When Mental Health Issues Hinder Employment, There’s Help

/ August 16, 2016

By Janet Shouse

Katie Lee is the Director of Wellness and Employment at the Tennessee Department of Mental Health and Substance Abuse Services, overseeing the Peer Wellness Initiative and the IPS Supported Employment Initiative.  Katie previously served as the Statewide IPS Trainer at Park Center in Nashville, and she served as the program manager of the My Health, My Choice, My Life health and wellness initiative at the Tennessee Department of Mental Health and Substance Abuse Services, funded through the federal Substance Abuse and Mental Health Services Administration. She also has worked at Centerstone as a case manager and therapist.

While I write weekly about disability and employment issues (or I persuade other knowledgeable folks to write for me), I seldom focus on issues regarding mental health and/or substance abuse. Yet, people with mental health concerns or substance abuse issues often experience many barriers to employment, and they often need support to find and keep the right job for them.

There’s a wonderful program with a name I can never remember that provides such support, and Katie Lee, the director of Wellness and Employment at the Tennessee Department of Mental Health and Substance Abuse Services, has been gracious enough to answer my questions about this relatively new program.

Tennessee now offers the Individual Placement and Support Program, which is a model of supported employment that has been the most successful of such programs in helping people with behavioral health disorders obtain competitive, integrated employment.

The IPS initiative is a partnership between the Tennessee Department of Mental Health and Substance Abuse Services and Vocational Rehabilitation. The program began several years ago with four sites. This past year, the IPS program expanded to include two community mental health agencies in West Tennessee, bringing the total number of participating agencies statewide to nine.   With federal monies, the state was able to expand services for transition-age youth and young adults, and homeless veterans and individuals who are chronically homeless and who also have mental illness, substance abuse disorders, or co-occurring disorders.

IPS is evidence-based, which is wonderful and somewhat unusual. Research, found at www.ipsworks.org, shows that IPS is three times more effective than other vocational approaches in helping people with mental illness to work competitively.

In Tennessee, during fiscal year 2016, the IPS program served 474 individuals, and 229 have been employed and receive a competitive wage.

So how does someone qualify for this program? The only qualification to be eligible for IPS services is to be an individual with mental illness, substance abuse disorders, or co-occurring disorders and who wants to work. Beyond that, there aren’t any eligibility guidelines, and clients do not pay for this service. Currently, 11 community mental health agencies across the state have IPS teams. Each “employment specialist” on the IPS team can carry a caseload of 20 individuals, so there may be a waiting list at some agencies, or a person may live in an area where IPS services are not available.

How does someone apply? Individuals are referred to IPS services through the community mental health agencies. Participating agencies are:

Frontier Health/Victory Center (Northeast Tennessee) Phone: 423-975-6000

Peninsula (East Tennessee) Phone: 865-374-7134

Helen Ross McNabb (Knox County) Phone: 865-544-3841

Ridgeview (East Tennessee) Phone: 865-481-6170

AIM Center (Hamilton County) Phone: 423-702-8015

Park Center (Davidson County) Phone: 615-650-2900

Pathways (West Tennessee) Phone: 731-541-4545

Lowenstein House (Shelby County) Phone: 901-274-5486

So, how is the program funded? It’s funded through both state mental health dollars and through Vocational Rehabilitation funding. Federal mental health dollars are funding IPS programs for the transition-age youth and young adults at agencies in Chattanooga and northwest Tennessee and the expansion of services to homeless veterans and individuals who are chronically homeless and who also have mental illness, substance abuse disorders, or co-occurring disorders.

What are the benefits of IPS? For most people with mental illness, employment is part of their recovery. IPS is cost-effective, improves long-term well-being, and has a high rate of successful implementation and sustainability over time. So, it’s a win-win-win situation.

Katie shared a couple of success stories with me.

Ben (not his real name) began receiving employment services through an IPS program at a community mental health agency in East Tennessee more than a year ago.  When Ben began working with his employment specialist, he had a history of substance use, anger issues, and was unable to keep a job.  Ben and his employment specialist worked together to find a job for Ben in a local factory.  More than a year later, Ben is still employed at the factory, and his supervisor says he is a valued and well-liked member of the team.  Ben states he has never had a job with the permanency he is now experiencing.

Hayden, who was referred to the IPS program by his case manager, had difficulties with employment because he was repeatedly hospitalized due to his mental illness. He also had little work history and no transportation. Hayden was living with family members but wanted to have a job to feel better about himself and to be like everyone else. Hayden wanted a job where he didn’t sit all the time, and he enjoys being around other people. With the help of an employment specialist, Hayden first found a position at a local retail store. This job, however, didn’t work out due to early hours and transportation issues. So then Hayden and his employment specialist immediately began searching for another job and found a local grocery store that was willing to accommodate certain hours so he could ride the bus to and from work most days. This meant his family no longer had to find a way to get Hayden to work. He has excelled in his time working at the store. He has benefited from the integrated care IPS provides. When Hayden has an issue at work, his employment specialist is able to connect with his case manager and medication provider.  This has helped keep Hayden from being absent at work and helped the employment specialist to keep the employer informed when there is a problem to address. Hayden has been working for 15 months with no hospitalizations during that time. This is a major accomplishment for Hayden.

Additional information about Tennessee’s IPS program can be found at www.tn.gov/behavioral-health/article/supported-employment1.

If you know someone with mental health issues or substance abuse issues and who has had difficulty finding and keeping a job, please share this information. This is important work.

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