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IPS  SUPPORTED EMPLOYMENT IPS  SUPPORTED EMPLOYMENT

IPS SUPPORTED EMPLOYMENT - PowerPoint Presentation

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IPS SUPPORTED EMPLOYMENT - PPT Presentation

The EvidenceBased Practice for Employment 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 Costeffective alternative to day treatment ID: 744157

job employment work supported employment job supported work treatment based consumers competitive ips consumer evidence mental specialists outcomes team services health agency

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Slide1

IPS SUPPORTED EMPLOYMENT

The Evidence-Based Practice for EmploymentSlide2

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

Cost-effective alternative to day treatmentSlide3

Benefits of Steady

Competitive Employment

Increased income

Improved self esteem

Improved social networks

Increased quality of life

Better control of symptoms

Reduced substance use

Reduced use of mental health servicesSlide4

Is Work

Too Stressful?

As compared to what?

Joe Marrone, an employment trainer:

If you think work is stressful, try unemployment.

Stresses of work do

not

translate into higher rates of hospitalizationSlide5

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)Slide6

Competitive Employment for People with Severe Mental

Illness: The Gap

Say they want to work:

66%

Are currently working:

<20%

Have access to evidence-based employment services: 2%Slide7

Evidence-Based Practice

Program model validated by rigorous research (different investigators)

Has guidelines describing critical components

Has a treatment manualSlide8

Quotes from Consumers

I feel so much better about myself now that I have a job.

Holding down my job is not always easy but it has helped my self esteem.

When I go to work I don

t hear the voices.

Now that I am working again I can buy my daughter presents.

”Slide9

Quotes from Family Members

I worried that if my son got a job he would get stressed. But just the opposite happened. He is doing so much better than before.

I feel better that she tries working when she has the support of mental health.

I was really glad that my son

s employment counselor asked me about work ideas. He landed a job that I suggested.

”Slide10

Quotes from Employers

Andre is as good as any worker that I have.

Automotive parts store manager.

I count on Juanita. If she is feeling stressed, she sits in the back room for awhile. That

s OK; she gets the job done.

Bakery supervisor.

The employment counselor helped me understand why Tony paces. It

s okay in the security business.

Security business owner. Slide11

Competitive Employment Rates in 22 Randomized Controlled Trials of IPSSlide12

Overall Findings for 22 RCTs

All 22 studies showed a significant advantage for IPS

Mean competitive employment rates for the 22 studies:

56

% for IPS

23

% for controlsSlide13

Definition of

Supported Employment

Mainstream job in community

Pays at least minimum wage

Work setting includes people who are not disabled

Service agency provides ongoing support

Intended for people with most severe disabilitiesSlide14

Evidence-Based

Practice

Principles

Eligibility is based on consumer choice

Competitive employment is the goal

Supported employment is integrated with treatment

Personalized benefits planning is provided

Rapid job search is encouraged

Employment specialists build employer relationships

Follow-along supports are continuous

Consumer preferences are importantSlide15

Eligibility Is Based on Consumer Choice

Consumers 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.Slide16

Competitive Employment Is the Goal

The agency needs to devote sufficient resources to supported employment to permit full access to all consumers who seek competitive employment

Consumers interested in employment are not steered into day treatment or sheltered work.Slide17

IPS Is

Integrated with Mental Health Treatment

Employment specialists coordinate plans with the treatment team, e.g., case manager, therapist, psychiatrist, and other community providers, e.g., Vocational RehabilitationSlide18

Personalized Benefits Planning Is Provided

Benefits planning and guidance help consumers make informed decisions about job starts and changes.Slide19

Rapid Job Search Is Encouraged

Job search starts soon after a consumer expresses interest in working.

Pre

-employment assessment, training, and counseling are kept to a minimum.Slide20

Employment Specialists Build Employer Relationships

Employment specialists meet face-to-face with employers over time to learn about business needs and positions.

Each specialist makes at least 6 contacts with hiring managers each week.Slide21

Follow-Along Supports Are Continuous

Employment

specialists

continue to stay in regular contact with consumer and (when appropriate) the employer without arbitrary time limits.Slide22

Consumer Preferences Are Important

Job finding is based on consumers

preferences, strengths, and work experiences, not on a pool of jobs that are available.Slide23

Job Preferences Are ImportantSlide24

Key Factors in Implementation

Build Consensus

Maximize Financing

Examine Agency Philosophy

Identify Leadership

Key on Organizational Structure

Provide Ongoing Training

Make Time Commitment

Track Process and OutcomesSlide25

Build Consensus

Commitment of state mental health authority is not enough

Better to involve all stakeholders - consumers, family members, providers, and local and state MH and VR administratorsSlide26

Maximize Financing

Determine how supported employment services can be funded

Explore funding through Mental Health, Vocational Rehabilitation, and Medicaid

Reallocate resources to supported employment when feasibleSlide27

What Does IPS Cost

?

Estimates of per-client annual costs

$2500 (Latimer et al., 2004)

$4300 (HMC, 2006)

$6400 (Cimera, 2007)

Adjusting for inflation, 2014 estimates range from $3200 to $7300

Factors affect cost: severity

of disability, local

wages, indirect

costs and

which clinical

services

includedSlide28

Examine Agency Philosophy

Determine if service agency

s philosophy, mission statement, and service paradigm are consistent with recovery-oriented, evidence-based approach to

IPS supported

employment.Slide29

Identify Leadership

You need a champion!

Identify committed leader with sufficient authority to oversee and ensure implementation

Leaders at all levels visibly show support for supported employment

Center director buy-in is critical

Leadership from Vocational Rehabilitation

aids

collaboration

Slide30

Leadership Roles

Provide necessary resources

Seek buy-in from consumers, families, and practitioners

Give recognition to staff and consumer for successes

Rapp

s finding

– Critical role of supervisor in program successSlide31

Organizational Structure

Employment specialists

Join one or two treatment teams.

Share office space with treatment team.

Communicate frequently with treatment team members.

Team integrates supported employment, benefits counseling, case management, psychiatric services, and dual diagnosis treatment.Slide32

Provide Ongoing Training

Initial training for all team members, including medical staff

Continuing access to expert consultation

Ongoing supervision that is outcomes-orientedSlide33

Make Time Commitment

Typically, 6 - 12 months needed to develop skills, interest, and confidence for implementing evidence-based supported employment Slide34

Track Implementation Process and Outcomes

Track employment outcomes monthly

Set goals: 40% rate of competitive employment is achievable

Use the IPS-25, a 25

-item

supported employment fidelity scale

to measure

implementationSlide35

Summary

People with severe mental illness can work in competitive employment

Programs following evidence-based principles of supported employment have better outcomes

Programs must address financial and organizational barriers to be successful