Episode 29 - Dr. David Biegel: Facilitators and Barriers to Supported Employment for Individuals with Co-Occurring Disorders

Monday, September 21, 2009, 8:57:47 AM

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In this episode, Dr. David Biegel discusses his latest research examining facilitators and barriers to employment for individuals with co-occurring serious mental illness and substance use disorders, and implications for agency practices.

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Average Rating: 4.3 stars (3 listener reviews )

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Average Rating: 4stars  supportive employment review, Wednesday, April 13, 2011

By Corinne Miga :

I found Dr. David Biegel’s research on supportive based employment for those with co-occurring disorders both interesting and informative. I did not realize the prevalence, of approximately 4 million Americans suffering from both mental illness and substance abuse issues. Supported based employment proves to be a beneficial program that seeks to assist this client population with finding employment within an area they are interested in. The program has a zero exclusion policy, which prohibits any client with dual diagnosis from being denied the service of this program. The program is also designed to have a case manager assist with rapid job search to place and train the employee in a competitive work field. The fidelity rate is high, with 61% of clients entering competitive employment through this program. However, many barriers exist in which clients do not take advantage of the benefits of this program. Therefore, it is important for clinicians and case managers to work together as an interdisciplinary team to both educate and provide mental health services in order to increase the self-efficacy of clients, so that they are able to obtain opportunities through this program.

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Average Rating: 4stars  challenges to obtaining supported employment, Sunday, February 28, 2010

By Shirley Wright :

This podcast was enlightening and I whole-heartedly recommend it for all those interested in working (or currently work with) this vulnerable population. However, Dr. Biegel does not fully discuss all barriers to supported employment, particularly those most evident in rural areas. One barrier is a lack of reliable public transportation to supported employment programs or competitive employment for that matter. Another barrier is the relatively few number of supported employment opportunities available. Once consumers have secured these few positions, they are reluctant to leave them. If consumers don’t quickly move on to competitive employment, there are no opportunities (open slots) for other consumers to take advantage of supported employment. Motivational interviewing may be beneficial in assisting consumers to move on but where would they go in this economic climate? Finally, although Dr. Biegel did not list benefits as a barrier to employment, regulations regarding federal benefits should be considered by consumers with mental illnesses before agreeing to employment. These regulations place limits on what consumers can earn before their benefits are jeopardized. For example, one young consumer at my field placement agency can earn $65 a month before her benefits are affected. Sixty-five dollars a month is roughly equivalent to 9 hours of work each month. While she readily admits that 9 hours a month is “better than nothing” she yearns for the opportunity to be gainfully employed during those times when her mental health symptoms are abated.

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Average Rating: 5stars  response to dr. biegel's podcast, Tuesday, January 19, 2010

By Sabrina D. :

According to The National Mental Health Information Center, supported employment is an approach “to help people with mental illnesses find and keep competitive employment within their communities.” ("Evidence-based practices: shaping,"). Dr. Biegel’s podcast provides insight on this approach. He focuses primarily on agencies that work with clients of co-occurring mental illnesses and/or substance use disorders, examines barriers to employment for clients who are in mental health agencies and focuses on the effectiveness of supported employment services offered to clients of this population.

With regard to substance users, Dr. Biegel reports that approximately 60 percent of clients diagnosed as having substance dependency are not referred to supported employment. This statistic is alarming to me since from my own personal experience, while interning at an addictions agency, I have incessantly observed social workers help clients link with vocational services so that they can seek employment or obtain a higher level of education. After processing this information, I am interested in knowing if this statistic was measured between the 90 days of intake for clients. As Dr. Biegel mentioned, a goal of supported employment programs is to have clients employed within 90 days of intake. This is an interesting perspective to me, because I believe that every client is at their own stage in recovery and some may not be equipped within 90 days in treatment to manage the everyday life stressors that the workforce entails...(con't)

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