Lennox Archer had a good job teaching English as a second language to international college students. Then their life spiraled out of control.
“I was married, and that fell apart,” said Archer, 37. “My mental health sort of took a nosedive.”
Archer, who has schizoaffective disorder, needed inpatient treatment to get stable again. But that was only the first step in their recovery. Once they were discharged from the hospital, they needed to go back to work, but at that point, re-entering the job market seemed like an insurmountable challenge.
Then a counselor told Archer about the supported employment program offered by Benton County Behavioral Health. Archer signed up for the program in November 2017, and now they have not one but two part-time jobs, as well as a budding home business.
After being unemployed for three years, Archer said, it feels good to be working again.
“When you have work, you have a routine. It gives you a sense of purpose, a sense of accomplishment,” they said. “When you’re having all those dark thoughts, it doesn’t help not to be working.”
A stabilizing influence
Two out of three people with serious mental illness want to work, but fewer than one in six has a job, according to the IPS Employment Center, a research and training group affiliated with the nonprofit Rockville Institute.
But IPS — an acronym for individual placement and support — is starting to change that. Developed in the 1990s, IPS is an evidence-based model that has been used across the country to find stable employment for people with significant mental health issues, including schizophrenia, bipolar disorder and clinical depression.
As of March 31, the IPS Employment Center reports, 43 percent of the 18,806 clients served by IPS programs in the United States were working. That’s more than 8,000 people who might otherwise have had little or no chance of finding and keeping a job.
In Oregon, 35 of the state’s 36 counties are served by at least one supported employment program. All use the IPS model, with training and oversight from the Oregon Supported Employment Center for Excellence.
The Benton County program started in 2014 and receives referrals from the county’s mental health professionals. Participation is voluntary, and there’s no charge to the client.
Funding comes primarily from insurance coverage and the state. The county can bill private insurance or Medicaid for services, and the Oregon Health Authority provides funding for indigent clients. In some cases, money is also available from the state’s Vocational Rehabilitation program.
Doing what it takes
Rather than providing sheltered employment in a segregated setting, the program aims to give people with mental health issues the help they need to find and keep employment in the competitive job market.
“Some people come to us and they’ve already had an interview and they think, ‘Oh, my gosh, now what?’” said Sara Kaye, the county’s supported employment team lead.
“Some people come to us and they’ve never worked because they’ve been homeless for 25 years, but they think, ‘Now I can, because I’m stable.’”
Kaye and the team’s other two employment specialists try to provide whatever assistance the client may need, from help writing a resume to sitting by their side during a job interview. After the hire, team members can coach clients through the initial adjustment period and can work with employers on accommodations that can help clients succeed in the workplace. If need be, they can even provide assistance with transportation to and from work.
“Basically, it’s a ‘do what it takes’ model,” Kaye said.
Over its five years of existence, the Benton County Supported Employment Program has worked with about 70 clients and had more than 1,800 contacts with employers.
In the first quarter of this year, according to data compiled by the Oregon Supported Employment Center for Excellence, the county program worked with 21 clients of whom nine had jobs, a 43 percent employment rate.
A similar program in Linn County had 33 clients, with 12 of them employed for a 36 percent success rate. Statewide, supported employment programs served 1,817 clients during the first quarter of 2019 and helped 724, or 40 percent, find and keep jobs.
How do those job numbers compare to the population with mental illness as a whole? According to a 2014 report from the National Alliance on Mental Illness, the average unemployment rate for people receiving public mental health services was around 80 percent. The jobless rate for Oregon was nearly 88 percent.
For clients, finding appropriate employment can have a tremendous therapeutic effect, according to Kaye.
“Work is a stabilizing influence in all our lives,” she said. “The benefits of working are a recovery force in and of itself when a good match is found.”
The Oregon chapter of NAMI, the National Alliance on Mental Illness, is a strong supporter of the IPS model.
Executive director Chris Bouneff said the available data shows people who are working and contributing to their own welfare feel a stronger connection to their community and have a greater stake in their own recovery, which means they’re less likely to suffer a major relapse or future mental health crisis.
People with better mental health tend to be healthier physically, as well, which helps hold down health care costs on both the individual and the societal level.
“For better or worse, in our culture our sense of worth and health is entwined with our ability to work and contribute in similar ways to our community,” Bouneff said.
“Competing for employment just like everyone else, gaining such employment and maintaining employment — this adds rich purpose to our lives. Having such purpose helps people lead healthy lives.
You have free articles remaining.
“Plus,” he added, “it’s better than the alternative: telling people on disability that their lives are over, shutting them up in institutions and watching them deteriorate until an early death, which is pretty much what we used to do routinely.”
Finding a match
Clients of Benton County Supported Employment have found a wide variety of jobs, from janitorial and landscaping work to positions as cashiers, administrative assistants and veterinary hospital aides.
Archer is juggling two part-time jobs, one transcribing reports for insurance claims adjusters and another proofreading manuscripts for textbook authors, working from home on a computer.
At first, they said, it was tough getting back into the groove of holding down a job after a long period of unemployment. Archer had lost jobs in the past because of mental health issues, and in the back of their mind was the thought that it could happen again.
But having personalized support from a county employment specialist helped to ease those anxieties.
“I really think the most helpful thing was figuring out how to manage mental health and employment. … There were practical resources, but most of my benefit from it is this place in my mind that says, ‘Yes, I have mental illness and I have this job, and I can manage both,’” Archer said.
“Now I can explain myself and I can say, ‘This is who I am,’ and not be ashamed,” they added.
“Before it was like I had this terrible secret and now it’s just this is what it is. It maybe doesn’t sound like much, but it’s a huge change for me.”
There are benefits for employers as well.
County employment specialists get to know the needs of local businesses and program participants are prescreened to determine what kinds of jobs they’re suited for, so managers can be confident they’re getting qualified people.
In some cases employers may qualify for financial incentives, such as state funding for on-the-job training, tax breaks and federal bonding for workers with a criminal record.
And if an issue comes up on the job, the employment specialists can frequently iron it out before it becomes a serious problem.
One thing employers shouldn’t have to worry about is a violent outburst in the workplace.
“Our clients are not at any greater potential danger for violence in the workplace than any other ‘normal’ person — and I say that with air quotes,” said Dannielle Brown, director of Benton County Behavioral Health.
An analysis of medical literature published in February 2015 in the American Journal of Public Health cited studies showing that fewer than 5% of crimes committed in the United States involve people with mental illness. The same study cited statistics from the Centers from Disease Control and Prevention showing that fewer than 5% of gun-related homicides in a recent 10-year period were committed by someone diagnosed with mental illness.
“One of the biggest myths we need to bust is that mental illness is associated with violence, and it’s not,” Kaye added. “It’s an unfortunate myth promoted by the media.”
In addition, Kaye said, the department’s trained clinicians do safety planning with all of their clients.
“If it is an issue,” she said, “we would be six steps ahead of that ever reaching the workplace.”
McClellan Temporaries, a Corvallis Employment service, has been working with the supported employment program almost from the beginning and has placed three or four program clients in manual labor, custodial and manufacturing jobs, office manager Susan MacNeil said.
“I think this is a great idea. I’m very supportive of what Benton County is trying to do,” she said. “Making the leap into the job market can be difficult, even for someone who does not have a disability.”
The company prides itself on making sure the workers it supplies employers are a good fit for the job, and it hasn’t been able to find appropriate positions for some of the county’s clients. But when a good match is found for a worker with mental health challenges or another disability, MacNeil said, it can be deeply satisfying.
“It’s a little bit extra,” she said, “but I think that’s what you do to pull everybody along on the same road.”
Reason for hope
Archer graduated from the Benton County Supported Employment Program about eight months ago and no longer gets regular services. But if they ever feel the need for more help, all they have to do is pick up the phone.
“If I need to go back to them later, they still have my file,” Archer said. “They’re not out of your life.”
In the meantime, Archer has settled into a routine of putting in 20 hours or more each week at their two jobs. They like the feeling of having a regular income again, as well as the sense of accomplishment that comes from finishing a task, such as seeing a manuscript they’ve edited get turned into a published textbook.
But Archer’s not stopping there. In their free time, they’ve been hand-painting smooth stones with decorative motifs and inspirational reminders such as “Fight” and “Rest.” The painted rocks are starting to sell, and Archer plans to apply for a microloan from the Vocational Rehabilitation program to expand the home-based business.
All in all, things are looking up, and Archer is feeling a renewed sense of optimism.
“This is kind of my bridge thing,” they said. “Who knows where this bridge is going to lead?”