Supported Employment: the employment consultants' perspective

Supported employment (SE) organisations work to support people with mental illness into employment. This study sought to examine the experiences and perspectives of staff that work for a SE service. This qualitative study was undertaken as the existing literature examining this area is limited. Nine employment consultants from a New Zealand SE service participated in a focus group that involved questions about their experiences and perceptio ns of the SE programme. The data was audio-recorded and transcribed verbatim. A thematic analysis was then performed. A number of themes were identified in the data. These included: factors can that act as incentives or disincentives to employment, factors that can work to impede or assist the employment process, positive and negative factors about the SE service, strategies that are employed to overcome barriers, and potential improvements that could be made to the service. The findings are discussed along with the potential changes that could be made to SE programmes to increase effectiveness. Supported Employment: The ECs‟ perspective 1 Mental health problems can often lead individuals to face huge obstacles in their lives. Many people with mental illnesses commonly report feelings of loneliness, treatment as unequal members of society, limited employment opportunities, and reduced life sat isfaction (Rapp & Goscha, 2006). There are a number of strategies that can be engaged to help people with mental illness, and these include medication and rehabilitation treatments (Sullivan, 1992). Although these methods can work towards improving the symptoms of an individual‟s illness, they often cannot completely cure the mental illness. As some mental disorders cannot be cured, it is important to recognise at least the ways in which they can recover from their mental illness (Mueser et al., 2002). Recovery can be looked at in terms of symptom reduction, but it is also looked at as the developing of factors such as well-being, increase of self confidence, positive life meaning, and hope. In order to achieve recovery, personal goals are often set and can include aspects such as learning how to use public transport or getting back into employment. The obtaining and maintaining of employment is commonly identified as one of the most important and effective steps in recovery from mental illness (Clark, Xie, Becker, & Drake, 1998). There are many organisations that have been put together to support people who have mental health issues into employment and these can range from job skills training, prevocational training and supported employment (SE) programmes. The existing research suggests that SE services are generally the most effective method to support clients with mental illnesses into employment (Bailey, Ricketts, Becker, Xie, & Drake, 1998). The majority of research that has examined SE has focused on measuring its effectiveness in terms of vocational outcomes. Although these studies have contributed towards SE as now being viewed as an evidenced based practice (Henry & Lucca, 2004), they do not reveal much insight about the specific characteristics of the SE services. Some studies have been undertaken that have looked at SE programmes from the perspective of the clients however the research examining SE from other sources, such as the SEP s taff that work with the clients, is very limited. The current study was proposed in order to develop an understanding of a SE service, from a perspective other than the clients. The current study will examine the experiences and perceptions of the employment consultants (ECs) of an SE Supported Employment: The ECs‟ perspective 2 organisation that operates in New Zealand. So that the SE service cannot be identified a pseudonym will be used for the organisation. This pseudonym that will be used for the organisation is Supported Employment NZ (SENZ). SENZ is described in more detail below. SENZ is a SE service that operates in New Zealand (no reference is provided for the material in this section as the source is confidential to avoid identifying the organisation). It is a part of the vocational service that is offered by a non-government organisation that provides community mental health services. The main principles of SENZ are centred on partnership between clients and staff, choice, and the provision of a quality service. Since 2007, the SENZ SE service has based its method of practice on the Strengths Model approach. SENZ is contracted and funded by the government and the contract is based on annual outcomes that the service needs to meet each year. The SENZ SE service features a team of specialist employment consultants (ECs) who work to find jobs and place clients into employment and to support them and their employer while the client remains employed. The SENZ team also includes a team leader and administration officer. The ECs participate in weekly team meetings and group supervision sessions. ECs also undergo monthly individual supervision. SENZ is a member of The Association for Supported Employment in New Zealand (ASENZ). ASENZ was set up in 1993 as an organisation that enabled the sharing of ideas and information that could lend towards the development of SE services in NZ (ASENZ, n.d). Its members now include service providers, service consumers, SE staff, and SE employers. ASENZ has devised a set of principles that guide and define SE services in NZ. These principles are:  Open employment (that clients will be included in the mainstream workforce);  Wages and benefits (clients will have access to the same wages and benefits as other mainstream employees);  Placement first (direct placement into jobs without prevocational training);  Inclusiveness (no exclusion criteria i.e. severity of disability); Supported Employment: The ECs‟ perspective 3  Individual and ongoing support (individualised to the client for as long as they require it);  Choices and career development (the employment is based on the clients‟ choices and preferences and the service is committed to further career development). For a client to be eligible for the service they must have had a mental illness experience as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders 4 Edition Revised (DSM IV-TR) classification system. A client must have identified the obtaining of employment to be a key goal and be committed and motivated to the process of obtaining employment. Furthermore the client must have a stable level of wellness over a period of the most recent 3 months. A client enters the service on a first in, first served basis, however there are times when a client may be placed on a waiting list when there are large number of referrals at one time. Once a client is able to enter the service they are allocated to an EC based on their geographical area. The EC then gets in touch with the client to make an initial appointment to meet and start the career planning process. In the first few meetings with the client a Strengths Assessment and Personal Plan are devised. Once these have been completed the job seeking process can begin. The choice of employment belongs to the client. If there is a situation in which the client may not be ready to enter into the employment of their choice, the EC then supports the client to complete the pathway that will lead either to that role or to a similar but more attainable role. The career planning process is constantly reviewed and is an ongoing process. The job search process is completed as collaboration between the EC and the client, but mainly driven by the client wherever possible. A number of methods can be used, including searching the SENZ database, using the Internet, or other job advertising media, such as the newspaper. The job search process has the aim of getting the client into either open employment, a work experience arrangement, a work trial with potential to lead into open employment, or further study. Once clients are placed into employment, the EC provides regular ongoing support to the client and their employer. Supported Employment: The ECs‟ perspective 4 A client can leave the service by one of two ways. Firstly, the client can make the decision to leave the service for any reason. Secondly, the ECs can remove the client from the service if they: do not regularly return the contact of the EC, display aggressive or threatening behaviour, do not display the commitment or motivation to obtain employment, or provide false information. The current project sought to examine the perspectives of the SENZ SE ECS that work to get the clients into the workforce. The findings of this study will expand on the existing literature in order to develop an in-depth understanding of some of the issues and experiences that can occur in a SE service. The findings may also be used as a base for further research into the areas that are identified by the ECs. Furthermore this research may potentially provide insight into what areas of the service the ECs find beneficial to their clients and what areas of the service are not particularly helpful in supporting their clients and adjustments may be made as required. Supported Employment: The ECs‟ perspective 5