mental health and employment in tvr work building on our strengths as tribal programs
TRANSCRIPT
Mental Health and Employment in TVR Work
Building on Our Strengths as Tribal Programs
Medical Model
Medical Model v. Traditional Perspective
FOCUS ON INDIVIDUAL INCAPACITY
DIAGNOSIS RATHER THAN FUNCTIONING
LOOKS AT PEOPLE AT WORST TIMES IN THEIR LIVES
PERSON INDEPENDENT FROM ENVIRONMENT AND SUPPORTS
WESTERN MEDICINE VALUES CURE OVER MINIMZATION OR REMEDIATION OR ADAPTABILITY
Medical Model Traditional Perspective
Medical Model v. Traditional Perspective
VR Considerations
Mental Illness Defined Mental illness refers to a wide range of mental
health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.
Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.
Indigenous View Lack of traditional acknowledgement of
mental illness
Often not looked at as illness causing disconnect and inability to identify
Things viewed as broken in the medical model are at odds with traditional medicine beliefs (visions and channeling others emotions)
The more we accept the medical model the further we get away from the traditional teachings
RECOVERY VALUES IN WORKING WITH PEOPLE W. MI
CULTURE OF CLIENT BENEFIT – LIVING, WORKING, RELATIONSHIPS
PEOPLE HAVE RIGHT TO CONTROL THEIR LIVES, THEIR TX, & KINDS OF HELP THEY RECEIVE. STAFF SHOULD INFLUENCE.
ALL PEOPLE NEED HOPE & SUPPORT
PEOPLE W. MI DO GET BETTER --- > 60%
SYMPTOMS NOT PREDICTIVE IN OTHER AREAS
PEOPLE CAN WORK, SO THEY SHOULD WORK
PEOPLE W. MI BEST SERVED IN COMMUNITY
COMMUNITY/ PEER/ FAMILY SUPPORTS + PROS
Is there room for our IDENTITY?
Merging the Western and Traditional
Preparing for Employment…Assessment
PERSON
ABILITIES - CAN DO?
TOLERANCES - WHERE DO?
VALUES - WANT/ NEED TO DO?
EMPLOYER JOB
NEEDS ABILITIES
VALUES TOLERANCES
JOB MATCH
IF YOU THINK WORK IS BAD FOR
PEOPLE WITH MENTAL ILLNESS,
THEN WHAT ABOUT POVERTY,
UNEMPLOYMENT, AND
SOCIAL ISOLATION?
The Importance of Focusing on Wellness
How Has the Non-Native World Influenced Your Consumers?
LIZZIE BORDEN SYNDROME
LINE MANAGER -- S.F.
“ I CAN’T IMAGINE HIRING SOMEONE
WITH A PSYCHOLOGICAL
PROBLEM. “
RECRUITER -- BALTIMORE
“ I’D MUCH RATHER DEAL WITH THOSE WITH
PHYSICAL CHALLENGES. SIMPLY BECAUSE THEIR
WORK ETHIC IS BETTER & THEY’RE LESS LIKELY TO
STAB YOU TO DEATH.”
STIGMA REDUCTION:ABILITY TO CHANGE BEHAVIOR THROUGH
EDUCATION IN THIS AREA IS NEGLIGIBLE
IF YOU THINK WORK IS BAD FOR
PEOPLE WITH MENTAL ILLNESS,
THEN WHAT ABOUT POVERTY,
UNEMPLOYMENT, AND
SOCIAL ISOLATION?
IF YOU THINK WORK IS BAD FOR
PEOPLE WITH MENTAL ILLNESS,
THEN WHAT ABOUT POVERTY,
UNEMPLOYMENT, AND
SOCIAL ISOLATION?
What to Expect When Working With Consumers
ResistanceDeflectionProjection
Theory of Change Model
HELPING PEOPLE CHANGE:
HOPE,
HELP,
AND
HASSLING
(What does “hassling” mean for different cultures?)
HELPER’S RESPONSIBILITY TO ENGAGE & MOTIVATE
HOPE VS. OPTIMISM? ---
PAT ON BACK VS.
COMMUNICATING THAT: YOU CARE
YOU UNDERSTAND
YOU WILL BE THERE
YOU HAVE IDEAS & HELP TO OFFER
People don't resist change. They resist being changed.
~ Peter Senge
NO MOTIVATION(DO YOUR CLIENTS GET LABELED WITH THIS?)• FEAR OF FAILURE• NO SELF - CONFIDENCE• POOR EXPERIENCES• LOSS OF BENEFITS• LACK OF INFORMATION• LAZINESS • ? OTHERS
MOTIVATIONAL INTERVIEWING
•Express empathy•Develop discrepancy•Avoid argumentation•Roll with resistance•Support self-efficacy
Miller, W. & Rollnick, S. (1991).
Group Discussion
How do you incorporate tribal values, beliefs and teachings into the VR process?
What is working?Where are the disconnects?
Thank You
Lanor Curole, DirectorUnited Houma Nation Vocational Rehabilitation Services
(985)[email protected]
Joe MarroneUniversity of Massachusetts Institute for Community Inclusion