Works

1. How Working is Promoting Recovery for
People with Mental Illness
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2. How Working is Promoting
Recovery for People with Mental
Illness
PRESENTED BY:
SAMHSA SOAR TECHNICAL ASSISTANCE CENTER
POLICY RESEARCH ASSOCIATES, INC.
UNDER CONTRACT TO:
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

3. Welcome!
KRISTIN LUPFER, LMSW, PROJECT DIRECTOR,
SOAR TECHNICAL ASSISTANCE CENTER,
POLICY RESEARCH ASSOCIATES, DELMAR, NEW YORK

4. Webinar Instructions
Muting
Recording availability
Downloading documents
Evaluation
http://soarworks.prainc.com/article/soar-
webinar-employment

5. Learning Objectives
Define IPS and describe core principals of IPS (Individual
Placement and Support) model.
Understand how IPS model can support individuals with
mental illness who have experienced homelessness seek
competitive employment in the community.
Provide an example of a SOAR program offering job
supports.

6. Agenda
IPS Model: Dartmouth Psychiatric Research Center (PRC), Lebanon, NH
 Robert E. Drake, M.D., PhD., Professor of Psychiatry and of Community and Family Medicine
 Deborah R. Becker, M.Ed., CRC, Director of Supported Employment Programs at the PRC,
Associate Research Professor
SOAR Program: Columbus House Inc. / Pathways to Independence, New Haven, CT
 Thomas Fortuna, Pathways to Independence Manager
 Carl Reynolds, Pathways to Independence Employment Services Coordinator
Questions & Answers
 Facilitated by SOAR TA Center Staff

7. Poll Question #1
Does your SOAR program connect SSA beneficiaries to
employment support services?
a. Yes
b. No
c. Unsure
d. Making plans to in the future

8. Supporting Individuals Experiencing
Homelessness with Individual
Placement and Support (IPS)
ROBERT DRAKE, PROFESSOR & DEBORAH BECKER, ASSOCIATE RESEARCH
PROFESSOR
DARTMOUTH PSYCHIATRIC RESEARCH CENTER
HANOVER, NEW HAMPSHIRE

9. Quotes from Workers
 “When I am working, the noise in my head gets
quieter.”
 “Working gives me a reason to get up in the
morning. And that is the best medicine.”
 “The money is nice but I feel good telling my son
that I have to go to work tomorrow.”

10. Four Main Points
 Many people with serious mental illness want to
work
 People with serious mental illness can work
 IPS Supported Employment Fidelity Scale is a
program road map
 Work is everybody’s business

11. Recovery and Work
 Work promotes recovery and wellness-
 Emotional
 Financial
 Social
 Spiritual
 Physical
 Intellectual
 Environmental
M. Swarbrick, Collaborative Support Programs of New Jersey

12. Competitive Employment
Say they want to work: 60-70%
Are currently working: <15%
Are receiving supported employment: <2%

13. IPS Principles
 Open to anyone who wants to
work
 Focus on competitive
employment
 Rapid job search
 Systematic job development
 Client preferences guide
 Individualized long-term
supports
 Integrated with treatment
 Benefits counseling included

14. 1. Every Person Interested in Work is Eligible
 Zero exclusion
 People with justice system involvement
 People who have experienced homelessness
 People with co-occurring substance use disorders
 Encouragement about work and school

15. Focus on Employment
 “Have you thought about a job?”
 “Would you like to know about work incentives
(benefits planning)?”
 “Tell me about your work experience?”
 “How will you know when you are ready to
work?”

16. Build a Culture of Work
Clients share their back to work stories with other
clients and staff, for examples:
Written stories in waiting rooms, newsletters…
Speakers at treatment groups, picnics, agency meetings…
Posters and brochures about work

17. Short Conversations About Work
Talk about work over time.
Don’t push; help people explore the
possible benefits and costs of employment.
“I believe you can work. It’s up to you.”
Make sure people have good information
about benefits, jobs available, etc.

18. 2. Competitive Jobs are the Goal
 Pays at least minimum wage
 Integrated community setting
 “Owned” by the worker
 Not set aside for people with disabilities
 Part-time or full-time jobs

19. Competitive Jobs
Landscaper
Machine Operator
Photographer
Receptionist
Reporter
Sales Clerk
Security officer
Welder
Baker’s assistant
Childcare Worker
Data Entry
Deli Meat Cutter
Grocery Bagger/Carriage
Attendant
Housekeeper
Dishwasher

20. 3. Employment Services & Mental
Health Services are Integrated
Team approach
Help team think about work/school for others
Connect with Vocational Rehabilitation
Connect with families

21. Team Approach
IPS worker assigned to 1-2 teams
Participate in weekly team meetings
Communicate outside of meetings
Share office space
Help team think about work/school for others
Connect with Vocational Rehabilitation
Connect with families

22. Work is Everybody’s Business
Team members share:
Person strengths, experiences, wellness
strategies
Ideas for job types
Job leads
Job support

23. 4. Preferences Are Honored

24. Individual Preferences
Job type
Job setting
Work hours
Disclosure
Role of employment specialist with employer contact
Job support

25. Offered to all clients seeking work
Provided by specially trained staff
Impact on Social Security, Medicaid, other
government entitlements
Offered when making changes in work hours
and pay
5. Benefits Planning Is Offered

26. 6. The Job Search Occurs Rapidly
 Avoid lengthy assessment, training,
counseling
 Face-to-face contact with employers within
30 days
 Investigate job types and settings
 Employer contacts based on person’s
preferences, strengths

27. 7. Systematic Job Development
Develop employer relationships.
Employment specialists meet with employers
over time to learn about business needs and
positions.
Specialists make at least 6 contacts with
hiring managers each week.

28. Job Finding Techniques
First meeting, schedule a 15-minute appointment.
Meet with employer for 15 minutes to learn about
the business and hiring preferences.
Go back to talk about the strengths of a person who
would be a good fit for that business. Ask for an
interview.

29. 8. Job Supports are Continuous
Ongoing as needed and desired
Individualized

30. Ongoing Job Support
Face-to-face before job start
Day of job start
Weekly contact
Transition out of IPS

31. Individualized Job Support
Individualized support
Employer support
Career development
Enhanced team support

32. IPS Supported Employment Guidelines
 8 Practice Principles
 25-item Fidelity Scale

33. Wellness and Recovery
Wellness moves the focus from thinking
one needs treatment forever to capitalizing
on the strengths and abilities of the
individual and his/her family and
community.
M. Swarbrick, CSPNJ

34. What People Say
“When you are working, you are part of the real world.
You feel connected. Having a job gives me stability. I have
something to look forward to every day.”
“In the past, people might have used labels to describe
me such as ‘homeless,’ ‘mentally ill,’ and ‘welfare
mother.’ Now my titles are ‘financial administrator,’
‘college student,’ and ‘working mom.’”

35. Resources
http://www.dartmouthips.org
 ASK
 Online courses for practitioners and supervisors
 IPS Supported Employment: A Practical Guide

36. A Few Facts
 70% of people with mental health issues want to work
 IPS can help 60% or more to become competitively
employed
 Most people work about half-time, like their jobs, and
benefit in many ways from employment

37. Controlled Trials
22 Randomized Controlled Trials (RCTs) of Individual
Placement and Support (IPS):
 Best evidence available on effectiveness
 RCTs are gold standard in medical research

38. Controlled Trials: Findings

39. Overall Findings for 22 RCTs
 Every study showed a significant advantage for IPS
 Mean competitive employment rates:
 56% for IPS
 23% for controls

40. Homelessness
Baltimore study
Majority recently homeless
27% vs. 7% employment
Washington, DC study
Majority recently homeless
71% vs. 9% employment
Combined NH, DC, CT, and IN studies
Over 20% recently homeless
Employment outcomes unrelated

41. 2 Long-Term IPS Studies
Salyers
(2004)
Becker
(2007)
Combined
Currently Working 47% 71% 59%
Worked During
Follow-up
92% 82% 87%
Worked > 50%
Follow-up
33% 71% 52%
Length of Follow-
up
10 years 8-12 years 10 years
Samples Size 36 38 74

42. IPS Is Effective for a Wide Variety of Subgroups
PTSD diagnosis
Mental illness + substance
use
Older adults
First episode of psychosis
Homeless
Criminal justice history
Disability beneficiaries
African American
Hispanic

43. Contact Information
Dartmouth Psychiatric Research Center
Lebanon, NH
(603)448-0263
http://www.dartmouthips.org
Robert E. Drake, M.D., PhD.
Professor of Psychiatry and of Community and Family Medicine
Robert.E.Drake@dartmouth.edu
Deborah R. Becker, M.Ed., CRC
Director of Supported Employment Programs at the PRC, Associate Research Professor
Deborah.r.becker@dartmouth.edu

44. Poll Question #2
What is one myth our presenters debunked?
a. Most people work about half-time, like their jobs, and benefit in
many ways from employment
b. Most people with mental illness do not wish to work.
c. IPS can help 60% or more to become competitively employed

45. Income=Empowerment:
The Pathways to Independence
Program
THOMAS FORTUNA, MANAGER AND
CARL REYNOLDS, EMPLOYMENT SERVICES COORDINATOR
COLUMBUS HOUSE INC./PATHWAYS TO INDEPENDENCE
NEW HAVEN, CONNECTICUT

46. Pathways to Independence
Combining SOAR & employment incomes with a
holistic approach to recovery, housing and
community reintegration.
Using holistic, recovery-based incentives to support
individuals to engage in employment.
Targeted services for individuals experiencing
homelessness and a disabling condition.

47. Our Core Mission and Values
Mission Statement
To increase housing, income and health security for individuals
who are homeless and experiencing a behavioral health and/or
substance use disorder.
 Values
Pathways to Independence promotes Hope, Personal Responsibility,
Education, Self-Advocacy and Support, helping to provide opportunities,
skills, and the education necessary to become independent and
productive.

48. Program Goals
Maximize our client’s access to income
Employment and SOAR assistance (dual screening)
Employment Network: Ticket to Work
WorkFare
Provide connection to healthcare providers
Facilitate and nurture opportunities for client employment
Educational support and assistance for client’s financial stability and
improved quality of life
Identify and secure housing options in the community

49. Program Components
Housing Services
Employment Services
Financial Literacy, Employment Training (EEC)
Enrollment into Benefit Programs (SOAR)
Representative Payee
Healthcare Referral
**All Individuals Served Participate in EEC**

50. PTI
Employment
Enrichment
Center
Case
Manage-
ment
Income
Housing

51. Employment and Enrichment Center
Funded in part by the United Way of Greater New Haven
Through Education, Enrichment and Employment, graduates will discover:
 Greater Self-Esteem
 Stronger Recovery from addiction
 Better control of psychiatric symptoms
 Greater Confidence
 Greater Life Satisfaction
 Enjoy a life worth living
 Have a life worth saving
Instructors are certified Recovery Support Specialists
Also facilitated through a relationship with a local community bank: START

52. Employment and Enrichment Center
Curriculum: 90 hours, classes include:
Intro to Computers
Math, Reading &
Comprehension
Teambuilding
Resume, Cover Letter Writing
and Interviewing Skills
Housing Education
Employment and Search Tools
Key Train, ONET training & job
identification
Wellness & Recovery Action
Plan (WRAP)
Starting Your Own Business
And More!

53. Extra Curricular Classes
Regular Classes: Monday through Friday, 9:00 AM to 12:00 PM
Jobs Club: Tuesday and Thursday 1 PM to 3 PM
Focus on interviewing skills, online applications, and gaining field
work/experience outside of the classroom
Computer Lab: Monday and Friday 1 PM to 3 PM
 Housing Resource Class: Wednesday 1 PM – 3 PM
Resources on tenancy, fair housings rights, etc.

54. Additional Resources Provided
Interview clothing including suits and shoes
Transportation including bus passes and rides
Gift cards for personal necessities
Consistent phone and computer access to streamline the
job-hunt process

55. Dress for a Successful Interview!

56. The End Result=Employment
Resume
Cover Letter
Working Email
Account
Interview Practice
Interview Clothing
Working Cell Phone
Direct Connection to a
Local Banking Resource

57. Community Partners
Career Resources / Connect
To Work
New Haven One Stop / CT
Labor Office
STRIVE
Veteran’s Affairs
Bureau of Rehabilitation
Services
START Community Bank
Social Security
Administration
Cornell Scott Hill Health
Center (local community
health center)

58. WORKFARE trains people facing homelessness for careers in the custodial
trades and the food service industry so they can obtain stable full time
employment.
Learn how to write a résumé and cover letter, attend interviews, develop a
personalized Action Plan, and gain basic computer and job-search tools.
Free Hands-On training at Columbus House facilities, where you work
alongside talented professional staff and volunteers.
Great for Ticket to Work program participants!
Columbus House
WORKFARE
Want a Job?
We Can Help!

59. WorkFare Benefits
 Certificates: Receive a Certificate valued by employers to show you have
successfully completed the training.
 Job Search: Meet with job search counselors, learn how to fill out
applications, go to interviews, use email, and find jobs on the internet and
through commercial publications.
 Graduate Support: Graduates may attend additional sessions for regular
ongoing job advice, employment search assistance, and help with a variety of
other social service resources.
 Also includes a guaranteed and extended shelter bed stay for Emergency
Shelter occupants

60. Employment Network (EN)
Employment Network designation
 Generates revenue to support and sustain PTI
 Direct connection to the SSA = Streamlined communication
Ticket to Work program
 In house, collaborative resources for SSA Beneficiaries
Access to Employment & Enrichment Center, Jobs Club, Employment Specialist
Services

61. PTI Program Results: Looking Back
SOAR
77 applications approved over 3.5
years
Over $1.5 Million in cumulative
income
EMPLOYMENT
104 Individuals Hired and Retained
3.5 years
Over $3.5 Million in Earned Income
EEC Results:
Last 12 months
• 89 Attended Initial Orientation
• 63 Completed the Program
• 31 Employment Placements
• Average Wage: $10.25
• 67 Referred to External Programs: GED
prep, occupational training, local
community college enrollment
Over 3.5 years
Housed: 205 Individuals
Rep Payee: 53 Enrolled

62. Supportive Services for Veteran
Families (SSVF)
Employment Services
SOAR Services
Housing Services
Case Management
Homelessness Prevention
Direct Financial Assistance
Homeless Veterans
Reintegration
Program (HVRP)
 Employment
Services
 Employment &
Enrichment Center
Additional Columbus House Programs

63. The Benefits of Working and Providing
Support
CARL REYNOLDS, EMPLOYMENT SERVICES COORDINATOR
COLUMBUS HOUSE INC./PATHWAYS TO INDEPENDENCE
NEW HAVEN, CT

64. Providing Support
Peer Experience
Employment Spectrum
Job Developing
Employment and Training
EEC Trainings

65. Contact Information
Columbus House, Inc./Pathways to Independence
592 Ella T Grasso Blvd
New Haven, CT 06519
Fax 203-772-4097
Thomas Fortuna, Pathways to Independence Manager
203-772-4200 ext. 2139
tfortuna@columbushouse.org
&
Carl Reynolds, Pathways to Independence Employment Services Coordinator
(203)772-4200 ext. 2117
creynolds@columbushouse.org

66. Questions and Answers
Facilitated By:
SAMHSA SOAR Technical Assistance Center
Policy Research Associates, Inc.
Please type your question into the Q&A panel located underneath
the participant tab, or
To ask a question by phone, please raise your hand by clicking the
hand icon in the participant pod. We will unmute you so you can ask
your question.

67. For More Information on SOAR
http://soarworks.prainc.com
SAMHSA SOAR TA Center
345 Delaware Avenue
Delmar, New York 12054
(518) 439 – 7415
soar@prainc.com
www.facebook.com/soarworks
@SOARWorks