15 / 46
October 2016
Policy&Practice
15
and have limited social supports. There
are, however, a number of evidence-
based models and best practices that are
successful in helping this group succeed
in the workforce.
We must utilize evidence-based
practices to identify and address
behavioral health issues and assist
individuals with mental health
conditions to attain and retain
meaningful employment.
The first step to addressing these
employment barriers is identifica-
tion. Regardless of the “door” through
which a human service customer
enters, initial client assessment should
include screening for mental health
and substance use problems. There
are a number of screening tools that
nonclinical front-line human service
workers can use to identify individuals
who may be experiencing behavioral
health issues. A list of screening tools
and resources can be found on the
SAMHSA–HRSA Center for Integrated
Health Solutions website.
For a decade, New York City’s
Human Resources Administration
(HRA) has been using the WeCARE
model (Wellness, Comprehensive
Assessment, Rehabilitation, and
Employment) to assess and address
the needs of cash assistance recipients
with clinical barriers to employment.
The WeCARE model begins with a
biopsychosocial assessment,
11
and
provides comprehensive services,
including individualized service
plans, referrals, case management,
vocational rehabilitation, and job
development. The WeCARE model
has been successful in assisting many
participants in stabilizing their mental
health conditions and achieving
self-sufficiency through transition to
employment. More information about
WeCARE is available on HRA’s website
and the Office of Family Assistance’s
peer technical assistance website.
Even when their mental health needs
are being appropriately addressed,
traditional employment and vocational
rehabilitation services are inadequate
for some individuals with mental
health conditions, as they are typically
time-limited. Due to the chronic and
episodic nature of most mental health
conditions, individuals may require
ongoing or intermittent supports to
remain attached to the workforce.
12
Supported Employment (SE) is the
strongest evidence-based vocational
rehabilitation model for individuals
with mental health conditions. The
approach emphasizes helping these
individuals obtain competitive work
in the community and providing the
supports necessary to ensure their
success in the workplace. The principal
philosophy of SE is the belief that every
person with a mental health condition
is capable of competitive employ-
ment if the right kind of job and work
environment can be found. Therefore,
the main goal of SE is not to change
consumers, but to find a natural “fit”
between their strengths and experi-
ences and jobs in the community.
13
The SE model has been the most
extensively studied model of voca-
tional rehabilitation for people with
mental illness. It has been found to
produce better employment outcomes
than comparison programs, such as
transitional employment. Consumers
in SE programs are more successful
in obtaining competitive work,
working more hours, and earning
higher wages.
14
For those interested
in learning more about SE and how
to build and implement SE programs,
SAMHSA offers a free Supported
Employment Evidence-Based Practices
toolkit on its website.
A great example of a model SE
program is the Community Support
Program offered by the Family &
Children’s Center (FCC), a nonprofit
organization in Wisconsin. FCC’s
Community Support Program (CSP)
provides comprehensive mental health,
substance abuse, and case manage-
ment services to adults diagnosed with
See Jobseekers on page 39
■
Eligibility is based on consumer choice.
■
SE services are integrated with com-
prehensive mental health treatment.
■
Competitive employment is the goal.
■
Personalized benefits counseling is
important.
■
Job search starts soon after con-
sumers express interest in working.
■
Follow-along supports are continuous.
■
Consumer preferences are important.
Practice Principles
of Supported Employment
The SEmodel has been
themost extensively
studiedmodel of
vocational rehabilitation
for peoplewithmental
illness. It has been
found to produce better
employment outcomes
than comparison
programs, such as
transitional employment.