Employment and Mental Health Services: The community feedback period for this project began on 8/8/18 and ended on 10/6/18

What is the problem that needs to be addressed? Please describe how it is related to mental health.

PROJECT IMPETUS: When the great recession hit Orange County as early as 2007, the Orange County Community Services Providers, such as the One-Stop Employment Centers serving the County, saw an influx of job seekers with devastating stories of financial ruin and job loss. Case managers were well equipped to assist the masses with job searches but not as prepared for the collateral emotional and mental health support that their clients were in need of. Many referrals out to mental health professionals were provided during that time but in the years since then, we continue to find a strong correlation between unemployment and emotional/mental health issues that effects successful job search and employment gain.

Preliminary research confirms that psychologists dating as far back as 1933 have proposed that unemployment negatively impacts emotional and mental health (Jahoda et al. 1933). “A widespread conviction in psychology is that the response to stressful events, such as unemployment, takes the form of progression through stages. Shock tends to characterize the initial phase, during which the individual is still optimistic and unbroken. As unemployment advances, the individual becomes pessimistic and suffers active distress, and ultimately can become fatalistic about their situation. Thus, the unemployed are expected to exhibit poorer mental health due to elevated levels of anxiety, frustration, disappointment, alienation and depression” (Goldsmith and Diette, 2012).

INNOVATION PROJECT PROPOSED: We propose that the co-location and integration of mental health clinicians at existing local employment centers/agencies will positively impact the unemployed job seeker’s emotional and mental health thereby leading to more success in gaining and retaining employment. The clinicians will have the capacity to address mental health issues associated with unemployment as part of the One-Stop environment and integrated case management team.

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?

ADDRESSING AN UNMET NEED: Currently there are no employment-focused centers that have co-located mental health support to provide services to unemployed jobseekers in Orange County. To address the emotional and mental health symptoms at its earliest stages in connection to unemployment and the job seeking experience.

Our project would be the first of its kind and the learning contributions from this project would not only inform practices locally but possible nationwide for federally funded employment centers.

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?

NO EXISTING PROJECTS: To vet our proposed project’s innovation and unique components, we began with a search through existing employment center services on the internet, calls to local field offices to inquire about mental health services onsite, and a thorough online search of links between unemployment, mental health and employment services. A thorough search of existing federally funded employment centers known as American Job Centers or One-Stop Centers discovered a full array of employment related services and tools such as: career counseling, job search assistance, resume building, interviewing skills, computer basics workshops, networking seminars, etc. with no mention of supportive mental health services at any locations. A call to the local field offices of One-Stop Center systems returned the same results of no supportive mental health services onsite, but referrals were given to mental health service clinics and providers located throughout the County.

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.

INNOVATION: This project is innovative in that it introduces a new entry point into the mental health system. Our research supports that there is a link between unemployment and mental health but that there are no federally funded employment centers with co-located mental health support and services.  The co-location of mental health and employment services would increase access to mental health services that unemployed clients may not have considered or desired previous to exposure through this project.  Access to on-site mental health services will reach participants who are at risk of developing a mental illness or displaying early signs of emotional, behavioral, or mental instability or co-occurring substance abuse disorders that coincide with their unemployment.  The program goals are to prevent the development of mental health conditions and intervene early in their manifestation to reduce risk factors/stressors and prevent conditions from getting worse. This project will provide mental health counseling, education, support and referrals/linkages to appropriate community resources.

INNOVATION PROJECT OBJECTIVES: Our project aims to test if the co-location and integration of mental health clinicians at existing local employment centers will positively impact the unemployed job seeker’s emotional and mental health thereby leading to more success in gaining and retaining employment. This project is unique in that it has never been implemented before in this capacity. There are supported employment programs that are successfully operated through the mental health lens, whereas this new and innovative idea proposes taking that model which addresses employment as one goal towards the client’s overall mental health wellness and flipping it to focus on the unemployed job seeker whose primary goal is employment and adding the opportunity and access to address emotional and mental health issues on their journey towards employment. The results of this innovative project have the potential to impact learning in Orange County, the State and Nation wide to include mental health support in America’s Job Centers- increasing access to mental health services to unemployed jobseekers and thereby increasing employment gain and retention rates.

RESEARCH: Our research supports that there is a link between unemployment and mental health but that there are no federally funded employment centers/agencies with co-located mental health support and services.   Our project would be the first and the learning contributions from this project would not only inform practices locally but possible nationwide for other federally funded employment centers.

Our search on links between unemployment and mental health yielded abundant results supporting our initial discoveries of the strong link between mental health and unemployment but found no existing programs at employment centers or staffing firms with both services co-located. There is one model that links mental health to employment for consumers with severe mental illness (SMI) called Supported Employment.  We found that the National Alliance on Mental Illness (NAMI) cites that “Supported employment is a well-defined approach to helping people with disabilities participate in the competitive labor market, helping them find meaningful jobs and providing ongoing support from a team of mental health professionals” (NAMI, 2014).

WHAT MAKES OUR PROJECT INNOVATIVE: However, our project is proposing a different model than the supported employment model; our goal is to provide mental health as an ancillary support for any unemployed individuals facing the emotional and mental health stressors that unemployment challenges bring. We believe that giving jobseekers access to onsite co-located mental health support and counseling will not only help address those symptoms at early stages but also increase rates of employment gain and retention.

An article from the American Psychological Association (APA) notes, “The body of evidence offered by social scientists, including psychologists, suggests that ignoring mental health costs understate the negative effects of long-term unemployment. Thus, public policies aimed at improving labor market performance should account for and include the mental health costs of joblessness” (Goldsmith and Diette, 2012). Once again, our research supports that there is a link between unemployment and mental health but that there are no existing federally funded employment centers with co-located mental health support and services.  There is a gap in services and with this innovation project- ours would be the first to co-locate mental health services at employment centers.

FOLLOWING PLEASE FIND OUR RESEARCH REFERENCES: Eisenberg, P., & Lazarsfeld, P. F. (1938). The psychological effects of unemployment. Psychological Bulletin, 35, 358-390.Erikson, E. H. (1959). Identity and the life cycle. Psychological Issues, 1, 50-100.Feather, N. T. 1982. Unemployment and its psychological correlates: A study of depressive symptoms, self-esteem, Protestant ethic values, attributional style and apathy. Australian Journal of Psychology, 34(3), 309-323.Fryer, D. M., & Payne, R. L. (1986). Being unemployed: A review of the literature on the psychological experience of unemployment. In C. L. Cooper & I. Robertson (Eds.), International Review of Industrial and Organizational Psychology (pp. 235-278). Chichester, England: Wiley.Goldsmith, A. H., Veum, J. R., & Darity, Jr., W. (1997). Unemployment, joblessness, psychological well-being and self-esteem: Theory and evidence. Journal of SocioEconomics, 26(2), 133-158.Jahoda, M., Lazarsfeld, P. F., &  Zeisel, H. (1933). Marienthal: The sociography of an unemployed community (English translation, 1971). Chicago: Aldine.Kessler, R. C., Turner, J. B., & House, J. S. (1988). Effects of unemployment on health in a community survey:  Main, modifying, and mediating Effects. Journal of Social Issues, 44(4), 69-85.Kessler, R. C., Turner, J. B., & House, J. S. (1989). Unemployment, reemployment, and emotional functioning in a community sample. American Sociological Review, 54(4), 648-657.Liem, R., & Liem, J. H. (1988). Psychological effects of unemployment on workers and their families. Journal of Social Issues, 44(4), 87-105.McKee-Ryan, F. M., Song, Z., Wanberg, C. R., & Kinicki, A. J. (2005). Psychological and physical well-being during unemployment: A meta-analytic study. Journal of Applied Psychology, 90(1), 53-76.Paul, K. I., and Moser, K. (2009). Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior, 74(3), 264-282.Seligman, M. E. P. (1975).  Helplessness: On depression, development and death. San Francisco: W. H. Freeman.Tiggemann, M., & Winefield, A. H. (1984). The effects of unemployment on the mood, self-esteem, locus of control, and depressive affect of school-leavers. Journal of Occupational Psychology, 57(1), 33-42.Warr, P. B. (1987). Work, unemployment and mental Health. Oxford, UK: Oxford University Press.

What is the project idea? Please describe how this project will operate.

TARGET POPULATION: This project will aim to serve Orange County Community Services’ high priority populations which include but are not limited to: individuals who are unemployed or at risk of unemployment, adults, transitional age youth, foster youth, seniors, veterans and *TANF recipients. *(The Temporary Assistance for Needy Families (TANF) program is designed to help needy families achieve self-sufficiency). Services will be available to individuals seeking employment assistance at the employment-focused agencies located in Orange County. We have locations throughout the County as well as a station at the Los Alamitos Joint Forces Training Base to serve veterans. In addition to One-Stop locations, we also have several community based youth, veteran and older adult providers serving those individuals with employment services.

SERVICES: This project will provide mental health support, education and counseling as related to supporting successful transition from unemployment to active job searching to gaining unsubsidized employment. Services may include: supportive individual counseling, brief therapy, mental health education workshops, and mental health support groups. Any individual deemed in need of intensive therapy not included in the scope of this project, will be referred out to local mental health clinics and/or providers who will be able to best meet their needs.

INTAKE AND ASSESSMENT: A brief mental health and quality of life screening and assessment will be included in enrollment and intake packets for new clients. Existing clients will receive the screening and assessment tools via their career counselor/case manager. The scores from these initial screening and assessments will be used to establish a pretest baseline. Clinicians, located onsite, will review assessments and flag clients that evidence scores at risk of or showing signs of emotional and mental health symptoms. Clinicians will reach out to these individuals and offer supportive individual mental health counseling throughout their job search. Clients will be given a choice whether or not to access the mental health supportive services. Those clients that decline will establish the control group which will provide a comparative sample to examine if the addition of mental health support correlates to increased employment gain.

OUTCOMES: The pretest will be given to clients at intake to establish a baseline to be used for data analysis. A post-test will be given to clients at exit, whether the exit occurs because employment has been obtained or the client voluntarily discharges from services. The pre and post-tests will be used to evaluate the learning objectives for this project include but are not limited to: PHQ-2; PHQ-9; GAD-7; WHO-5; Becks Depression Inventory; Worry and mood scales; Negative and Positive mood states checklists. The exact tools to be used would be determined upon program design and implementation.

Additional Information

PROJECT SERVICES: This project will provide mental health support, education and counseling as related to supporting successful transition from unemployment to active job searching to gaining unsubsidized employment. Services may include: supportive individual mental health counseling (can be accessed throughout job search), brief therapy (no more than 16 sessions), mental health education workshops, and mental health support groups. Any individual deemed in need of intensive therapy and/or services not included in the scope of this project, will be referred out to local mental health clinics and/or providers who will be able to better meet their needs. The weekly mental health education workshops and support groups will be included on general events calendars and made available to clients (even if their assessment scores did not get flagged by a Clinician). Participants of mental health education workshops and support groups will be given a satisfaction survey after each session. Project participation will be tracked.

 

June 27, 2018

1 comment

The INN team presented an Employment and Mental Health Impact proposal to the Mental Health Services Oversight and Accountability Commission in September and October of 2016. Unfortunately the proposal was rejected. See links below.

http://www.mhsoac.ca.gov/sites/default/files/documents/2016-09/092216_MHSOAC_Commission_Meeting_Packet_0.pdf
http://www.mhsoac.ca.gov/sites/default/files/documents/2016-10/102716_Commission_Meeting_Packet.pdf
http://www.mhsoac.ca.gov/sites/default/files/documents/2016-11/111716_OAC_Commission_Meeting_Packet.pdf

Due to these results, we will not be able to move forward with this idea. Thank you.

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