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Ways to Work Demonstration Programs. New York Work Exchange Coalition of Voluntary Mental Health Agencies. December, 2002. Colleen Gillespie, PhD NYU Wagner Center for Health and Public Service Research Evaluator. Background. - PowerPoint PPT Presentation
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Ways to Work Demonstration
Programs
New York Work ExchangeCoalition of Voluntary Mental Health Agencies
December, 2002
Colleen Gillespie, PhDNYU Wagner
Center for Health and Public Service Research
Evaluator
Background
The New York Work Exchange, a project of the Coalition of Voluntary Mental Health Agencies, funded five Ways to Work Demonstration Programs beginning in January, 2002.
The Ways to Work initiative was launched to promote the creation of effective new service delivery methods targeted at increasing the integration and coordination of employment and clinical services.
The overarching goal of Ways to Work is to increase the number of people with psychiatric disabilities who get and retain competitive employment.
Principles of the Ways to Work Demonstration Project include: Consumers of mental health services can work. Work and the role of work are important parts of the recovery process. Integrating employment and clinical services improves consumers’ employment
outcomes. Those agencies that were selected for funding each proposed innovative and effective means
of enhancing services by integrating employment services into their array of existing Continuing Day Treatment and/or Clinic programs.
The following five agencies were selected through the RFP process to develop and implement Ways to Work programs:
Brooklyn Bureau of Community Services Jewish Board of Family and Children’s Services Riverdale Mental Health Association Postgraduate Center for Mental Health Transitional Services for New York, Inc.
The two major goals of the evaluation are: to document the effectiveness of integrating employment services with clinical
services among these pilot projects and to use these agencies’ experiences to show mental health service providers
throughout the country how they can most effectively promote competitive employment within clinical settings.
These objectives stem from the nature of these projects as demonstration projects – the emphasis is on qualitative description and documentation of process, rather than on the quantitative impact of the programs, given that the effectiveness of employment services has been well established.
Evaluation activities will focus on three major components of the projects: How do agencies design the programs and introduce a focus on competitive
employment to their continuing day treatment programs and clinics? How do agencies implement these new programs, overcome any barriers
that may arise, and sustain the programs over time? What is the impact of the programs on consumers, clinicians, and
agencies? What changes are associated with the Ways to Work programs? The following represents some preliminary information on the Ways to Work
programs, who they serve, how many consumers have participated to date, reasons why consumers signed up, and how satisfied consumers are when they first start out in their Ways to Work programs.
Evaluation of the Ways to Work Demonstration Projects
Agencies with Ways to Work Programs
Agency Name Location Description Size
Transitional Services for New York, Inc. (TSI)
Queens Provides a continuum of rehabilitative services to enrich the lives of the mentally ill and facilitate their transition to increased levels of independence.
2,000
Served/Yr
Riverdale Mental Health Association (RMHA)
Bronx Offers child, adolescent, and adult services, continuing day treatment for post-hospitalized and seriously mentally ill persons, a substance abuse treatment program, supported employment and welfare-to-work programs, mental health consultation and educational programs, a 15-bed supervised community residence, and a supported apartment program.
1,600
Served/Yr
Jewish Board of Family and Children’s Services (JBFCS)
Central Offices:
Manhattan
Services:
All of NYC
Operates a diverse network of more than 160 community-based programs serving the adult mentally ill, emotionally disturbed children and adolescents, victims of domestic violence, the homeless, children at risk of abuse and neglect, people with AIDS, substance abusers, Soviet émigrés, the developmentally disabled, and people suffering from trauma and bereavement.
55,000
Served/Yr
Postgraduate Center for Mental Health
(PCMH)
Manhattan Offers individuals with mental illness a full continuum of care, including outpatient clinic programs, continuing day treatment, intensive psychiatric rehabilitation, a full complement of employment services, a large residential services division, and a division for services to persons living with or affected by AIDS.
4,000
Served/Yr
Brooklyn Bureau of Community Services (BBC)
Brooklyn Serves Brooklyn residents with the greatest needs, including adults and adolescents with serious mental illness, adults with physical and developmental disabilities, parents at risk of losing their children to foster care, and children in need of academic support.
15,000
Served/Yr
The agencies vary significantly in terms of size, mission, target populations served, experience with employment services and location.
CDTPs Associated with Ways to Work Programs
Agency
CDT
Program
# Participants
Age Ethnicity
/Race
Gender
TSI Jamaica Consultation
Center 100+ groups
TSI has strong vocational focus
98 90% < 55 yrs 52% African American
24% Latino/a
20% White
4 % Asian
32% Women
68% Men
RMHA Continuing Day Treatment Program
40% in RMHA housing
51 18 – 55 yrs 22% African American
16% Latino/a
55% White
8% Other
71% Women
29% Men
JBFCS Coney Island CSS
(4 CDTPs and clinics)
adult home residents
want to develop vocational expertise
400 26% 21 - 39 yrs
26% 40 - 49 yrs
37% 50 – 65 yrs
11% 65+ yrs
20% African American
15% Latino/a
50% White
15% Asian/Other
56% Women
44% Men
PCMH Westside CDTP
Westside Outpatient Mental
Health Clinic many homeless
CDT: 177
Clinic: 262
31% 18 – 39 yrs
42% 40 – 49 yrs
27% 50+ yrs
30% African American
18% Latino/a
50% White
2 % Asian
37% Women
63% Men
BBCS Project Moving On many young adults
95 95% < 55 yrs 76% African American
16% Latino/a
7% White
44% Women
56% Men
The Ways to Work programs are situated in Continuing Day Treatment Programs and Clinics that serve different populations.
Diagnoses of CDT Program Participants at Ways to Work Agencies
Most of the consumers participating in the Continuing Day Treatment Programs and Clinics at Ways to Work agencies have a psychiatric diagnosis of schizophrenia.
The proportions of diagnoses represented are very similar across the five Ways to Work agencies.
65% Schizophrenia
21% Schizoaffective
10% Bi-Polar
4% Major Depression
21% Schizoaffective
How the Ways to Work Programs Work
CDTP Participants
Determine Who Wants To Work
Consumer Choice(e.g., sign-up list)
Ways to Work Program
AssessmentJob Profile
Career Interests/Goals
Rapid Job SearchJob Development (Client Specific)
Individualized Job Placement
Job Support (Follow Along Supports)
Job CoachingPeer Support
Family Support
Integration with CDTP and Mental Health Treatment Services
Work Incorporated
Into All TX Goals/Plans
Integration of Work & Clinical Goals• Team Meetings/Case Conferences• Regular Communication
On-the-Job Assessment• Regular Communication• Management of
MedicationsSymptoms
Other SupportsPsychosocial ClubsFamily Education
HousingBenefits
Counseling
What is Competitive Employment*
The goal is to assist consumers in obtaining competitive and satisfying jobs in community
The work pays at least minimum wage
People are employed in a work setting that includes non-disabled co-workers
Service agency provides ongoing support
Intended for consumers with a desire to work
Includes people with the most severe disabilities
Eligibility for Supported Employment services is based on consumer choice
Consumer preferences are important
Supported employment is integrated with mental health treatment
Competitive employment is the goal
Job search process starts soon after a consumer expresses interest in working
Follow-along supports are continuous for employed consumers
*Evidence-Based Practices Project(SAMHSA, CMHS, Robert Wood Johnson Foundation, West Family Foundation
Johnson & Johnson Corporate Contributions & Community Relations)
Distinguishing Features of Each Ways to Work Program
Approach/
Philosophy
Staffing
($: What Does Ways to Work Finance?)
Employment
Innovations
TSI/
JCC
Ways to Work tracks added on after CDTPInvolvement of both CDTP & Vocational staff
Job Developer and Supported Employment SpecialistSupervised by Dir of Voc’l Services and Clinical Dir$:Half-time each Job Developer + Employment Specialist
Seasonal positions
RMHA Job and Career Clubs incorporated into CDTPImportance of integrationOn-site and off-site job development
Employment Specialist performs all Ways to Work activities, with assistance from Job CoachReports to CDT Program Director and Director of Employment Services$: Full-Time Employment Specialist
Work try-outsDisclosure encouraged
JBFCS
CI CSS
Importance of belief in ability to workImportance of self-management in relation to work
Role of Peer Counselors in providing support, role modeling, and especially motivationFocus on educating clinicians about employment$: Job Developer and Peer Counselors/Job Coaches
Need to develop work experience (to help identify work interests and goals)
PCMH Directed job search with individualized supportProgram physically located in CDTP/Clinic
Employment Specialist performs all Ways to Work activities, with assistance from Job CoachReports to Employment Services Director$: Full-Time Employment Specialist
Role for affirmative businessesDisclosure discouraged
BBCS/
PMO
Importance of assessment (Workplace Center, Columbia Univ. School of Social Work)Employment programming co-located on-site with CDTP
Ways to Work Coordinator performs all activities while working closely with clinical staffReports to Director of CDTP and Director of Psychiatric Rehabilitation Services$: Coordinator with some Job Developer/Coach time
Community-based opportunitiesImportance of training/certification
Each agency’s approach to promoting employment within their clinical settings is based on agency philosophy, staffing and employment options.
# Ways to Work Participants Enrolled Monthly (Jan 2002 – Sept 2002)
7 7
10
23
15
9 10 11 10
0
5
10
15
20
25
Jan Feb Mar Apr May Jun Jul Aug Sep
102 Ways to Work Participants Enrolled in First 9 Months
…
Reasons Why Ways to Work Participants Signed Up
0%
10%
20%
30%
40%
50%
Not surprisingly, most consumer sign up for the Ways to Work program because they want to work – however, others cite
both more practical concerns ($) and more recovery-focused concerns (to get a better life, improve self-esteem).
Sociodemographic Characteristics of Ways to Work Participants
43%
57%
46%
39%
11%3%
36%
31%
29%
5%Gender Race/Ethnicity
Education
Male
Female
African American
White
Latino/a
Asian
HS Grad
Less Than HS
Some College
or Post HS
College Graduate
Initial Satisfaction with Ways to Work Employment Services
2.452.38
1.00
1.50
2.00
2.50
3.00
Help in Finding Job Help in Preparing for Job
Very Satisfied
Somewhat Satisfied
Not At All Satisfied
Overall, consumers are pretty satisfied with the services they receive early on as part of the Ways to Work program.
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