Sheila H. Akabas

Developing Strategies to Integrate Peer Providers into the Staff of Mental Health Agencies

This study informs new strategies that promote integration of peer providers into the staff of social service agencies. Executive directors, human resource managers, supervisors and co-workers at 27 agencies in New York City were interviewed in-depth. Focus groups with peers were conducted. Consistent with previous research, respondents identified attitudes toward recovery, role conflict and confusion, lack of policies and practices around confidentiality, poorly defined job structure and lack of support as problems that undermined integration. Emerging from the data are strategies related to human resource policies and practices and workgroup relationships and operations that can improve employment of peer staff.

Disability management : a complete system to reduce costs, increase productivity, meet employee needs, and ensure legal compliance

An overview of disability management -- Legislation affecting disability management practices -- Components of a disability management program -- Preparing to implement disability management : an organizational perspective -- Laying out the policy on disability management -- Case management as a disability management tool -- Ensuring continuity of disability management -- Profiles of corporate disability management programs -- How do we know disability management will work?.

Building capacity in social service agencies to employ peer providers.

OBJECTIVE While there is evidence that peer providers are valuable to service delivery teams, the agencies where they work face difficulties in fulfilling the potential of including peers on staff effectively. The purpose of this article is to report findings of a pilot test of a workplace strategy that promoted inclusion of peer providers at social service agencies by building organizational capacity to support people with mental health conditions in peer provider roles. The strategy included training, goal setting and ongoing consultation. METHODS Seventy-one peer, non-peer and supervisory staff participated from 6 agencies over a one year period. Goal attainment scaling and data from in-depth interviews about perceptions of differences in the ways in which staff are supported, administered prior to and after the consultation period, were used to assess strategy impact. RESULTS Most frequently staff set goals to respond to role conflict or a lack of support. Staff that met or exceeded their goals utilized the formal structure of consultation to improve communication among themselves, had leadership that sanctioned changes and felt that their participation was of value to the organization and contributed to their individual development. Strategy participation promoted inclusion by initiating changes to policies and practices that devalued the peer provider role, increased skill sets, and formalized lines of communication for sharing information and understanding related to peer providers. CONCLUSIONS Findings demonstrate that a strategy of training, goal setting and consultation can positively affect perceptions of inclusion, and promote implementation of practices associated with inclusive workplaces.

Women and AIDS Prevention

Many women are unaware of their potential risk of becoming infected with the human immunodeficiency virus (HIV), the virus presumed to cause AIDS. Other women are confused about what prophylactic measures to adopt to lower their susceptibility to infection. Moreover, the needs of women who do not inject drugs have been largely ignored in media and public information campaigns. Rising rates of AIDS infection among women underscore the need for targeted prevention efforts. In this paper, the risks of the spectrum of HIV-related disease,i.e., HIV seropositive, lymphadenopathy syndrome, AIDS-related complex or full-blown AIDS, for women are described. Methods of disease transmission, prevention means, and issues and barriers to adopting practices for reducing risk of exposure to and transmission of the human immunodeficiency virus are reviewed. Finally, practice, research and policy initiatives for AIDS prevention are offered.

Inclusion of People with Mental Health Disabilities into the Workplace: Accommodation as a Social Process

A review of the literature reporting on the employment status for people with serious mental health conditions typically begins with a litany of statistics demonstrating their continued poor employment outcomes.

Performance-based contracting: turning vocational policy into jobs.

The New York State Office of Mental Health has implemented a 2-year demonstration to determine if performance-based contracting (PBC) improves rates of competitive employment for people with serious persistent mental health conditions, and promotes best practice among providers. This article reports the interim findings from the demonstration. Initial results suggest that PBC is reaching the target population and promoting employment for a significant proportion of participants. It is also stimulating agency re-evaluation of consumer recruitment strategies, job development models, staffing patterns, coordination with support services, methods of post-placement support, and commitment to competitive employment for consumers.

Women, work and mental health: Room for improvement.

Womens labor force participation rates have steadily risen in recent years; today, approximately 45% of all workers are women. But there are factors that aversely affect womens physical and mental health. For example, working women play multiple roles: worker, wife, mother, caretaker of the elderly. Most women work—and are stuck in—low paying jobs that are stressful and uninteresting. Microelectronic devices pose yet other stresses at the work place. Preventive actions include organizing for better jobs and working conditions; passing legislation for better care of children and the elderly; and equalizing responsibilities in family roles through social change.

Meeting the Demands of Work and Responsibilities of Caring for a Child With Asthma: Consequences for Caregiver Well-Being

ABSTRACT This study explores work–caregiving conflicts for 98 randomly selected low-income, single parents of children with asthma and how it affects caregiver well-being. Participants, who worked in unionized hospitals in a large urban area and had young children with asthma, were given an in-depth phone survey, which measured quality of life, depressive symptoms, caregivings positive impact, caregiving burden, work–caregiving conflict, and social support. The findings suggested that work tended to conflict with caregiving more than caregiving conflicted with work, as most participants perceived work as inflexible. In addition, parents relied more on family and friends as social support rather than on workplace or union support, as the union fulfills its responsibility to assure employment maintenance despite difficult working conditions. And although caregiving was viewed as a positive experience, it negatively affected quality of life. This population would benefit from education about policies governing the use of personal time, assistance with developing a plan to disclose their work–caregiving conflict and on how to activate workplace supports, and focus on this assistance being provided at the onset of asthma. Future research and recommendations are made.

Reconciling the Demands of Work with the Needs of Families

Despite years of jawboning about the mutual interests of and the complementary relationship between employees and employers, American employers, for the most part, have not yet created programs hospitable to employees with dual concerns of work and family. Innovative and helpful programs such as flexible work schedules and job guarantees for employees who need to take dependent-care leaves, funding help for community day-care and eldercare programs, investments in worker safety so that the United States ceases to have the highest workplace death rate of any major industrial country, and provision of adequate health insurance for all employees and their family members have been virtually ignored by many companies as well as the federal government. To apply a well-turned phrase to the work-family situation in this country, if “all the world’s a stage, and all the men and women in i t merely players,” 1 think we need a better director for the work-family scenario. As long as the two basic elements of human activity-family and work-are in conflict, our society is in serious trouble. This conflict, I believe, can be resolved only through public policy initiatives. This essay explores some of the changes that are occurring in the world of work and among labor force participants, speculates on how these changes will influence the connections between work and family, and considers the role of human service providers in establishing the social policy and practice initiatives necessary for harmonizing the demands of work with the needs of families.

Have I Got a Worker for You: Creating Employment Opportunities for People with Psychiatric Disability

Barriers to employment for people with persons with serious, persistent mental health conditions. psychiatric disabilities are under attack from the combined weight of legislative Contrary to the belief of employers and providers alike, research shows that peomandates, consumer pressure, and changing health care and benefit policies. Deple with serious, persistent mental health conditions can work (Akabas & Gates, spite these forces, the unemployment rate for this group, as for all Americans with 1998; Akabas & Gates, 2000; Weiner, Akabas, & Sommer, 1973; Bond & Meyer, disabilities, remains dismally high. Of the 16.9 million working-age Americans with a 1999). Data suggest that high unemployment rates cannot be explained by a lack disability that limits the amount or kind of work they can do, many of whom have of desire or ability of consumers to work (Louis Harris and Associates, 1994). Nor psychiatric disabilities, more than two thirds (11.9 million) do not participate in does the explanation of high unemployment lie with labor market conditions. the labor force (LaPlante, Kennedy, Kaye, & Wenger, 1997). The purpose of The national unemployment rate is the lowest since the 1960s (reported as 4.1% this paper is to explain how providing vocational rehabilitation services contributes in May 2000 by the U.S. Department of Labor), which suggests that more people to these rates and to describe a cutting edge strategy, the Neighborhood Labor who were often left jobless, such as those with few skills or minimal education, now Market Employment Strategy, which may increase employment opportunities for have jobs (Weinstein, 1999). If consumers are willing and able to work and if jobs are available, then we Lauren B. Gates, Ph.D., and Sheila H. Akabas, must ask why more of them are not emPh.D., are affiliated with the Center for Social ployed successfully. The problem can be Policy and Practice in the Workplace, Columbia explained, at least in part, by a paucity of University School of Social Work. Elana Zwelling, M.S., is affiliated with Towers Perrin. linkages between providers and employAddress for correspondence: Lauren B. ers. Providers of vocational services can Gates, Ph.D., Workplace Center, Columbia Uniplay a determining role in consumer emversity School of Social Work, 622 W. 113th ployment outcomes: They evaluate conStreet, New York, NY 10025. E-mail: lbg13@ sumer readiness for competitive employcolumbia.edu.