Building Supported Your Program Employment U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services www.samhsa.gov Building Supported Your Program Employment U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Mental Health Services Acknowledgments This document was produced for the Substance Abuse and Mental Health Services Administration (SAMHSA), by the New Hampshire-Dartmouth Psychiatric Research Center under contract number 280-00-8049 with Westat under contract number 270-03-6005, with SAMHSA, U.S. Department of Health and Human Services (HHS). Neal Brown, M.P.A., and Crystal Blyler, Ph.D., served as the Government Project Officers. Disclaimer The views, opinions, and content of this publication are those of the authors and contributors and do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), SAMHSA, or HHS. Public Domain Notice All material appearing in this document is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization from the Office of Communications, SAMHSA, HHS. Electronic Access and Copies of Publication This publication may be downloaded or ordered at www.samhsa.gov/shin. Or, please call SAMHSA’s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). Recommended Citation Substance Abuse and Mental Health Services Administration. Supported Employment: Building Your Program. DHHS Pub. No. SMA-08-4364, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2009. Originating Office Center for Mental Health Services Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road Rockville, MD 20857 DHHS Publication No. SMA-08-4364 Printed 2009 Building Your Program Building Your Program is intended to help mental health authorities, agency administrators, and Supported Employment (SE) leaders think through and develop the structure of SE programs. The first part of Supported this booklet gives you background information about the SE model. Employment This section is followed by specific information about your role in implementing and sustaining your SE program. Although you will work closely together to build SE programs, for ease, we separated tips into two sections: n Tips for Mental Health Authorities; and n Tips for Agency Administrators and SE Leaders. In preparing this information, we could think of no one better to advise you than people who have worked successfully with SE programs. Therefore, we based the information in this booklet on the experience of veteran SE leaders and administrators. For references, see the booklet The Evidence. This KIT is part of a series of Evidence-Based Practices KITs created by the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. This booklet is part of the Supported Employment KIT that includes a DVD, CD-ROM, and seven booklets: How to Use the Evidence-Based Practices KITs Getting Started with Evidence-Based Practices Building Your Program Training Frontline Staff Evaluating Your Program The Evidence Using Multimedia to Introduce Your EBP What’s in Building Your Program What Is Supported Employment?. 3 Supported Tips for Mental Health Authorities . .9 Employment Tips for Agency Administrators and Supported Employment Leaders. .17 Building Your Program What Is Supported Employment? People with serious mental illnesses have SE programs help consumers find jobs many strengths, talents, and abilities that that pay competitive wages in integrated are often overlooked, including the ability settings (i.e., with other people who and motivation to work. Research has don’t necessarily have disabilities) shown the following: in the community. n About 70 percent of adults with serious mental illnesses desire work (Mueser The overriding philosophy of SE is the et al., 2001; Rogers et al., 2001). belief that every person with a serious mental illness is capable of working n Consumers and families consistently competitively in the community if the identify finding and keeping jobs as a right kind of job and work environment top priority. can be found. Rather than trying to n Approximately 60 percent of consumers sculpt consumers into becoming “perfect can be successful at working when using workers” through extensive prevocational SE services (Bond et al., 2001). assessment and training, consumers are offered help finding and keeping jobs that Supported Employment (SE) is an capitalize on their personal strengths and approach to vocational rehabilitation motivation. Thus, the primary goal of SE for people with serious mental illnesses is not to change consumers, but to find that emphasizes helping them obtain a natural “fit” between consumers’ competitive work in the community strengths and experiences and jobs and providing the supports necessary in the community. to ensure their success in the workplace. Building Your Program 3 What Is Supported Employment In contrast to other approaches to vocational rehabilitation, SE de-emphasizes prevocational Practice Principles assessment and training and puts a premium on of Supported Employment rapid job search and attainment. The job search is conducted at a pace that is comfortable for n Eligibility is based on consumer choice. consumers and is not slowed down by any programming prerequisites. n SE services are integrated with comprehensive mental health treatment. Individuals with serious mental illnesses differ from n Competitive employment is the goal. one another in terms of the types of work they prefer, n Personalized benefits counseling is the nature of the support they want, and the decision important. about whether to disclose their mental illness to employers or coworkers. SE programs respect these n Job search starts soon after consumers individual preferences and tailor their vocational express interest in working. services accordingly. n Follow-along supports are continuous. n In addition to appreciating the importance of Consumer preferences are important. consumer preferences, SE programs recognize that most people with serious mental illnesses benefit or other problems, including substance abuse and from long-term support after successfully getting cognitive impairment. a job. Therefore, SE programs avoid imposing unrealistic time limitations on services, while The core philosophy of SE is that all consumers can focusing on helping consumers become as work at competitive jobs in the community without independent and self-reliant as possible. prior training, and no one should be excluded from this opportunity. As consumers succeed in working in the community, their self-perceptions often change, and they view SE does not try to bring consumers to some themselves as workers and contributors to society. preconceived standard of “work readiness” before Furthermore, as people in the community see they seek employment. Consumers are “work ready” consumers working, consumers are less stigmatized when they say they want to work. Research shows for their mental illnesses and they become more that symptoms, substance abuse, and other socially accepted. consumer factors are not strong and consistent predictors of work when consumers receive SE programs are based on a core set of practice assistance from an SE program. Therefore, no principles. These principles form the foundation justification exists for excluding consumers who of the program. are interested in working from SE programs. Principle 1: Eligibility is based Principle 2: SE services are integrated with on consumer choice comprehensive mental health treatment All consumers who want to participate in SE Closely coordinating SE services with other mental are eligible—no one is excluded. Consumers health rehabilitation and clinical treatment ensures who are interested in work are not prevented that all mental health practitioners (not just from participating in SE, regardless of their employment specialists) support consumers’ psychiatric diagnosis, symptoms, work history, vocational goals. For this reason, it is important that What Is Supported Employment 4 Building Your Program SE staff participate regularly in clinical treatment n Consumers’ self-esteem often improves. team meetings. As consumers see that they are able to work competitively, that their work is valued, and that Participating in team meetings gives you a vehicle they can contribute to society, some consumers to discuss clinical and rehabilitation issues that are experience improvements in symptoms and relevant to work, including the following: self-esteem. n Medication side effects; Historically, many vocational programs have placed n Persistent symptoms (e.g., hallucinations); consumers into noncompetitive jobs, often paying subminimum wages, with only rare progression into n Cognitive difficulties; or competitive employment. Experience shows that n Other rehabilitation needs (e.g., skills training consumers can successfully work at competitive to improve ability to socialize with co-workers jobs without previously participating in training or self-assertion skills). programs or noncompetitive job