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Workforce Retention in Supported Employment: Promising Practices
Amy Gelb, MS, CAGS, CRC, CPRP- [email protected]
Rick Kugler, M.S., CPRP- [email protected]
The Institute for Community Inclusion-UMass Boston
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Questions…
Why talk about mental illness and work? What are the current vocational outcomes for this
group? What are the issues involved in maintaining (or
finding) employment? What are some possible strategies to increase
workforce tenure?
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Work and Mental Illness
• The majority of people with mental illness report the desire to work
• The employment rate is low• Unemployment is costly for everyone
– Living on $600 - $900 a month?– SSA distributes over $75 billion a year on disability benefits:
25% - 30% are beneficiaries with SMI
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Three Myths and a Fact Generally, stress from employment make it
more likely for someone to be hospitalized People who are unemployed have more time
to invest to control their symptoms People with SMI and a substance abuse
problem are likely to benefit from SE services
Clinical benefits for people with SMI who work are rare
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Research and SE
People with SMI may require more support and have difficulty with retention than people with chronic disease/disabilities (non- cognitive)*
Most of the current research is comparative in nature –one program vs. another
Over a decade of research demonstrates that 40% - 60% can obtain employment through SE interventions**
Hoekstra et al., 2004 & Lerner et al., 2004, ** Bond, 2004
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What Are the Reasons People Go to Work?
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What Are The Reasons People Stay At Work?
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Principles for Effective SE: Evidence - Based Principles
Consumer Choice Integration of vocational and clinical Competitive employment is the goal Rapid Job search Individualized job finding Follow-up supports are continuous Work Incentives Counseling
Principles based on work done by Becker, Bond, and Drake
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Employment Outcomes
SE studies (mainly IPS) lasting 18 to 24 months: People work 15-30 weeks -job tenure 15-20 weeks
SE participants followed up after 10 years* 1/3 of worked five or more years Average job tenure at <3 years
Retention Rates - Clubhouse – Working members averaged 300 days over 3 years** 10-year span - average tenure of working member <3
years(?)***
* Salyers, Becker, Drake, Torrey & Wyzik, 2004 ** Mckay, Johnsen & Stein, 2005 *** Dorio, 2004
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Turnover for Other Populations
Convenience store workers - 130% Leisure/Hospitality - 45% * National Average - 40% ** Low Wage Earners – 4 in 10 jobs
turnover quarterly***
*Employment Policy Foundation, 2005 **Tumulty - Gannett New Service, 2002 ***Lane-HHS, 1999
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What Interferes With Work: Problems
Reasons for turnover are not prevalent in the literature
Resignations and terminations are more common than career advancement & layoffs
The relationship of substance abuse and work yields inconsistent results*
* Drake, Becker & Bond, 2003
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What Interferes With Work: Problems
Studies also identify struggles with: psychiatric symptoms & hospitalizations physical illness involving interpersonal issues unattractive, low paying jobs the same problems that people without
mental illness confront
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Know the Job Seeker What skills does the job seeker
bring? What abilities do they have? What are their strengths? What can they do for an employer? What kind of work culture works
best for them?
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Know the Employer What do they do / make? What jobs do the typically hire for? What hiring needs do they have? What tasks are not getting done? What areas of business do they want to expand? Are tasks getting done by high paid employees that
someone else could do?
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Now... Look for a match between the businesses
needs and the skills and strengths of the job seeker and…
Identify how the employer will profit from hiring the job seeker.
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Potential Factors That Help Perpetuate Employment
Provision of ongoing support services (needs more study) One FACT study yielded better consistency than IPS*
People who hold on to their job report intrinsic rewards Job satisfaction through better matches Attachment to better paying, ‘benefited’ jobs and or
ones with potential Teach skills, “soft” skills, retention strategies, etc.**
* McFarlane et al., 2000
**Wallace & Tauber, 2004
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Recommendations Start: Use EBP principles Include: Good job matches, if the pay can’t
be great, the job should at least be “looking up a stairway” SSA Considerations- Make sure people know
what they will earn
Include: Integrative and Collaborative services-vocational, clinical and social
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Recommendations
Include: Provide community based-services, assertive outreach Help develop natural supports
Explore: Employment support staff need to encourage consumer participation in ongoing skills development
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Resources Articles on SE @ Dartmouth NH – Psych Research
Center (click publications; vocational) www.dartmouth.edu/~psychrc/ …or …visit www.naric.com/research/ for information
from research and training centers Find out more about Work Incentives @
www.socialsecurity.gov/work/ SAMHSA Workbook on SE
www.mentalhealth.samhsa.gov/media/ken/pdf/toolkits/employment/16.SE_workbook.pdf
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Acronyms
FACT= Family-aided assertive community treatment IPS= Individual Placement & Support Model SE= Supported Employment SMI= Serious mental illness SSI= Supplemental Security Income SSDI= Social Security Disability Insurance SSA= Social Security Administration
