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Evidence-Based Practices:
Shaping Mental Health Services Toward Recovery
Supported Employment
Workbook
Chapter 1: Introduction to Supported Employment
Most people who live with a severe mental illness want to work.
Chapter Overview
This chapter provides a brief introduction to supported employment.
Why supported employment?
The goal of supported employment is to help people with severe mental illnesses find and keep competitive jobs. Supported employment facilitates the recovery of work-interested consumers by supporting them in their efforts to get on with life beyond illness.
Supported employment has a real impact on people’s lives
Getting on with life beyond illness
Gabriel had his first manic episode during college where he was studying music and playing in a band. When he wasn’t in the hospital with acute symptoms, he spent much of the next several years drinking and smoking marijuana with people he met while receiving services at the local community mental health center. One day, Gabriel spelled out for his clinical case manager how terrible he felt about his life and berated himself for being “a mental patient” and not working like his old high school and college friends. After assuring himself that Gabriel was not acutely suicidal, Gabriel’s case manager followed up on this expression of interest in work by introducing him to the team’s employment specialist.
While out for coffee the next day, the employment specialist asked Gabriel what his work life will look like after he has recovered from the demoralizing impact of his mental illness. Gabriel was surprised by the questions but able to say that he had always dreamed of recording his own music. The employment specialist wondered aloud what steps might be available now that could lead to such a career. He also mentioned that he had just that morning seen an ad for a part-time job in the music section of a local bookstore.
Two years later, Gabriel is now working as the manager of the bookstore music section and playing guitar on weekends with a few musicians who are steady customers at the store. He stopped drinking completely and smokes little marijuana because it interferes with work. Feeling better about himself, he has taken more initiative in managing his symptoms and has not been in the hospital since he took the job. He meets monthly with his employment specialist to sort out next steps in his career.
Pupose of this wookbook
This workbook is designed to introduce you to the principles and strategies you will need to be an effective employment specialist. As an employment specialist you will have an opportunity to make a meaningful positive impact on the lives of others such as that illustrated in this example.
So What is supported employment?
Supported employment is an approach to vocational rehabilitation for individuals with disabilities that emphasizes helping people obtain competitive work in the community, and providing the supports necessary to ensure success at the workplace. The emphasis in supported employment programs is on helping individuals find jobs paying competitive wages in integrated settings (i.e., with others who don’t necessarily have a disability) in the community. In contrast to other approaches to vocational rehabilitation, supported employment de-emphasizes prevocational assessment and training, and puts a premium on rapid job search and attainment.
Individuals with disabilities differ from one another in terms of the types of work they prefer, the nature of the support they want, and the decision whether or not to disclose their disability to the employer or co-workers. Supported employment programs respect these individual preferences, and tailor their vocational services accordingly. In addition to appreciating the importance of consumer preferences, supported employment programs recognize that most individuals with disabilities benefit from long-term support after successful job attainment. Therefore, supported employment programs avoid imposing unrealistic time limitations on services, while focusing on helping consumers become as independent and self-reliant as possible.
The overriding philosophy of supported employment is the belief that every person with a disability is capable of working competitively in the community if the right kind of job and work environment can be found. Rather than trying to sculpt the consumer into becoming the “perfect worker” through extensive prevocational assessment and training, individuals are offered help finding and keeping jobs that capitalize on their personal strengths and motivation. Thus the primary goal of supported employment is not to change the consumer, but to find a natural “fit” between the consumer’s strengths and experiences and a job in the community. As consumers succeed in working in the community, their self-perceptions often change and they view themselves as workers and contributors to society. Furthermore, as people in the community see individuals with disabilities working, consumers are less stigmatized for their mental illness and they become more socially accepted. Supported employment is a successful approach that has been used in various settings by culturally diverse consumers, employment specialists, and practitioners.
Chapter summary
Many consumers are experiencing recovery from mental illness by acquiring employment. Supported employment programs offer consumers assistance in their work efforts. Evidence-based supported employment incorporates the following points:
- Supported employment is a well-defined approach to helping people with mental illness find and keep competitive employment. “Competitive employment” means work in the community that anyone can apply for and pays at least minimum wage. The wage should not be less than the normal wage (and level of benefits) paid for the same work performed by individuals who do not have a mental illness. Supported employment is a successful approach that has been used in various settings by culturally diverse consumers, employment specialists, and practitioners.
- Supported employment programs are staffed by employment specialists who have frequent meetings with the treatment team (i.e., practitioners who provide services, such as case manager, therapist, psychiatrist) to integrate supported employment with mental health treatment.
- Supported employment programs help anyone who expresses the desire to work. People are not excluded because they are not “ready” or because of prior work history, substance use, or symptoms.
- Employment specialists help people look for jobs soon after entering the program, instead of requiring extensive pre-employment assessment and training, or intermediate work experiences (like prevocational work units, transitional employment, or sheltered workshops).
- Support from the employment specialist continues as long as consumers want the assistance. The help is often outside of the work place and it can include help from other practitioners, family members, coworkers, and supervisors.
- Jobs are seen as transitions. People commonly try several jobs before finding a job they want to keep. Employment specialists help consumers find further jobs when they leave jobs.
- Finally, evidence-based supported employment follows the philosophy that all choices and decisions about work and support are individualized, based on the person’s preferences, strengths, and experiences.
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