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Supported Education and Supported Employment for College Students with Mental Health Challenges Abraham Rudnick 1 *, Marnie Wedlake 1,2, Wendy Lau 3, Bob.

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Presentation on theme: "Supported Education and Supported Employment for College Students with Mental Health Challenges Abraham Rudnick 1 *, Marnie Wedlake 1,2, Wendy Lau 3, Bob."— Presentation transcript:

1 Supported Education and Supported Employment for College Students with Mental Health Challenges Abraham Rudnick 1 *, Marnie Wedlake 1,2, Wendy Lau 3, Bob McEwan 4, & Erica Lundberg 1,4 1. University of Western Ontario, 2. Canadian Mental Health Association, 3. Leads Employment Services, 4. Fanshawe College. * Email:

2 Background Many people with a serious mental illness (SMI) are commonly unemployed or underemployed (Mueser, Salyers & Mueser, 2001). People with SMI experience barriers to employment, such as stigma and cognitive deficits (Mueser et al, 2001)

3 Background Approximately 5-12% of the college student population report psychiatric symptoms (Megivern et al, 2003). Persons with mental health challenges have lower educational levels & experience more disruptions in education (eg. Kessler, Foster, Saunders & Stang,1995). Hence people with SMI have a low chance of gainful (trained/skilled) employment without special support.

4 Background Supported employment is successful in securing gainful employment for people with mental illnesses (e.g. Cook, Leff, Blyer et al., 2005; Best, Still & Cameron, 2008; Gutman, 2008). However, Supported Employment does not usually target skilled work. There is a lack of connection between supported education and supported employment, although this combination may enhance gainful/skilled employment for people with SMI.

5 Background Emerging evidence (e.g. Rudnick & Gover, 2009) indicates that combined supported education and supported employment services are beneficial to persons with SMI, by enhancing education and gainful/skilled employment success and personal wellbeing.

6 Fostering Recovery Project Collaboration between Fanshawe College, Leads Employment Services, and the University of Western Ontario Goal was to facilitate successful college education and employment of students with mental health issues via combining supported education and supported employment. Funded by Ontarios Ministry of Community & Social Services-Ontario Disability Support Program, Innovation Funds

7 Fostering Recovery Project Fanshawe College Over 14, 000 students; approximately 1,600 with disabilities Offers over 100 programs leading to certificates, diplomas, and degrees. Provides counselling and a variety of student supports

8 Fostering Recovery Project Leads Employment Services Employment assistance for persons with barriers to employment due to physical health, mental health, developmental or learning disabilities. Provide job preparation, job and skills development, transitional employment, job coaching, and job retention supports

9 Fostering Recovery Project 37 students were enrolled in the project in 2008-2009 school year. Students saw both a college counselor and an employment specialist (at the college) on a regular or as needed basis. College counselors and employment specialists communicated with each other as needed. The 37 students in the project: went to 60 interviews were placed in 29 positions (paid and non-paid) those in paid positions earned $8.75-$18.17/hr (average $10.89/hr) 19/29 placements were maintained 13+ weeks.

10 Research Objective & Question To explore what is the lived experience of key involved stakeholders in relation to this project – of students, their significant others, and their college counselors and employment specialists.

11 Method Funding for evaluation was received by CAREMH. HSREB and CRIC approvals, as well as written voluntary informed consent, were obtained. Participants: 6 students 4 females, 2 males; 19-46 years Bipolar disorder (2), Schizoaffective disorder (2), major depression (2), generalized anxiety disorder (3), panic disorder (4), Obsessive compulsive disorder (3) enrolled in: culinary, interior decorating, tourism, computer programming, and social service worker 5 significant others of these students parents, spouses, children 2 College Counselors, 2 Employment Specialists.

12 Method A primarily phenomenological methodology with first person and shadowed data collection, by means of semi-structured interviews. Student interviews: at the outset of the project (diagnostic assessments and qualitative interviews) mid-year end-of-year Shadowed data from students significant others and project counselors interviews: mid-year end-of year

13 Analysis Thematic analysis was conducted on the transcribed and validated interview data. Peer debriefing and triangulation across interviewee groups – for trustworthiness.

14 Results - Project Benefits Psycho/Social: Increased skills: social, organization, stress management Increased self-esteem Students coping more effectively with their illnesses – expressed & demonstrated desire to better understand & manage their illnesses Desire for independence – expressed importance of being independent

15 Results-Project Benefits Educational/Vocational: Found it helpful to have someone to talk to; comfortable with counselors; liked hands-on Leads coaching & help with job search Some students able to gain employment - felt good about finding & keeping work and earning income Increased quality of schoolwork, socialization, confidence & sense of pride, self-advocacy Overall a good experience for the counselors

16 Results - Project Challenges Scheduling issues sometimes made it difficult to see project staff Schoolwork + work were overwhelming Some students needed to take time off for physical & mental health problems Not all students were able to obtain employment College and employment environments were, at times, more difficult for older students Counselors noted that students with more serious mental illness were more difficult to serve Communication was sometimes difficult between collaborators Employment specialist not present in the college enough

17 Results – Student Related Barriers Psycho/Social: Effects of students illness; Some had poor insight into illness Students easily affected by stress Low self-confidence Student Immaturity Difficulty with initiative Personality conflicts with other students; Some engagement in socially inappropriate behaviours Less than adequate social support network Juggling education with family life was problematic at times

18 Educational/Vocational/Financial: Some delay in seeking help; some did not wish to disclose their illness to staff History of personal & academic struggles Attention problems and problems with organization & time management often interfered with tasks Programs chosen by students not always a good fit for their needs, limitations, employment prospects Limitations imposed by financial pressures (barriers related to low income) Results - Student Related Barriers

19 Results - Student Related Enablers Motivated and determined to succeed Hopeful, optimistic Strong focus on college Enjoyed the challenge, enjoyed going to college & work Strong career and educational goals College involvement may have put students further ahead than typical Leads clients (those with supported employment but without supported education)

20 Results - Others Related Barriers Students needed more support College set-up and schedule a poor fit for students with mental illness Older students were rejected by younger peers who were perceived as immature Professors lack of understanding/knowledge about mental health problems or learning disabilities Employer stigma Lack of job stability

21 Results - Others Related Enablers Good liaisons between project staff & family and/or other services in the community Helpful to have support during difficult times Support by family, some peers, and some professors College accommodations

22 Results - Suggestions for Improvement Address need for increased social support Improve coordination with other mental health care services Make the college better fit student needs Have Leads in the college more often, every week Expand the project to other types of disabilities

23 Limitations of study (evaluation) Exploratory design, e.g., small sample size, no control/active comparison Short longitudinal evaluation (as compared to time needed to complete college and find and keep suitable work)

24 Conclusions Various themes were found in relation to the lived experience of this project that combines supported post-secondary education with supported employment for people with mental illness. Project content, process and context were relevant, some as barriers and some as enablers.

25 Future Directions Further research is required and planned for more rigorous study of combining supported post-secondary education with supported employment for people with mental illness. Adding cognitive remediation to this combination may further benefit this population, particularly people with SMI and with learning disabilities.

26 References Best, L. J., Still, M. & Cameron, G. (2008). Supported education: Enabling course completion people experiencing mental illness. Australian J of Occupational Therapy, 55, 65-68. Cook, J. A., Leff, S., Blyler, C. R., Gold, P. B., Goldberg, R. W., Mueser, K. T., Toprac, M. G., McFarlane, W. R., Shafer, M. S., Blankertz, L. E., Dudek, K., Razzano, L. A., Grey, D. D., Burke-Miller, J. (2005) Results of a multisite randomized trial of supported employment interventions for individuals with severe mental illness, Arch of Gen Psychiatry, 62, 505-512. Gutman, S. A. (2008) Supported education for adults with psychiatric disabilities. Psychiatric Services, 59, 326-327. Kessler, R. C., Foster, C. L., Saunders, W. B., & Stang, P. E. (1995) Social consequences of psychiatric disorders, I: Educational attainment. Am J of Psychiatry, 152, 1026-1032. Megivern, D., Pellerito, S. & Mobray, C. (2003). Barriers to higher education for individuals with psychiatric disabilities. Psychiatric Rehabilitiation Journal, 26, 217-231. Mueser, K. T., Salyers, M. P., & Mueser, P. R. (2001). A prospective analysis of work in schizophrenia. Schizophrenia Bull, 27, 281–296. Rudnick, A. & Gover, M. (2009) Combining Supported Education and Supported Employment in Relation to Skilled (Vocational) Occupations.

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