Rachel Post, Director of Supportive Housing and Employment at Central City Concern knew that Individual Placements in Supported Employment (IPS) could work at Central City Concern, and it has. “I really believe in the strength orientations of this model. I believe that with the right kind of supports, people can work and be self-sufficient, in spite of every imaginable barrier or disabling condition,” says Rachel. Central City Concern (CCC) is a SAMHSA Services in Supportive Housing grantee.
Employment is often overlooked as a priority for people transitioning out of homelessness who are also struggling with mental illness, substance use, and prior criminal histories. But Rachel Post believes that IPS/Supported Employment is essential to recovery, sustained housing tenure, and self-sufficiency. Supported Employment is an evidence-based practice.
Central City Concern’s two-year retrospective study on the impact of the IPS model found that 71 percent of the 319 individuals enrolled in the employment program were successful in securing integrated and competitive employment.
The organization was surprised that their findings were so high, given that the average success rate for implementation of this model is typically 40-60 percent. All individuals enrolled in the program had been homeless. Forty percent of participants experienced co-occurring disorders, 60 percent experienced primary substance use disorders, and 70 percent had histories of felony convictions. Individuals were placed in both half-time and full-time positions across twelve different work sectors.
The study was conducted from June 2007 to June 2009. It examined administrative data from HMIS, data from three different employment programs, and data on substance use treatment information. The study was developed at the Dartmouth Psychiatric Research Center by Robert Drake and Deborah Becker, and research was conducted by Heidi Herinckx, independent evaluator and Assistant Director of the Regional Research Institute for Human Services at Portland State University.
All participants in the program were living in CCC’s alcohol and drug free housing programs. “We think that the recovery community plays a big part in our success. It is not enough to simply go to treatment. Longer support is required from the recovery community to help people learn to live a clean and sober, relational life,” says Rachel. All of the people who participated in the study had made a choice that they wanted to be in recovery. They estimate that one third of participants received medical care from their Health Care for the Homeless Old Town Clinic, which uses Motivational Interviewing techniques, offers compassionate care, and carries a message of hope about the future.
Program participants worked with case managers and housing specialists, many of whom are in recovery as well, offering their own life experiences as a model for what is possible. “What is critical is that we know we are recognizing that ending homelessness requires a continuum of support. We really have to address all areas of people’s lives,” says Rachel.
The CCC Supported Employment Program works closely with potential employers, often posing the question: what kinds of criminal charges will you exclude when hiring? They found that potential employers have often had experiences with family members who suffered from the tragic losses that often accompany substance use. Others have seen the remarkable progress of people in their lives who have recovered. “It is surprising how many people in the general population know someone who has experienced any one of these challenges,” says Rachel. Other times, CCC has used a less intensive approach, coaching participants on preparing job applications, interviewing skills, clothing, and how to talk about past criminal charges.
Heidi Herinckx says a unique component of the Supported Employment program is the ability of job developers to forge relationships with both participants and potential employers. “Job specialists develop new relationships in the community with employers based on participant interests, resulting in opportunities for more meaningful work experiences,” says Heidi.
It was important for Rachel to show funders, the federal government, and elected officials that employment is integral to long-term housing retention. CCC has been very successful in helping people to find meaningful work very quickly. The IPS model has the potential to support other systems, such as housing, healthcare, and a combination of mental health and recovery treatment services, especially in the current economic climate.
“The housing authority has asked us how they could apply this model. Many communities could add this as a component to their services and find that other housing resources would go further,” says Rachel.
While the IPS model does not prescribe incorporating housing specialists and case managers who are in recovery, CCC’s adaptation of this component has been critical. “We believe that everyone has the potential to recover and to be transformed. I think it is the most important thing we can do. So many people have never had the opportunity, the support or the role modeling.”
Heidi believes that the findings of the study point to the need for further research on the effectiveness of IPS with people who have a primary diagnosis of substance use. “Employment can be a motivation for people to stay sober. Traditionally substance use treatment providers emphasize focusing exclusively on recovery first. Then, people could move onto employment. There was a fear that employment could jeopardize recovery, but that has been shown not to be true.”
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