IF YOU THINK WORK IS BAD FOR PEOPLE WITH SIGNIFICANT DISABILITIES,

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• IF YOU THINK
  WORK IS BAD FOR PEOPLE WITH
  SIGNIFICANT DISABILITIES,
• THEN WHAT ABOUT POVERTY,
  UNEMPLOYMENT,
  AND
  SOCIAL ISOLATION?

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ALL CHANGE IS DIFFICULT NO MATTER HOW LONG YOU
PUT IT OFF.

• ------ JOE MARRONE

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• JOE MARRONE
• INSTITUTE FOR COMMUNITY INCLUSION
• MAIN OFFICE BOSTON, MA
• NW OFFICE
• 4517 NE 39TH AVENUE
• PORTLAND, OR 97211-8124
• TEL [phone]
• HOME TEL [phone]
• FAX [phone]
• EMAIL JM61947_at_AOL.COM
• WEB WWW.COMMUNITY INCLUSION.ORG

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• I CANT UNDERSTAND WHY PEOPLE
  ARE FRIGHTENED OF NEW
  IDEAS IM
  FRIGHTENED OF THE OLD ONES.
• JOHN CAGE, COMPOSER

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VISION OF RECOVERYJOE MARRONE

• RECOVERY MAY BE A JOURNEY
• BUT IF YOU NEVER GET ANYWHERE,
• IT CAN EASILY BECOME A TREADMILL.

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VISION OF RECOVERY

• SHOULD WORK,
• NOT JUST
• MEANINGFUL OR PRODUCTIVE ACTIVITY
• BE AN ESSENTIAL PART OF RECOVERY VISION?

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REMAINING UNEMPLOYED IS WORSE FOR YOU THAN BEING
EMPLOYED IS GOOD FOR YOU.AVOIDING LONG TERM
UNEMPLOYMENT IS A BETTER OPTION THAN WAITING FOR
AN IDEAL OR PERFECT JOB MATCH.
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OUTCOMES THAT SHOULD BE SOUGHT IN COMMUNITY
SERVICES

• BECOMING A BETTER PERSON AND
  SELF REALIZATION IS
  THE CONSUMERS RESPONSIBILITY.
• HELPING PEOPLE GET EMPLOYED,
  GET HOUSING, STAY OUT OF HOSPITAL ( JAIL)
  AND REDUCE SYMPTOM IMPACT ARE
  STAFFS RESPONSIBLITIES IN PARTNERSHIP WITH THE
  PERSON.

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• LIFE LIVED WITHIN THE CONFINES OF THE HUMAN
  SERVICE REHABILITATION LANDSCAPE IS A LIFE IN
  WHICH THE FREEDOM TO BECOME MAKE YOUR OWN
  FUTURE IS DIMINISHED
• PATRICIA DEEGAN
• 20th World Congress Rehab International Oslo,
  Norway JUNE 2004

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• PEOPLE SAY TO ME
• ISNT IT BETTER TO WORK 2-3 HOURS A WEEK
  AT SOMETHING A PERSON LIKES THAN
  15-20 HOURS WEEK (OR MORE)
  JUST TO MAKE A LIVING?
• SIMPLE ANSWER NO
• HOW DO YOU ANSWER THIS QUESTION FOR YOURSELF OR
  YOUR LOVED ONES?

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THE REAL ISSUES TO WORRY ABOUT

• DISCRIMINATION NOT STIGMA
• BEHAVIOR NOT ATTITUDE
• CITIZENSHIP/CIVIL RIGHTS NOT CONSUMERISM
• POWER/CONTROL NOT CONSUMERISM
• COMPETENCY NOT COURTESY
• ECONOMIC ENGAGEMENT NOT VOCATIONAL PROGRAMMING

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OUTCOMES THAT SHOULD BE SOUGHT IN
COMMUNITY SERVICES

• Employment and educational outcomes
• Housing outcomes
• Course of illness, including hospitalizations
  distressing symptoms and/ or self - injurious
  behavior
• Community participation/ citizenship
• Income support
• Client satisfaction with their own lives
• Client satisfaction with services

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OUTCOMES THAT SHOULD BE SOUGHT IN
COMMUNITY SERVICES

• IS SELF SUFFICIENCY AND MOVING AWAY FROM PUBLIC
  ASSISTANCE A REASONABLE GOAL?

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• IF PEOPLE
• CAN WORK
• PEOPLE
• SHOULD WORK

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• IT IS NEARLY IMPOSSIBLE TO MAKE
  YOUR OWN FUTURE
  WHEN YOU ARE NOT PART OF
  THE
  ECONOMIC FABRIC OF THE
  CULTURE YOU LIVE IN
• PATRICIA DEEGAN
• 20th World Congress Rehab International Oslo,
  Norway JUNE 2004

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Ships are safe in harbor,but that is not what
ships are built for.

• ------ Anonymous

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UNEMPLOYMENT IS BAD FOR YOU !!!
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MH SYSTEMS /EMPLOYMENT FIGURES 2004
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REMAINING UNEMPLOYED IS WORSE FOR YOU THAN BEING
EMPLOYED IS GOOD FOR YOU.AVOIDING LONG TERM
UNEMPLOYMENT IS A BETTER OPTION THAN WAITING FOR
AN IDEAL OR PERFECT JOB MATCH.
20
Dooley, D., Fielding, J., Levi, L. (1996).
Health and unemployment. Annual Review of
Public Health
Bruffaerts, R, Sabbe, M., Demyttenaere, K. (2004)
Effects of Patient Health-System
Characteristics on Community Tenure of Discharged
Psych Inpatients Psych Serv 55685-690, June
2004-- increases in rehospitalization
Kasl, S. V., Rodriguez, E., Lasch, K. E.
(1998). The impact of unemployment on health and
well-being. In B. Dohrenwend, (Ed.).
Adversity, Stress and Psychopathology
Lennon, M. C. (1999). Work and unemployment
as stressors. In A. Horwitz, T. Scheid,
(Eds.). A Handbook for the Study of Mental
Health Social Contexts, Theories and Systems
21
Dooley, D., Catalano, R., Hough, R.
(1992). Unemployment and alcohol disorders in
1910 and 1990 Drift versus social causation.
Journal of Occupational Organizational Psych
----- increases alcohol use Linn, M. W.,
Sandifer, R., Stein, S. S. (1985). Effects of
unemployment on mental and physical health.
American Journal of Public Health ---- increases
in anxiety Dooley, D., Catalano, R., Wilson,
G. (1994). Depression and unemployment Panel
findings from the Epidemiologic Catchment Area
study. American Journal of Community Psychology
----- increases in depressionWarr, P.B.
(1987).
Work, unemployment
and mental health.
Clarendon Press, Oxford
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Murphy, G.C. Athanasou, J.A (1999). The
Effect of unemployment on mental health.
Journal of Occupational and Organizational
Psychology--- large effect size for employment
positive, smaller effect size for unemployment as
bad. Darity, W.A. (2003). Employment
Discrimination, Segregation, and Health.
American Journal of Public Health--- bouts of
unemployment lead to lower self esteem, lower
motivation Darity, W.A. (1999). Who Loses from
unemployment. Journal of Economic Issues---
cross national data greater spousal abuse and
suicide Winefield, A.H., Tiggemann, M.,
Winefield, H.R., Goldney, R.D. (1993). Growing
up with unemployment A longitudinal study of its
psychological impact.--- youth with similar
characteristics in school after long term
unemployment more depression and anxiety
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SIDE EFFECTS OF UNEMPLOYMENT IN THE GENERAL
POPULATION

• Increased substance abuse
• Increased physical problems
• Increased psychiatric disorders

• Reduced self-esteem
• Loss of social contacts
• Alienation and apathy
• Warr, P.B. (1987), Work, Unemployment and Mental
  Health, Clarendon Press, Oxford

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• WHAT DRIVES ME UP THE WALL IS THE INTENTIONAL
  TEACHING OF FEAR OF HAVING ANY KIND OF MEANINGFUL
  LIFE BECAUSE YOU WILL DECOMPENSATE OR
  YOU ARE STRESS
  SENSITIVE. THE MOST STRESSFUL THING
  IN THE WORLD IS BEING A COACH POTATO WITH NOTHING
  TO DO, NO
  WHERE TO GO, AND
  NO ONE TO TALK TO.
• ED KNIGHT, PH.D.

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THOMAS EDISON

• RESULTS!
• WHY, IVE GOTTEN A LOT OF RESULTS.
• I KNOW SEVERAL THOUSAND THINGS THAT WONT WORK.

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Poverty Rates
Source CPSBurkhauser et al, 1999
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Employment Rates of People with Psychiatric
Disabilities

• In 2004, 28.5 of people with mental health
  disabilities were employed
• In 2004, 37.5 of people with any disability were
  employed
• In 2004, 77.8 of people without a disability
  were employed
• Source Houtenville 2006 Disability Status Report

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Full-Time Full Year Employment

• In 2004, 14.2 of people with mental health
  disabilities were employed compared to 22.4 of
  people with any type of disability and 56.2 of
  people without disabilities.
• Median income for people with mental health
  disabilities was 26, 400 in 2004 compared to
  30,000 for people with any disability and 35,000
  for people without a disability HOWEVER
• Median HOUSEHOLD income for people with mental
  health disabilities was 28,200 compared to 34,300
  for people with any disability and 60,000 for
  people without a disability.
• Source Houtenville, 2006, 2004 Disability Status
  Report

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Poverty Rates by Disability

• In 2004, people with mental health disabilities
  had a poverty rate of 30 compared to 24 for
  people with any type of disability and 9.1 for
  people without disabilities.
• People with mental health disabilities have the
  highest rate of poverty than any other disability
  group listed in the American Community Services
  dataset from the U.S. Census.
• Source Houtenville, 2006

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THE FIFTH DISCIPLINEPeter Senge
ASOHS DEFENSE
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Clearview Employment ServicesA program of
Columbia River Mental Health Services
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What activities and services best deliver
employment results?

• Easy Access to Services
• Open Orientations
• Rapid assignment to Employment Specialist to
  develop a vocational plan
• Assumption of readiness
• Coordination of Services
• Meet with Case Managers, Therapists, Doctors,
  Nurses etc.
• Other systems DSHS, DVR, Corrections, DA
  counselors, DDD, WorkSource

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What activities and services best deliver
employment results?

• Individualized Approach
  Person Centered
  Planning/Rally
• Focusing on Preferences, Contributions,
  Conditions for Employment
• Career Exploration
• Informational Interviews
• Tours
• Job Shadows
• Volunteering
• Supported Education
• Community Based Assessments/
  Situational Assessments

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What activities and services best
deliver employment results?

• Supported/ Customized Employment
• Job Carving
• Job Coaching
• Job Retention
• Self Employment
• Braided Funding
• Services to Employers
• Job Analysis
• Identifying Natural Supports
• Meeting the Employers needs
• Diversity Training
• WorkSource Business Services Unit
• On-The-Job Training

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What activities and services best deliver
employment results?

• Supported Education
• Individualized Plan to obtain career goals
• Tours/coaching at the Schools
• Assistance to obtain financial aid
• Coordination with Disability Support Services
• Utilizing Individual Training Accounts - WIA
• Peer Services (40 of Clearview Staff self
  identify as having MH issues)
• Human Services Training (Intro to Peer
  Certification Training)

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Develop Partnerships and Access Community
Resources

• Transportation
• Work Incentives
• Financial Assistance
• Clothing Resources
• Housing Resources
• Training
• Education
• Child Care

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What Employment Services are being Provided?
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Working For Success
5 year grant from DOL ODEP serving consumers
with disabilities - working in conjunction with
Workforce System community partners - provide
employment to Olmstead type clients.
2 OBJECTIVES 1 System Change through Policy
Change, Advocacy, Education 2 System Change
through Direct Service
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• Self Employment Plan
• Business Plan
• Everyone contributed to the plan
• Outside Resources were developed
• Joint Marketing for the Business with the Team

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Braiding Funding!!

• Beas Example
• Bea Received Clerical Training from DVR
• Employer Received On-the-Job Training funds from
  WorkSource (Clearview WorkSource worked with
  the employer)
• Bea received job coaching support from Mental
  Health Services On and Off site support

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Hope Vocations Progress
Dept of Education/ RSA grant to assist
homeless individuals to become employed
rebuild their lives

• GOALS
• Develop Stronger Partnerships with Transitional
  Housing and Shelters
• Assist individuals who are currently in need of
  housing and employment assistance
• Learn Peoples stories
• Human Services Training

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Description

• Use Peer Support Counselor located at YW Housing
  and Share Inc. to identify, engage and assist
  participants
• Develop a person centered
  employment and career planning process
• Emphasize rapid job entry and wraparound planning
  and support
• Provide Individual Job Development

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Whats Working...

• Easy Access to Services
• No Preconceived Perceptions of population
• Providing results quickly
• Individualized Services
• Utilizing WorkSource
• Staff that are knowledgeable of the community,
  services and resources
• Partnerships between programs

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Thom HartmanADD, An Alternate View

• I am not inattentive,
• you are just boring.

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John Galbraith

• Given a choice between changing and proving that
  it is not necessary,
• most people get busy with the proof.

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JERRY GARCIA

• SOMEONE HAS TO DO SOMETHING AND ITS PRETTY
  PATHETIC ITS GOT TO BE ONE OF US