The menu approach to employment services: Philosophy and five-year outcomes.

Abstract

The first part of this paper presents a vocational rehabili tation model for persons with severe and persistent psychiatric disabilities; the second part tests the model against 5-year outcomes. The Menu Approach to employment combines elements of other approaches under a new philosophi calframework. The philosophy has four principles: (1) work offers many bene fits besides a means to " pay the bills"; (2) virtually all consumers can participate in and benefitfrom meaningful paid work; (3) consumers should be able to choose from a "menu" of employment options, and; (4) multiple tri als of different kinds of paid work are an important part of developing long term employment in competitive settings. An empirical evaluation of the approach, analyzing 5 years of employment data from 102 participants in anACT-based program, found 74% tried paid work, half working competitively; the average number of jobs was 3.6, with an overall average tenure of 19.8 months for all jobs combined; workers earned $561,000 over 5 years, averag ing $2,054per job; those working at competitive jobs earned more and worked more hours per week than those working at jobs in agency-owned businesses.

Vocational services research: Recommendations for next stage of work

“…Unfortunately, no published fidelity measures exist for the other vocational interventions commonly used and no fidelity measures exist that measure the intervention received at the individual VS participant's level such that variations in intervention fidelity betweenparticipants could be examined. Published studies on interventions, such as selective or direct placement as funded by state and Federal VR programs, social enterprise, and self-employment programs [20,37] and other non-IPS SE programs, have little or no data to document the degree to which the services received by participants in the study actually match the targeted intervention model.…”

Rétablissement et travail

“…De fait, les êtres humains souf frant de trou bles men taux dési -rent non seu le ment tra vailler mais obte nir un emploi véri ta ble dans des envi ron ne ments habi tuels de tra vail (Chand ler et al, 1999 ;Ribeiro, 1999 ; col lo que Santé men tale et tra vail, 1999 ; Vin ce lette, 1995a, 1995b ; Bec ker et Drake, 1994 ;Rogers et al, 1991) contre une rému né -ra tion réelle (Tanz man et al, 1990 ;Bell et al, 1993). Pour quoi ces indivi dus incom mo dés par des symp tô mes sévè res aspirent-ils tant au travail ?…”

“…Il cons ti tue le prin ci pal véhi cule d'in clu sion dans la société (Dor vil et al 1997) ; il repré sente une tri bune per met tant « [d']avoir le sen ti ment de maî tri ser sa vie » (MSSS, 1998) ; il favo rise l'exer cice de son pou voir d'ac tion et la libre par ti ci pa tion à la société (Chand ler et al, 1999) ; il est essen tiel à l'au to no mie finan cière (Emploi-Québec, 1999) ; il assume les fonc tions de passe-temps (se lever, sor tir de chez-soi, évi ter l'en nui, etc. ), de pré-requis au temps libre (le con traire du tra vail) et de voie d'en trée au mar ché de la con som mation (Arveiller et Bon net, 1991) ; il donne accès à l'iden tité sociale, au rang social, à la sécu rité et à l'estime de soi, aux rela tions humai nes et à la socia li sa tion (Dor vil et al, 1997 ;Vézina et al, 1992).…”

“…Au cours des trente der niè res années, deux cou rants prin ci paux ont mar qué le déve lop pe ment, aux États-Unis, des pro gram mes enca drés de réadap ta tion au tra vail (Chand ler et al, 1999). Le modèle type des emplois de tran si tion (« tran si tio nal employ ment model ») s'ins pire du modèle des clubs « Foun tain House ».…”

Perceived barriers and meanings: The experiences of people accessing northern mental health services.

“…(a) that communities have a range of housing options available for consumers (Carling, 1995;Trainor, Morrell-Bellai, Ballan-tyne, & Boydell, 1993); that the employment market is diverse and refleets multiple opportunities for work (Chandler, Levin, & Barry, 1999); and (c) that various services-such as psychiatry, hospitals, social work, and nursing-are readily available within the community, or at least are available within close proximity (Anthony, Cohen, & Farkas, 1990). (p.77) As previously discussed, these assumptions do not reflect the reality for northern, rural communities.…”