Increasing employment and career opportunities Jonathan Delman, - - PowerPoint PPT Presentation

Jonathan Delman, PhD, JD, MPH Senior Researcher Technical Assistance Collaborative

Employment and young adults with Serious mental health conditions: Increasing employment and career

• pportunities

Introduction

• For young adults (ages 16-30) with

SMHC high rates of un- and under- employment

• Reasons (some)
• Delay/behind [experience/education/training]
• Symptoms, Treatment
• Social Security incentives
• Lack of social/family support
• Lack of confidence/resilience
• Difficult work environment

Summary

• 1. What is different about young adults with

serious mental health conditions?

• 2. Effectiveness and acceptability of

employment interventions for young adults

• 3. Preferences and components specific to

young adults

• 4. The necessary and growing role of the

employer

• 5. Takeaways re increasing employment rates
• f young adults with SMHC

• 1. What is different about young adults

with serious mental health conditions? Developmental Personal challenges Young adult life/culture Systemic Issues Special considerations for First episode Capital Framework

Developmental

• Brain
• Psychological
• Risk taking
• Self-defining
• Early in career [Figure]

Vocational thinking for young adults [14-30] Interventions for: Career development (thinking, efficacy) Employment (competitive) Post- secondary Education Internships

Young adult life

Generational

• Technology
• Values- tolerance and sensitivity
• Substance abuse and use
• Economic uncertainty and labor

markets

• Family formation

Personal challenges for young adults with SMHC

• Incomplete education
• Lack of work experience
• Low self-efficacy
• Confidence
• assertiveness

Systemic Issues

• Experience of (services) and

education as adolescents

• “Aging out” process
• Adult system not meeting

developmental needs nor prepared to do so

Special considerations for first episode psychosis (FEP)

• Impact of stigma…..
• “Dropped right into it”
• More work experience
• Cognition
• Different types of employment goals?
• DUP does not necessary predict

employment outcomes

Capital Framework

Delman & Klodnick in press

• Human Capital
• Cultural Capital
• Positive Psychological capital
• Personal Social Capital
• Organizational Social capital

• 2. Effectiveness and acceptability of

employment interventions for young adults

• Supported employment and related

models

• Vocational rehabilitation models
• Emerging approaches

Supported employment and related models I

• Supported employment- major components
• Competitive employment is the goal
• Rapid job search
• Zero Exclusion: Eligibility is based on client choice
• Attention to client preferences.
• Benefits counseling is important.
• Systematic job development
• Time-unlimited support
• With Supported education
• With Cognitive Enhancement supports

Supported employment and related models II

• Integrated Placement and Support
• Supported employment is integrated with

treatment

• Integrated Placement and Support +++
• Concurrent course in workplace skills
• Family information sessions
• Vocational peer mentor

Difficulties with recent models

• ACCESS
• Direct costs of service provision
• Lack of [insurance] coverage,
• High demand
• QUALITY
• Fidelity
• OUTCOMES

Jobs obtained are usually low-paying, part time and without a career pathway

• RESEARCH

Very early in research on young adult interventions

State government vocational rehabilitation agencies

Provide direct services to people with disabilities, including:

• Guiding the development of an Individual Plan for

Employment, organized around a specific client-chosen employment outcome;

• Assessment, counseling, resume development, coaching,

and transportation;

• Services to high school students with disabilities, including

provision of career planning, counseling and preparation services;

• For people in college or training programs, job placement,

job search assistance and on-the-job training.

• Specialized services for people with psychiatric disabilities,

including IPS, Clubhouses, contracting out.

WIOA: New focus for State Rehab Agencies

• Employers
• Apprenticeships
• Youth, Young adults

Innovations, more career oriented

• Self-determination theory
• Career Visions, http://www.pathwaysrtc.pdx.edu/proj-

1-careervisions

• RENEW (Rehabilitation, Empowerment, Natural

Supports, Education, and Work).

• Jump On Board for Success (JOBS)
• Becoming a peer specialist
• Career pathway
• Social Enterprise for Homeless Young Adults

• 3. Preferences and components

specific to young adults

PREFERENCES

• Employment [search] preparation
• Resume development
• Interview practice
• Family support- engagement of family
• Young adults with children
• Encouragement/discouragement
• Strong education and training component
• Readily Available Workplace Supports
• Culturally driven

Other notable components

• Workplace (soft) skills training
• Career guidance
• Self-determination
• Meta skill development
• SE components are good, but consider
• Rapid job search necessity and under what

circumstances

• How rapid?
• Rapid education/training search
• How to create time unlimited supports….
• Role of employer
• “Career aims” ??????????

• 4. The necessary and growing

role of the employer

• Organizational culture
• Best practices
• Organizational infrastructure
• Employer carrots and sticks

Organizational culture

(Universal design)

• Workplace wellness
• Staff understand requirements of the ADA and

the Reasonable Accommodations Framework

• Education
• Clear process for complaints or requests
• Supporting young employees
• Mentors
• Actively addressing stigma and discrimination
• E.g., NAMI’s ‘CEOs against stigma” campaign

Employer best practices 1

• Hiring
• Criminal record considerations
• Supervision
• Individualized
• Regular
• Instructional re handling assignments
• Patience
• Other staff supportive
• Staff orientation , training and accountability

Best practices 2

• Building young adult resilience and

developing soft skills

• Mentorship
• Training
• Reasonable accommodation (RA) framework.
• FIRST, assess which job functions are not being

performed well, do not start by with illness, symptoms et al.

• Young adult reluctance to disclose
• Confidentiality
• Extent of disclosure
• Limited number of employees can know

Organizational Infrastructure

• Committed leadership
• Internal and external messaging
• Staff orientation and training
• Quality control
• staff

Employer Incentives:

Carrot and Stick

• ADA enhancements
• “Obvious”
• “Disability”
• DOL regulation requiring federal contractors to set a

seven percent workforce utilization goal for employing individuals with disabilities

• WIOA placing greater funding emphasis on both

employer responsibilities and supporting young adults

• Tax credits/incentives- Apprenticeships
• Growth of young adult peer provider role

• 5. Takeaways re increasing employment

rates of young adults with SMHC I

• Understand young adulthood as a unique

developmental stage and culture

• Intervention research is early, complicated by

questions about how we measure vocational

• utcomes, model fidelity issues, and what we

research

• Current models (e.g., SE)
• Enhancements
• Adaptations
• Newer models and approaches
• Link employment and educational

supports/specialists, along with career supports

Takeaways re increasing employment rates of young adults with SMHC II

• Anxiety related to feeling unprepared, lack of

job experience, and mental health symptoms

• Resume development, job interview practice
• Role of family
• Criminal records
• Encourage and develop positive

psychological capital

• Persistence
• Resilience
• Confidence

Takeaways re increasing employment rates of young adults with SMHC III

• Universal design workplace approach
• Health/wellness/family company benefits
• Americans with Disabilities Act and Reasonable

accommodations

• Understanding
• Access
• Mentors for young people
• Promoting diversity and addressing stigma in the

workplace

• Educate employees, young adults in particular, about
• rganizational policies and benefits
• Follow WIOA and Voke Rehab Agency new foci, including

more direct systemic work with employers

References

• Abdel‐Baki, A., Létourneau, G., Morin, C., & Ng, A. (2013). Resumption of work or studies after first‐episode psychosis:

the impact of vocational case management. Early intervention in psychiatry, 7(4), 391-398.

• Bond, G. R., Drake, R. E., & Campbell, K. (2014). Effectiveness of individual placement and support supported

employment for young adults. Early intervention in psychiatry.

• Burke-Miller, J., Razzano, L. A., Grey, D. D., Blyler, C. R., & Cook, J. A. (2012). Supported employment outcomes for

transition age youth and young adults. Psychiatric Rehabilitation Journal, 35(3), 171-179.

• Caruana, E., Cotton, S., Killackey, E., & Allott, K. (2015). The relationship between cognition, job complexity, and

employment duration in first-episode psychosis. Psychiatric rehabilitation journal, 38(3), 210.

• Davis, M., Delman, J., & Duperoy, T. (2013). Employment and careers in young adults with psychiatric disabilities. In M.

Davis (Ed.) Tools for system transformation for young adults with psychiatric disabilities: State of the science (pp. 59-94). Retrieved from http://labs.umassmed.edu/transitionsrtc/Resources/publications/Compendium.pdf

• Delman, J., & Klodnick, V. (in press) Young Adults with Mental Health Conditions as Peer Support Workers: Perspectives
• f Workers and Supervisors, Community Mental Health Journal.
• Ferguson, K. (2013). Using the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) models to

improve employment and clinical outcomes of homeless youth with mental illness. Journal of Social Work and Mental Health, 11(5), 473-495. doi:10.1080/15332985.2013.764960

• Hollenbeck, K. (2015). Promoting Retention or Reemployment of Workers after a Significant Injury or Illness (No.

99caa302888a4be68d16d276cabec012). Retrieved from http://www.mathematicampr.com/~/media/publications/pdfs/disability/sawrtw_promotingretention.pdf

• Luciano, A., & Meara, E. (2014). Employment status of people with mental illness: National Survey Data from 2009 and
• 2010. Psychiatric Services, 65, 1201–1209.
• Stone, R. A. T., Delman, J., McKay, C. E., & Smith, L. M. (2015). Appealing features of vocational support services for

Hispanic and non-Hispanic transition age youth and young adults with serious mental health conditions. The Journal of Behavioral Health Services & Research, 42(4), 452-465.

• Tapfumaneyi, A., Johnson, S., Joyce, J., Major, B., Lawrence, J., Mann, F., ... & Fisher, H. L. (2015). Predictors of

vocational activity over the first year in inner‐city early intervention in psychosis services. Early intervention in psychiatry, 9(6), 447-458.