supported education and supported employment summit may 3 rd, 2010
TRANSCRIPT
Supported Education and Supported Employment Summit
May 3rd, 2010
BASICS
Supported education may be defined as the provision of support and services to help persons with psychiatric disabilities gain access to and succeed in a postsecondary college or technical school.
What is Supported Education? Supported Education Programs are
community partnerships made up of mental health consumers, family members, agency staff and college personnel.
The purpose of these partnerships is to pool resources to maximize educational opportunities and employment outcomes for persons with psychiatric disabilities.
What is Supported Education (Cont.) Agency staff provide individualized and/or
programmatic support to consumers returning to school.
Supported Education Programs provide supports and services that are over and above existing educational services.
Programs vary in structure and design according to the unique assets of each community, college, and participating agency.
Not One Model–Rather Principles
Principles based on psychiatric rehabilitation and recovery: Normalization Self-determination Support, skills and resources Hope and recovery System change
A wide range of mental health service delivery models are in use
MH agency, self-help or wellness groups or organizations, clubhouses, mobile staff, on-campus program can provide support
Eligibility usually requires acceptance of illness, being in treatment and target group diagnosis
Why is Supported Education Needed?
Stigma and prejudice Fluctuation of student needs Service coordination Psychosocial effects of mental Illness Inadequate Disabled Student
Services funding
Why is Supported Education Needed: Statistical Context (Cont.)
86% of persons with psychiatric disability withdraw from college prior to getting degree
There are only 9,000 persons in California post secondary school with psychological disabilities but 650,000 public mental health consumers (34% with at least high school education)
In 2007 only 6 social work of 833 undergraduates with psychological disability got a degree and 12 of 1,200 got a masters in social work
PROGRAM ELEMENTS
Supported Education program elements focus on three domains of intervention:ACCESSRETENTIONOUTCOMES
Supports to Facilitate ACCESS
Outreach and recruitment
Orientation and “walk-through” visits
Identified Contact Person
Assistance with registration
Assistance with financial aid
On-site support staff
Transitional Classes
Faculty training Peer Counseling Study labs
Book funds Tutoring Crisis
intervention Social activities Safe place to
meet
Supports to Facilitate RETENTION
Supports to Facilitate OUTCOMES
Service and plan coordination Coordinated career planning Assistance with degree application Assistance with transfer application Liaison with transfer sites or
employers
SUPPORTED EDUCATION OUTCOMES & FINDINGS
“There are many positive outcomes for providing supported education services to people with psychiatric disabilities. A major one is that mental health consumers become college students. The role of college student in our society is highly valued. The role of mental health consumer is very devalued. With this change in role and identity, students realize they are not their illness, but a functioning, productive member of the community. Symptoms become something to be taken care of so goals can be accomplished.”
Karen Unger, MSW, EdD
Evidence-base for supported education: Overview
Virtually all studies report positive results, but… Methodology is generally weak
• 19 studies total• 2 are unpublished• 9 were pilot projects• 1 randomized control comparison (but weak intervention)• 1 three site comparison• 1 quasi-experiment
Outcomes are inconsistently measured from study to study and usually rely on self-report
Is an “effective practice”
Program Participants in the Three Best Studies
Average age: 34, 36 (17 to 75), 29 Hospitalizations:
San Mateo: Average of 7 hospitalizations Unger: 86% hospitalized
Diagnosis primarily schizophrenia spectrum disorder, major depression, bipolar disorder
Participants (Cont.)
High proportion take psychiatric medications
Tend to have more education and employment than other persons receiving mental health services:
Mowbray: half had some college already
Unger: 50 of 124 already had at least AA degree
But (Unger) 29% had been homeless and 38% had been arrested
Success is Associated with:
Mowbray: Productive activity at baseline, or having a partner
Unger: Fewer hospitalizations, having a car
In neither study were diagnosis, symptoms, or duration of illness associated with any measure of success
Evidence of success in 3 best studies Measures inconsistent across studies and vary
widely in effectiveness Drop-outs reported by Mowbray: 44% Class enrollment rate 28% Mowbray; 83% Unger
study (includes San Mateo); 42% Cook Course completion rate: 42% Mowbray; 90% Unger;
average of 3.6 courses, Cook Reduced hospitalizations (Unger)
Evidence of success (cont.) Grade point average: 3.1 Unger Received degree or certificate: 14% Cook, 21%
Unger Quality of life and self-esteem improve in one site
(Mowbray), self-esteem alone (Cook), neither improved (Unger)
Our Experience in California Accommodations and services required by students with
psychiatric disabilities are similar or identical to those provided to students with other disabilities.
Students with psychiatric disabilities are neither prone to crisis or disruptive to the campus environment.
As a result of participating in Supported Education program, students experience improvements in work readiness, social skills, and self-esteem.
The development of personal supportive relationships with peers and other students is a key factor in the success of students with psychiatric disabilities.
Most problems are related to the stigma of mental illness or due to role confusion on the part of the college staff.
SUPPORTED EDUCATION & EMPLOYMENT
Employment is Common among Supported Education Participants
Many students also work Unger: 49% worked concurrently Cook: 78% employed within 3 year study
period and half those employed at end Doughterty: 78% some employment in 18
month study period Employment after leaving school
San Mateo: 51% work, 69% of these as part of MH system
School and Job Internships Boston University (2007):
Combined college classroom computer training with community internship.
Baseline work 18%, at one year 64%
Kansas University (2005) Similar model but for peer counseling At 6 months 63% employed
Housel (1993): On-campus Aide Training. 13 of 15 hired as MH aides after
program
San Mateo
Programs providing supported education and supported employment
An early model (Egnew 1993) County MH contracted with one agency for
both services Preliminary counseling covers short/long
term and both employment and school Mobile approach used for both services School grads get special supported
employment intervention
Programs providing supported education and supported employment (2)
Nuechterlein(2005, 2008) Serve first break college drop outs Adapted IPS for work or school IPS Supported employment program also helped
with return to education, performing all supported education functions
93% were successful returnees to:• 36% School only• 31% Jobs only• 33% School and work
Getting to work!