A Working Life for People with Severe Mental Illness.
Deborah Becker and Robert Drake are clinical rehabilitation specialists at the Dartmouth School of Medicine in New Hampshire. Their latest book, A Working Life for People with Severe Mental Illness, represents a milestone in the understanding of what constitutes effective vocational planning and outcomes for people with severe mental illness. The book challenges much of the conventional wisdom that pervades the field of psychiatric rehabilitation by attempting to dispel many of the myths that society has about what people with mental illness are capable of accomplishing vocationally. The authors divide the book into three major parts. Chapters one to four of part one give professionals a comprehensive overview of the historical, conceptual, and theoretical foundations that underlie the individual placement and support approach to supported employment for individuals with severe mental illness. Becker and Drake argue that unlike most vocational rehabilitation programs in the field of psychiatric rehabilitation that stress various types of pre-employment and social skills training before an individual with severe mental illness can be placed in a suitable job, the Individual Placement and Support (IPS) intervention model is a consumer driven approach that allows employment specialists to place individuals with mental illness into competitive jobs of their choice in the community more quickly and effectively by giving them the individualized supportive services they need to maintain employment once they are on the job. Becker and Drake continually stress throughout the book that individualized vocational services that are customized to the particular needs of each client are central to helping people with severe mental illness to achieve their vocational goals.
In chapter five, Becker and Drake review research findings that support the implementation of the IPS service model. They argue that studies have found that the IPS approach to vocational services has many practical organizational advantages over more traditional vocational rehabilitation programs that provide services to people with mental illness. IPS provides consumers with a more integrated, better coordinated service delivery system that allows vocational rehabilitation specialists to work collaboratively with other members of the clinical team to find appropriate job matches for every client who wants to work. The authors point out that findings from scientific studies conducted in major cities around the country indicate that clients who participate in IPS driven vocational service programs have more successful vocational outcomes and are able to maintain employment longer. The studies also found that IPS clients tend to earn higher wages and are generally more satisfied with their jobs than those participating in traditional day treatment programs or sheltered workshop settings. The remainder of the chapter focuses on a review of studies that have examined non-vocational outcomes associated with IPS intervention as well as the economic cost and impact of these programs on clients with mental illness and service providers.
Chapters six to eleven of part two of the book provide a detailed description of the various stepwise strategies that mental health agencies can utilize to implement IPS vocational service programs in their particular organization. The authors discuss some practical guidelines that agencies can use to integrate IPS into the range of clinical services they offer clients. Topics discussed include team building and planning, staff attitudes and training, commitment of resources, setting up eligibility requirements for IPS programs, client referral, record keeping, outcome measurement techniques, vocational assessment methods, the role of workplace and family supports in the rehabilitation process, and job search and follow up techniques that help clients find and maintain employment. Detailed case histories are used throughout to illustrate how employment specialists can apply the philosophical principles of IPS intervention to real life client oriented vocational situations.
Chapters twelve to fifteen of part three of the book provide rehabilitation professionals with a detailed understanding of some of the special issues that employment specialists must deal with when they attempt to implement IPS intervention services with their clients. Topics addressed in these chapters include employment and the dually diagnosed individual with a history of drug and alcohol use, special problems associated with finding suitable job placements for individuals with severe mental illness with high levels of skill and education, utilizing supported education as a way of helping clients develop job skills that will increase their employability, and the need for employment specialists and other team members to develop cultural sensitivity that will allow them to deliver culturally competent employment and other clinical services to diverse client populations. Once again, as in part two, the authors draw upon the use of illustrative case vignettes in each chapter to highlight the special issues discussed along with a set of practical recommendations for service providers.
From the perspective of this reviewer, A Working Life for People with Severe Mental Illness is an excellent book that should be on the reading list of university faculty teaching courses that train rehabilitation counselors and other mental health professionals to provide employment and other clinical rehabilitation services to individuals with severe mental illness. The book would also make an extremely useful educational resource for clinicians who work in community mental health agencies that provide treatment services to clients with mental illness and their families.
Mitchell A. Kaplan PhD, CPSP
Research Project Manager
Institute for Education and Research on Pain and
Beth Israel Medical Center, New York City
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|Author:||Drake, R. E.|
|Publication:||The Journal of Rehabilitation|
|Article Type:||Book review|
|Date:||Jan 1, 2006|
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