The Americans with Disabilities Act: A Tool to Combat Poverty

Abstract

Statistics consistently demonstrate that people with disabilities are the poorest, least educated, and largest minority population in America. This article examines the employment provisions of Title I of the recently enacted Americans with Disabilities Act (ADA) and its use in combating poverty for individuals with disabilities. The ADA in its entirety, and Title I in particular, is useful both as an advocacy and pedagogical tool to understand and alleviate poverty, oppression, and discrimination. Suggestions for infusing this content into the professional foundation curriculum are included.     

Predicting the effect of disability on employment status and income

Research shows that participation in employment contributes to life satisfaction for persons with disabilities [18]. Title I of the Americans with Disabilities Act (ADA) sought to prohibit discrimination against persons with disabilities in the workplace, however, the ADA's effectiveness remains controversial. This research utilizes data from the disability supplement of the 2000 Behavioral Risk Factor Surveillance System to examine the impact of disability status on predicting employment status and income. Confounding variables such as gender, age, educational level, race and marital/parental status are examined regarding their influence on results. Results from analysis utilizing zero-order correlation, linear and logistic regression analysis techniques revealed that disability status has a significant predictive effect on inability to work. Furthermore, results continue to show that despite legislation, the higher the level of disability, the lower the employment status (those employed for wages) and income. Finally, disability status, coupled with being female or decreased educational level, consistently shows significance in predicting lower employment status and income than men or non-minorities with disabilities. Future research opportunities and policy implications are discussed with regard to the results presented.     

Transitions to work for persons with serious mental illness in northeastern Ontario, Canada: examining barriers to employment

This paper considers the importance of place in the conceptualization of transitions to work for persons with serious mental illness (SMI). A qualitative case study was conducted to explore the influence of place on access to employment for persons with SMI. In-depth interviews, focus groups, and demographic data collected from urban and rural residing individuals who experience SMI, mental health and vocational service providers, and decision makers across northeastern Ontario inform this paper. The results highlight the primary theme, stuck in the mud, which explains how people with SMI, service providers and decision makers are stuck regarding employment. Ultimately, their being stuck creates a variety of place-related tensions and a tendency to settle for less in the area of employment for persons with SMI. The condition of being stuck in the mud is expressed as a metaphor depicting the existing tensions between ideas which govern provincial employment policy for persons with SMI and the mainstream or dominant discourse governing local organizations, programs and practices in the case communities and supports the need to consider place in policy implementation.     

The variation in family background amongst young homeless shelter users in Denmark

This article analyses variation in the family background of young homeless people in a cohort of young Danes. The study is based on administrative data for individuals who were 18 years old in 2007 and their parents. Homelessness is measured by shelter use over a five-year period. Data also cover education, employment, mental illness, substance abuse problems and placement outside home in childhood for the young persons, and education, employment, civil status, mental illness and substance abuse problems for their parents. A cluster analysis identifies two groups, each comprising half of the young shelter users. In the first group, social marginalisation is transmitted between generations, as most parents have low education and mental illness or substance abuse problems, and are unemployed. In contrast, the young people in the second group come from wider socioeconomic backgrounds, with few of their parents having mental illness or substance abuse problems. These young people develop psychosocial problems and become homeless without strong predictors from their family background. Amongst the young shelter users from families with severe social problems a higher share are in the Not in Education, Employment or Training group. They also have more shelter stays, compared to young shelter users from families with fewer social problems.     

The mental health recovery movement and family therapy, part I: consumer-led reform of services to persons diagnosed with severe mental illness

In 2004, the U.S. Department of Health and Human Services issued a consensus statement on mental health recovery based on the New Freedom Commission's recommendation that public mental health organizations adopt a "recovery" approach to severe and persistent mental illness, including services to those dually diagnosed with mental health and substance abuse issues. By formally adopting and promoting a recovery orientation to severe mental illness, the United States followed suit with other first-world nations that have also adopted this approach based on two decades of research by the World Health Organization. This movement represents a significant paradigm shift in the treatment of severe mental health, a shift that is more closely aligned with the nonpathologizing and strength-based traditions in marriage and family therapy. Furthermore, the recovery movement is the first consumer-led movement to have a transformational effect on professional practice, thus a watershed moment for the field. Part I of this article introduces family therapists to the concept of mental health recovery, providing an overview of its history, key concepts, and practice implications. Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts.     

A Youth Perspective on Life with a Disability

Abstract

A momentous piece of legislation, the Americans With Disabilities Act (ADA) of 1990 provided for the elimination of discrimination against individuals with disabilities and more significantly is aimed toward improving their employment opportunities. There is, however, evidence that the ADA implementation has not moved fast enough in increasing employment opportunities for persons with disabilities. This article reviews the literature on disability and employment barriers, federal statutes, societal attitudes and biases, and human relations misconceptions associated with disabilities. It discusses social work roles, advocacy for social justice, implications for rehabilitation counselors, and issues related to disabilities and employment.     

Smoking and persistent mental illness: an exploratory study

The rate of smoking is alarmingly high among persons with persistent mental illness and they are no less susceptible to the harmful effects of smoking. Nicotine is a potent, addictive drug which affects neurotransmitters. Smoking can affect psychiatric symptoms as well as blood levels of psychotropic and other medications. Most persons with mental illness are aware of the detrimental health risks of smoking and many are interested in quitting. Poor physical health is associated with efforts to quit. Personal commitment is important to successfully quitting.     

Employment services for persons with serious mental illness in northeastern Ontario: The case for partnerships

Objective: To better understand why employment success is low, a case study was conducted to examine the influence of place on access to employment for persons with serious mental illness (SMI) residing in two northeastern Ontario communities (Rebeiro, in progress). Methods: Community-based participatory research methods were used to engage persons who experience SMI, decision-makers and providers in the research. Forty-six interviews were conducted, complemented by primary and secondary quantitative data sources.Results: While most consumers consider employment to be a key element of their recovery, employment rates for persons with SMI remain limited in northeastern Ontario, Canada. The findings of this case study reveal the importance of collaborative partnerships to fostering better employment outcomes in northeastern Ontario. Conclusion: The challenges of collaboration due to rural and northern tensions, as well as various jurisdictional and funding tensions existing at the level of community support the case for partnerships in the provision of employment services in northern and rural places.     

Work, employment, and mental illness: expanding the domain of Canadian social work

Despite established evidence that work and employment are an important component of recovery for people who experience mental illness, social work education in Canada seldom offers graduate training or courses on the significance of work in peoples' lives or on the practices involved in helping to gain and retain employment for these individuals. In this article the authors argue that the high levels of unemployment among people who experience mental illness, and the rising incidence of mental health and addictions issues in workplaces, offer the opportunity, as well as the mandate, for social work educators to provide professional education in the area of employment support and assistance.     

Patterns of employment among individuals with mental illness in vocational recovery

This article provides empirical evidence about the patterns of competitive employment among individuals with serious mental illness who are in vocational recovery. The findings are based on a 5-year longitudinal study on sustained employment, conducted with a national sample of 529 individuals with serious mental illness who were in vocational recovery at the time of study enrollment. Data analysis from the 328 participants who completed the study-from baseline through all five annual follow-up assessments-revealed three different postrecovery employment patterns: continuous, stable, and fluctuating. Although many participants demonstrated the capacity to sustain competitive employment during prolonged periods of time, others experienced employment interruptions. Work interruptions were most frequently attributed to exacerbation of psychiatric symptoms. Schizophrenia spectrum disorder, difficulties with daily functioning, and current receipt of disability benefits predicted the psychiatric-based work interruptions in this sample. Implications for clinical practice are also discussed.     

Nursing home admissions and long-stay conversions among persons with and without serious mental illness

The appropriateness of nursing homes for individuals with serious mental illness remains a controversial issue in long-term care policy more than a decade since the landmark U.S. Supreme Court Olmstead decision in 1999 , which affirmed the rights of persons with disabilities to live in their communities. Using national nursing home Minimum Data Set assessments from 2005, the authors compared the demographic, clinical, and functional characteristics of persons with and without serious mental illness newly admitted to nursing homes. They found that newly admitted people with serious mental illness were younger and more likely to become long-stay residents than those admitted with other conditions, despite a higher proportion of residents with serious mental illness, including the elderly, classified as low-care status. The most substantial and clinically significant difference for rates of low-care status 90 days after initial admission are for persons younger than 65 with serious mental illness versus those younger than 65 without serious mental illness (33% vs. 8.5%, or 3.9 times greater). There is a notable difference in low-care status between persons aged 65 and older with serious mental illness and those aged 65 and older without serious mental illness (14% vs. 6.6%, or 2.1 times greater). These results suggest that a substantial number of adults with serious mental illness residing in nursing homes may have the functional capacity to live in less restrictive environments.     

Evidence-Based Social Work Practice with Mentally Ill Persons who Abuse Alcohol and Other Drugs

Abstract

The current article outlines a comprehensive approach to evidence-based social work practice, and applies it to persons with severe and persistent mental illness who also abuse alcohol and other drugs. Representative empirical literature is summarized within a framework that delineates the three major functions of evidence-based social work practice: assessment, intervention and evaluation. Assessment protocol, which incorporates the use of valid scales to complement the qualitative interview, is based on domain-specific research that outlines relevant psychosocial risk factors, and highlights those that are amenable to change. Intervention strategies are derived from the growing body of controlled research findings, but flexibility in implementation is recommended to accommodate clients' individual needs and the vagaries of daily practice. Naturalistic evaluation methods are used to capitalize on the use of brief, valid process and outcome measures to augment individual qualitative evaluation and to aggregate data for program evaluation. The implications of this integrated evidence-based strategy for social work practice are discussed.     

Building Community Capacity to Help Persons with Mental Illness

Abstract

In a time of crisis, persons with mental illness who encounter the police are often sent to jail or are involuntarily committed for psychiatric evaluation when mental health services are not readily available. To better serve these persons and the community, law enforcement and mental health professionals in one Iowa county joined together to ensure these individuals received the assessment and treatment needed. The results of a mixed methods program evaluation are detailed and suggest that the process to develop the program was as critical as the conduct of the program itself. Implications for program development are discussed.     

How to reduce the risk of HIV infection for the seriously mentally ill.

1. The professional literature increasingly indicates the need to educate persons with serious mental illness regarding HIV/AIDS. 2. Community-based organizations currently responding to the AIDS epidemic are poorly equipped to respond to the special needs of persons with serious mental illness. 3. Persons with serious mental illness are concerned by HIV/AIDS. Some, however, will incorporate education into their pathology via delusional systems or misunderstandings. 4. Effective programs for this population can be developed following community health nursing principles.     

Financial insecurity and risk experiences of justice involved persons with severe mental illness

More information is needed about the financial experiences of justice-involved persons with severe mental illness. Qualitative and quantitative methods were used to examine the financial resources, financial risk experiences, and financial literacy of a random sample of 12 mental health court participants. Mental health court participants had limited financial resources, frequently ran out of money, and had engaged very few financial tools to manage their money. Justice-involved persons with severe mental illness need financial management interventions to help develop strategies for managing depleted resources and to develop the financial resources needed to live in community settings.     

Students' Attitudes to the Inclusion of People with Disabilities in the Community

This study measures and compares the attitudes of students studying different subjects to the inclusion of people with mental retardation and mental illness in the community. The Community Living Attitude Scale (comprising the four subscales of Empowerment, Exclusion, Sheltering, and Similarity) was administered to a random sample of 149 Israeli college freshmen and women (social work: n = 43: law: n = 24; natural science: n = 42; and social science: n = 40). Overall, the students endorse Empowerment and perceive the Similarity of persons with disabilities to themselves more than they agree with the Exclusion attitude of segregating persons with disabilities from community life. Social work students showed more positive inclusion attitudes to people with disabilities than other students. Students were more likely to endorse Exclusion for people with mental illness than for people with mental retardation.     

Mental illness, supported education, employment and recovery: Ben's story

Supported education programs aim to facilitate the successful return to higher education for people living with mental illness who may have experienced educational interruptions due to their illness. This article shares the story of Ben who lives with mental illness and his experience of participating in an Australian supported education course. The two authors draw on a qualitative life history approach as they reflected on Ben's experiences of mental illness, educational disruption and returning to education and employment. The losses associated with educational disruption and the positive and empowering experience of becoming a student again are described as positively impacting recovery. Ben's story is shared in anticipation that other people living with mental illness, their family and carers, or workers supporting those people, may draw from his determination and success, in their own journeys of recovery.     

The Americans with Disabilities Act in Federal Court: litigating against public entities

This study represents the first systematic inquiry into the outcome of litigation against state and local public entities under Title II of the Americans with Disabilities Act (ADA) of 1990. Because Congress instituted a system of judicial review that established the courts as the final authority of rights and responsibilities under the Act, Title II litigation has a potentially significant impact on the disability policymaking of state and local governments in the United States. The analysis is based on all reported federal court rulings through June 2000 in which the court adjudicated a Title II claim against a public entity. The results show that plaintiffs are moderately successful in their suits against public entities, especially when compared to their record in litigating against private employers. However, the courts, particularly at the appellate level, still exercise restraint about interfering in the disability policies of subnational governments when implementing the ADA.     

A quit smoking group. Pilot study

1. While the rate of smoking is extremely high among persons with mental illness, there have been efforts to assist this population to quit. A 10-week smoking cessation program was provided for 10 highly nicotine dependent persons with persistent mental illness. 2. No significant differences were found in psychiatric symptoms or drug side effects prior to and after smoking cessation efforts. Four months later, for the 7 subjects who completed the program, 14% were abstinent, 43% maintained reduced tobacco intake, and 43% had resumed previous smoking patterns. 3. Specific barriers to quitting include a lack of nonsmoking coping skills, long-term identity as a smoker, ready access to tobacco products, nicotine addiction, and limited nonsmoking social support.     

An Overview of and Comments on the Americans with Disabilities Act (ADA)

Abstract

The authors overview the key components of the ADA in this article. A discussion is offered on why and how persons with disabilities are discriminated against. Critical United States Supreme Court decisions are presented; these decisions have greatly limited the power of the ADA in protecting the rights of persons with disabilities. Even though the United States Supreme Court has narrowed the impact of the ADA in American life, a number of Equal Employment Opportunity Commission (EEOC) cases are presented suggesting this federal agency is attempting to protect persons with disabilities against discrimination. Finally, the authors deal with the topic of advocacy; advocacy may well be one of the most effective tools to help insure that the rights of people with disabilities are protected.