ERIC EJ841390: Excerpts from: Transitioning Youth with Mental Health Needs to Meaningful Employment and Independent Living

2008·0.11 MB·English

by  ERIC

The Journal for Vocational Special Needs Education 9
Excerpts from: Transitioning Youth with Mental Health Needs to
Meaningful Employment and Independent Living
by Lindsey Woolsey and Judith Katz-Leavy, ODEP, Office of Disabilities Employment Policy, NCWD for
Youth National Collaborative on Workforce and Disability
Preface
Transitioning into adulthood is Employment Policy (ODEP) in the It is the hope and intention
challenging for everyone. “Be- U.S. Department of Labor. The of ODEP and NCWD/Youth that
coming an adult” typically de- report presents the findings from this report will add to the bur-
mands a complex set of deci- case studies of five promising pro- geoning body of knowledge
sions and steps that an indi- gram improve transition out- around practices and policies
vidual has never encountered comes, look at young adult needs that most effectively support
before: leaving home; living in- holistically, and incorporate youth and young adults with
dependently; enrolling and suc- strong career preparation and mental health conditions to
ceeding in school; getting to and employment components sites, leading independent and pro-
from home, school, and work; selected from a national scan of ductive lives, gain access to the
budgeting resources for basic the field, and identifies program services and supports they need,
necessities and recreation; mak- design features that appear to make choices about work and
ing job and career choices; find- improve transition outcomes, career opportunities, build
ing a place to live; and develop- look at young adult needs holis- strong connections to their com-
ing social and personal relation- tically, and incorporate strong munities, and develop meaning-
ships. Every decision requires career preparation and employ- ful relationships.
ment components.
making one choice over another.
Executive Summary
This report uses the term
For most young adults, this pro-
cess relies on direction and sup- “youth and young adults with …Integration into society, in-
port from family members or mental health needs” to describe cluding the workplace, is key
other caring adults, mentors, the population served by the to the recovery process.
social networks, and other sup- programs highlighted in this Many youth with diagnosed
port systems. For the more than study, in accordance with Tun- mental health needs experience
three million young adults diag- nels and Cliffs: A Guide for poor transition outcomes. It is
nosed with serious mental Workforce Development Practi- estimated that up to 50 percent
health conditions, however, tioners and Policymakers Serv- of incarcerated youth and young
these choices can be enormously ing Youth with Mental Health adults have an emotional distur-
challenging.1 Many experience Needs, co-produced by NCWD/ bance, up to 20 percent have a
higher than average academic, Youth and ODEP in 2006.2 This serious emotional disturbance,
social, and employment failure. term refers broadly to youth and and at least 10 percent have a
Although the precise clinical ori- young adults who have been di- specific learning disability.4
gins of their emotional distur- agnosed with serious mental Sixty-five percent will drop out
bances can remain complicated health conditions and those who of school before obtaining their
and enigmatic, some promising have such needs but have no high school diploma.5 In com-
approaches to reversing these formal diagnoses. According to parison to other youth who drop
negative trends are emerging. the Diagnostic and Statistical out of high school, youth with
The National Collaborative Manual of Mental Disorders,3 emotional disturbances are
on Workforce and Disability for which four of the five programs three times as likely to live in
Youth (NCWD/Youth) and the use to determine eligibility for poverty.6 They experience longer
researchers/authors of this re- services, “psychiatric disabili- delays before obtaining employ-
port carried out its study and ties” include a wide range of di- ment, and have higher unem-
writing as part of a series of re- agnoses – from schizophrenia to ployment rates than youth with
search activities on successful learning disorders. Because the other types of disabilities who
strategies for assisting youth researchers did not want to limit overall exhibit bleak unemploy-
with mental health needs as the discovery of promising prac- ment rates of over 60 percent.
they transition to postsecondary tices based on a narrow defini- Against this dreary back-
education, employment, and in- tion of the target population, the drop, historical changes in the
dependent lives. Funding came degree and severity of mental treatment of mental illness over-
from the Office of Disability health conditions or needs were all, including deinstitutionaliza-
not criteria utilized for this study
10 Volume 31, Numbers 1-3, Fall 2008
tion, community mental health During these site visits, a nity that fit the individual’s
services, and new developments collection of common design fea- readiness to live independently.
in psychotropic medications, tures emerged, which are de- Part III of the report, Sys-
have productively informed the scribed in detail in Part II of this tems Factors that Affect Pro-
field in two critical ways: (1) Re- report, Addressing Individual gram Design and Sustainability,
covery is possible, and (2) Inte- Barriers: What Works at Service presents systems-level factors
gration into society, including Delivery. The highlighted design that affect success at the service
the workplace, is key to the re- features address commonly delivery and individual outcome
covery process. Promising inter- cited challenges to successful levels. Three themes emerged
ventions continue to emerge, transition by youth with mental from the programs in this re-
resulting in the creation and health needs, including the search.
implementation of recovery stigma of traditional mental First, successful programs
models that minimize and re- health therapy; feelings of low actively seek out partnerships
verse negative outcomes. This self-esteem and lack of self- with service agencies and orga-
includes interventions/practic- worth; a lack of ownership by nizations in their community to
es that recognize youth with youth over their own life plans; provide the comprehensive ar-
mental health needs are not the low expectations by society on ray of services needed by youth
same as adults and, therefore, the ability of youth to succeed; and young adults with mental
that their treatment should be traditional work-exposure and health needs. These partner-
youth oriented. The programs employment models that do not ships can be informal, but are
described in this report operate maximize individual strengths; most successful when formal-
under this premise and have and a lack of appropriate tran- ized by memoranda of under-
tailored their models to support sitional housing in the commu- standing and supported by for-
youth in transition. nity. The features addressing mal community governance
The researchers undertook a these challenges that were com- structures (e.g., advisory bod-
national scan of programs that mon across programs in the ies). Formalized partnerships
indicated a dual focus on youth study include the following: (1) address service gaps, allow col-
and young adults with mental Program locations that are dis- laborative identification of ap-
health needs and on career tinct and separate from adult propriate services, and create
preparation, work-based experi- service program locations; (2) the possibility of seamless care.
ences, employment, and related Staffing choices that promote The second theme is the
services. The scan relied on in- engagement of youth and young ability of programs to identify,
put from knowledgeable sources adults; (3) Individualized men- access, and leverage funding
in the fields of mental health tal health interventions that are streams to enhance and expand
intervention, education and youth-friendly and innovative, program services. This includes
training, and workforce develop- assisting youth/young adults in private funding sources and
ment. During telephone inter- managing their conditions, en- “reimagined” public funding
views with promising program gaging in social relationships, sources from local, state, and
sites, five programs were se- identifying life goals, and under- Federal levels. Finally, the third
lected for further study, which standing their choices for theme that emerged is state-
included site visits and struc- achieving those goals; (4) As- level capacity to promote sys-
tured interviews with mental sessment and service planning tems change to the benefit of the
health staff; education, training, processes that facilitate the population of transition-age
and employment staff; case identification of individual youth with mental health needs.
managers; youth and family mem- strengths, talents, and skills States have the authority to pass
bers. that can lead to education and legislation, target funding, more
These five programs are: career goals; (5) Exposure to the effectively utilize Medicaid fund-
• The Village Integrated Service world of work and career op- ing and service options, and de-
Agency’s Transitional Age Youth tions, including individualized velop statewide coordination
program in Long Beach, CA; support by program staff to plans that seek to improve con-
• Options in Vancouver, WA; identify training, work-based nections to schools and other
• Our Town Integrated Service experiences, and jobs that are delivery systems that help pre-
Agency in Indianapolis, Indi- most appropriate and rewarding pare youth for the world of work.
ana; for individual clients; and (6) Formalized partnerships ad-
• Transitional Community Treat- Access to a range of transitional dress service gaps, allow col-
ment Team in Columbus, OH; housing options in the commu- laborative identification of
• YouthSource in Renton, WA.
The Journal for Vocational Special Needs Education 11
appropriate services, and cre- • Cultivate relationships with • Explore state codification of
ate the possibility of seamless employers in the program’s com- models for serving youth and
care. munity to assist them in seeing young adults with mental health
The service delivery and sys- the benefits of hiring program needs.
tems-level themes highlighted in clients and create open lines of • Create model Medicaid waiv-
this report are intended to add communication between pro- ers for states to use that will
to the growing body of knowl- gram staff, the client, and the cover an array of services for
edge about what can be done to employer. youth and young adults with
assist transitioning youth and • Be the mentor, family mem- mental health need
young adults with mental health ber, parent, teacher, or other
PART II
needs in becoming self-sufficient positive influence that may be
adults who live independently missing from the life of the
Addressing Individual
and experience work and career youth/young adult client by
Barriers: What Works at
success. Toward that goal, Part teaching independent living
Service Delivery
IV of the report includes recom- skills and positive social engage-
mendations for programs, staff ment in daily activities. Among the many barriers to
members, and policymakers. • Understand the Federal and overcome during the transition
state laws and regulations that to independent living, the com-
Recommendations for
affect the program’s services and monly cited challenges across
Programs and Staff
funding. It’s important to find the programs in this study in-
• Incorporate youth “voices” into out whether information that is cluded the following: (1) Mistrust
the development and implemen- accepted as “common knowl- by youth of organized programs,
tation of program service and edge” is an actual Federal or especially if perceived to be
policy to improve client engage- state requirement or simply in- driven by a public system or
ment, participation, and indi- formation that’s been passed on adults; (2) The stigma attached
vidual ability to utilize the learn- anecdotally. to traditional mental health
ing, services, and opportunities • Tailor and test Assertive Com- therapy; (3) Low-self esteem and
offered. munity Treatment (ACT) and self-worth; (4) Low societal ex-
• Utilize a successful process Systems of Care models that tar- pectations on the ability of youth
that identifies individual get youth with mental health to succeed; (5) Traditional em-
strengths or “gifts” as the step- needs. ployment models that do not
ping stone to the development maximize individual strengths;
Recommendations for State
of education, career, and life and (6) A lack of appropriate
goals, and the gateway to dis- and Federal Policy Makers transitional housing in the com-
covery and hope. • Scale up staff capacity in munity. The design features de-
• Invest the time and resources workforce development, includ- scribed below represent com-
required to build partnerships ing those in the K-16 education mon operational principles ex-
across relevant services and sys- system, to effectively work with hibited by the five contributing
tems in the community. all youth and young adults, in- programs which address these
• Incorporate on-site and “non- cluding those with mental barriers. Although the sites use
traditional” approaches to men- health needs. different strategies to address
tal health interventions that • Design and fund more pilot these design features, they con-
work with youth and young and demonstration projects that sider them critical elements for
adults at their own pace and in implement and evaluate prom- their program’s success. It should
a highly individualized, youth ising practices to support youth be noted that because this study
friendly way. and young adults with mental consisted of only five sites, these
• Train all program staff (not just health needs in their transitions design features should not be ac-
the career developers) how to into work, industry-relevant cepted as evidence-based prac-
individualize exposure to the education, fulfilling careers, and tices. Within the limits of this
world of work and to incorporate independent living. study, they simply codify opera-
activities that meet youth and • Create a task force to explore tions across the five sites. None-
young adults “where they’re at” and address the linkages be- theless, their alignment with ex-
across all phases of employ- tween significant, but currently isting research (including Clark
ment, including training and disconnected, policy issues im- and Davis, the Guideposts for
preparing for work, getting hired, pacting youth in their transition to Success, Marrone and Boeltzig)
retaining jobs, and advancing to adulthood and the world of work. should not be overlooked.
better jobs and careers.
12 Volume 31, Numbers 1-3, Fall 2008
Design Feature 1: A Place to factor. All four of the sites op- COMMON DESIGN FEATURE
Call Their Own erating in a location separate Staff patterns should reflect
from adult mental health ser- a blend of knowledge of men-
A powerful message emerged
vices serve as drop-in centers, tal health and work develop-
during interviews with youth at
with access to computers, ment strategies that are ap-
the site visit to the TAY program
phones, comfortable couches, propriate to different ages
in California: youth felt strongly
and recreation. The top floor of and developmental stages.
that co-location with adult men-
Options, for example, is a youth-
tal health services, and there-
only recreation room. Adults Staffing choices should re-
fore with adults with severe
may enter only upon invitation flect a balance between the ex-
mental illness, prematurely ex-
by a youth client. Three of the pertise and guidance that
posed them to their own possi-
four sites with separate service adults can provide with the
bly depressing and un-inspiring
locations also highlighted some peer support and sense of
futures. In other words, youth
authority by youth to select the youth ownership that youth
felt that they were seeing them-
décor of the program site as a can provide.
selves in years to come and were
way to further engage and trans-
discouraged. This honest articu-
fer ownership to clients. Professional development of
lation of their experience with
According to the sites, a all staff is essential and
adults with severe mental health
youth-friendly, separate service should include gaining knowl-
illness confirmed a primary fea-
location from adult services is a edge of community resources
ture of four of the five programs:
critical factor for at least two youth need to become success-
a distinct, physical program lo-
reasons: (1) Youth do not want ful adults.
cation separate from adult men-
to feel that they are transitioning All five sites include and
tal health service programs. In
into the adult mental health sys- value a mix of staff, with diver-
all programs except TCTT in
tem, rather than the adult world sity of age (including some staff
Ohio, a separate location is con-
of living independently; and (2) who are older and some who are
sidered critical to effective youth
Youth feel a sense of ownership closer in age to the clients) and
engagement.
of the program, and therefore a race/ethnicity, cultural compe-
COMMON DESIGN FEATURE
sense of belonging. This trans- tency, and knowledge of mental
A distinct program identity, in-
lates to longer engagement and, health. This mix improves en-
cluding a separate physical lo-
therefore, greater chances of gagement of youth and young
cation, promotes attachment
positive outcomes. adults upon entrance into the
and engagement of youth.
program and during their par-
Design Feature 2: Staffing
The first challenge that any
ticipation.
program serving youth must Choices that Maximize
The Transitional Community
overcome is engagement. For Engagement
Treatment Team program in
programs serving youth and Facilitating service delivery to Ohio illustrates the effect of staff
young adults with mental health maximize opportunities for early cultural competence on the level
conditions, this endeavor be- and on-going engagement of of comfort, and therefore en-
comes enormous. This popula- youth clients depends on the gagement, of participating
tion typically is weary of adults right mix of staff. The sites in youth. TCTT offers diverse staff
telling them what to do and mis- this study identified at least trainings, including Serving Per-
trustful that adults actually three elements of the “right mix” sons with Appalachian Back-
know what is best. One staff – age, cultural competence, and grounds and Islam 101. The site
member best summarized this experience with individuals who also makes efforts to hire staff
by saying “[t]hese kids are stig- have mental health needs. under the age of 30. Similar in
matized and systematized. They Across the sites, staff members intent, at the TAY program in
have heard ‘we are here to help’ brought strong backgrounds in Long Beach, two student aides
all their lives. They will test you social work and related fields. are a unique addition to the staff
to the nth degree, and frankly Interviews at all sites em- because they are former clients
they have a right to.” Assuming phasized the value of on-site of the program and are respon-
this observation is true, pro- mental health professionals for sible for motivating and guiding
grams may get only one chance peer learning about the mental current clients. They also play a
to engage an individual in ser- health needs of their clients. key role in advising on improve-
vices, making the appeal and at-
ments to the program. YouthSource
tractiveness of the program site
in Renton, Washington has cli-
to the young person a critical
ents provide customer service in
the reception area.
The Journal for Vocational Special Needs Education 13
Clients and staff members of Across the sites, the pres- clude providing access to men-
Options in Vancouver, Washing- ence of on-site psychiatrists tal health treatment without
ton agree that staff closer in age and/or mental health profes- the stigma of traditional
to clients are highly beneficial, sionals was a critical component therapy, and outreach and
but also specifically highlighted of care. More importantly, staff follow-up to keep the youth
clear benefits of older staff – they and youth clients alike praised engaged or to re-engage them
exhibit lower turnover rates, the non-traditional approach to if needed.
possess the needed level of life mental health treatment utilized
Design Feature 4: Assess-
experience that young staff typi- by programs. A youth at the TAY
ment and Service Planning
cally do not possess, and tend program in California described
Processes that Build on Indi-
to not burn out as quickly. Char- the approach as “[n]o more
acteristics more important than therapy, no more file reading. I vidual Strengths
age are being young at heart and get individualized attention, goal All five programs use assess-
being respectful of youth culture. setting, and support in whatever ment instruments to identify the
Traditional job descriptions I need but with guidance and a current status of youth clients
found in many clinical settings push to do it myself.” The five across the domains of employ-
are also altered. At YouthSource, sites agreed that non-traditional ment, housing, education, and
the on-site mental health pro- approaches to mental health community life. Other domains,
fessional is more than a friendly, treatment incorporate the fol- depending on the site, include
non-traditional mental health lowing: • A personalized ap- clinical recovery, health and
counselor – she also serves as proach that allows a meaning- wellness, family and natural
an “integrator” of the mental ful trust relationship between supports, social networks, cul-
health and the workforce devel- professionals and clients; tural and spiritual aspects, and
opment systems. Because she • Honest discussions between personal empowerment. As part
understands both, she acts as professionals and clients that of the assessment and service
a bridge between otherwise allow the clients to initiate self planning process, programs
separate “service tunnels.” In exploration; and, work to varying degrees with cli-
this role, she educates staff from • “Anywhere, anytime” treat- ents to develop future improve-
each service system about the ment, i.e., counseling and men- ments or goals within each do-
other, and creates connections tal illness management that is main. This is part of each client’s
for youth that may not have ex- integrated into daily activities, individualized service plan/
isted before. such as talking over coffee or strategy, treatment plan, Vision
Design Feature 3: Mental lunch, during tutoring, at the Quest process (TAY), or “Success
grocery store, or while playing Plan” (Options).
Health Intervention without
pool. Across the sites, program
the Stigma
During the site visits, staff emphasize the need to de-
The type and severity of mental interviewees further asserted velop assessments and individu-
health conditions varied widely that building trust between alized service plans that are
across the client populations of youth and the on-site mental rooted in the individual’s
the five programs in this study, health professional during other strengths and interests. This is
and even within single pro- activities and before attempting a keystone of the Transition to
grams. Many youth were diag- one-on-one sessions are impor- Independence (TIP) system,26
nosed with serious emotional tant to success. which the TAY and Options pro-
disturbances at an early age, All five programs place a grams use as a central feature
and have spent their lives in and strong emphasis on outreach of their services. The TIP system
out of traditional mental health and continuous follow-up with offers seven guiding principles
treatment, with less than posi- clients as part of the therapeu- that build on the premise of in-
tive outcomes and experiences. tic process. Care coordinators dividualized, strength-based
Others have experienced high and case managers make home services:
rates of academic and social fail- visits if a client misses several • Engage young people through
ure in their lives, but have never appointments. This often in- relationship development, per-
known why. In both cases, op- volves looking for youth “on the son-centered planning, and a
portunities to manage their con- street” and re-engaging them. focus on their futures;
ditions have been missed, with COMMON DESIGN FEATURE • Tailor services and supports to
tough consequences as they Effective strategies for serv- be accessible, coordinated, de-
transition to adulthood. ing transition— age youth velopmentally appropriate, and
with mental health needs in- built on strengths to enable the
14 Volume 31, Numbers 1-3, Fall 2008
young people to pursue their DESIGN FEATURE 5: EMPLOYMENT — choose career pathways based
goals in all transition domains; PREPARING FOR IT, FINDING IT, on informed decisions, their in-
• Acknowledge and develop per- KEEPING IT dividual strengths and interests
sonal choice and social respon- Four of the five sites place em- must be identified and acknowl-
sibility with young people; ployment and training at the edged. Staff support and capac-
• Ensure that a safety-net of forefront of their goals and ac- ity, therefore, must be sufficient
support is provided by a young tivities, citing career preparation to assess skills, readiness, and
person’s team, parents, and and skills development as “cor- interests, and then customize a
other natural supports; nerstones” and “the main focus.” unique employment opportunity.
• Enhance a young person’s All five programs utilize some
COMMON DESIGN FEATURE
competencies to assist them in form of individualized exposure
Individualized exposure to
achieving greater self-sufficiency to work and employment and, in
work and employment path-
and confidence; cases where the youth or young
ways is critical for all youth,
• Maintain an outcome focus in adult is ready, program staff cre-
regardless of the severity of
the TIP system at the individual ate opportunities for work-based
their condition. Meeting youth
young person, program, and learning, abiding by the philoso-
“where they’re at” increases
system levels; and, phy of “place and train” instead
the chances of employment
• Involve young people, parents, of “train and place.” For some
success.
and other community partners youth, this means placement in
One story from Options illus-
in the TIP system at the prac- competitive employment in the
trates the value of building on a
tice, program, and community community with minimal sup-
client’s strengths and interests.
levels. port. For youth with severe con-
In this case, a young adult was
To assess clients, the TAY ditions, this might mean work
re-arrested for a parole violation
and Options programs use an experience with an employer that
(of an original conviction of car
interview method called Core is on-site, with active involvement
theft) on the first day of his new
Gifts Identification.27 The Op- by a supervisor. To be success-
job as a car mechanic. With help
tions Program Manual describes ful, some youth need reasonable
from program staff, upon release
this intervention as a way for accommodations in the work-
he was able to return to the job.
staff to help youth identify per- place, such as flexible schedules
Despite the fact that the young
sonal strengths and gain posi- or a mentor coworker. Program
man’s interest was initially
tive insight into themselves at a staff at the sites also identified
manifested through stealing
critical juncture in their lives. the following employment-re-
cars, he was able to turn a pre-
The Core Gifts philosophy dis- lated activities as important:
viously misguided interest into
cerns between skills (what you • Identifying and building on the
a skilled vocation. There are two
have learned to do, although you young adult’s strengths and in-
important features in these pro-
may not feel joy in doing them); terests;
grams that have been used with
talents (what you have an innate • Exposing clients to jobs and
success in workforce develop-
capacity to do, but may not career paths;
ment programs for other “at-
choose to engage or develop); • Teaching clients that all indi-
risk” youth. The first is expos-
and gifts (the talents that you viduals must set career goals
ing youth to the value of work.
feel the deepest connection to, and design step-by-step pro-
Incentives in the form of cash
most compelled to learn about, cesses to get there; and,
or other equally tangible rewards
and eager to give). YouthSource • In the meantime, providing
can be a powerful mechanism to
uses the Child and Adolescent opportunities for temporary
keep youth engaged in working
Needs and Strengths-Mental work experiences and immedi-
toward their goals and can teach
Health (CANS-MH) tool, an “in- ate income to those clients who
them about the value of work.
formation integration tool” de- are ready. Program staff across
This is highlighted by incentive
signed to support individual at least three of the sites recog-
systems at the TAY and
case planning. nized that most youth are un-
YouthSource programs. Both
aware of the diverse jobs and
COMMON DESIGN FEATURE offer cash incentives for partici-
careers available in their com-
Utilization of a specific as- pation and completion in certain
munity, and that exposure to
sessment and service plan- activities, including weekly
these jobs, their pay scales, and
ning process assists clients in classes attainment of GEDs, and
the steps needed to obtain them
addressing their current sta- other achievements.
can play a big role in a young
tus and future goals across The second important fea-
person’s motivation to pursue
multiple life domains. ture focuses on supporting em-
employment. For youth to
ployers. Finding employers will-
The Journal for Vocational Special Needs Education 15
ing to become engaged in work- a critical issue. The shortage of expensive and time consuming
ing with youth involved in these housing in most communities is to sustain. The new complex will
programs can be challenging. an obvious barrier to the goal of support 12 youth living indepen-
Designing and implementing a living independently. Programs dently. The program will pay a
“win-win” situation for employ- must rely on existing options in property manager to loosely
ers and youth clients can result the community (e.g., homeless monitor activity, and will hire
in meaningful work experience shelters, subsidized housing two housing specialists to pro-
or a paid job for clients, and a waiting lists, and SoberLiving vide on-site supervision in the
good employee for a company. programs), which do not always evenings and on weekends.
YouthSource’s employer engage- fit the needs of individual youth. Our Town, which does not
ment strategy illustrates what is operate its own apartments, uti-
COMMON DESIGN FEATURE
possible with local companies lizes memoranda of agreement
Housing is an important part
when employers see what they with community-based organi-
of the service mix for older
stand to gain by placing a zations for its clients to be able
youth.
YouthSource client in their to access apartment units in the
Three of the programs pre-
ranks: 160 hours of subsidized same building as the program’s
fer to operate their own transi-
wages by the program; a one offices, and 10 additional off-site
tional housing units to increase
month no-cost employee trial apartments are currently under
the quantity of suitable housing
period; and the opportunity to construction. These units, in
for youth and to also manage the
give back to the community in a addition to rental assistance for
circumstances of the use of the
tangible way. YouthSource youth, are paid for through a
housing, depending on the
works with over 130 local em- “Shelter-Plus-Care” grant from
greatest needs of their client
ployers and staff stay with the the U.S. Department of Housing
population and available options
youth through the trial period and Urban Development.
in the wider community. Other
to assist both the young person
approaches used are to estab-
PART IV
and the employer.
lish partnerships in the commu-
The Options example of the
nity for the use of transitional Recommendations: Putting
young car mechanic also illus-
housing units and to utilize Fed- the Pieces Together
trates the importance of estab-
eral or other grants (either directly
The intent of this research is
lishing a relationship with em-
or through community partners)
two-fold: (1) to share common
ployers. Because of the
to subsidize the expense.
design features of programs that
employer’s relationship with
The Options and TAY pro-
are integrating service to youth
Options and his understanding
grams operate their own transi-
with mental health needs and
of the goals of the program, the
tional housing units and TCTT
exposure to work experience and
employer reserved the job for the
will begin doing so in the near
career development; and (2) to
young man while he served his
future. Options owns an apart-
identify systems-level features
time. As a result, today the em-
ment triplex for youth in need
that positively influence service
ployer has a competent and loyal
of transitional, supported inde-
delivery. The recommendations
employee who has worked for
pendent living. The triplex
below illustrate the points of in-
him for two years.
serves three clients at a time,
tersection between these, and
Design Feature 6: Housing and is strictly barred from be-
suggest areas for further study.
as a Critical Part of the ing utilized as a temporary shel-
ter in emergency situations, RECOMMENDATIONS FOR PROGRAMS
Service Mix for
even if a unit is available. This AND THEIR STAFF MEMBERS
Older Youth • Incorporate youth voices into
is part of the program’s commit-
the development and implemen-
All five sites view the shortage ment to non-duplication of ser-
tation of program services and
of suitable and affordable tran- vices that are otherwise avail-
policies. This will improve client
sitional housing for this popu- able in the community.
engagement, participation, and
lation as one of the greatest For youth to choose career
individual ability to utilize the
challenges to individual success, pathways based on informed
learning, services, and opportu-
particularly for older youth who decisions, their individual
nities offered. Programs should
are most likely to be unattached strengths and interests must
consider how the youth are uti-
to family or other support net- be identified and acknowl-
lized through at least three fil-
works. Because many clients edged.
ters: (1) Youth involvement in
arrive to the programs in a state The previous arrangement
daily program activities; (2)
of homelessness or at-risk of called for on-site, around-the-
Youth guidance and input on
becoming homeless, housing is clock staffing, which proved too
16 Volume 31, Numbers 1-3, Fall 2008
program policies and services; • Train all program staff (not just formation that’s been passed on
and (3) Youth direction on deci- the career developers) how to anecdotally. Regulations and
sions that directly affects ser- individualize exposure to the policy guidance, particularly for
vices and policies. world of work and to incorporate complex funding sources like
• Utilize a successful process activities that meet youth and Medicaid, may be misunder-
that identifies individual young adults “where they’re at” stood or misinterpreted, result-
strengths or “gifts” as the step- across all phases of employ- ing in missed opportunities for
ping stone to the development ment, including training and eligibility or additional funding.
of education, career, and life preparing for work, getting • Tailor and test Assertive Com-
goals, and the gateway to dis- hired, retaining jobs, and ad- munity Treatment (ACT) and
covery and hope. Staff members vancing to better jobs and ca- Systems of Care models that tar-
and youth clients across the five reers. Programs in this research get youth and young adults with
programs emphasized the value utilized a combination of expo- mental health needs.
of utilizing a tool or instrument sure to jobs/careers, job readi-
RECOMMENDATIONS FOR STATE AND
that assists youth and young ness guidance, work-based
FEDERAL POLICY MAKERS
adults in identifying their indi- learning, and customized em-
The overarching recommenda-
vidual strengths. ployment.
tion for policy makers is to elimi-
• Invest the time and resources • Cultivate relationships with
nate the “tunnels and cliffs”
required to build partnerships employers in the community,
caused by legislation and regu-
across relevant services and sys- assist them in seeing the ben-
lations that generate barriers
tems in the community. The in- efits of hiring program clients,
among the core systems serving
tensive and individualized case and create open lines of commu-
youth and young adults. To do
management approaches that nication between program staff,
this will require that policy mak-
work for the programs in this clients, and employers that can
ers explore and meaningfully
research rely on partnerships so be accessed on an on-going ba-
address the linkages between
that individual clients have ac- sis. All of the programs in this
policy issues (e.g., industry skill
cess to the comprehensive array study achieve this to varying lev-
shortages and large populations
of services available in a com- els, but for at least one the pay-
of youth unprepared for further
munity, which no single pro- off of making employer engage-
education or employment,
gram can offer alone. Partner- ment a priority is clear (i.e., 130
homelessness and un-managed
ships with the child welfare, ju- actively engaged employers).
mental illness, and mental ill-
venile justice, education and • Be the mentor, family mem-
ness and incidents of juvenile
training, and housing systems ber, parent, teacher, or other
delinquency). In addition, state
are particularly critical. Partner- positive influence that may be
and Federal policy makers
ships take time and effort, but missing from the life of the youth
should take the following steps:
the rewards/benefits for youth or young adult client by teach-
• Scale up staff capacity in the
and young adults with mental ing independent living skills and
workforce development field, in-
health needs are significant. positive social engagement in
cluding secondary education in-
• Incorporate on-site and non- daily activities. All programs in
stitutions, to effectively work
traditional approaches to men- this research heavily emphasize
with all youth and young adults,
tal health interventions, work- the staff time dedicated to as-
including those with mental
ing with youth and young adults sisting clients in making ap-
health needs. It is important to
at their own pace and in a highly pointments, accessing public
note that none of the programs
individualized, youth friendly transportation, setting up bank
incorporated substantive strat-
way. Across the sites, the pres- accounts, managing finances,
egies to work with school dis-
ence of on-site psychiatrists building healthy relationships,
tricts in their programs, in spite
and/or mental health profes- doing laundry, going grocery
of the fact that mental health
sionals was a critical component shopping, and cooking for them-
issues are often first identified
of care, although not based on selves.
in school settings. Currently,
prior approaches. Staff and cli- • Understand the Federal and
many of the youth mental health
ents alike lauded the non-tradi- state laws and regulations that
practitioners who are effectively
tional approaches to mental affect the program’s services and
finding and expanding outreach
health treatment utilized by pro- funding. It’s important to find
and engagement strategies for
grams. Therapy and file reading out whether information that is
youth and young adults with
are replaced by relationship- accepted as “common knowl-
mental health needs do not have
building, fun, and determination edge” is an actual Federal or
expertise in work and career
of each youth’s “core gifts.” state requirement or simply in-
preparation specifically. Career
The Journal for Vocational Special Needs Education 17
educators and workforce devel- • Explore state codification of tal health needs. Policymakers
opment professionals have that models for serving youth and at all levels of government must
expertise, but do not have the young adults with mental health tap the expertise of youth with
specific knowledge of engaging needs. mental health needs, programs
young people with mental health • Create model Medicaid waiv- and service providers, research-
needs. This is a classic situation ers for states to use that will ers, and practitioners to improve
of disconnection and could be cover an array of services for the likelihood of successful tran-
addressed through demonstra- youth and young adults with sition outcomes. Youth service
tion projects. mental health needs. professionals who work with
• Design and fund pilot demon- youth with mental health needs
The overarching recommenda-
strations that develop and evalu- across systems will be more suc-
tion for policy makers is to
ate promising practices to tran- cessful if apprised of the policy
eliminate the “tunnels and
sition youth and young adults directions, promising practices,
cliffs” caused by legislation
with mental health needs of all and the views of youth and fami-
and regulations that generate
severities into work, industry lies. Successful programs must
barriers among the core sys-
relevant education, and fulfill- actively seek out partnerships
tems serving youth and young
ing careers. Gather input into with service agencies and orga-
adults.
the design of such pilots (includ- nizations in their community to
ing requirements for multi- PART V provide the comprehensive ar-
agency coordination and fund- ray of services needed by youth
Conclusion
ing commitments) from effective and young adults with mental
programs. Multiple Federal Transition is an awkward period health needs.
agencies should fund and imple- of life for any young adult. Many There is much we know, and
ment these pilot demonstrations youth with diagnosed mental yet so much more that we need
to promote/support state level health needs experience poor to learn, about supporting these
initiatives. The design features transition outcomes and are youth as they move from the dif-
identified in this research among this country’s least un- ficult adolescent years toward
should be key features of the derstood and most vulnerable independence, adulthood, work,
demonstrations. Demonstra- youth. This report presents the and self sufficiency. The service
tions should additionally en- findings from case studies of five delivery and systems-level
courage (1) Innovative ap- promising program sites and themes highlighted in this report
proaches to the major barriers identifies program design fea- are intended to add to the grow-
of cross-system collaboration, tures that appear to improve ing body of knowledge about
including sharing information transition outcomes, incorpo- what can be done to assist
across agencies and organiza- rate a holistic approach to meet- transitioning youth and young
tions; (2) Implementation strat- ing youth needs, and incorpo- adults with mental health needs
egies that clarify and incorporate rate strong career preparation in becoming self-sufficient
the youth voice across the con- and employment components. adults who experience personal
tinuum of empowerment — Additionally, the report presents and employment success.
youth driven, youth directed, systems-level factors that affect Policy makers at all levels of
and youth guided; (3) Connec- success at the service delivery government must tap the ex-
tions that support transitional and individual outcome levels. pertise of youth with mental
housing; and (4) Relationships This case study research health needs, programs and
with schools that create oppor- demonstrates that no one gov- service providers, research-
tunities for earlier intervention ernment agency, state entity, ers, and practitioners to im-
to prevent the downward spiral local organization, program or prove the likelihood of suc-
of too many youth. project, or individual can do this cessful transition outcomes.
• Create a task force to explore hard work alone. Families, pro- _______________________________
and address the linkages be- grams, and governmental enti-
tween significant, but currently ties must all work together,
disconnected, policy issues im- across silos and boundaries, if
pacting youth in their transition there is any hope of improving
to adulthood and the world of the outcomes of youth with men-
work.
18 Volume 31, Numbers 1-3, Fall 2008
The preceeding document was ucts or organizations does not For information on the Collabora-
developed by the National Col- imply the endorsement by the tive, see http://www. ncwd-
laborative on Workforce and Dis- U.S. Department of Labor. The youth.info. For information on the
ability for Youth, funded by a National Collaborative on Office of Disability Employment
grant/contract/cooperative Workforce and Disability for Policy, see http://www.dol.gov/
agreement from the U.S. Depart- Youth (NCWD/Youth) is com- odep.
ment of Labor, Office of Disabil- posed of partners with expertise Reprinted with permission from:
ity Employment Policy (Number in disability, education, employ- Woolsey, L., & Katz-Leavy, J.,
#E-9-4-1-0070). This document ment, and workforce develop- (2008). Transitioning Youth With
was reprinted in the Journal of ment issues. NCWD/Youth is Mental Health Needs to Meaning-
Vocational Special Needs Edu- housed at the Institute for Edu- ful Employment & Independent
cation under permission granted cational Leadership in Washing- Living, Washington, DC: National
in the original document that ton, DC. The Collaborative is Collaborative on Workforce and
states any individual may repro- charged with assisting state and Disability for Youth, Institute for
duce any part of it: local workforce development sys- Educational Leadership. NCWD/
The opinions expressed herein do tems in integrating youth with Youth publications can be down-
not necessarily reflect the posi- disabilities into their service strat- loaded for free from the web at
tion or policy of the U.S. Depart- egies. www.ncwd-youth.info.
ment of Labor. The mention of
trade names, commercial prod-