1. Presented by: Larry Abramson, Director of Vocational Services at St. Luke’s House Inc. And Sheila Cuomo, DPN for Montgomery/Prince George’s County

2.  Background on Maryland’s work with Mental Health Agencies and job seekers with Mental Illness  St. Luke’s House originally provided mental health expertise and training to one-stop partners and staff members to better serve jobseekers with mental health needs

3.  Began with assigning a mental Health Expert from St. Luke’s house co-located at Montgomery Works One- Stop ◦ Mental Health Expert assigned case load of 10 job seekers ◦ Collaborated with partners particularly training programs: Workforce Investment Act (WIA) to work with shared job seekers ◦ Referrals were made from partners within One-Stop to mental health expert (i.e. Veterans, Intensive Services, Ex- offender programs) to assess job seekers needs ◦ If job seeker was in need of mental health services mental health expert provided mental health resources to that individual or staff members serving them ◦ Conducted Intakes for St. Luke’s House on-site at the One- Stop

4. Mental Health expert provided: ◦ Training to core staff and partners on how to work with job seekers with mental health challenges ◦ Training on the signs and symptoms of mental health issues job seekers may present to One-Stop staff and partners  “Important: This was not an attempt to teach partners how to diagnose mental health disorders”  Information on available resources in the county for job seekers who experience mental health issues

5. Recruited Mental Health Expert to become the Navigator: ◦ Addressing the needs of Intensive Service job seekers with mental health issues ◦ Continuing to provide all-staff training to other partners and core staff on how to work with job seekers ◦ Meeting with Intensive Service staff 1x per month to conduct case consultation ◦ Conduct mental health training to other One-Stop Career Centers outside of home One-Stop

6.  Continued trainings to One-Stop staff and partners on types of mental illness on a more frequent level  Increased collaborative relationship between One-Stop partners and Navigator to provide holistic services to job seekers  Developed & implemented crises intervention training for Intensive Services Staff  Met with partners and job seekers as needed  Developed & implemented stress management training tailored for job seekers (1x/mo.)

7.  Mental Health Navigator worked with a Core Staff member in the Resource Room to identify job seekers accessing One-Stop over long time periods who had difficulty obtaining/retaining employment ◦ Harvey – Homeless Veteran ◦ Rona – Unemployed with untreated Depression ◦ Debbie – Initially denied service

8. Harvey  Became homeless after losing his job as a result of mental health problems and inability to maintain work schedule (heard voices, very depressed)  Harvey was not taking his medications, did not have money to purchase medications and was currently not seeing his psychiatrist at the VA  Navigator helped job seeker get free medications from free clinics in order to stabilize mental health  Worked Collaboratively with Navigator and Department of Labor Veterans Program to help Harvey secure employment after his mental health was stable  Navigator counseled job seeker on the importance of maintaining mental health as a precursor to job stability  Department of Labor Veteran Program -Provided transportation funds for Harvey to attend interviews  Harvey conducted daily job search with assistance from veterans programs, navigator and assistance with core staff  Harvey secured employment and became stable

9. Rona  Job seeker was fired from her job as medical assistant  Core services referred Rona to intensive services for training  Staff noticed Rona was very depressed which potentially could hinder training and job search process  Intensive services staff member referred her to navigator to assess level of mental health needs  Rona was not open to mental health counseling or medication therapy for depression  Navigator and Intensive service staff developed a relationship with Rona and implemented plan to support her while she received training in phlebotomy (i.e. phone calls, meetings, resume development, job search techniques, etc.)  Rona completed training and found employment 1 month after training in the field of phlebotomy.

10. Debbie  Intensive services referred job seeker to Mental health expert/Navigator  Debbie was diagnosed with depression and had difficulty securing employment  Received Private insurance through her spouse which made her ineligible for the supported employment services until she was referred to Division of Rehabilitation by Navigator  Division of vocational rehabilitation referred Debbie to St. Luke’s to fund supported employment services  Debbie became employed, was laid off due to downsizing but later became employed as an administrative assistant with an elder care program  Debbie was also referred to the Medicaid buy-in program for benefits counseling

11.  One Stop Staff feel more comfortable in working with job seekers who experience mental health issues ◦ DOL Veteran’s Program: “I don’t know what we would do without you here to consult with us, these guys have a lot of issues, without the mental health piece and our ability to collaborate together to help these guys, they would not get employed” ◦ One Stop Core Staff: “We definitely appreciate the mental health expertise of the navigator because they work with us and coach us on how to work effectively with job seekers with obvious mental health problems” ◦ One Stop Intensive Services Staff“ “Now we’re able to assess the mental health needs of our job seekers and offer resources to them such as information on Medicaid buy- in programs, mental health resources in the community and direct job seekers to where they need to go for additional services”  Increased employment outcomes for job seekers due to staff’s knowledge and understanding of how to accommodate mental health issues  Increased collaborative efforts of partners to meet the holistic needs of job seekers, (i.e. Vets: work clothing, transportation funds, Navigator: psychiatric referral)

12.  Director of Operations used networking connections to establish One-Stop relationship with the Rehabilitation Counseling Program at area University: ◦ Developed Practicum site for 1 intern, which evolved into 2 more interns ◦ Internship: 2 masters level counselors ◦ 100 hour practicum ◦ Evolved into 600-hour practicum per intern

13. Mental Health Internship at One-Stop  Interns provide the following to job seekers in Intensive Services: ◦ vocational services ◦ case management services, and ◦ individual counseling  Interns are supervised by Mental Health Navigator licensed to supervise ◦ Evaluates interns based on:  Feedback from Intensive Services staff  Feedback from director  Observation, etc.

14.  Intern: “I’ve learned so much through my internship. I’ve had the opportunity to work with many job seekers with various types of barriers to employment which makes my experience here worthwhile. As a result of this work, I’ve increased my counseling skills level.”   Director of Intensive Services: “Our Mental Health intern was able to work with a very difficult job seeker who could not maintain employment because she was not medication compliant. The intern was able to provide mental health interventions to the job seeker in addition to our services to help improve the mental health stability of this client. She has now been meds compliant since January, 2009”

15. Future Developments: 1. (2) 600-hour Practicum Interns receiving masters degrees in counseling-rehabilitation 2. Begin advertising mental health counseling through the One-Stop 3. Each intern will: ◦ Carry a caseload of job seekers ◦ Provide individualized services to job seekers  Mental health counseling  Vocational counseling 4. Exploring the possibility of Interns working in conjunction with workforce development specialist to develop goal plans for job seekers with significant barriers to employment

16.  If you have a question or comment please do one of the following: ◦ Use the “raised hand icon” on the right hand menu bar to alert the facilitator that you would like to un- mute your phone line to ask your question. ◦ Use the Q&A function on the right hand menu bar to write in your question and have it read to the presenters.

17. Larry Abramson, Director Vocational Services at St. Luke’s House Inc. (301) 493-4200 ext. 401 Abramson@stlukeshouse.com Sheila Cuomo, Navigator Montgomery/Prince George’s County Maryland (240) 283-1577 scuomo@montgomeryworks.com Miranda Kennedy, Training Coordinator NDI Consulting, Inc. (720) 890-3990 mkennedy@ndi-inc.org