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1.
Psychiatr Rehabil J ; 43(1): 60-64, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31714100

ABSTRACT

OBJECTIVE: The aim of this study was to propose individual placement and support (IPS) as an important component of modern labor market policies and as a paradigm to be considered while drafting and adopting them. BACKGROUND: Modern European labor market policies, termed activation policies, aim to support a personal commitment to seek employment by linking welfare benefits to active engagement in job search. METHOD: In this essay, the authors describe European "activation policies," outline labor market regulations in Italy in the last 3 decades, and analyze core components of IPS in the light of labor policies. FINDINGS: IPS, which provides individual psychological and practical support, has become a highly successful method for helping people with mental disorders to reach competitive employment in Italy. It has been effective in many countries, regardless of local employment conditions and market regulations. Its effectiveness may be greater in places with weaker employment protection legislation and integration efforts and less generous disability benefits, as is the case in Italy. Conclusions and Implications for Policies: Labor market policies should carefully balance financial benefits, integration efforts, and individual support. They should include IPS for people with mental disorders. Modified versions of IPS may also be beneficial to nonpsychiatric unemployed populations. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Employment, Supported , Psychiatric Rehabilitation , Public Policy , Rehabilitation, Vocational , Workforce , Employment, Supported/legislation & jurisprudence , Humans , Italy , Psychiatric Rehabilitation/legislation & jurisprudence , Public Policy/legislation & jurisprudence , Workforce/legislation & jurisprudence
2.
Schizophr Bull ; 44(1): 22-31, 2018 01 13.
Article in English | MEDLINE | ID: mdl-29036727

ABSTRACT

As Individual Placement and Support (IPS) has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. This meta-analysis used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product (GDP), local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce. Regulatory moderators represent facilitators and barriers to employment that may reinforce or detract from the effectiveness of IPS. Across 30 sites drawn from 21 randomized controlled trials in 12 countries (33% in the United States), IPS recipients were 2.31 (95% CI 1.99-2.69) times more likely to find competitive employment than recipients of alternative vocational rehabilitation services. The significant competitive-employment rate advantage of IPS over control services increased in the presence of weaker employment protection legislation and integration efforts, and less generous disability benefits. Policy makers should recognize and account for the fact that labor and disability regulations can create an arrangement of incentives that reduces the relative efficacy of supported employment.


Subject(s)
Employment, Supported/statistics & numerical data , Gross Domestic Product/statistics & numerical data , Labor Unions/statistics & numerical data , Mental Disorders/rehabilitation , Mentally Ill Persons/statistics & numerical data , Rehabilitation, Vocational/statistics & numerical data , Unemployment/statistics & numerical data , Employment, Supported/legislation & jurisprudence , Humans , Labor Unions/legislation & jurisprudence , Mentally Ill Persons/legislation & jurisprudence
3.
Adm Policy Ment Health ; 44(3): 311-319, 2017 May.
Article in English | MEDLINE | ID: mdl-28062932

ABSTRACT

The individual placement and support (IPS) model of supported employment for people with serious mental illness is an evidence-based practice. Factors including a national learning community promoting IPS and enforcement of the Supreme Court's Olmstead decision have spurred the growth of IPS nationwide. In this study we first evaluated the national prevalence and quality of IPS programs. We then evaluated the impact of learning community membership and Olmstead settlements on IPS program penetration and quality across the United States. We interviewed representatives from 48 state behavioral health agencies and 51 state vocational rehabilitation agencies. Survey questions examined the number of IPS programs in each state, the presence of an Olmstead settlement mandating employment services for people with serious mental illness, and the presence of three indicators of quality in IPS programs: collaboration between state behavioral health and vocational rehabilitation agencies, regular, independent fidelity monitoring, and technical assistance and training for IPS programs. Respondents from 38 (75%) states, including 19 states in the IPS Learning Community and 19 outside the learning community, reported a total of 523 IPS programs nationwide (M = 14, SD = 16). The state IPS program penetration rate (number of IPS programs per 1,000,000 people) ranged from 0.05 to 16.62 (M = 3.61, SD = 3.62) among states with IPS. The penetration rate was similar for learning community and non-learning community states with IPS, but learning community states were much more likely than non-learning community states with IPS to report the presence of each of three quality indicators. Eleven states reported Olmstead or other settlements that positively impacted employment services for people with serious mental illness, but among the 38 states with IPS programs, Olmstead states did not differ from non-Olmstead states in IPS program penetration or on the quality indicators. Nationally, most states provide IPS programs, but the within-state penetration rate and quality of implementation vary widely. While learning community and non-learning community states with IPS do not differ in the prevalence of IPS programs, learning community states are much more likely to report key quality indicators, which may enhance these states' potential for sustaining and expanding IPS. Olmstead settlements have not yet shown a direct impact on the penetration and quality of IPS, but as the Department of Justice continues to enforce the Supreme Court's Olmstead decision, their significance may increase.


Subject(s)
Employment, Supported/organization & administration , Mental Disorders/rehabilitation , Cooperative Behavior , Employment, Supported/legislation & jurisprudence , Employment, Supported/standards , Humans , Inservice Training/organization & administration , Interinstitutional Relations , United States
6.
Fed Regist ; 80(156): 48443-9, 2015 Aug 13.
Article in English | MEDLINE | ID: mdl-26292366

ABSTRACT

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program. The Assistant Secretary may use this priority for competitions in fiscal year 2015 and later years. We take this action to provide training and technical assistance to State vocational rehabilitation agencies to improve services under the State Vocational Rehabilitation Services program and State Supported Employment Services program for individuals with disabilities, including those with the most significant disabilities, and to implement changes to the Rehabilitation Act of 1973, as amended by the Workforce Innovation and Opportunity Act (WIOA), signed into law on July 22, 2014.


Subject(s)
Disabled Persons/rehabilitation , Employment, Supported/legislation & jurisprudence , Rehabilitation, Vocational , Rehabilitation/education , Rehabilitation/legislation & jurisprudence , Disabled Persons/legislation & jurisprudence , Government Programs , Humans , United States
8.
Cult Med Psychiatry ; 39(1): 134-61, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25292449

ABSTRACT

Based on ethnographic fieldwork in London, Ontario, Canada, with homeless and street-involved youth in a youth drop-in shelter that I call "At Home", this paper is an ethnographically grounded narrative analysis of interview content and participant observation with a centre focus on my key informant, a youth from Eastern Europe whom I call "Marius". Like many other street youth, Marius lives a life marked by precarity. His daily life is marked by traumatic memories of abandonment and abuse, which has lead to an inability to work; and structural violence facilitated by Ontario's workfare program called Ontario Works, especially its mandate that all "participants" (i.e. those in receipt of social assistance, such as Marius) seek employment or face termination of their social assistance check. For Marius, the recounting of traumatic memories at At Home opened up a shared rhetorical space from which he could narratively align himself vis-à-vis other street youth as a victim of precarity and trauma and therefore absolve himself of the onus to find employment. Regardless of his narrative positioning, he is constantly terminated from Ontario Works for not submitting proof of citizenship and proof of job-seeking activities. In conclusion, the only way for Marius to find any form of solace from his past and the constraints of OW is through isolation: a cultural stance that serves as a coping mechanism, and allows Marius to muddle through each day, all the while holding precarity and its pursuant anxiety and depression at bay.


Subject(s)
Cultural Deprivation , Homeless Youth/psychology , Life Change Events , Social Marginalization/psychology , Stress, Psychological/psychology , Adolescent , Canada , Employment, Supported/legislation & jurisprudence , Employment, Supported/methods , Employment, Supported/psychology , Government Regulation , Humans , Male , Narration , Social Adjustment , Social Welfare/legislation & jurisprudence , Social Welfare/psychology , Young Adult
9.
Fed Regist ; 79(122): 35951-4, 2014 Jun 25.
Article in English | MEDLINE | ID: mdl-25011164

ABSTRACT

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Rehabilitation Research and Training Center (RRTC) Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for an RRTC on Employment for Individuals with Intellectual and Developmental Disabilities. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on areas of national need. We intend for this priority to contribute to improved employment outcomes of individuals with intellectual and developmental disabilities.


Subject(s)
Academies and Institutes/legislation & jurisprudence , Disabled Persons/rehabilitation , Education, Special/legislation & jurisprudence , Employment, Supported/legislation & jurisprudence , Employment/legislation & jurisprudence , Rehabilitation/education , Research/legislation & jurisprudence , Disabled Persons/legislation & jurisprudence , Humans , Rehabilitation/legislation & jurisprudence , United States
10.
J Nerv Ment Dis ; 202(6): 498-500, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24821277

ABSTRACT

Since Basaglia's pioneering work in the 1960s, programs geared to employment have been considered hallmarks of good practice in Italian community psychiatry. These programs mostly include "train and place" schemes: sheltered workshops, training placements and temporary grants with public/private employers, and social enterprises (cooperatives). Law 68/1982 on disability and work demanded a "quota of workplaces" to be reserved for citizens with disability by public and private employers, but application to the psychiatric field proved problematic. Despite large investments, outcomes in terms of competitive employment have decreased over the decades, and now, less than 10% of all attenders of these programs attain the open labor market. More recently, some "place and support" programs have been tried with promising results. Individual Placement and Support is practiced in one third of mental health centers in the Emilia-Romagna Region and in pilot programs in three more regions. It is difficult to forecast how the rapid changes brought by the current financial crisis will impact on Italy, but very likely, supported employment programs will find more space in Italian mental health services.


Subject(s)
Employment, Supported/standards , Mental Health Services/standards , Rehabilitation, Vocational/standards , Employment, Supported/legislation & jurisprudence , Humans , Italy , Mental Health Services/legislation & jurisprudence , Mental Health Services/organization & administration , Pilot Projects , Social Planning
11.
Psychiatr Rehabil J ; 37(1): 68-70, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24660952

ABSTRACT

TOPIC: In the Declaration of Independence, Thomas Jefferson stated that citizens of the new republic had fundamental and inalienable rights to "life, liberty and the pursuit of happiness." PURPOSE: The purpose of this article is to reframe inequities experienced by people living with severe mental illnesses in terms of violations of Jeffersonian rights to "life, liberty and the pursuit of happiness." We simultaneously consider governmental and clinical efforts to address identified inequities and uphold these rights. SOURCES USED: The broad research literature on severe mental illnesses was examined. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: People with severe mental illnesses experience numerous inequities regarding "life, liberty and the pursuit of happiness." These inequities include diminished life expectancy, excessive involuntary commitment and elevated rates of unemployment and homelessness. Governmental and clinical responses to such inequities include the Affordable Care Act and the Olmstead Decision, as well as recovery-oriented interventions such as Supported Employment and Supported Housing.


Subject(s)
Human Rights/legislation & jurisprudence , Mentally Ill Persons , Quality of Life , Employment, Supported/legislation & jurisprudence , Health Status Disparities , Humans , Patient Protection and Affordable Care Act/legislation & jurisprudence , Public Housing , Social Discrimination/prevention & control , Socioeconomic Factors , United States
12.
Fed Regist ; 78(90): 27036-8, 2013 May 09.
Article in English | MEDLINE | ID: mdl-23658999

ABSTRACT

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Disability and Rehabilitation Research Project (DRRP) on Traumatic Brain Injury Model Systems Centers Collaborative Research Project. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend this priority to improve outcomes among individuals with traumatic brain injuries.


Subject(s)
Brain Injuries/rehabilitation , Disabled Persons/rehabilitation , Rehabilitation/organization & administration , Community Integration/legislation & jurisprudence , Cooperative Behavior , Employment, Supported/legislation & jurisprudence , Humans , Rehabilitation, Vocational , United States
13.
Fed Regist ; 78(90): 27038-44, 2013 May 09.
Article in English | MEDLINE | ID: mdl-23659000

ABSTRACT

The Assistant Secretary for Special Education and Rehabilitative Services announces priorities for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for Rehabilitation Research and Training Centers (RRTCs) on Community Living and Participation for Individuals with Physical Disabilities (Priority 1), Employment of Individuals with Physical Disabilities (Priority 2), Health and Function of Individuals with Intellectual and Developmental Disabilities (Priority 3), and Community Living and Participation for Individuals with Intellectual and Developmental Disabilities (Priority 4). If an applicant proposes to conduct research under these priorities, the research must be focused on one of the four stages of research defined in this notice. The Assistant Secretary may use these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve outcomes among individuals with disabilities.


Subject(s)
Developmental Disabilities/rehabilitation , Disabled Persons/rehabilitation , Intellectual Disability/rehabilitation , Rehabilitation/organization & administration , Research/organization & administration , Community Integration/legislation & jurisprudence , Employment, Supported/legislation & jurisprudence , Humans , Rehabilitation, Vocational , United States
16.
Phys Med Rehabil Clin N Am ; 21(2): 267-79, 2010 May.
Article in English | MEDLINE | ID: mdl-20494276

ABSTRACT

Aging with disabilities, such as multiple sclerosis, spinal cord injury, muscular dystrophy, and postpolio syndrome, can lead to barriers to participation, including employment barriers. Many individuals develop strategies for overcoming these barriers that may become less successful as they experience more secondary conditions concomitant with the aging process. Rehabilitation professionals can help to overcome barriers to workplace participation and should work with clients to enhance employment outcomes.


Subject(s)
Aging/physiology , Disabled Persons/rehabilitation , Employment/legislation & jurisprudence , Rehabilitation, Vocational/standards , Aged , Disability Evaluation , Employment/statistics & numerical data , Employment, Supported/legislation & jurisprudence , Employment, Supported/statistics & numerical data , Female , Humans , Male , Middle Aged , Multiple Sclerosis/rehabilitation , Muscular Dystrophies/rehabilitation , Postpoliomyelitis Syndrome/rehabilitation , Program Evaluation , Quality of Life , Rehabilitation, Vocational/trends , Spinal Cord Injuries/rehabilitation , United States , Workplace
17.
J Occup Rehabil ; 20(4): 456-71, 2010 Dec.
Article in English | MEDLINE | ID: mdl-19680793

ABSTRACT

INTRODUCTION: As concerns grow that a thinning labor force due to retirement will lead to worker shortages, it becomes critical to support positive employment outcomes of groups who have been underutilized, specifically older workers and workers with disabilities. Better understanding perceived age and disability discrimination and their intersection can help rehabilitation specialists and employers address challenges expected as a result of the evolving workforce. METHODS: Using U.S. Equal Employment Opportunity Commission Integrated Mission System data, we investigate the nature of employment discrimination charges that cite the Americans with Disabilities Act or Age Discrimination in Employment Act individually or jointly. We focus on trends in joint filings over time and across categories of age, types of disabilities, and alleged discriminatory behavior. RESULTS: We find that employment discrimination claims that originate from older or disabled workers are concentrated within a subset of issues that include reasonable accommodation, retaliation, and termination. Age-related disabilities are more frequently referenced in joint cases than in the overall pool of ADA filings, while the psychiatric disorders are less often referenced in joint cases. When examining charges made by those protected under both the ADA and ADEA, results from a logit model indicate that in comparison to charges filed under the ADA alone, jointly-filed ADA/ADEA charges are more likely to be filed by older individuals, by those who perceive discrimination in hiring and termination, and to originate from within the smallest firms. CONCLUSION: In light of these findings, rehabilitation and workplace practices to maximize the hiring and retention of older workers and those with disabilities are discussed.


Subject(s)
Civil Rights/legislation & jurisprudence , Disabled Persons , Employment, Supported , Prejudice , Adolescent , Adult , Age Factors , Aged , Disabled Persons/legislation & jurisprudence , Disabled Persons/psychology , Disabled Persons/rehabilitation , Employment, Supported/legislation & jurisprudence , Employment, Supported/statistics & numerical data , Female , Humans , Job Application , Male , Mental Disorders , Middle Aged , Organizational Policy , Workplace , Young Adult
18.
Psychiatr Serv ; 60(12): 1637-41, 2009 Dec.
Article in English | MEDLINE | ID: mdl-19952154

ABSTRACT

OBJECTIVES: The aim of this study was to document and analyze common strategies used by supported employment specialists to overcome criminal justice issues among clients with severe mental illness. METHODS: Semistructured qualitative interviews were conducted with a group of 22 supported employment specialists and their supervisors. Interviews were open ended and supplemented by ethnographic observation. Data were examined thematically by content analysis. RESULTS: Assisting clients with past and present criminal histories to find employment was confirmed as one of the hardest self-identified challenges for employment specialists. Three specific strategies commonly used by specialists for this subpopulation are documented and analyzed. These include taking an incremental approach with clients vis-à-vis obtaining work and career advancement, using a strengths-based model that emphasizes the client's strong points, and focusing the job search on "mom and pop" businesses that typically do not conduct background checks or do not have rigid recruitment policies. Enacting these strategies led to some deviation from the individualized placement and support model of supported employment. Participants noted that they felt most challenged when attempting to serve and assist clients with sex offenses. CONCLUSIONS: The findings imply that specialists are challenged when dealing with clients with criminal justice issues and use several approaches to overcome these challenges. Current specialist training may be deficient in preparing staff to effectively serve people with criminal justice issues. Further research should assess the efficacy of the approaches outlined in this article to give more guidance to specialists working with clients with criminal justice issues.


Subject(s)
Criminal Law/legislation & jurisprudence , Employment, Supported/legislation & jurisprudence , Prisoners/legislation & jurisprudence , Psychotic Disorders/rehabilitation , Adult , Attitude of Health Personnel , Female , Humans , Job Application , Male , Middle Aged , Motivation , Personnel Selection/legislation & jurisprudence , Personnel Selection/methods , Persuasive Communication , Registries , Sex Offenses/legislation & jurisprudence , Sex Offenses/psychology , United States
20.
Health Aff (Millwood) ; 28(3): 761-70, 2009.
Article in English | MEDLINE | ID: mdl-19414885

ABSTRACT

Social Security Administration disability programs are expensive, growing, and headed toward bankruptcy. People with psychiatric disabilities now constitute the largest and most rapidly expanding subgroup of program beneficiaries. Evidence-based supported employment is a well-defined, rigorously tested service model that helps people with psychiatric disabilities obtain and succeed in competitive employment. Providing evidence-based supported employment and mental health services to this population could reduce the growing rates of disability and enable those already disabled to contribute positively to the workforce and to their own welfare, at little or no cost (and, depending on assumptions, a possible savings) to the government.


Subject(s)
Disability Evaluation , Employment, Supported/legislation & jurisprudence , Health Care Reform/legislation & jurisprudence , Health Policy/legislation & jurisprudence , Mental Disorders/rehabilitation , Social Security/legislation & jurisprudence , Evidence-Based Medicine/legislation & jurisprudence , Health Services Accessibility/legislation & jurisprudence , Humans , Mental Health Services/legislation & jurisprudence , Rehabilitation, Vocational , United States
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