1. Employment as Part of Recovery Johnson & Johnson-Dartmouth Family Advocacy Project for Supported Employment Networking Session NAMI National Convention June 29, 2012 Discussants: NAMI-IPS Team Members Michael J. Cohen, Sandy Reese, Dartmouth Psychiatric Research Center

2. Family Advocacy Team Progress 13 family teams coordinated by NAMI state affiliates, On average 70 active, trained, NAMI members and volunteers in any one quarter deliver IPS education, awareness and advocacy activities In the last quarter of 2011, over 1200 people participated in team events Since 2008 over 3800 people participated in an educational program or heard a family testimonial on the meaning and benefits of IPS.

3. Family Advocacy Team Initiative - Dartmouth Psychiatric Research Center (PRC) and Johnson & Johnson Corporate Contributions partner with selected NAMI state -Family Teams work with DMH/VR to improve family understanding of IPS supported employment and promote collaboration with Centers -Families help to advocate for IPS programs, policies and financing to improve access and implementation of high quality IPS throughout the Mental Health and VR Service Systems.

4. Associated Benefits of Competitive Employment for Persons with Mental Illness* Increased income Improved self esteem Increased quality of life Reduced symptoms Being employed significantly reduces the possibility of violence even further (Elbogen &Johnson, 2009) *Rogers, J.A. (1995). Work is key to recovery. Psychosocial Rehabilitation Journal,, 18(4),5-10. Working is transformative: Sources: Arns, 1993, 1995; Bond, 2001; Fabian, 1989, 1992; Museser, 1997; Van Dongen, 1996, 1998

5. Is Work Too Stressful? As compared to what? “If you think work is stressful, try unemployment”* *Marone & Golowka, Psychiatric Rehabilitation Journal, 1999

6. The Evidence: Supported Employment Works in Programs with High Fidelity* In 14 of 14 studies (randomized controlled trials), supported employment had significantly better competitive employment outcomes than usual care (61% vs. 24%). 2/3 with competitive jobs work 20 hrs or more/week. Time from 1 st contact to get a job was 10 weeks less than the usual care groups. Average time working in a year was 25 weeks. *Updated from Bond, Drake, Becker – Psychiatric Rehab Journal, 2008

7. NAMI CT, VT and IL Teams- Ready to Go!

8. NAMI OR, MO, OH, SC Teams- Ready to Go!

9. NAMI KY, MD and DC Teams- Ready to Go!

10. NAMI KS, MN, WI Teams Ready to Go!

11. Eight Principles of IPS Every individual who wants employment is eligible Services are integrated with treatment through a team approach Competitive employment is the goal Personalized benefits counseling is provided

12. Eight Principles of IPS Job search starts soon after a person expresses interest in working Employment specialists build relationships with employers based upon client job interests Follow-along supports are continuous Individual preferences are important

13. Dartmouth PRC13 Recovery & IPS- Supported Employment Holistic Peer Support Non- Linear Strength- Based Responsibility Empowerment Person Centered Self-Direction Hope Respect Work fulfills a human need along with health, relationships, housing and spirituality Work fosters hope and motivation for a better future People actively participate in goal setting, job finding and maintaining work Treatment and services are based on each individual’s goals People make decisions about job type and setting People have the right to choose their supports and participate in work decisions Job and school transitions are supported as part of career development Services align with strengths, talents, skills and preferences Peers share personal stories about work, school and recovery to benefit others Competitive employment builds confidence and self- respect

14. Supported Education and Employment Early Treatment Program RAISE Research Project Recovery After Initial Schizophrenia Episode 19 Sites in 19 States More education is correlated with better employment and better pay Many people with FEP are motivated to continue their education Education and employment offer hope and new opportunities for growth and careers

15. Family Teams Follow the NAMI Model Awareness: to demonstrate that Supported Employment is an effective service to promote recovery from mental illness Education and Training: to expand knowledge and skills of families to assure opportunities for Supported Employment in their state and communities and mental health centers Advocacy & Action for Policy: to improve access to high quality Supported Employment – IPS -services for persons with mental illness

16. Family Employment Team Activities Presentations at local mental health agencies to share family interest in IPS, break down communication barriers and improve trust. Work with DMH/VR staff to improve quality of IPS Supported Employment. Educate families to increase involvement in employment activities to improve care coordination and help loved ones attain employment goals. Educate community about the family interest in work and its benefits to recovery.

17. Family Teams Have Done their Work Short talks in the community about the meaning of work Make sure families have good information about benefits, jobs available and supports to help. Articles about work and recovery in your local newspapers/NAMI newsletters

18. Families and Consumers Share Stories with Members of the Mental Health Caucus

19. NAMI MN State Team-Presenting to Legislature

20. NAMI IL Develops Site Map for IPS

21. Benefits to NAMI State Organizations Belonging to a National Learning Community facilitated by Dartmouth PRC has given an “ascribed status” to the NAMI organizations New, knowledgeable members joined thru a common advocacy issue Potential new leadership pool New roles for family members in the CMHC and VR systems More effective family voice in your community

22. Benefits to NAMI Advocacy Agenda Advocacy issues: – IPS as part of the states’ essential Medicaid and Medicaid Managed Care benefits package – IPS into the new Health Exchanges. Common advocacy issues/agenda with the state mental health authority and VR A vehicle for NAMIs to promote public, community, employer awareness of mental illness like any other illness and greater acceptance of individuals with mental illness Increased placements in local businesses of persons with mental illness, reduces stigma New friends in the legislature

23. Summary Employment is a vehicle for recovery. Work outcomes improve over time with focus on IPS program fidelity. Families have a role to help promote recovery by advocating for high fidelity IPS supported employment. NAMI Family Advocacy Teams are trained, motivated and capable to educate and advocate, making systems change NAMI organizations are strengthen by their participation in the Dartmouth-J&J Project

24. Dartmouth IPS Supported Employment Center Working has helped further my recovery more than any other single thing I have done – more than therapy, case management or medication alone. My job helps me stay focused on something other than illness. My co-workers, especially, have helped me improve the way I see myself. Extra money is great, too! Nicole ========================================================== The Dartmouth IPS Supported Employment Center is a component of the Dartmouth Psychiatric Research Center, Lebanon, NH ==========================================================Dartmouth Psychiatric Research Center Home Site Map IPS Supp. Employment Our Center ASK about IPS J & J-Dartmouth Program Families & Supp. Employment Justice Involvement Fidelity Dartmouth PRC ● Rivermill Commercial CtrFidelity Resources85 Mechanic St. ● Suite B4-1Resources Online Training in IPS SE Lebanon, NH 03766 603.448.0263Online Training in IPS SE IPS in the News http://www.dartmouth.edu/~ips/IPS in the News Job Openings Vocational Rehabilitation To Order Materials Free Newsletter

25. Contact Information http://www.dartmouth.edu/~ips Michael J. Cohen, MA,CAGS 603-496-1657; mjchealthsolutions@comcast.net Sandy Reese, BA, Trainer 603-448-0263; Sandra.Langfitt.Reese@dartmouth.edu Deborah R. Becker, M.Ed., CRC 603-448-0263; deborah.r.becker@dartmouth.edu