Ways to Work Demonstration Programs

1. Ways to WorkDemonstrationPrograms 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

2. 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.

3. Evaluation of the Ways to Work Demonstration Projects • 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.

4. Agencies with Ways to Work Programs The agencies vary significantly in terms of size, mission, target populations served, experience with employment services and location.

5. CDTPs Associated with Ways to Work Programs The Ways to Work programs are situated in Continuing Day Treatment Programs and Clinics that serve different populations.

6. Diagnoses of CDT Program Participants at Ways to Work Agencies 4% Major Depression 10% Bi-Polar 65% Schizophrenia 21% Schizoaffective • 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. 21% Schizoaffective

7. How the Ways to Work Programs Work Determine Who Wants To Work Consumer Choice (e.g., sign-up list) Other Supports Psychosocial Clubs Family Education Housing Benefits Counseling CDTP Participants Ways to Work Program Assessment Job Profile Career Interests/Goals Rapid Job Search Job Development (Client Specific) Individualized Job Placement Job Support (Follow Along Supports) Job Coaching Peer Support Family Support • On-the-Job Assessment • Regular Communication • Management of • Medications • Symptoms Work Incorporated Into All TX Goals/Plans • Integration of Work & Clinical Goals • Team Meetings/Case Conferences • Regular Communication Integration with CDTP and Mental Health Treatment Services

8. 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)

9. Distinguishing Features of Each Ways to Work Program Each agency’s approach to promoting employment within their clinical settings is based on agency philosophy, staffing and employment options.

10. # Ways to Work Participants Enrolled Monthly (Jan 2002 – Sept 2002) 102 Ways to Work Participants Enrolled in First 9 Months …

11. Reasons Why Ways to Work Participants Signed Up 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).

12. Sociodemographic Characteristics ofWays to Work Participants Asian Latino/a Female White Male African American Gender Race/Ethnicity College Graduate Less Than HS Some College or Post HS HS Grad Education

13. Initial Satisfaction with Ways to Work Employment Services 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.