Individual Placement and Support IPS/Supported
Employment: An Evidence-Based
Practice
Debbie Homan- CRSS-E DMH Williams/Colbert IPS Trainer
Matt Christensen- DMH IPS Trainer Region 1 & 2
Objectives
What is IPS Supported Employment
Employment and Recovery
Principles of IPS
Implementing IPS with Job Seekers
IPS Fidelity
Prevalence and Expansion of IPS
Philosophy
Belief that every person with
a disability is capable of
working competitively in the
community if the right kind of
job and work environment
can be found
IPS is an
Evidence-
Based
Practice
“An evidence-based
practice is a CLINICAL
INTERVENTION which has
been consistently shown
in several research
studies to assist
CONSUMERS in achieving
their desired goals of
health and wellness.”
www.mentalhealthpractices.org
Evidence Based Practice
Program model validated by rigorous research (different investigators)
Definable Measurable Outcomes
Has guidelines describing critical components
Has a treatment manual
Statistics on Supported EmploymentCompetitive Employment Rates
25 Randomized Controlled Trials of IPS
Overall
Findings
for 25
RCTs
All studies showed a significant
advantage for IPS
Mean competitive employment rates:
•56% for IPS
•23% for controls
Job Seekers in IPS:
•Attain employment faster, hold jobs longer and work more hours.
Long Term RCT for IPS:
•3x more likely to achieve employment
•Worked 4x as many hours
For most people Employment is
a part of Recovery
2/3 of people with serious mental illness want to work
but only 15% are employed.
Until the 1990s, no models found effective in helping
people with SMI get stable competitive employment
Work is the best treatment we have for serious mental
illness (i.e., people with schizophrenia spectrum
disorder, bipolar, or depression). (Luciano, Bond, &
Drake, 2014).
Only 2.1% of clients with SMI in the U.S. public mental
health system receive IPS
Benefits of Steady
Competitive Employment
Increased Income
Improved Self Esteem
Improved Social Networks
Increased Quality of Life
Better Control of Symptoms
Reduced Substance Use
Viewed by Many as Essential Part of Recovery
Typical Role for Adults in our Society
Cost-effective Alternative to Day Treatment
Reduced Use of Mental Health Services
8 Principles of
IPS Supported
Employment
Evidence-Based IPS
Principles
Competitive Employment is the Goal
Zero Exclusion
Client Preferences Honored
Integration of Vocational and Mental Health Treatment services
Benefits Counseling
Rapid Job Search
Employment Specialists Build Relationships with Employers
Follow Along Supports are Time Unlimited
Competitive Employment is
the Goal
Focus on community jobs
Work settings includes
people who do not have a
disability
Pay at least minimum wage
Part-time and full-time
Volunteer jobs, enclaves, or
training programs are not the
goal
Zero Exclusion IPS programs welcome any person who
expresses interest in work
People are never excluded due to
Legal Histories
Symptoms of MI
Decisions about Treatment
Personal Presentation
Missed Appointments
Substance Use Disorder
Homelessness or Unstable Housing
Cognitive Disorders
Past Problems with Employment
• Eligibility based on job seeker choice
Client Preferences are Honored
Choices and decisions about
work and support are
individualized
Based on the person’s
preferences, strengths, and
experiences
Not on a pool of jobs that are
available
Even the way that SE services
are provided should be based
upon client preferences
Integration of Vocational and Treatment Services
Coordinated services between
the treatment team that are
seamless (mental health
team, voc team, therapist,
psychiatrist, housing etc.)
Family (if possible and as self
defined) should be involved in
integration
Integrated, multidisciplinary
approach- not parallel
interventions in separate
agencies or systems
Personalized Benefit Planning is Provided
Important part of decision making process
Clear information of how work will affect ones entitlements is vital
Should happen as soon as job seeker is starting to talk about work
One-on-one benefits planning sessions between job seeker and an expert (State benefit planner, City of Chicago benefit planner, DRS, etc.) should be set-up by employment specialist
Rapid Job Search
Job search starts soon after job
seeker expresses interest in
working
No extensive pre-employment
assessment and training
Initial assessment is done quickly
Gathers information
Discuss with treatment team
Develop employment plan
Adjust as needed
Employment Specialists Build
Relationships with Employers
Employment specialists build relationships with employers based upon job seeker interests
Employment specialists meet face-to-face with employers over time to learn about their business needs and the positions in their business
Each specialist makes at least six employer contacts each week with a person who has hiring responsibilities
If job seeker does not want to disclose ES can still gather and share information about a business or opportunity
Job Supports are Time
Unlimited
Individualizes supports
to maintain
employment
Time Unlimited- as
long as job seeker
want the assistance
Types of supports are
diverse
Implementing
IPS
Implementing IPS
Referral
Get the Word Out
Process Simple
Engagement
• Identify Supports/Strengths
• Treatment team involved
• Discuss Benefit Counseling
Assessment
Develop Voc Profile
Gather Information
Revise and Update Job Finding
Begin Individualized Job Search (30 days)
Disclosure Discussion
Build Social Capacity/Network
Planning for Success
Starting a Job First Day Worries
Friends and Family
Work Day Schedule
Transportation
Dressing for Work
Arriving at Work
Revisiting Benefits Counseling
Maintaining a Job Wages and Benefits
Disclosure of Mental Illness
Accommodations and Support
Work Tasks
People at Work
Family and Friends Support
Additional Services
Resume Building
Preparing for Interviews
Job Shadow
Job Exploration
Job Maintenance
Natural Supports
Utilizing Community Resources
Identifying Roles & Responsibilities
Financial
-Education
-Literacy
-Empowerment
Leaving a Job
Appropriate Job Leaving
Maintaining Relationships
Celebrating Success
Working Again
IPS Fidelity
Supported Employment
Fidelity Scale
An accuracy scale that has
been developed to measure
“the adequacy of
implementation” of Supported
Employment programs
125 Criterion:
Scored on a scale of 1-5
115-125 = Exemplary Fidelity
100-114 = Good Fidelity
74-99 = Fair Fidelity
73 and below = Not IPS
Staffing
1) Manage Caseloads of up to 20
2) Provide only vocational services
3) Carry out all phases of vocational service
(engagement, assessment , job
development, job placement, job coaching,
and follow-along supports)
Organization
1) Integration of rehabilitation with mental health
treatment (team assignment)
2) Integration of rehabilitation with mental health
treatment (frequent team contact)
3) Collaboration between ES and DRS
4) Vocational unit
5) Role of employment supervisor
6) Zero exclusion criteria
7) Agency focus on competitive employment
8) Executive team support for SE
Services
1) Work incentive planning
2) Disclosure
3) Ongoing, work-based vocational assessment
4) Rapid job search for competitive job
5) Individualized job search
6) Job development – Frequent employer contact
7) Job development – Quality of employer contact
Services
8) Diversity of job types
9) Diversity of employers
10) Competitive jobs
11) Individualized follow-along supports
12) Time-unlimited follow-along supports
13) Community based services
14) Assertive engagement and outreach
Prevalence and
Expansion of IPS
IPS in Illinois
One-stop source on IPS/Supported Employment for Illinois citizens with psychiatric disabilities, their
employers, and service providers.
Pathways to Employment
Putting Illinois to Work
VISIT US AT: http://www.illinoisips.org/
The Day the Voices Stopped
“…I feel so strongly about the need
to be given meaningful work instead
of the make-busy tasks or rote
assignments that make up the bulk
of what we are offered. If people
are treated as capable they often
surprise everyone and live up to
expectations.”
-Ken Steele
“Recovery”
Beliefs for IPS Programs
• In order to effectively provide
Employment via Individual Placement &
Support programs, all staff providing
mental health services, need to believe
that people with mental illnesses:
• Can and do recover
• Learn, achieve and grow through
success and failure experiences
• Stagnate when they are sheltered
from real life experiences
“If you think work
is stressful
try unemployment” -Joe Marrone at the Institute of Community Inclusion
According to Peter Warr in his book – Work,
Unemployment and Mental Health – “The side effects
of Unemployment in the General Population are the
following:”
Increased Substance Abuse
Reduced Self-Esteem
Increased Physical Problems
Loss of Social Contacts
Increased Psychiatric Disorders
Alienation and Apathy
Contact Information
Debbie Homan CRSS-E
DHS/Division of Mental Health
Williams/Colbert IPS Trainer
Chicago Read
Mental Health Center
4200 N. Oak Park Ave.,
Chicago, IL 60634
ph: 773-794-4255
Matt Christensen
DHS/Division of Mental Health
Region 1 & 2 IPS Trainer
Chicago Read
Mental Health Center
4200 N. Oak Park Ave.,
Chicago, IL 60634
ph: 773-794-4249
References: Becker, D.R. (2005) PSR 101: Supported Employment: A working Life for People
with Serious Mental Illness. An audioconference presented 3/23/05 from
3:00pm – 4:00pm EST
Becker, D.R., Drake, R.E., & Naughton Jr., W.J. (2003) Supported Employment
for People with Co-Occurring Disorders. Psychiatric Rehabilitation Journal, 27(3), 332-338
Becker, D.R., & Drake, R.E. (n.d.) Supported employment for people with severe
mental illness: A guideline developed for the Behavioral Health Recovery Management Project. (Available from Deborah R. Becker, New Hampshire-Dartmouth Psychiatric Research Center, 2 Whipple Place, Suite 202, Lebanon, NH 03766
Bond, G.R., Becker, D.R., Drake, R.E., & Vogler, K.M. (1997). A fidelity scale for
the Individual Placement and Support model of supported employment. Rehabilitation Counseling Bulletin, 40(4), 265-284
Gowdy, E.L., Carlson, L.S., & Rapp, C.A. (2003) Practices differentiating high-
performing from low performing supported employment programs. Psychiatric Rehabilitation Journal, 26(3), 232-239
Gowdy, E.L., Carlson, L.S., & Rapp, C.A. (2004) Organizational factors
differentiating high performing from low performing supported employment programs. Psychiatric Rehabilitation Journal, 28(2), 150-156
Substance Abuse and Mental Health Services Administration. (Draft Version
2002) Supported Employment Implementation Resource Kit for Practitioners and Clinical Supervisors. Chicago, IL
www.mentalhealthpractices.org