: Consumers Get and Keep Jobs: Research FindingsResearch Findings
Gary R. BondGary R. BondDartmouth Psychiatric Research CenterDartmouth Psychiatric Research Center
Oregon SE Statewide TrainingBreakout Session
July 26, 2011
When starting up a new supported employment program, the first step should be to provide intensive training for new staff.
FALSE
Limitations of Training
Intensive training in early stages often premature (waste of time)–Problems of staff turnover–Limitations of lectures and
PowerPoints–Practitioners learn more from field
mentoring
Most Important Factors in Implementing a New Program
(Torrey et al., 2011)
Exerting leadership -- by both center administrators and SE team leader
Selecting appropriate staff Developing infrastructure (see
fidelity standards)
Consumers who use alcohol or drugs are less likely to be successful in employment.
FALSE This is a belief that dies hard, This is a belief that dies hard,
despite numerous studies that show despite numerous studies that show no difference between mental no difference between mental health consumers with and without health consumers with and without substance usesubstance use
Will Employers Hire People with Will Employers Hire People with Criminal Justice Histories?Criminal Justice Histories?
Conventional wisdom: –Most types of businesses will not
Research evidence: –Very little research!
Many mental health consumers have criminal justice histories (Frounfelker, 2011)
Past events disclosed at admission
Arrests 345 38% 546 50%Charges 255 28% 389 36%Convictions 203 22% 338 31%Incarcerations 156 17% 273 25%
Total 913 1,085
Receiving IPS Services
Admitted During 2009
X2=.10 p=.12
t =1.79 p=.08
t =1.14 p=.26
t =-1.96 p=.06
Test of Significance
No CJI N = 81
CJIN = 73
Competitively employed during follow-up
30 (37%) 18 (25%)
28.8 (8.6)
Days employed
N =30 N =18
Hourly wages
Hours worked per week
Mean (SD) Mean (SD)
29.4 (68.2)54.0 (97.3)
Worker Sample
$9.55 (3.8)
23.8 (8.2)
$8.46 (1.2)
Employment Outcomes for IPS Clients with and without CJI
(Frounfelker, 2010)
Employer Survey:Employer Survey: Hiring People with Felonies Hiring People with Felonies
128 employers in 9 states– Many kinds of businesses
63% had knowingly hired someone with a felony– Few had written policies– No strong pattern in which businesses
more likely to hire
(Swanson, Reese, & Bond, submitted)
Employers reasons for Employers reasons for hiring a person with a felonyhiring a person with a felony
31 (42%) Qualifications to do the job
16 (22%) Good interviewing skills
13 (18%) Referral from a person the employer knew
11 (15%) Belief that the person had changed
10 (14%) Length of time since last conviction
6 (8%) Sincerity and honest when talking about record
5 (7%) Belief that the person would be dependable
3 (4%) Conviction not related to the job
Employers won't hire someone with a criminal justice history.
MOSTLY FALSE Finding jobs are more challenging Many employers do screen out known
felons, especially drug offenses But many employees are flexible
Training in interviewing and social skills is the best way to prepare consumers for jobs.
FALSE Extended skills training before Extended skills training before
looking for a job has been shown looking for a job has been shown to to reducereduce employment rates. employment rates.
After starting a job, skills training After starting a job, skills training has little or no effect.has little or no effect.
Should Consumers Disclose Their Should Consumers Disclose Their Mental Illness? Mental Illness?
Very little research, and the research is unclear
Consumer preferences are critical consideration
What, when, and to whom matter greatly
Disclosure of Mental Illness at Disclosure of Mental Illness at Workplace (Jones, 2011) Workplace (Jones, 2011)
Disclosure to supervisor associated with increased emotional support
Disclosure to co-workers associated with increased criticism
Consumers are better off not disclosing their mental illness.
NEITHER TRUE NOR FALSE
IT DEPENDS!
Is it harder to find jobs Is it harder to find jobs for consumers in rural areas?for consumers in rural areas? Common assumption: Employment is
more difficult in rural areas The research says:
– Rural programs have as much success achieving high-fidelity SE and getting people jobs
– But methods differ somewhat from urban programs
Urban vs. Rural SE Programs (Becker, 2006)
26 sites in 7 states–12 urban–14 rural (population < 50,000)
Examined predictors of competitive employment outcomes–Predictors included SE fidelity
Comparing Rural to Urban Sites Comparing Rural to Urban Sites in Becker Studyin Becker Study
SE fidelity was almost identical (rural = 63.6 vs. urban = 63.8)
Access to supported employment was very similar
Competitive employment rate was slight better in rural sites
Outcomes in 87 Urban & Rural IPS Programs (Haslett, 2011)
Crucial Implementation IssuesCrucial Implementation Issuesfor Supported Employment for Supported Employment
in Rural Areasin Rural Areas Transportation Small population base SE unit supervision Job development Stigma
(Thanks to: Sarah Swanson, Linda Carlson, Debbie Becker, David Lynde, Laura Flint)
Transportation: StrategiesTransportation: Strategies Ask: “How does everyone else
get to work?” Ask at church or civic groups Informal taxi service/coworkers Rural mass transit less rigid
(senior ride program) Kansas solution: Donate cars Job develop/interview using client’s
expected transportation system
Job Development: Issues
Fewer options for job matchingFewer options for job matching Economy may be tied to a single Economy may be tied to a single
employeremployer What happens if only factory shuts What happens if only factory shuts
down?down? Confidentiality issues associated
with rural familiarity
Job Development Strategies Skillful persistent job
development still crucial Different interpersonal approach
to employers in rural areas compared to cities
Personal networks Self-employment??
Stigma: Issues
Everyone knows everyone – Cannot hide behind anonymity
Reputation may be hard to overcome
May be a barrier to hiring
Strategies for Overcoming Stigma
Familiarity can be used to advantage Rural communities “take care of
their own” “Word of mouth” produces quick
information on job leads Consulting frequently with local
VR counselor
It’s harder to find jobs It’s harder to find jobs for consumers in rural areas.for consumers in rural areas.
FALSE
The type of medications a consumer takes can greatly
influence success in employment.PROBABLY TRUE,
BUT EVIDENCE LACKING Skilled medication management is
an important adjunct to SE One finding: Type of antipsychotic
does not affect employment(Resnick, 2008; Percudani, 2004)
Suggesting coping skills on the job can make a big difference in
helping consumers keep jobs.TRUE
McGurk and Mueser (2006): Employment specialists who suggested more coping strategies had greater success helping consumers keep jobs.
For transitional-aged youth, the best way to help them gain work experience is to place them in unpaid internships.
UNKNOWN Very little research to date on
employment for this important population.
Is long-term support important after consumers get a job?
For how long? –How often should the
employment specialist meet? –Can it be by telephone?
What type of support should employment specialist provide?
How Often Should Employment Specialists Meet After
Consumer Begin Working? Few studies to answer this (Lots of studies showing
importance of job development) Bond and Kukla (2011) examined
2-year follow-up of 100 IPS consumers who started a job
Monthly Employment Specialist Contact with Consumers (Bond & Kukla, 2011)
QuickTime™ and aGraphics decompressor
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Importance of Ongoing Support After Consumers Start Work
Frequency of contact correlated with months employed over 2 years (r=.27)
Brief contacts (<30 min.) were as effective as long contacts (>30 min.)
Face-to-face contact was effective Telephone contact was not
Conclusions: How Often Should Employment Specialists Meet
After Consumer Begin Working? Close contact in the first few days and
weeks are critical Long-term contact appears to make a
difference (for 2 or more years) Brief monthly contact probably adequate
most of the time Contacts should be face-to-face
Once a consumer gets a job, the contact can be by phone.
FALSE
What Makes for a Successful What Makes for a Successful Employment Specialist? Employment Specialist?
Belief that clients can work Time management skills Passion for job Thick-skinned Team orientation % of time spent in the community
(Glover, in press; Gowdy, 2003; Taylor, submitted; Whitley, 2010)