Resource Promotes Employment Despite Homelessness, Mental Illness

By Jon Bowen

People with mental illness who are homeless often realize that having a job would improve their lives dramatically, and most service providers know that finding employment for them is a crucial step in their journey from lives of dependency and despair to lives of independence and hope.

Day to day, however, individuals who are homeless often are derailed by the debilitating effects of their mental illness, and service providers are faced with ongoing challenges to find adequate resources.

To help, SAMHSA has published a new guidebook that provides a blueprint for increasing employment possibilities. Work as a Priority: A Resource for Employing People Who Have Serious Mental Illnesses and Who Are Homeless is designed to help service providers, as well as policymakers, program managers, case managers, and employment specialists, make informed decisions as they guide people who are homeless and have mental illnesses into employment. This new guide offers practical guidance for assisting individuals in finding jobs through employment service programs.

In preparation for this guidebook, providers of services for mental health and homelessness across the Nation were surveyed. Text includes summaries of innovative programs that readers can use as models to create new programs. One example is New York City-based Project Renewal, a program committed to showing people who are homeless and who have serious mental illnesses how to make the transition. The organization's Culinary Arts Training Program, a 6-month tutorial in commercial food preparation, has graduated 40 people since it opened its doors in 1995. The program's job placement rate is 85 percent.

In addition to its culinary program, Project Renewal provides clients with a variety of tailored employment services and training in life skills necessary for getting and keeping a job.

Another program, Life Link in Santa Fe, NM, created its own business advisory committee to stay attuned to the training and hiring needs of local businesses and to facilitate employer-employee match-ups. LAMP, Inc., a homeless services agency in the Skid Row district of Los Angeles, has made a commitment to hiring graduates of its programs to work within the agency. Approximately one-third of staff members are former guests of LAMP.

First-person testimonials illustrate how important work is to individuals with serious mental illnesses. One woman writes, "The thought of employment seemed far-fetched and out of the question for me. But my mind was changed by seeing other tenants working at various jobs within the building. I thought to myself, I can do that."

The guidebook includes a review of the relevant literature, a summary of promising employment programs, and a discussion of policies and laws addressing employment support services for people who are homeless and have serious mental illnesses.

The information is presented in seven chapters:

1. What We Know So Far
   This chapter contains a brief review of writings and research studies on employment for people who have serious mental illnesses and are homeless. Findings presented in this chapter demonstrate that mental health recovery and homelessness reduction are directly linked to an individual's ability to obtain and retain a job. This chapter also outlines the critical elements of successful employment programs, with case studies provided as examples.

2. A Recovery-based Foundation
   Many people who are mentally ill and homeless view employment as crucial to their recovery. This chapter presents a framework for providing recovery-based employment and outlines specific program elements that work. Cultural and environmental factors are also discussed in this chapter. Health practitioners are encouraged to build their awareness of cultural differences among the individuals they serve.

3. Employment Approaches
   For the past two decades, a number of best practices have been developed to increase employment success for people with serious mental illnesses. This chapter summarizes a variety of proven employment models. The evidence supports that "long-term worker role recovery" happens through employment that provides work at competitive wages, offers the opportunity to work with non-disabled co-workers, and offers long-term, post-placement support. Information in this chapter can help service providers plan and establish programs that are designed to facilitate recovery, provide marketable skills, and expand opportunities needed for successful employment.

4. The Impact of Homelessness
   Many housing programs are not equipped to provide job training and assistance for people with serious mental illnesses. This chapter addresses personal, program, and system-level challenges to employment. Case studies provide examples of how to meet these challenges.

5. Joining the Workforce
   Service providers cannot use a "one-size-fits-all" approach to meet the employment needs of people who are homeless and have serious mental illnesses. This chapter highlights agencies across the Nation that use flexible and innovative programs to coordinate employment services. The chapter also describes how collaboration with area businesses and public housing authorities can help service providers expand and enhance the employment opportunities they provide. Key factors for developing successful employment services are also included.

6. The State Office of Vocational Rehabilitation
   State departments of vocational rehabilitation (VRs) can be powerful allies in the effort to find employment for people with mental illnesses who are also homeless. This chapter provides an overview of VR services, discusses their effectiveness in meeting the employment needs of people with mental illnesses, and considers ways to create collaborations between mental health and VR systems. The chapter describes how selected VRs are working with people who are homeless and who have serious mental illnesses, as well as recent VR/mental health integration efforts.

7. The Right to Work
   Several Federal statutes provide a foundation to help people with disabilities find jobs. This chapter highlights those statutes, including the Americans with Disabilities Act, the Workforce Investment Act, and the Ticket to Work/Work Incentives Improvement Act.

For a print copy of Work as a Priority: A Resource for Employing People Who Have Serious Mental Illnesses and Who Are Homeless, contact the National Mental Health Information Center at P.O. Box 42490, Washington, DC 20015. Telephone: 1 (800) 789-2647 or 1 (866) 889-2647 (TTY). Online, the publication is available through SAMHSA's National Resource Center on Homelessness and Mental Illness at www.mental
health.samhsa.gov. For more information on homelessness, visit www.samhsa.gov. 

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