ERIC ED409154: An Examination of the Vocational Rehabilitation Needs of American Indians with Behavioral Health Diagnoses in New York State. Final Report.

126 Pages·1996·1.5 MB·English

by  ERIC

DOCUMENT RESUME
RC 021 107
ED 409 154
Marshall, Catherine A.; And Others
AUTHOR
An Examination of the Vocational Rehabilitation Needs of
TITLE
American Indians with Behavioral Health Diagnoses in New
York State. Final Report.
Northern Arizona Univ., Flagstaff. American Indian
INSTITUTION
Rehabilitation Research and Training Center.
National Inst. on Disability and Rehabilitation Research
SPONS AGENCY
(ED/OSERS), Washington, DC.
ISBN-1-888557-70-2
REPORT NO
PUB DATE
96
129p.
NOTE
H133B30068
CONTRACT
American Indian Rehabilitation Research and Training Center,
AVAILABLE FROM
Northern Arizona University, Institute for Human
Development, P.O. Box 5630, Flagstaff, AZ 86011 ($10).
Reports - Descriptive (141)
PUB TYPE
MF01/PC06 Plus Postage.
EDRS PRICE
Action Research; *American Indians; *Delivery Systems;
DESCRIPTORS
*Disabilities; Human Services; *Mental Disorders; *Public
Agencies; Substance Abuse; *Vocational Rehabilitation
Barriers to Participation; *New York; Service Delivery
IDENTIFIERS
Assessment
ABSTRACT
A participatory action research project examined vocational
rehabilitation (VR) services provided in New York State to American Indians
with behavioral health diagnoses, including dual diagnoses involving
substance abuse. In 1991, the New York public VR system had 81 American
Indians apply for VR services (only 2.8 percent of American Indians with
disabilities that prevent them from working). Of the 81, 43 were accepted for
services and 16 of these had a behavioral health diagnosis. Eight persons
with such a diagnosis were closed as rehabilitated. A substantial number of
American Indians who applied for VR services "refused services" at
application or after eligibility was determined. Other data include a review
of documentation on public agency cooperation and service delivery to
disabled American Indians in New York; a summary of databases about this
population, including those of the U.S. Census, Office of Mental Health, and
office of Vocational and Educational Services for Individuals with
Disabilities (VESID); and interviews with program clients, service providers
on an Indian reservation, and VR agency staff. The project's "action"
component was dissemination of research and training information at a
statewide 2-day symposium in November 1995 in Syracuse, New York. Results
indicate that while a comprehensive and integrated delivery system exists on
paper, it fails to reach the service population studied. Recommendations
focus on needs for aggressive outreach, cultural awareness, and greater
program accountability. Contains 35 references. Appendices include data
tables on disabled American Indians in New York and an annotated bibliography
of literature available from VESID.
(SV)
AN EXAMINATION OF THE VOCATIONAL REHABILITATION
NEEDS OF AMERICAN INDIANS WITH BEHAVIORAL
HEALTH DIAGNOSES IN NEW YORK STATE
FINAL REPORT
1996
Principal Investigator:
Catherine A. Marshall, Ph.D., CRC
Susanne Bruyere, Ph.D., CRC
Co-Investigators:
David Shern, Ph.D.
Lois Jircitana, J.D.
American Indian Rehabilitation Research and Training Center
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stated in this
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Northern Arizona University
PO Box 5630
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Funded by the National Institute on Disability and Rehabilitation Research (NIDRR)
Office of SpeCial Education and Rehabilitative Services, U.S. Department of Education, Washington DC
Grant No H133B30068
The content of this report is the responsibility of the American Indian Rehabilitation Research and Training
Center and no official endorsement by the U.S. Department of Education should be inferred.
Northern Arizona University is an Equal Opportunity /Affirmative Action Institution
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BEST COPY AVAIL
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AN EXAMINATION OF THE VOCATIONAL REHABILITATION
NEEDS OF AMERICAN INDIANS WITH BEHAVIORAL
HEALTH DIAGNOSES IN NEW YORK STATE
FINAL REPORT
1996
Principal Investigator:
Catherine A. Marshall, Ph.D., CRC
Co-Investigators: Susanne Bruyere, Ph.D., CRC
David Shern, Ph.D.
Lois Jircitano, J.D.
American Indian Rehabilitation Research and Training Center
Institute for Human Development
Northern Arizona University
PO Box 5630
Flagstaff, AZ 86011
[phone]
ISBN # 1-888557-70-2
3
TABLE OF CONTENTS
List of Tables
i v
List of Figures
Acknowledgments
v i i
Summary
ix
INTRODUCTION
1
3
SUMMARY OF RELEVANT LITERATURE
METHODOLOGY
5
Subject Population / Participants
7
RESULTS
8
Existing Documentation
8
Summary of Existing Databases
26
U.S. Census Data
26
Office of Mental Health Data
27
Vocational and Educational Services for Individuals with
Disabilities Data
31
American Indian applicants
31
American Indian applicants accepted for services
35
American Indian behavioral health applicants
42
Qualitative Data
48
Behavioral Health
48
American Indian Community
51
Public Vocational Rehabilitation
53
DISCUSSION AND PROJECT OUTCOMES
53
American Indians with Behavioral Health Diagnoses
55
Considerations Regarding Level of VESID Service Delivery
56
ii
4
Cultural Considerations
58
"Lessons-Learned" Regarding Participatory Action
Research Strategies
60
Project Action Outcomes
61
66
CONCLUSIONS AND RECOMMENDATIONS
Recommendations
69
References
73
Appendix A: PAC Letters
78
Disability Status of American Indian Civilian Non-
Appendix B:
institutionalized Persons in Non-reservation Land
Areas of New York State in 1990
84
Frequencies of Persons Ages 15 to 64 Living on Reservation
Appendix C:
and Trust Land in New York State in 1990, by Reservation
87
Disability Status of American Indian Civilian
Appendix D:
Non-institutionalized Persons on American Indian
Reservations and Trust Land in New York State in 1990
89
Rehabilitation of American Indians with Behavioral Health
Appendix E:
Disorders in New York State: Workshop Agenda
92
Literature from the Office of Vocational and Educational
Appendix F:
Services for Individuals with Disabilities
96
iii 5
LIST OF TABLES
Occupations at Closure of Rehabilitated VESID American Indian
Table 1
Behavioral Health Consumers in 1991
48
6
iv
LIST OF FIGURES
Disabilities of OMH American Indian Working-Age
Figure
1
Clients During 1991 Survey Week
29
Diagnosis Categories of OMH American Indian
Figure 2a
Working-Age Clients During 1991 Survey Week
30
SPMI / SED Status of OMH American Indian Working-Age
Fig Ure 2b
Clients During 1991 Survey Week
30
Figure 3
Frequencies of Services Provided to VESID American
Indian Applicants in 1991
32
Figure 4
Type of Closure of VESID American Indian Applicants in 1991
33
Reasons Given for VESID American Indian Applicants
Figure 4a
Not Accepted for Services in 1991
34
Reasons for Closure of VESID American Indian
Figure 4b
Applicants Accepted for Services but Not Rehabilitated
35
Figure 5
Referral Sources of VESID American Indian
Applicants Accepted for Services in 1991
36
Frequencies of Services to VESID American Indian
Figure
6
Consumers in 1991
37
Figure 7
Primary Source of Support at Application of VESID
American Indian Applicants Accepted for Services
39
Major Disabling Conditions of VESID American
Figure 8a
Indian Consumers in 1991
40
Major Disabling Conditions of VESID American
Figure 8b
Indian Applicants Not Accepted for Services in 1991
41
Figure 9
Major Disabling Conditions of VESID American
Indian Consumers Successfully Rehabilitated in 1991
42
7
Occupations at Closure of VESID American
Figure 10
Indian Successfully Rehabilitated Consumers in 1991
43
Behavioral Health Diagnoses of VESID American
Figure 11
Indian Applicants Accepted for Services in 1991
43
Behavioral Health Diagnoses of VESID American
Figure 12
Indian Applicants Not Accepted for Services
44
Frequencies of Services Provided to VESID American
Figure 13
Indian Behavioral Health Consumers in 1991
45
Frequencies of Services Provided to Rehabilitated VESID
Figure 14a
American Indian Behavioral Health Consumers
46
Frequencies of Services Provided to VESID American
Figure 14b
Indian Behavioral Health Clients that were Not Rehabilitated
47
vi
ACKNOWLEDGMENTS
By definition, participatory action research involves the participation
of members of a given community. Relationships form. Trust develops.
This project attempted to utilize participatory strategies on a state-wide basis
and found that a sense of "community" is much harder to instill in a research
effort at the state level than at a true community level. Nonetheless, several
individuals throughout New York State believed in the importance of
investigating the level of service delivery available to American Indians with
behavioral health diagnoses--they are among those listed below in the Project
Advisory Committee (PAC); their belief in the importance of this project was
always sincerely appreciated by the research team. It is hoped that
information provided in this report will enable interested PAC members to
continue the work in their local communities. The researchers would also
like to acknowledge two individuals from the AIRRTC who worked tirelessly
to assist in data analysis, Patricia M. Rose, M.S., CRC and George
Gotto, IV, M.A.
Project Advisory Committee
William Anthony, Ph.D.,
Barbara T. Abrams, Director
American Indian Program
Project Director
Cornell University
RTC for Persons with Long-Term
Mental Illness, Center for Psychiatric
Ithaca, New York
Rehabilitation
Boston University
Boston, Massachusetts
Jim Bronstein, Program Coordinator
Frank Abrams
Opportunities Unlimited of Niagara
Albany, New York
Niagara Falls, New York
Project Advisory Committee, continued
David Burganowski, Associate Director
Elissa Lang, M.Ed., M.A., CRC,
Director of Psychiatric Rehabilitation
RRCEP II
State University of New York at Buffalo
New York Hospital-Cornell
Medical Center
Buffalo, New York
White Plains, New York
William Carpenter, Manager
Grace Sage, Ph.D.
Educational Institution Linkages
Cornell University
Office of Vocational & Educational
Psychological Services
Gannett Health Center
Services for Individuals with
Ithaca, New York
Disabilities (VESID)
Albany, New York
Ken Dougherty
Dr. Ed Starr
State University of New York at Buffalo
Lewiston, New York
Buffalo, New York
Joanne Francis
Margaret Terrance, Executive Director
Hogansburg, New York
St. Regis Mohawk Tribe Health Services
Hogansburg, New York
Minerva White, Coordinator
Dr. Frank Herstek
Native American Indian Education Unit
BOCES
New York State Education Department
Sanborn, New York
Albany, New York
Anthony Hunter, Director
Dan Wong, Ph.D., Assistant Professor
Health and Human Services
Dept. of Counseling, Research, Special
American Indian Community House
Education & Rehabilitation
Hofstra University
New York, New York
Hemstead, New York
Ron La France
Ithaca, New York
viii 10