Brianne Lott MRC CRC Jackie Tijerina MEd Center on Community Living and Careers Indiana Institute on Disability and Community Indiana University NationalAPSE2015 Lott amp Tijerina APSE 2015 ID: 610986
Download Presentation The PPT/PDF document "Employment Supports for Individuals with..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Employment Supports for Individuals with Psychiatric Disabilities and Substance Abuse Disorders
Brianne Lott, MRC, CRCJackie Tijerina, M.Ed.Center on Community Living and CareersIndiana Institute on Disability and CommunityIndiana University
#NationalAPSE2015Slide2
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide3
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide4
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide5
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide6
Lott &
Tijerina
APSE 2015 Slide7
Why Does it Matter?Average of 80% of individuals with mental illness are unemployed
Estimated 9.6 million adults in the U.S. (4.1% of the population) have a serious mental illnessTwice as likely to have a co-occurring substance abuse disorderLott & Tijerina
APSE 2015
#NationalAPSE2015Slide8
Bipolar Disorders
Lott & Tijerina APSE 2015
Depression
Elevated or irritable mood
Impulsive
Easily distracted
Pressured speech
Flight of ideas
#NationalAPSE2015Slide9
Schizophrenia & Related Disorders
Unable to think clearlyDifficulty relating to othersImpaired reality testingOdd sensory experiencesSevere mood disturbancesFalse beliefsPositive symptomsHallucinations, delusions, and disorganized speech
Negative symptomsFlat affect, lack of motivation, ambivalence
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide10
Anxiety Disorders
Panic DisorderSudden sense of doomIncreased heart rate, difficulty breathing, dizziness, and terrorGeneralized Anxiety DisorderConstant worry
Obsessive-compulsive DisorderIntrusive thought and impulses with ritualistic and illogical behaviorPost-traumatic Stress DisorderExtreme emotional reaction including nightmares and flashbacks
Estrangement from others and poor concentration
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide11
Personality Disorders
Antisocial Personality DisorderViolates the rights of others without remorseBorderline Personality DisorderInstability of interpersonal relationshipsNarcissistic Personality DisorderExaggerated sense of self-importanceHistrionic Personality Disorder
Very emotional and attention seekingAvoidant Personality DisorderExtreme social discomfort
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide12
One Woman’s Story http://
www.independentmail.com/news/anderson-woman-with-bipolar-disorder-struggled-to-find-a-job_73473290Lott & Tijerina APSE 2015
#NationalAPSE2015Slide13
MethamphetamineAfter quitting psychotic symptoms can last months, even years (typically precipitated by stress)
Changes activity in the dopamine system of the brain which can lead to impairments in verbal learning & reduced motor speedEmotional & cognitive problems/deficitsLott & Tijerina
APSE 2015
#NationalAPSE2015Slide14
Prescription Opioids
Depressed respiration (hypoxia) can cause brain damageDeterioration of white brain matter may lead to difficulty making decision, regulating behavior & responding to stressful situationsLink to using heroin (cheaper & easier to obtain)Lott &
Tijerina APSE 2015
#NationalAPSE2015Slide15
Heroin
Deterioration of white brain matter may lead to difficulty making decision, regulating behavior & responding to stressful situationsHeart lining & valves can become infected, abscesses, gastrointestinal cramping, and
liver or kidney diseasePulmonary complications including pneumonia
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide16
Injection Drug Use and HIV & HCV Infection
Injecting drugs = high risk of HIV and HCV infectionsHIV treatment side effectsDizziness, pain & nerve problems, fatigue, decrease in bone density (increase risk of injury)Hepatitis considerations
Fatigue, confusion, drowsiness, and slurred speech
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide17
Austin, IN: A case study
https://www.youtube.com/watch?v=lmsvOO0ZXUcPopulation ~ 4,000171 HIV positive as of 6/10/201515 times national estimatesIV drug use, sharing needles
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide18
Rehabilitation & Employment Ideas
Lott &
Tijerina APSE 2015
#NationalAPSE2015Slide19
General Considerations
Employment goalCultureIdeasBeliefsValuesBenefits currently receivingSSDI/SSIMedicare, Medicaid, other health insurance
Housing subsidies Food stamps/TANFNatural supports
Lott &
Tijerina
APSE 2015
#NationalAPSE2015Slide20
Medications and side effects
Traditional antipsychotics can cause tardive dyskinesia (involuntary movements of the mouth and face), listlessness, and blurred visionAtypical antipsychotics can cause weight gain leading to associated risk factors (diabetes, hypertension, etc)Mood stabilizers have side effects including sedation and irregularity of the cardiovascular system
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide21
Strategies for Support
Lott & Tijerina APSE 2015 On-site AccommodationsJob coaching/extra training to
reach full productivityElectronic organizersTo do listsWeekly meetingsClear goals and consequences in writing
Assistance modifying schedule to improve attendance
#NationalAPSE2015Slide22
Strategies for Support
On-site AccommodationsAssistance concentrating on work tasksReduce distractionsPrivate work areaFrequent BreaksAddressing work safety issues (common employer concern)
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide23
Strategies for Support
Off-site AccommodationsAssistance with transportation (increase attendance rates)Interpersonal skills & stress tolerance counselingPraise and positive reinforcement Employee assistance programsEducating on rights
Contact Job Accommodation Network (JAN)Know provisions and limitations of ADAWhen and how to contact the EEOC
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide24
References
http://www.drugabuse.gov/publications/drugfacts/heroinhttp://www.drugabuse.gov/publications/research-reports/methamphetamine/what-are-long-term-effects-methamphetamine-abusehttp://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medicationshttps://www.aids.gov/hiv-aids-basics/just-diagnosed-with-hiv-aids/treatment-options/side-effects
/http://www.mayoclinic.org/diseases-conditions/hepatitis-c/basics/symptoms/con-20030618
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide25
Referenceshttp://
www.nih.gov/news/health/jan2014/nida-03.htmhttp://www2.nami.org/Template.cfm?Section=press_room&template=/ContentManagement/ContentDisplay.cfm&ContentID=169616http://www.nimh.nih.gov/health/statistics/prevalence/index.shtml
Lott & Tijerina APSE 2015
#NationalAPSE2015Slide26
References
Walls, R.T., Batiste, L.C., Moore, L.C., Loy, B. (2009). Vocational Rehabilitation and Job Accommodations for Individuals with Substance Abuse Disorders. Journal of Rehabilitation, (75)4, 35-44.Beimers, D., Beigel, D.E., Guo, S., Stevenson, L.D. (2010). Employment Entry through Supported Employment: Influential Factors for Consumers with Co-Occurring Mental and Substance Abuse Disorders.
Best Practices in Mental Health, (6)2, 85-102.
Lott &
Tijerina
APSE 2015
#NationalAPSE2015