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IPS SUPPORTED EMPLOYMENT

IPS SUPPORTED EMPLOYMENT. EVIDENCE-BASED PRACTICE. Presenters: Tish Thomas, State Trainer, DMH/VR/MU Bianca Farr, Director of Employment DMH – Division of Behavioral Health. Missouri Partnership. Vocational Rehabilitation & DMH. Why Focus on Employment?.

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IPS SUPPORTED EMPLOYMENT

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  1. IPSSUPPORTED EMPLOYMENT EVIDENCE-BASED PRACTICE Presenters: Tish Thomas, State Trainer, DMH/VR/MU Bianca Farr, Director of Employment DMH – Division of Behavioral Health

  2. Missouri Partnership • Vocational Rehabilitation & DMH

  3. Why Focus on Employment? Viewed by many as an essential part of recovery Most people want to work A typical role for adults in our society Cost-effective alternative to day treatment

  4. Positive Outcomes from Competitive Work Higher self-esteem Better control of psychiatric symptoms More satisfaction with finances and with leisure (Bond et al., 2001)

  5. Is Work Too Stressful? • As compared to what? • Joe Marrone, an employment trainer said: “If you think work is stressful, try unemployment.” • Stresses of work do not translate into higher rates of hospitalization

  6. Negative Effects of Unemployment in General Population • Increased substance abuse • Increased physical problems • Increased psychiatric disorders • Reduced self-esteem • Loss of social contacts • Alienation and apathy (Warr, 1987)

  7. Competitive Employment for People with Severe Mental Illness • Say they want to work: >70% • Are currently working: <13%

  8. What is EBP ? • A practice validated through rigorous research • Has guidelines describing critical ingredients • Has been successfully implemented in a wide range of settings

  9. Evidence-Based Principles Eligibility is based on individual choice Supported employment is integrated with mental health treatment Competitive employment is the goal Personalized benefits planning is provided Job search starts soon after a person expresses interest in working Follow-along supports are continuous Individual preferences are important Systematic job development

  10. Eligibility Is Based on Choice People are not excluded because they are not “ready” or because of prior work history, hospitalization history, substance use, symptoms, or other characteristics. No one is excluded who wants to participate.

  11. Supported Employment Is Integrated with Mental Health Treatment Employment specialists coordinate plans with the treatment team, e.g., case manager, therapist, psychiatrist, etc.

  12. Competitive Employment Is the Goal • The agency needs to devote sufficient resources to supported employment to permit full access to all people who seek competitive employment • Individuals interested in employment are not steered into day treatment or sheltered work.

  13. Personalized Benefits Planning Is Provided Benefits planning and guidance help individuals & families make informed decisions about job starts and changes.

  14. Job Search Starts Soon After A Person Expresses Interest In Working • Pre-employment assessment, training, and counseling are kept to a minimum. • Rapid job search is more effective than a step-wise vocational approach.

  15. Follow-Along Supports Are Continuous Employment Specialists continue to stay in regular contact with the person and (when appropriate) the employer without arbitrary time limits.

  16. Individual Preferences Are Important Job finding is based on a person’s preferences, strengths, and work experiences, not on a pool of jobs that are available. Match the person with the job, work environment and support that meets their desires and needs rather than trying to change the person to fit the job.

  17. Summary People with severe mental illness can work in competitive employment Programs following evidence-based principles of supported employment have better outcomes

  18. Fidelity Scale • Dartmouth Supported Employment Fidelity Scale (2008) • 25 items, 2 day reviews • http://www.dartmouth.edu/~ips/

  19. Current Sites • Tri-County Mental Health Services, KC • Truman Behavioral Health, KC • Pathways, Clinton • Arthur Center, Mexico & Fulton • BJC, St. Louis • Independence Center, St. Louis • Places for People, St. Louis

  20. Future Expansion • Emerging Sites • Community Counseling Center (Cape) • Preferred Family Health (Kirksville) • AO Treatment Serv. CSTAR (Springfield) • Ozark Center (Joplin) • 1915(i) State Plan Amendment • More people trained to assist with fidelity reviews

  21. Questions? • Tish.Thomas@dmh.mo.gov • Bianca.Farr@dmh.mo.gov

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