Monday, July 14, 2014

Employment and Mental Illness: Investing in Programs that Work

By Dania Douglas, NAMI State Advocacy Manager

“My mental condition was horribly debilitating for many years. I had no reason to get out of bed in the morning….I had no direction and no purpose. Now, when my feet hit the floor, I get to go to work every day and practice my passion.” – Stephanie Joseph, CPA, Office Administrator NAMI, Montgomery County.

Ask 100 different people what work means to them, and you are likely to get 100 different responses. It can simply mean a source of income; it can provide a purpose; it can create order in life; it can be an opportunity for creativity and building something new; it can be a chance to help others.

People with mental illness work successfully in a range of professions: at artists, scientists, famers, engineers, lawyers, construction, workers, chefs. Look anywhere and you will find people with mental illness leading and innovating.

Yet, the reality in America is that many people with mental illness are either unemployed or underemployed. Bouts of illness, difficulty concentrating, trouble communicating with co-workers, medical appointments and absences from work can make getting and keeping a job difficult. Stigma and discrimination can also be great barriers to overcome.

NAMI just released a report, Road to Recovery: Employment and Mental Illness, which explores the current state of mental illness and employment in the United States. It examines the reasons for low unemployment rates among people with mental health conditions, and describes the most effective supported employment programs that have been developed to date. The report is also a call to action for policymakers and advocates. It includes policy recommendations and model legislation that leaders could use to make supported employment programs available to the people who need them.

Almost 80 percent of the nearly 7 million individuals served by the public mental health system in this country are unemployed. About 60 to 70 percent of these same people want to work and would work if they had appropriate support. The current employment support systems we have in place are simply not effective for most people with mental health conditions. It is time for a change.

The good news is that there are employment programs that have been studied, tested, and shown to help people with mental illness choose, get and keep a job.

Individual Placement and Support (IPS) Supported Employment is a system that focuses on rapid placement in competitive employment and in jobs that match an individual’s talents and interests. IPS has a strong evidence-base shown to significantly improve the opportunities for people with mental illness to find and keep employment.

Clubhouses are community centers open to anyone with a mental illness. Clubhouses offer a variety of employment services including transitional employment and independent employment programs. Both have been proven through research to help improve opportunities to find and keep employment.

Assertive Community Treatment (ACT) is a team-based system that provides intensive support services to people with serious mental illness in the community whenever and wherever they are needed 24/7. Every ACT team should include a vocational specialist. ACT has a proven track record of helping people find and keep employment.

When we invest in programs that work, we invest in real lives, in real people, in real success and real recovery.


Joe Patriot said...

I am 53, with 14 years developing, suffering with, and presently overcoming a diagnosis of Major Clinical Depression. After 5 years of downhill descent, my body and mind shut down and I was hospitalized. After 7.5 years of major effort to turn it around, I was fired from my job. I had become a major people-pleaser, had done all I could to overcome hateful people, etc. Nothing had worked, and going into a hospital was for me the final act of failure. I was convinced my life was over.

However in there I had a 'spark of hope' in a class on black and white thinking, and one item the person said triggered my belief I could recover. For 9 years now I have sought career recovery in conjunction with overcoming depression. I've driven all over CA and NV, literally thousands of miles for a 1/2 hr interview or 2-hour test. My intense desire to work and get out of the same circumstance year after year has driven me to attempted suicide once.

I've failed many interviews, but also had city jobs, electric utility jobs, IT management jobs (my core career) and have even worked at Pep Boys. None have worked out to date, and have included shutdowns, layoffs, unhealthy environments, and even firings (stupid mistakes on my part, one hired over my qualifications), troubles I have never experienced before. I mean, I worked at my first job ever for 15 years. My second job was 7.5 years.

I've encountered 'in your face' age discrimination 3 times, with looks, sarcasm, and actual words regarding how "young our team is", a VERY humiliating experience.

Still unemployed, and now with no income at all, I now have 5 months mental health volunteering, am a certified Peer Support Specialist, have a Business degree and well-developed career skills and work ethic. I have interviewed twice now for county mental health jobs, and got none yet.

I suffer the struggle to maintain hope and continued perseverance. I have no income and my savings are running out. Every day I have mild panic attacks, have to manage my thoughts that trigger anger, frustration, etc., all normal feelings to an extent when you fear homelessness for the first time in your life.

With so many groups getting special hiring treatment, sometimes I wish states / feds would create a program supporting the over-40 age group. If not over-40, then over-50. I know many older people are sadly killing themselves because they can't get a job, and based on my experience, I know some, perhaps many, are experiencing age discrimination. "Old" people are really looked down upon in this culture, and I believe it is a MAJOR issue.

I don't share these things in bitterness, but as harsh realities of this world. I honestly believe all my suffering has purpose, has brought me into the peer / mental health field so I can help others like me. I talk to many employed peers, and they share much the same understanding. I know I have the experience and skills to excel in peer support. I just need the opportunity.

I know other peers who have had similar interviewing trials, and that has been comforting. I'm not the only one struggling with the interview process.

I hope this will help others. The ups/downs are extremely difficult for some of us to handle. Depression, and all its symptoms, is a horrible affliction. I get confused, I don't know if I am on the right path at times, don't know what is going to happen to me, but I am doing something by volunteering at the clinic. I am doing the best I can to control my life.

My continued hope, my choice to keep believing regardless how I feel, is that someone will realize what an excellent employee I am, and see how my career experience, talents and skills, education, and MH experience can contribute in a major way to their organization, but especially to the consumer / client.

If you know of an organization seeking an intelligent, educated, ethical, people-oriented, genuinely caring person, please forward my email to them --

Francis Kittredge said...

We need legal protection under the ADA. We have some, but what protection we had was gutted by the SCOTUS several years ago. Today, if you have a mental illness and are working, you can be targeted for harassment and your illness can be used against you.

Anonymous said...

The article gives contradictory information. In one paragraph, the author states that reasons are being searched for low unemployment among the mentally ill. The next paragraph states that there is an 80% unemployment rate among the 70 million mentally ill people.

Canada Bear said...

I have very severe mental illness, and it was very hard for me to find a job that I am able to do and KEEP. I now have a job that I got through the Vocational Rehabilitation program, and I have had my job for about a year and a half now. I am so grateful for this program, bc now I do not live paycheck to paycheck, I no longer have to go to food pantries just to have food in my house, I am able to buy clothes for myself for the first time in YEARS, and I am able to go and do fun things w my friends such as see a movie from time to time. I am now saving up money to use as a down payment on a HOUSE that I am hoping to buy in the next few years. Without the Vocational Rehabilitation program, none of these things would even be remotely possible, so again, I am REALLY grateful for this program!

Susan Inman said...

This report is very valuable but it ignores the plight of the most vulnerable people with the most severe mental illnesses. As NIMH states, the largest factor in the ongoing disability of people with schizophrenia arises from the significant cognitive losses associated with the illness. I couldn't find any reference to these cognitive losses in this report. And there are no references to the the cognitive remediation programs which provide the greatest hope for these people.

One obstacle to progress is the lack of awareness of these well-researched problems within the mental health community. This report could have helped build awareness of this population's needs and could have, at least, discussed the value of supported volunteer programs.

It seems like this report focuses on needs of all other groups except the ones the NAMI was originally created to meet.

Finished At Fifty said...

One of the hardest things is trying to balance hope with reality.

I believe that there clearly is a moment when people over 50 who don't have jobs give up looking, accept their fate and find other ways to make life meaningful.

Anonymous said...

I am in full support of the clubhouse model and the ACT teams. They work well in communities with professionals to support them for the majority population. What is lacking are funds to support Deaf/Hard of Hearing and Deaf Blind individuals who suffer from higher unemployment, mental heatlh and addiction rates due to isolation, challenges in accessing health care and communication ~ being the biggest barrier all around. I would like to see an ACT team to be able to help in crisis situations and a REAL clubhouse model in our community for this population and Deaf Can Inc is the program to do it!

Anonymous said...

Most people who do well have family that employ them, take them under their wing and support them.

I have a few acquaintances who had to make it on their own they went into recycling, were able to succeed with their musical ability and one person I met sold bottles of water to commuters in on a heavy traveled road at the stop light.

Work is more than money it is socialization and for some a feeling of accomplishment. For some the medicine makes much fatigue and people don't get it. I found the Employment Commission in North Carolina very supportive and helped my buddy get part time work.

James Morgan said...

Many unemployed consumers are looking for their wanted find jobs opportunities but you just a limited number of people obtain the work opportunities that they prefer the almost all.