Statewide Educational Advisory Board Report on Employment, Education and Training

Executive Summary

November 2002

In fall 2001 the New York State Office of Mental Health Division of Community Care Services engaged the New York Work Exchange (NYWE) of the Coalition of Voluntary Mental Health Agencies, Inc. to develop a portfolio of employment services educational curricula for use throughout New York State.

To accomplish this task, the NYWE convened a Statewide Educational Advisory Board (SWEAB), with members drawn from public and private universities, think tanks, consultants, consumer organizations, and selected state, city, and federal agencies. Throughout its work the SWEAB sought to meld evidence-based practices and a recovery perspective. As the project evolved, the SWEAB identified existing curricula founded on evidence-based practice, noted areas where significant gaps need priority attention, and recognized system and organizational actions that must be taken to improve employment outcomes. This Executive Summary highlights priority findings and recommendations. The full Report describes the SWEAB process and products in detail.

The SWEAB Report is built upon the fundamental principles that citizens with psychiatric disabilities have the same rights and responsibilities for self-determination and self-sufficiency as other citizens; that recovery from mental illness is possible and desirable; and that people with a psychiatric disability can be assisted in achieving their career-oriented employment goals through organizations that provide recovery-oriented evidence-based employment services. The report notes that it is incumbent upon leaders, policy-makers, funders, and service providers to inform people with psychiatric disabilities about evidence-based employment practices and, together with them to encourage and support hope and belief in recovery. The SWEAB concurs with the disability rights advocacy expression, "nothing about us without us." The SWEAB Report articulates a vision that all interested persons with psychiatric disabilities attain and keep chosen career-oriented employment, leaving and changing jobs according to their career goals.

The SWEAB recognizes the leadership, authority, and oversight roles of the New York State Office of Mental Health (OMH) and county governments in promoting evidence-based employment practices and facilitating requisite staff training. Many recommendations speak directly to these governmental bodies. Others call upon the cooperation of "external" constituencies including academic institutions, unions, employers and trade associations.

As its highest priority, the SWEAB unanimously recommends that the State immediately reallocate funds currently used for sheltered workshops in order to increase available best practices-based career-oriented employment services for individuals with psychiatric disabilities. The SWEAB also recommends that OMH supported employment follow-along funds be more flexible and available to assist any employed individual with a psychiatric disability in sustaining employment.

OMH and county funding and contracts should systematically promote accountability by setting specific employment outcomes and requiring evidence that previously determined employment outcomes have been met. Incentives and sanctions are recommended to assure compliance with required outcomes. Rigorous evaluation of employment services should include both subjective and objective evidence at individual and systems levels in order to assure that all relevant perspectives have been considered. Individual considerations include the impact of achievement of and ongoing employment on well-being and health, and the perceived relationship between recovery and employment. At the systems level, measures of consensus are suggested to identify the extent of systems change toward a recovery-focused employment mission.

To advance career-oriented employment, staff members need education and training in evidence-based practices and recovery using training modalities that are quickly transferable to practice. Among the most pressing staff training needs identified by the SWEAB are: fundamentals of career-oriented employment services; communications training for all stakeholders; diversity awareness training; and training in legal skills, finances, and entitlements. Individualized staff education and training action plans can help in workforce enhancement, retention, and career development. Providers should work in partnership with individuals with psychiatric disabilities, assuring that their viewpoints are utilized in developing, offering, and modifying education and training and programming. Employers, human resources staff and managers need training as well regarding recruitment, hiring, and retention of persons with a psychiatric disability. The SWEAB also noted that supervisors are often neglected as targeted recipients of training; they need training in effective communication, planning, management, coaching and mentoring. The SWEAB developed a comprehensive set of Employment Services Practitioner Competencies that can be used to identify staff standards and training needs. To ensure that academic preparation is consistent with progressive practice, the report additionally recommends that academic curricula and related certification and licensing examinations in healthcare-related fields include content on recovery, employment and rehabilitation, while affording students access to "real world" experiences of persons with psychiatric disabilities.

Program design and structure influence the quality and effectiveness of career-oriented employment services. Employment services programs should operate with an awareness of prevailing labor market conditions, economic opportunity and career growth. They should adhere to effective practices, including the integration of clinical and employment services, articulation of optimism and belief in recovery, and promotion of peer networking and support. Program operations should be flexible in concert with participants’ requests. Employment services programs should partner with other providers involved in meeting program participants’ basic and broader needs. To assist providers and programs in ongoing assessment and improvement of organizational culture, structure, and functioning, management consultation should be readily available to mental health organizations through funding earmarked for this purpose. A compendium of Organizational Change Factors developed by the SWEAB can help assess organizational status and readiness for change.

The SWEAB report presents a thorough compilation of existing and needed education and training curricula as well as systemic and organizational prerequisites to increase the availability and effectiveness of evidence-based employment services and improved employment outcomes. The SWEAB recommends the adoption and dissemination by OMH, providers, and consumer groups of a recovery-focused employment mission statement to guide the activities described in this Executive Summary. Some recommendations in the SWEAB report can be implemented rapidly, while others require further planning and additional interventions. We invite all stakeholders to review the full report and appendices and to work together towards implementation.