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Vocational Service. Birmingham Early Intervention Service. Why Set up a Vocational Service?. Employment and education promotes social inclusion (Social Exclusion Unit, 2004)
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Vocational Service Birmingham Early Intervention Service
Why Set up a Vocational Service? • Employment and education promotes social inclusion (Social Exclusion Unit, 2004) • Important in maintaining mental health and social functioning in people with severe mental health problems (Royal College of Psychiatrists) • Majority of young people with mental health problems want to work/enter education (Scottish Executive, 2003)
Why Set up a Vocational Service? • Some people recovering from severe mental health problems obtain vocational/educational roles within mainstream settings (Bond et al., 2001) • Social and governmental policies (SEU, 2004) have supported the importance of employment for young people with severe mental health problems • Governmental policies have ensured lack of equality and lack of discrimination in the labour market (Discrimination Disability Act, 2005).
Why Set Up a Vocational Service? • Developments in the UK (DoH, 2000) have resulted in development of Nationwide Early Intervention Services to provide intensive psychiatric care to young people experiencing severe and enduring mental health problems • Despite these developments over 70-80% of young people have disengaged from vocational/educational roles upon contact with mental health services (including early intervention and community mental health teams)
Traditional Services • Mental health services have attempted to help service users to engage with educational and vocational roles in addition to managing mental health • This approach not successful due to: • lack of vocational expertise • poor communication between services • vocational services not equipped to manage mental health needs • lack of time to provide ongoing support
Integrated Services • Two studies in London demonstrated that mental health services which employed a vocational worker produced improved vocational outcomes (Rinaldi & Perkins, 2007) • St Georges EIS: Services users not in employment or education (NEET) dropped from 65% to 7% after 12-months • Two CMHT’s: NEET levels dropped from 70% to 37% at 12-month follow up
Birmingham Vocational Service • Resource Manager • 4 Vocational Outreach Workers • Connexions Worker • These staff work alongside mental health staff to improve vocational outcomes of service users
Service Provides • Assessments • Social Support • Short Courses • Preparation (e.g., CV’s; Application Forms) • Links with mainstream educational organisations • Support with college applications • Links with mainstream vocational organisations (e.g., Job Centres; Connexions, Work Directions, Employment Agencies • Ongoing support (transport; advocacy)
Social Support • Social activities in the community • Individual support sessions with residual symptoms including anxiety; paranoia; negative symptoms • Individual support includes bus runs, visits to cafes, cinema, local communities • Working alongside clinical psychologists • Formulate a plan to increase social engagement • Establish rapport and develop trust and develop goals with service users • Social activities in groups including pool, gym, football
Assessments • Daily routine/activity levels • Functioning • These assessments are aided by information from mental health staff • If poor provide individual/group support along with clinical psychologist and care-coordinator • Educational/Vocational Assessment • Educational history (qualifications) • Employment and training history • Vocational/educational aims
Following Assessment • Development of vocational pathway • Referral to support services within vocational service • Job Club • 1: 1 Support • OR • Referral to mainstream services • Connexions; Work Directions • Training Providers (e.g., Learn Direct) • Colleges
Job Club • Basic Skills Training • Support and Guidance with CV’s • Completing application forms • Interview preparation • Accessing work data bases • Access to Learn Direct which is a mainstream organisation that provides Literacy and numeracy courses
Other Activities • Advice to service users and employers on Disability Discrimination Act • Advice to employers and training providers on mental health • Guidance and advice to employers on needs of individual service users • Advocacy and support to service users once employment is taking up
Music Courses • Provide 1:1 music courses • 2007: Developed 12-week music course with Birmingham University • Aim to familiarise service users with mainstream college/university setting • Provide a qualification that can lead onto a diploma/degree level qualification
Media Courses • Jump LTD-Professional Media Company • Service users enrolled on a media course • Received training on web design, filming, editing, interview skills and storyboarding • At end of course service users conceived, developed, filmed, edited a series of short films on mental health and early intervention • Course increased confidence and led to further training and education
Audit of Service • 92 Service Users referred to service between January 2006-January 2007 • Males = 75; Females = 17 • In employment: 13% • In education/training: 27% • Currently seeking employment following support: 15% • Deemed not ready and needing further support: 23% • Discharged from vocational service: 22% (e.g., due to relapses; non engagement due to symptoms)
Attendance at Different Activities • Job Club: 63% • Completed CV’s: 50% • One to one Support: 25% • Music Group: 10% • Gym Group: 9% • Social Group: 30% • Fork Lifting Course: 2% • Mechanics Course: 3%
Type of Work • Clerical: 35% • Construction: 16% • Retail: 22% • Security: 16% • Factory Work: 8% • Skilled:3%
Hours Worked • 16-36 Hours: 27% • 12-15 Hours: 47% • 9-11 Hours: 26% • Paid? • 72 % Paid Employment • 28% Unpaid Employment
Conclusion • Still low employment rates • Not all full time employment • Lowly paid jobs • BUT • Currently not a fully integrated service • Vocational workers not placed within individual teams • Currently a randomised trial (ENRICH) taking place in Birmingham investigating this issue based on Renaldi & Perkins (2007) model