Welfare Reform and Its Impact on the Employment Prospects of Individuals with Psychiatric Disabilities

ABSTRACT

Welfare policy in Australia has undergone a marked shift in direction since the election of the Liberal Coalition (Conservative) Government in 1996. This paper examines welfare policy and, in particular, the disability support pension, in the light of the vocational needs of those with psychiatric disabilities who seek to gain employment. Empirical data is presented concerning a case study of 65 clients participating in a vocational program. These participants had all been diagnosed with psychiatric disabilities, and were assisted to obtain open employment. The paper demonstrates that welfare policy, in conjunction with the recently privatized employment services network, not only fails to address the barriers faced by individuals with psychiatric disabilities, but undermines their efforts to gain employment and recover from the illness.     

Vocational outcomes of individuals with psychiatric disabilities participating in a supported competitive employment program

The objective of this paper is to report on the vocational outcomes of individuals with psychiatric disabilities participating in a supported competitive employment (SCE) program. A total of 458 subjects enrolled in the present SCE program which was developed on the basis of the Supported Employment Model developed by Wehman [23] and the principles of the Individual Placement and Support (IPS) developed by Becker and Drake [5]. Of the 458 subjects, 308 (67.3%) obtained competitive employment. The mean job tenure was 134 days. The mean salary was $4,740 for full-time jobs and was $2,321 for part-time jobs. The majority of subjects (59.4%) could sustain their job placement for more than 30 days, 74 (24.0%) subjects could work for more than six months, and 38 (12.3%) could maintain the job for more than one year. Subjects who became employed were compared to those who did not gain employment on a variety of demographic variables. Significant differences were found between two groups in terms of sex and source of referral. The rate of employment in the current study was slightly higher, but the job retention rate was lower than in earlier studies. Recommendations for future research on evaluation of the effectiveness of SCE program are suggested.     

Assessment of vocational opportunities and continuing job placement for persons with mental disabilities: factors indicating levels of necessary support

We determined primary factors in allocating support for vocational opportunities and continuing job placement for clients with mental disabilities. The study analyzed 29 items regarding work attitudes and vocational skills for 70 clients as assessed by the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Disabled. The evaluations were performed using the situational assessment approach with a 3-point support scale system assigned through observation of behavior. The results of these evaluations placed 35 clients in employment groups (A and B) and 35 clients in a sheltered workshop group (C). The data was analyzed by multivariate analysis. Predictions of success and functional differences among the groups were indicated by the data. Differences were found among the three groups in work attitudes and skills such as "self-direction" and "directions for social participation". Out of the 35 clients currently employed, 11 were recognized as needing ongoing assistance from supported employment offices. For the supported employment group (B), the major work attitudes and skills for which they required continuous services for maintaining stable jobs were 'emotional stability' and 'learning of working skills and accomplishment of work.' In a previous study, the major differences between the competitive employment group (A) and the sheltered workshop group (C) were in areas of 'responsibilities,' 'goals for life,' 'motivation for the work and understanding of contents for work,' and 'safety during work.' Our study supports these findings. In addition, transition from the sheltered workshop to supported employment required training to improve skills and support for 'responsibilities,' 'goals for life,' 'participation in leisure activities and community-based activities,' and 'preparation and cleaning for work.'     

Transitions to part-time work at older ages: the case of people with disabilities in Europe

This paper analyses the labour-force transitions of older workers with disabilities in general, particularly workers’ transitions to and from part-time employment within a European context. Using the two first waves (2004 and 2007) of the Survey of Health, Ageing and Retirement in Europe, we compare transitions between employment statuses for disabled and non-disabled individuals, even after controlling for different disability trajectories. In addition, we employ a multivariate framework to examine the determinants for remaining in part-time work in 2007 for those individuals who were part-timers in 2004. The results show that older people with long-term disabilities have a higher probability of staying in a part-time job than their compared counterparts. Policy-makers must promote part-time employment as a means of increasing employment opportunities for older workers with disabilities and support gradual retirement opportunities with flexible and reduced working hours.     

Self‐employment among people with disabilities: evidence for Europe

This paper examines the use of self‐employment among people with disabilities in Europe. Using data from the European Community Household Panel for the period 1995–2001 for 13 European countries we found that people with disabilities were more likely to be self‐employed than people without disabilities. Self‐employment provides flexibility and a better adjustment between disability status and working life. Moreover, the levels of satisfaction with job, type of job and working conditions of self‐employed disabled people are higher than those reported by disabled people who are wage and salary earners. Policy‐makers must encourage self‐employment to increase the levels of well‐being and employment of people with disabilities in Europe.     

Successful Vocational Rehabilitation for Individuals with Significant Mental Disabilities

ABSTRACT

Individuals with significant mental disabilities (SMD) frequently have scattered work histories (Finch, 1997; Tan, 1996). Often the SMD consumer is unable to find competitive employment or, if a job is secured, termination repeatedly ensues because of impaired interpersonal skills, faulty behaviors such as the inability to interact with coworkers, inadequate follow-through such as not reporting to work, and poor hygiene (Tan, 1996). The services provided to SMD consumers in this study were designed to address a cadre of support needs that would foster job retention and increase the number of successful employment closures. This cross-sectional exploratory study sampled 211 SMD consumers who received vocational rehabilitation support services through a vocational rehabilitation center in Columbus, Ohio. The SMD consumers sampled experienced both successful and unsuccessful employment closures.     

A longitudinal evaluation of government-sponsored job skills training and basic employment services among U.S. baby boomers with economic disadvantages

Job skills training is a cost-effective strategy for improving employment among individuals who have low income and employment barriers, but few U.S. government-sponsored employment program participants have received such training. To better understand long-term gains from job skills training, this study compared employment and earnings trajectories between program participants who received job skills training and those who received basic services only. Using data from the National Longitudinal Survey of Youth 1979, we estimated 33-year employment and earnings trajectories among U.S. baby-boomer cohorts while accounting for baseline group heterogeneity using inverse propensity score weighting. We found increases in employment rates over the life course, especially among Black women. Job skills training also increased earnings by up to 69.6 % compared to basic services only. Despite the long-term gains in employment and earnings, job skills training participation is not sufficient to address gender as well as racial and ethnic gaps in full-time employment. Findings reinforce the importance of incorporating job skills training as an essential service element of government-sponsored employment programs to improve long-term labor market outcomes among Americans with economic disadvantages.     

Childhood abuse and psychiatric impairment in a sample of welfare to work women

Since 1996, individuals who participate in welfare programs are mandated to find employment. Welfare recipients may have difficulty transitioning to the work force due to impairments in psychosocial functioning. Examples include mental health and substance use disorders, medical problems, academic and learning difficulties, and lack of resources such as childcare and transportation. In addition, many welfare recipients have histories of abuse and violence, which further complicate their job finding efforts given the documented relationship between past maltreatment and psychiatric impairment. An area unexplored is the relationship between a history of childhood abuse and psychiatric impairment in Welfare to Work (WtW) recipients. We evaluated the relationships among demographics, personality pathology, substance abuse, cognitive functioning, and histories of childhood abuse in a group of 158 WtW recipients in order to assess predictors of psychiatric impairment. Results suggest that participants with higher levels of psychiatric impairment also had higher levels of interpersonal problems related to personality pathology, higher drug and alcohol use impairment, and endorsed more severe histories of childhood abuse. Personality pathology, alcohol use severity, and self-reported childhood abuse emerged as the best predictor of psychiatric impairment in this WtW sample. These results have implications for identifying individuals at risk for unsuccessful transition into the work force and for the development of effective rehabilitation strategies that considers the unique needs of women in WtW programs.     

Social enterprises as enabling workplaces for people with psychiatric disabilities

In recent years, western governments influenced by neoliberalism have emphasized paid work as a key route to social inclusion and community participation for people with psychiatric disabilities. Although paid work can offer many rewards, access to mainstream employment for people with psychiatric disabilities is difficult as they continue to encounter discrimination and a lack of workplace accommodation. One response to these challenges has been the creation of social enterprises as ‘alternative spaces’ of employment for people with psychiatric disabilities. On the basis of interviews with key informants from 21 different social enterprises across Ontario, Canada, this paper critically analyzes the strategies used by organizations to create jobs that are both accommodating for people, but also conducive to the ongoing success of the business.     

Maximizing potential: innovative collaborative strategies between one-stops and mental health systems of care

Barriers to seamless service delivery between workforce development and mental health systems of care have kept both entities from maximizing their potential in regards to employment for job seekers with mental illness who are capable of work and seeking employment. Using a multiple case study design, this study examined the nature of collaboration between workforce development and mental health systems to understand the policies and practices in place to assist individuals with mental illness to find and keep work. The paper presents innovative strategies that involved staff from both workforce development and mental health agencies. Findings from this research identified the following collaborative strategies: (a) the creation of liaison positions and collaborative teams; (b) staff training on mental health and workforce issues; and (c) multi-level involvement of individuals with mental illness. Implications for workforce professionals are offered as a way to stimulate implementation of such strategies.     

A return to work program for injured workers: a reassignment model

The current workers' compensation system does not encourage permanently restricted workers who are disabled due to work related injuries to return to work. Workers are often labeled permanently disabled and are released from their positions with their employers. However, according to the Americans with Disabilities Act of 1990, these individuals may be qualified to return to productive employment. This paper will describe a Reassignment Model for occupational therapy supported by the rehabilitation frame of reference. This Model presents reassignment to a vacant position as a reasonable accommodation to return injured workers to productive employment. A case study will illustrate the successful implementation of the model. The potential benefits of using this Model will be described for clients, society, employers, and the occupational therapy profession.     

Partnering with the 21st century workplace: leveraging workplace ecology

The 'accessible' job market of the 1990's has given way to a challenging job market in a climate of economic uncertainty in the early Twenty-First Century. For vocational rehabilitation professionals this change requires the strategic use of workplace supports to increase the value and sustainability of work performed by people with disabilities in competitive jobs. An analytical framework for leveraging the natural supports of the workplace is provided by the workplace ecology as a bounded environment in which relationships between workers and supervisors promote learning and enhanced performance. The dynamics of the workplace ecology are explored with particular reference to workers with disabilities receiving supported employment services. Recommendations are made for leveraging the workplace ecology to the benefit of the supported worker. Implications for supported employment services in the new millennium are discussed.     

Stuck in a Loop: Individual and System Barriers for Job Seekers With Disabilities

Research conducted within Temporary Assistance to Needy Families (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) and Workforce Investment Act of 1998 systems indicates pervasive issues hindering program effectiveness for job seekers with disabilities. This population frequently experiences employment barriers beyond those of able‐bodied job seekers, including significantly lower self‐esteem. Service providers need and want information about disability but do not know how to obtain it. Program staff and job seekers with disabilities get stuck in a loop wherein each questions their ability and neither feels empowered to make meaningful changes to improve outcomes. Career counselors may need to expand their role to be more culturally relevant for these clients.     

Comprehensive career planning: The VCU Career Connections Program

Individuals with disabilities who complete post secondary education programs must be prepared to plan and direct their long-term careers. Despite recent legislation, students with disabilities exiting higher education continue to face obstacles such as negative employer attitudes, architectural barriers, and lack of necessary services and supports when attempting to access employment and pursue their careers. This article describes a comprehensive career-planning program designed to enhance employment opportunities for individuals with disabilities as they graduate from higher education.     

Recovering from Illness or Recovering your Life? Implications of Clinical Versus Social Models of Recovery from Mental Health Problems for Employment Support Services

Although valuable research has been undertaken in the United States little is yet known about the processes engaged in by supported employment projects for people with mental health problems. The study reported here explored these processes using semistructured interviews with employment project clients, their project workers and workplace managers. Of five projects involved in the research, two exemplified radically different approaches, one implicitly underpinned by a clinical model of recovery and the other by a social recovery model. In this article we draw on data from the seven cases studied from these projects to describe the two approaches and to consider their strengths and limitations. We conclude that approaches based on the social recovery model hold more promise, although such approaches would be enhanced through greater liaison with mental health professionals. In addition, funding structures are required that take account of job retention rates, rather than placement rates alone.     

The development of supported employment services for people with mental illness: local experience in Hong Kong

Before the 1960s in Hong Kong, specialized vocational services for people with mental illness were very limited, and sheltered workshop seemed to be the only option for their future vocational placement at that time. As discussed in the literature, there are still many shortcomings of the sheltered workshop model, that brings us to the emergence of another community-based vocational service: Supported Employment. Unlike traditional vocational services, the concept of supported employment emphasizes the placing of the clients into integrated work environments and then providing on-going support and work-related skills training in the job post. Though supported employment services help many clients to sustain a job in the competitive market, many service barriers and problems still remain unsolved. These service barriers and problems will be discussed in this article, and suggestions will be made.     

Successful Adoption of Children with Down Syndrome and Other Developmental Disabilities

Abstract

Children with many types of developmental disabilities have been successfully adopted. Nonetheless, there appears to be a belief among both adopters and some adoption workers that children with Down syndrome are especially easy to rear. The current paper uses different methodological strategies, including case-by-case matching and regression techniques, to test hypotheses relating to better outcomes for parents and families who have adopted children with Down syndrome in comparison to children with other developmental disabilities. The results demonstrated successful functioning for parents and families on a variety of measures, regardless of whether the adopted children had Down syndrome or other developmental disabilities. The positive stereotype for Down syndrome was not supported.     

Staff characteristics and the exclusion of persons with disabilities: evidence from the microfinance industry in Uganda

This study uses survey data from the microfinance industry in Uganda to investigate whether there are differences among industry staff members in beliefs and views regarding persons with disabilities. For several of the questions, various staff sub-groups respond significantly differently. A recurring result is that staff members who have a relative with disabilities often express views that differ from the views of other staff members. Moreover, we find significant differences related to the age of the staff members. For instance, younger staff members are more positive and optimistic regarding the potential to reach more clients with disabilities. The employment position of the individual staff member also appears to be relevant: credit officers are relatively more likely (than other staff types) to indicate that discrimination could be a problem in the microfinance industry. Interestingly, we do not observe any differences in views and beliefs that are related to staff member gender.     

Broadening opportunities for job seekers with disabilities: strategies to effectively provide assistive technology in One-Stop centers

The Workforce Investment Act (WIA) of 1998 mandates that partners in the One-Stop Career Center (One-Stop) system be prepared to serve a diverse customer base, including job seekers with disabilities. For many such individuals, effective service delivery depends in part on the existence of appropriate and efficient assistive technology (AT) options. This article presents challenges experienced by One-Stop partners related to AT provision as well as strategies for providing effective AT support. Findings from case study research conducted in several One-Stops across the country revealed three strategies that have enhanced employment services and addressed barriers. These are (a) an accurate assessment of AT needs, (b) staff training and practice using the equipment, and (c) the ability to make the most of limited financial resources. Implications for the most efficient ways to provide AT options are discussed.     

Some Questions for Linda Mitchel on Loss and Bereavement

Resolving loss is the theme of this issue's interview. Linda Mitchell offers something in her employee counseling services that more employee assistance specialists need to address - helping clients better understand and resolve the sense of loss. She is a skilled psychotherapist with a specialty in counseling on "loss-related issues." She has designed and conducted support groups dealing with issues such as bereavement, self-esteem, job loss. As a skilled psychotherapist she has provided counseling and education to families experiencing a death of a loved one. In addition to seeing chemically dependent clients in her practice, she has experience counseling people with AIDS. Another part of her practice a assisting individuals in dealing with various life issues such as a change in a job position, or the loss of employment.