Center Mental Health Consultant Orientation to Job Corps

Center Mental Health Consultant Orientation to Job Corps

Suzanne Martin, PsyD, Regional Mental Health Specialist Valerie Cherry, PhD, Lead Mental Health Specialist

Job Corps General Information

• America’s largest residential educational and career technical training program for economically challenged young adults aged 16-24

• In operation since 1964

• 124+ operational centers throughout the United States and Puerto Rico

• Serves over 60,000 students annually

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Job Corps National Snapshot

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National Leadership

National Office of Job Corps(Washington, D.C.)

National DirectorEdna Primrose

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Administration and Management

National Office• The National Office Health and Wellness staff

are responsible for developing and implementing the policies and procedures that guide the delivery of health care on center

• National Office Health and Wellness staff contacts include:– Edward Benton, Division Chief– Carol Abnathy, MSW, MPH, National Health and

Wellness Manager– Johnetta Davis, MPH, Program Analyst

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Administration and Management (continued)

Health Support Contractor• The health support contractor works with the

National Office, Regional Offices, and centers to:– Develop and enhance center health and wellness

services– Develop policy– Train center health staff– Develop resource materials– Collect and analyze program data– Pilot test new health initiatives– Manage Health Specialists– Provide technical assistance– Conduct center assessments

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Regional Offices

• Regional Offices award contracts and provide oversight, monitoring, and technical assistance

• Six Regional Offices, headed by a Regional Director (Boston, Philadelphia, Atlanta, Dallas, Chicago, San Francisco)

• Project Manager (PM)—the DOL representative and liaison who works closely with your center to ensure that you have the resources you need to do your job and that you are working successfully to meet the established program outcomes

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Regional Health Specialists

Each Region has the following Specialists:• Nurse Specialist• Medical Health Specialist• Mental Health Specialist• TEAP Health Specialist • Oral Health Specialist

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Regional Health Specialists:

• Provide technical assistance to center health and wellness staff– Answer questions– Clarify Job Corps policies

• Provide training to regional and center staff

• Provide up-to-date information that will assist center staff in meeting program requirements

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Regional Office Center Assessments

• Every 1 to 2 years, Health Specialists and Assessors visit each center as part of a Regional Office Center Assessment (ROCA) team

• Using the Program Assessment Guide (PAG), in conjunction with the Policy and Requirements Handbook (PRH), this team will conduct an overall assessment of your center’s health and wellness program

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Regional Office Center Assessments(continued)

• Assessments highlight the strengths of your program and provide feedback about areas that could be changed or improved

• Expect to have your health records, appointment books, and other records audited

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Center Health and Wellness Team

• All centers have the following staff as part of their health and wellness team:– Registered nurse (RN)– Staff nurse– Physician– Mental health consultant– TEAP specialist– Dentist and oral health staff– Disability coordinator

• Minimum health and wellness center staffing levels are determined by the center’s contracted student enrollment capacity

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Primary Objective of Job Corps Health and Wellness Program

• Improve each student’s employability by establishing and maintaining the student at his or her optimal health level

• Achieve this through provision and/or coordination of health care including case management of chronic illness, promotion of self management of health care, and through preventive health education to instill good wellness habits and prevent avoidable illness, injury, and death

• Mentor, model, and monitor good employability skills

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Wellness Philosophy

• Allows the roles of the health care practitioners to be redefined so they impact the student’s entire Job Corps experience, including the body, mind, heart, and spirit

• Health care practitioners interact with students not only when the student seeks health care due to illness, but also during times of good health

• Health staff may take on roles ofteacher, mentor, role model, or advisor

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Important Resources

• PRH—The Policy and Requirements Handbook contains the rules by which all centers operate; Chapter 6 (Sections 6.10-6.12) provides policy on ensuring students receive health and wellness services, support, and education that will enhance their employability and encourage and maintain a healthy lifestyle

• PAG—The Program Assessment Guide is a companion to the PRH and contains the parameters by which the quality of each center’s program is measured; it can also be used on an ongoing basis as a tool for determining program effectiveness

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Important Resources (continued)

• COPs/SOPs—Center Operating Procedures and/or Standard Operating Procedures for the health and wellness program; these procedures define how your program will operate on a day-to-day basis, describe staff roles and responsibilities, and provide guidance on center specific documentation, reporting, and communication protocols

• TAGs—Technical Assistance Guides are designed to aid center staff in meeting health and wellness program requirements; they are how-to guides that offer many suggestions but no additional program requirements

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Important Resources (continued)

• DRGs—Desk Reference Guides provide information and strategies to meet and exceed health-related Policy and Requirements Handbook (PRH) requirements, and contain all health and wellness program-related documents and forms. The DRGs will help new center health and wellness staff learn the foundations of their position, and experienced health and wellness staff will find the central location of forms and information useful.

DRGs are located on the Job Corps Community Website under the Health and Wellness Tab. Presently there are DRGs available for HWMs, center physicians, CMHCs, center dentists, and center disability coordinators.

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Health Directives

• PRH Change Notices—Contain new or revised policy with instructions to delete, replace, or add pages to the PRH

• Program Instructions—Provide one-time instructions with a designated expiration date and usually require center response (e.g., survey)

• Information Notices—Provide one-time announcements with information that is of interest to centers (e.g., data summaries, meeting or training announcement)

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Job Corps Health & Wellness Website

• Designed for Job Corps health and wellness staff—use it to connect with your peers, get the latest information on new initiatives and training events, learn about the health and wellness program, and link to related resources

• https://access.jobcorps.org

• To access this site, you will need to obtain a Citrix account from your center’s administration

• Log into Citrix, click on the Job Corps Community website, then click on Health and Wellness

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https://access.jobcorps.org/

Mental Health and Wellness Program Overview

• The Job Corps mental health and wellness program is conducted by licensed mental health professionals– Direct clinical services– Staff development– Consultation– Overall direction of the program with an

emphasis on employability

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• 5 hours/100 students/week is the minimum required level of mental health coverage

• Of the minimum required coverage per week, 50 percent must be used for a combination of the following activities: weekly consultation to staff, annual trainings, disability program support, or TEAP support

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• The general emphasis of the mental health and wellness program must be on– prevention – early detection – identification of mental health problems– helping students overcome barriers to

employability

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• The program utilizes an Employee Assistance Program (EAP) approach which includes:– short-term counseling with an employability focus– referral to center support groups – crisis intervention (such as emotional reaction to HIV

testing, rape, suicidal behavior, death, or other serious loss)

• It is important to note that short-term counseling is defined as six sessions or less for manageable conditions with periodic mental health checks as needed

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• Lastly, the mental health and wellness program is augmented by a center counseling component that focuses on students' individual needs and progress in personal and social development, basic education, and career technical training

– These counseling services are to be provided by career counselors, residential living staff, and other staff with the support and guidance of the CMHC

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Basic Mental Health Services

• Consultation with departments addressing center-wide issues such as staff morale, violence prevention, and promoting a positive center environment

• A written referral/feedback system documented in the student health record

• Steps/procedures for mental health emergencies and students who are a danger to self and others

• Collaboration with the center physician regarding students stabilized on psychotropic medications

Basic Mental Health Services

• Regular case conferences for information exchange (should include at a minimum counselors, TEAP specialist, and health and wellness manager, if possible)

• Provide referral for support services in the home community for students separating from Job Corps who have a mental health problem

CMHC Roles and Responsibilities

• The mental health and wellness program can be divided into two equally important functional areas: clinical services and staff development and consultation

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Clinical ServicesEmphasis on Employability

• Prevention– Center Wide Prevention Activities

• Early Intervention– Social Intake Form

• Assessment– Applicant Folder Review– Intakes– Direct Threat– Medical Separations

• Straight Medicals• MSWRs

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Clinical ServicesEmphasis on Employability

• Treatment– Short-term Counseling– Psycho Educational Groups– Psychotropic Medication– Crisis Intervention– HIV Management– Mental Health Chronic Care Management Plans– Referrals– Case Management

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Staff Development and Consultation

• Monthly organizational consultation to the center director

• Consultation to center departments

• Introduction to Center Life during CPP

• Staff development trainings

• Regular consulting meeting with TEAP specialist

• Participation on the Reasonable Accommodation Team

Wellness to Employability Model

• Helping students overcome obstacles to employability

• Weekly clinical staffing

• Obstacle – Discussion – Plan – Follow Up

• Clinical staffing members: CMHC, TEAP Specialist, Manager of Counseling, CSO, Counselors, Manager of Academics, and Manager of Residential Living

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Obstacles to Employability

• Behavior• Mental Health• Substance Abuse/Dependency• Psychiatric• Cognitive/Ability• Medical• Dental

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Obstacles to Employability

• Document in terms of obstacles of employability and strategies to help students overcome them and what staff should be involved

• Use the weekly clinical staff meeting to discuss – plan – follow-up; remember to document

• Become an expert on how to help students become employable

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Administrative Activities

Center/Standard Operating Procedures (COPs/SOPs)

• Specific procedures for operating the health and wellness center

• You must draft procedures for emergency psychiatric situations (e.g., suicide attempts, psychotic episodes, urgent referrals, danger to others)

• Include a process for 24-hour on-call services


Suicide Assessments/HospitalizationProcedures• CMHC should draft a COP/SOP for suicide

assessment, prevention, and debriefing as well as procedures for hospitalization

• In the event of a mental health emergency, students should be evaluated as soon as possible. If life threatening, 911 should be called

• Students who are a danger to self or others must be supervised continuously until the disposition of their case is resolved

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Health Care Guidelines (HCG)

• Treatment Guidelines• Symptomatic Management Guidelines

–HCGs related to mental health must be reviewed and approved by the CMHC each year


Child and Elder Abuse

• Know specific laws regarding child and elder abuse reporting

• Know ethical and legal criteria that apply in the State where your center is located

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Charting Procedures• Your assessment, treatment, and case management

notes must be legible and included in the student health record

• Intake notes should indicate reason for referral, presenting problem, history of presenting problem, mental status exam, diagnostic impression, and clear treatment plan

• Progress notes should indicate assessment, progress, and treatment plan (SOAP format)

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Conferences and Teleconferences

• Attend regional and national conferences to learn about the latest developments in policies and procedures as well as to communicate with other CMHCs regarding center mental health issues

• Participate in monthly teleconferences

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Medical Separations

• You may need to assess a student with a psychiatric disorder that clearly impairs his/her ability to complete or take part in the training program and recommend a medical separation

• Describe specific behaviors and symptoms that can be clearly related to the student’s inability to effectively participate in the Job Corps training program

• Medical separations are necessary so that students can receive the higher level of care they need

• Health and social service referrals are provided for all separating students

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Medical Separations (continued)

There are two types of medical separations:

• Medical separation with reinstatement (MSWR)—used when a student has a problem that can be resolved in less than six months with appropriate treatment

• Medical separation (also known as a straight separation)—requires the student to reapply to Job Corps after at least one year has elapsed; the application must be evaluated by the Regional Office

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Credentials

• You are responsible for maintaining your current license and liability insurance

• Copies of these documents must be on file in the health and wellness center

Special Programs

Open Retention Hours

• Keep 1 hour per week open for referrals for students who are at risk of failing to complete the program

Work Transition Groups

• Experiential and interactive groups can prepare students for the sometimes difficult transition between Job Corps and the working world

• Topics such as anger and anxiety management, coping with difficult employees and employers, drug and alcohol effects on employability, and conflict resolution

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Sexual Assault Response Team

• Each center is mandated to have a team of health care professionals, counselors, and other staff who can respond to a sexual assault

• The CMHC can be a part of this team and/or help draft and implement the sexual assault response policy on center

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Marketing Mental Health and Wellness on Center

• Include posters in the dorms, cafeteria, classrooms, and hallways advertising mental health and wellness services

• Include pamphlets and flyers in your office and in the health and wellness center waiting area

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Interaction with Community Contacts

• Department of Vocational Rehabilitation

• Extern/Intern Programs

• Community Educational Groups– Utilize community resources for anger, anxiety,

stress, and depression management

• Crisis Response Organizations

• Psychiatric Facilities

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Interaction with Community Contacts

Specialized Referrals

• Depending on the ethnic makeup of the center, specialized off-center referrals can provide more treatment for different ethnicities or lifestyles and at the same time support diversity

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Training Resources

• SafetyNet (located in SIMON on Citrix)

• Staff Development and Training Modules (located in Health and Wellness Website on Citrix)

Mental Health Specialists

• Region 1– David Kraft, MD, MPH– Maria Acevedo, PhD

• Region 2/Lead Mental Health Specialist– Valerie Cherry, PhD

• Region 3– Suzanne Martine, PsyD

• Regions 4 and 6– Andrew Berger, PhD– Vicki Boyd, PhD

• Region 5– Helena Mackenzie, PhD

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ROUND TABLE DISCUSSION

Questions and Comments

CMHC Orientation

Documents

Center Mental Health Consultant Orientation to Job Corps