Supported employment grant shows positive power of work

December 6, 2018

Christine Fleming, CDRS executive director.Researchers in the Auburn University College of Education are entering the final twelve months of a five-year grant that has studied the effectiveness of Individual Placement and Support (IPS) in helping people with mental illness obtain and keep employment as part of their recovery and rehabilitation process.

For the past four years, Auburn has been part of a team that addressed and implemented a wide range of services and supports related to supported employment for people with mental illness in Alabama. The total grant award of $4 million was made to the Alabama Department of Mental Health. Auburn’s sub-award was $500,000, which it used to evaluate the effectiveness of the program through fidelity reviews and providing unbiased feedback and input for improving program outcomes. The original grant was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).

Supported employment in general is a service that provides support to people with disabilities – in this case people with mental health diagnoses – to help them find, train for, and sustain employment.

According to Dr. Christine Fleming, principal investigator for the sub-award and assistant research professor in the College of Education’s Department of Special Education, Rehabilitation, and Counseling, the program has helped transform clients, clinicians, and the mental health centers/providers.

“We are now beginning year five of the grant,” Fleming said. “We are one of three partners implementing the supported employment program, with the other two being the Alabama Department of Mental Health and the Alabama Department of Rehabilitation Services. We are the evaluation component with the other two agencies implementing the actual program with clients, who primarily receive services from both agencies. Overall, we are seeing great results from people moving into the workplace and turning their lives around through the positive effects of working and earning an income.”

Fleming and her research team of Drs. Sharon Weaver and Angie Hall recently completed an outcomes report for the two agencies so they could examine the impact the program is having on individual mental health centers and the system overall. Fleming and associate professor Rebecca Curtis have also conducted focus groups and recently developed a publication on the perceptions and practices of mental health practitioners regarding supported employment.

“IPS is an evidence-based practice that research shows helps people with serious mental illness secure competitive integrated employment. What we are experiencing in Alabama is that clinicians are able to see work as part of the recovery process for the consumers they counsel,” Fleming said. “We’re also seeing the great quality of life improvements in those clients who go into the workplace.”

Fleming described the success of this program on individual lives as “transformational.” The clinicians are seeing the positive power of work as part of the therapeutic and recovery process. Fleming also stated that she has seen many remarkable success stories through the project.

“One of my favorite anecdotes is one individual who now has a much stronger sense of self because he can have ice cream in his freezer ‘like everyone else’ since he now has money from his job,” Fleming said. “Another great example of the impact of going to work is a person who was depressed and would not get out of bed or shower and dress daily. But with the support of the program he obtained a job where he now has to be at Hardee’s at 5:30 every morning to make biscuits. The group home manager, who herself is awesome, takes him to work every day. She loves it because he is motivated to get up and go to work. Hardee’s loves his work ethic and keeps adding shifts for him. It not only transformed this person’s life, but also the dynamic of the group home itself.”

Although there are many success stories, Fleming said the overall numbers still have room to improve. The program has enrolled about 390 people with 240 job starts, but only about 60 people from the three sites have kept their jobs for more than a year.

“Based on that, the job retention data is not as good as we would like, but the individual transformations are wonderful,” she said. “We are in our final year of the project, and several studies show that medical costs go down when people go to work. Our job now is to show that this is also true in our state.”

Drs. Fleming, Curtis, Hall, and Weaver will be collaborating with the implementation sites in 2019 to collect and analyze data regarding medical utilization before and after going to work with IPS services as well as to examine employment outcomes.