Employment Opportunities for the Mentally-Ill, Essay Example

The articles examine the efficacy of evidence-based interventions and practices aimed at enhancing mental health and social functioning. They also investigate the diverse barriers that prevent individuals afflicted by mental illness from gaining employment opportunities within an integrated society that only pays minimum wage. Waynor and Pratt (2011) examine the role of Assertive Community Treatment (ACT) program that is designed to assist the mentally ill persons attain their stated employment goals and objectives. In a different vein of thinking, Cathaleene et al. (2006) compares the assertive community treatment (ACT) program with a certified clubhouse for the delivery of supported employment goals among the mentally ill population. The research conducted by Gao and Dolce (2005) also aimed at determining the efficacy of one particular intervention, Assertive Community Treatment (ACT,) to improve employment outcomes. Finally, Gold et al. (2005) examined more than two variables, such as ethnic minority status, age, and educational attainment, with regards to how such demographic variables impacted the employment status of mentally ill persons. This paper will examine the various ideas proffered by the authors of the four aforementioned articles to infer and make the appropriate judgments regarding the conclusions drawn within the respective studies. Together, these competing narratives add nuance to an ongoing discussion about the employment opportunities and status available to members of the mentally ill populace and readers discern avenues for future research.

Gao and Dolce (2010) hypothesize that the implementation of the Assertive Community Treatment (ACT) program would help improve consumer employment rates in the state of New Jersey within a 12-month period. The study focuses on the assessment of this program to determine whether or not it would be reasonable to continue implementing similar programs to assist people who suffer from psychiatric disabilities find stable employment. Gao and Dolce (2010) carried out the research in New Jersey within a community mental health agency that serves both urban and suburban patients. The selection criteria were that the recipients of the service had at least one admission to the state, or multiple admissions to the county psychiatric hospital in the past. The sample size was limited to 60 participants, and the demographic characteristics of participants were not considered when measuring the results. The study by Gao and Dolce (2010) was conducted by first determining baseline measurements to understand how many members of this study population were employed. This value was compared to the level of employment that was observed after the implementation of the ACT program. Results showed that employment rates increased from 5% to 24% over a 12-month period. Because the ACT program intervention was rendered successful, Gao and Dolce (2010) proposed that it should be used in additional applications to improve the rate of employment among individuals with mental illness. Gao and Dolce (2010) also believe that it is valuable to examine other methods that could contribute to an increase in the employment rate mentally-ill individuals.

The research created by Gold et al. (2005) aimed at measuring the outcomes of ACT-IPS (Assertive Community Treatment and Individual Placement and Support) combined evidence-based intervention in a community that had characteristics different from those that have been studied previously. Therefore, the hypothesis was to find evidence that the program would not only work in urban communities, but also benefit individuals who live in rural areas with limited access to work, education, and support services. Gold et al. (2005) used selection criteria to identify the population to be included in the study. The criteria included being a client of SWCMHC for at least 6 months, lacking employment, being over the age off 18, and having an interest in pursuing competitive employment. The study by Gold et al. (2005) had to be redesigned at an early stage, due to the lack of qualified providers. The randomized trial included the creation of three project teams, consisting of a total of 177 participants, assigned to ACT-IVR, traditional, and IPS programs (Gold et al. 2005). The main goal was to determine which evidence-based practice delivers more positive results for individuals with mental illnesses.

Measuring the long-term (24 months) employment and mental health outcomes revealed that those assigned to the Supported Employment (SEP) programs were less likely to be in employment after 24 months, however, they were also less likely to be in mental health services. At the same time, the proportion of participants holding on to one job for 24 months was 36.4 percent in the ACT-IPS program, compared with 28.6 percent of those in the SEP program. Further, competitive employment was higher among participants of ACT-IPS. The total earned income among participants in the ACT-IPS programs was higher. The main finding of the study by Gold et al. (2005) is that while SEP provides almost immediate job placements, but it does not support mentally-ill individuals in securing competitive employment. The main limitation of the study is that the ACT and IPS teams worked independently, instead of alongside with other mental health services teams. This lack of collaboration may have detracted from the validity of the results yielded by this study, although it nonetheless sheds light on the potentiality of the various programs described and tested.

Waynor and Pratt (2011) carried out their studies intending to finding whether the ACT program assists the mental persons in the society attain their employment goals. Waynor and Pratt (2011) wanted to identify those factors that deter the ACT personnel in helping consumers with securing employment to find out the efficiency of the ACT program in assisting individuals with mental illness. According to Waynor and Pratt (2011), ACT program should increase the stability and improve the life conditions of individuals with mentally illness. Waynor and Pratt (2011) used ACT vocational models to gain insight into the vocational situation among individuals suffering from mental illness. The authors hypothesize that employment remains the only avenue in which mentally ill individuals are treated as equal members of society at-large. Waynor and Pratt (2011) utilize a two-step survey method, where the initial survey was comprised of 60 ACT staff members, and a second one that collected information from 134 staff members. New Jersey ACT team members carried out the research by Waynor and Pratt (2011). This methodology was rendered ideal for the collection of data because the study sought to find barriers that hinder mentally-ill consumers from attaining employment goals, thereby implying that the ACT staff was appropriate for the study.

According to the results from the article penned by Waynor and Pratt (2011), it is evident that there were several issues that they needed to sort out in order to enhance the efficacy of the ACT program. Again, looking at the results yielded by the study by Waynor and Pratt (2011), it is evident that the ACT staff needs to perceive of themselves as providers who assist individuals suffering from mental illness attain their employment goals. The results also pointed out the need for substance abuse specialists to play a leading role in the integration of vocational services for substance abuse treatment to dismantle the barrier that hinders the ACT staff from offering the necessary facilitating services (Waynor and Pratt, 2011).

Macias et al. (2006) believe that supported employment provide important tools that are tailored to assist those persons suffering from mental illness attain their employment goals. According to Macias et al. (2006), when an individual with mental illness is hired, it does not mean that he or she will succeed in their jobs due to the fact that employees demonstrated interest to enroll mentally-ill persons at the outset of the program, but as the program progressed only some of them succeeded. Furthermore, Macias et al. (2006) utilized a randomized-controlled trial methodology in which representatives from local organizations as well as from the National Alliance of Mental Illness Chapter in Worcester developed sample recruitment. The method was ideal because the study was meant to compare the ACT and certified clubhouse and the nature of the sample being heterogeneous adults favored the method of collecting data. The research conducted by Macias et al. (2006) was comprised of 177 participants, and each enrollee received a random assignment to the clubhouse or ACT programs. The results showed that there is the need of integrating supported employment in multiservice programs to attain broader diffusion of supported employment program, which is effective because there would be no need to reduce vocational service quality.

In conclusion, Waynor and Pratt (2011) and Macias et al. (2006) both faced various limitations in examining the role of supported employment programs in securing employment for mentally-ill persons. Macias et al. (2006) questions the fact the statewide funding for novel supported employment programs was in its second year, which meant that there was high likelihood this would have limited the participants. This assertion implies that the results may not represent the facts or the goal of the study. On the other hand, Waynor and Pratt (2011) examined only the ACT personnel attitudes and barriers towards employment goals. The results were biased because the study should have looked at different variables to get the results the study intended to find. Consequently, it was significant for the study to use different variables that could have allowed better analysis, hence conclusion of the topic. The study lacked the element of variability, which means that the results did not reflect the real picture of the efficacy of the ACT program. ACT and certified clubhouse can assist attaining employment outcomes like those of the exemplary supported employment team. Thus, integrating supported programs will mean that the employment opportunities will be availed, and the quality of vocational service will improve. The staff attitude as seen in the results indicates that employment plays a primary role towards recovery, which is an important observation. ACT program was found to be effective towards allowing persons with mental illness attain employment goals.

Also in the study conducted by Gold et al. (2005) and Gao and Dolce (2010) it is clear that employment focused mental health evidence based interventions have the potential of supporting patients finding suitable jobs. This could positively impact not only their social and coping skills, but also reduce the level of stress that can trigger further admissions to psychiatric hospitals. Therefore, it is recommended that the above discussed ACT, SEP, and IPS programs are implemented by community hospitals.

References

Gao, N., & Dolce, J. N. (2010). A Case Illustration of Strategies to Improve Employment Outcomes Among Individuals Receiving ACT Services. American Journal of Psychiatric Rehabilitation. doi:10.1080/15487761003756944

Gold, P. B., Meisler, N., Santos, A. B., Carnemolla, M. A., & Williams, O. H. (2005). Randomized Trial of Supported Employment Integrated With Assertive Community Treatment for Rural Adults With Severe Mental Illness. Schizophrenia Bulletin. doi:10.1093/schbul/sbi056

Macias, C., Rodican, C. F., Hargreaves, W. A., Jones, D. R., Barreira, P. J., & Wang, Q. (2006). Supported Employment Outcomes of a Randomized Controlled Trial of ACT and Clubhouse Models. Psychiatric Services, 57(10), 1406-1415. doi:10.1176/appi.ps.57.10.1406

Waynor, W. R., & Pratt, C. W. (2011). Barriers to Vocational Effectiveness in ACT: Staff Perspectives. Journal of the American Psychiatric Nurses Association, 17(1), 72-79. doi:10.1177/1078390310394844