Center for Practice Innovations Brings Best Practices to NYS: IPS Model of Supported Employment and Wellness Self-Manage

1. Center for Practice Innovations Brings Best Practices to NYS:IPS Model of Supported Employment and Wellness Self-Management (WSM) • NYAPRS Conference • September 23, 2010 • Carlos Jackson, Ph.D. • Paul Margolies, Ph.D. • Raymond Gregory • Anthony Salerno, Ph.D.

3. Who we are?

4. Public-Academic Partnership

5. Tony Salerno, Ph.D. Project Director, Wellness Self-Management Susan Essock, Ph.D. Director Paul Margolies, Ph.D. Associate Director Implementation Raymond Gregory IPS Trainer Carlos Jackson, Ph.D. Associate Director Operations

6. What we do?

7. On-line training Web-based Collaborations Distance Learning www.practiceinnovations.org

8. Building best practices with you.

9. Individual Placement and Support

10. Why Focus on Employment? • Viewed by many as an essential part of recovery • Most consumers want to work • A typical role for adults in our society

11. Competitive Employment for People with Severe Mental Illness Say they want to work: 70% Are currently working: <15% Current access to supported employment: <5%

12. What is Supported Employment? • Supported Employment helps people with mental illnesses find and keep meaningful jobs in the community. • The jobs exist in the open labor market, pay at least minimum wage, and are in work settings that include people who are not disabled. • SAMHSA Supported Employment Tool Kit

13. Evidence-Based Principles • Eligibility is based on consumer choice • Supported employment is integrated with treatment • Competitive employment is the goal • Personalized benefits planning is provided • Job search starts soon after a consumer expresses interest in working • Follow-along supports are continuous • Consumer preferences are important

14. Eligibility Is Based on Consumer Choice • All consumers who want to work are eligible for Supported Employment. • Consumers are not excluded because they are not “ready” or because of prior work history, hospitalization history, substance use, symptoms, or other characteristics.

15. Supported Employment Is Integrated with Mental Health Treatment • Employment specialists are treatment team members and coordinate their efforts with all team members

16. Competitive Employment Is the Goal • Employment specialists help consumers find jobs in the open labor market and that pay at least minimum wage, including part-time and full-time jobs. • Consumers interested in employment are not steered into day treatment or sheltered work. • The agency devotes sufficient resources to supported employment to permit full access to all consumers who seek competitive employment.

17. Personalized Benefits Planning Is Provided • Employment specialists help consumers understand how benefits (such as Social Security or Medicaid) are affected by working so that they can make informed decisions about starting or changing jobs. • Most consumers are able to work and receive some benefits.

18. Job Search Starts Soon After A Consumer Expresses an Interest in Working • Pre-employment assessment, training, and counseling are not required and are kept to a minimum.

19. Follow-Along Supports Are Continuous • Supported employment staff continue to stay in regular contact with consumer and (when appropriate) the employer without arbitrary time limits.

20. Consumer Preferences Are Important • Job finding is based on consumers’ preferences, strengths, and work experiences, not on a pool of jobs that are available.

21. Myths and Misconceptions about IPS • “Supported Employment? Oh, we do that!” • We have too much to do as it is… • Results aren’t real, they are exaggerated • This can’t be done with such a poor economy. There just aren’t any jobs out there. • No exclusion criteria??? • Rapid Placement??? • How can IPS fit into a Pros program???

22. Center for Practice Innovation’s Statewide IPS Initiative:Focus on PROS

23. Plan • To bring IPS to PROS programs: • Many PROS programs will receive significant technical assistance through learning collaboratives and distance learning approaches • Some PROS programs will receive significant on-site consultation, coaching and training

24. Goals • Clear understanding of priority placed on employment outcomes • Clear understanding of essential role of leadership in making and sustaining this change • Clear understanding of IPS fidelity and the need for adaptation to PROS environment • Implementation of IPS, adapted to PROS environment • Fully competent employment specialist(s) • Supervisory structure for IPS in place and functioning

25. Anticipated Outcomes • Employment outcomes for participating PROS programs are improved, • IPS practice is implemented in a manner that allows for successful adaptation to PROS environment

26. Learning Collaboratives/Distance Learning • Methods • Regional forums – learning collaborative meetings for PROS program directors and employment specialists • Guidance and support for implementation • Employment specialists receive training and coaching in critical skills • Consultation phone calls • For PROS program directors • Some regional, some program-specific • Online discussion threads including “Ask the Expert” threads • Webinars/videoconferences • Implementation guidelines, engagement guides, and other implementation supports

27. Significant on-site consultation, coaching and training • Methods Hands-on work with program and agency leadership, supervisor(s), and team members with special emphasis on employment specialists(s)

28. Significant on-site consultation, coaching and training • Programs Now Involved • HALI • Clubhouse of Suffolk • FEGS • Federation of Organizations • Putnam Family and Community Services • Occupations, Inc.

29. IPS • Some illustrations from our work with PROS programs….

30. Wellness Self-Management

31. Agenda What is Wellness Self-Management (WSM) and why is it important? WSM Personal Workbook – one key resource Statewide initiative and update Center for Practice Innovations: A resource for consumers, practitioners and agencies

32. What is Wellness Self-Management? Curriculum based practice designed to assist adults to effectively self -manage serious mental health and related problems The topics covered include a number of research informed approaches that are organized into a comprehensive and coordinated set of practices Integrates 3 key areas: Recovery Mental health wellness and relapse prevention Physical health

33. What is Wellness Self-Management? Continued Based upon several sources: Dartmouth/SAMHSA Illness Management and Recovery materials and implementation resource kits OMH Bureau of Recipient Affairs revision of Dartmouth materials Eli Lilly NTTP materials Feedback from focus groups involving consumers, practitioners, and experts on cultural competency

34. Eight Goals of the Program Learning about recovery and what it can mean for you Making the best use of your mental and physical health services Learning how mental health and physical wellness will help you to achieve your goals and support your personal recovery Staying well by decreasing symptoms of a mental health problem

35. Goals of the Program (continued) Learning how to manage day-to-day stress and prevent relapse Staying well by connecting with others Staying well by living a healthy lifestyle Recognizing and building on your cultural values and experiences to support your personal recovery

36. WSM:The Personal Workbook 57 lesson curriculum Integrates concepts of Recovery-Mental health Wellness and Physical health Structured lesson format Important information Discussion points Personalized worksheet Action step planning Non-prescriptive language

37. WSM: Logistics Group or individual format Meets at least once a week for 45+ minutes Group meets around a table Optimally closed group with 8-10 members Successfully employed in open groups Optimally co-led with a peer counselor May be customized to setting and population (Selected chapters and lessons)

38. Details about the WSM Program in the NYS Initiative Group Format Meets at least once weekly Lasts approximately 1 year Ideally, closed group where possible Encourage peer co-facilitation (e.g., peer specialists) Reinforced in individual meetings (consistency and continuity across services)

39. Going Statewide

40. Participating Agencies 105 programs participated in the statewide initiative (Nov 2007-Nov 2009) 22 Clinics 11 Inpatient programs 3 IPRT 8 Psychosocial Clubs 14 Residential programs (various types) 33 CDT’s 2 Adult home case management 2 PROS 2 ACT 1 COD program (VA of Northport, Long Island) 9 Forensic programs (1 inpatient and 8 outpatient programs located in prisons) ** 3 VA systems 12 State Operated

41. Statewide Initiative update Over 4500 participants and growing A recent survey based on the responses of 87 of the original 100 participating agencies indicate that 85% currently provide WSM groups; 13 % have plans to offer WSM starting in the fall and 2 % won’t be offering WSM. WSM spinoffs in field testing WSM+ (integrates mental health and substance use) KEY (Knowledge Empowers You) for youth WSM for individuals treated in prison mental health units

42. Goals Identified by Consumers at the Beginning of the WSM Program (n = 409) Percent of Consumers

43. Personal Assessment of Progress at the End of the Program

44. Sustainability of WSM: CPI Resources and Tool DevelopmentWWW.PRACTICEINNOVATIONS.ORG Informational/promotional materials Brochure Sample workbooks DVD with program description and participant testimonials Training materials Group skills DVD Full day comprehensive training DVD Group leaders quick guide Online course (1 ½ to 2 hours) 224 have registered; 127 (57%) have completed the course, 83 (37%) are in progress, and 14 (6%) have registered but not yet started the training. Program materials Workbooks (electronic and bound copies) English, Spanish, Korean and Chinese. Also, large print for visually impaired