Transcript SUPPORTED EDUCATION - California Institute for Behavioral

Supported Education and
Supported Employment Summit
May 3rd, 2010
SUPPORTED EDUCATION
Presented by:
Tim Stringari
[email protected]
Dan Chandler
[email protected]
BASICS
 Supported
education may be defined
as the provision of support and
services to help persons with
psychiatric disabilities gain access to
and succeed in a postsecondary
college or technical school.
What is Supported Education?
Supported Education Programs are
community partnerships made up of
mental health consumers, family
members, agency staff and college
personnel.
 The purpose of these partnerships is to
pool resources to maximize educational
opportunities and employment outcomes
for persons with psychiatric disabilities.

What is Supported Education
(Cont.)



Agency staff provide individualized and/or
programmatic support to consumers returning
to school.
Supported Education Programs provide
supports and services that are over and above
existing educational services.
Programs vary in structure and design
according to the unique assets of each
community, college, and participating agency.
Not One Model–Rather Principles

Principles based on psychiatric
rehabilitation and recovery:
 Normalization
 Self-determination
 Support, skills and resources
 Hope and recovery
 System change
A wide range of mental health service
delivery models are in use
 MH
agency, self-help or wellness
groups or organizations, clubhouses,
mobile staff, on-campus program can
provide support
 Eligibility usually requires acceptance of
illness, being in treatment and target
group diagnosis
Why is Supported Education
Needed?


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Stigma and prejudice
Fluctuation of student needs
Service coordination
Psychosocial effects of mental Illness
Inadequate Disabled Student
Services funding
Why is Supported Education Needed:
Statistical Context (Cont.)

86% of persons with psychiatric disability withdraw from
college prior to getting degree

There are only 9,000 persons in California post
secondary school with psychological disabilities but
650,000 public mental health consumers (34% with at
least high school education)

In 2007 only 6 social work of 833 undergraduates with
psychological disability got a degree and 12 of 1,200
got a masters in social work
PROGRAM ELEMENTS
 Supported
Education program
elements focus on three domains of
intervention:
 ACCESS
 RETENTION
 OUTCOMES
Supports to Facilitate ACCESS

Outreach and recruitment

Orientation and “walk-through” visits

Identified Contact Person

Assistance with registration

Assistance with financial aid
Supports to Facilitate RETENTION
 On-site
support
 Book
funds
staff
 Tutoring
 Transitional
 Crisis
Classes
intervention
 Faculty training
 Social activities
 Peer Counseling  Safe place to
 Study labs
meet
Supports to Facilitate OUTCOMES
 Service
and plan coordination
 Coordinated career planning
 Assistance with degree application
 Assistance with transfer application
 Liaison with transfer sites or
employers
SUPPORTED EDUCATION
OUTCOMES & FINDINGS

“There are many positive outcomes for providing
supported education services to people with psychiatric
disabilities. A major one is that mental health
consumers become college students. The role of
college student in our society is highly valued. The role
of mental health consumer is very devalued. With this
change in role and identity, students realize they are not
their illness, but a functioning, productive member of the
community. Symptoms become something to be taken
care of so goals can be accomplished.”
Karen Unger, MSW, EdD
Evidence-base for supported
education: Overview

Virtually all studies report positive results, but…

Methodology is generally weak
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19 studies total
2 are unpublished
9 were pilot projects
1 randomized control comparison (but weak intervention)
1 three site comparison
1 quasi-experiment
Outcomes are inconsistently measured from study to
study and usually rely on self-report
Is an “effective practice”
Program Participants in the Three Best
Studies
Average age: 34, 36 (17 to 75), 29
 Hospitalizations:

San Mateo: Average of 7 hospitalizations
 Unger: 86% hospitalized


Diagnosis primarily schizophrenia
spectrum disorder, major depression,
bipolar disorder
Participants (Cont.)

High proportion take psychiatric medications

Tend to have more education and employment
than other persons receiving mental health
services:


Mowbray: half had some college already

Unger: 50 of 124 already had at least AA degree
But (Unger) 29% had been homeless and 38%
had been arrested
Success is Associated with:
Mowbray: Productive activity at baseline,
or having a partner
 Unger: Fewer hospitalizations, having a
car
 In neither study were diagnosis,
symptoms, or duration of illness
associated with any measure of success

Evidence of success in 3 best
studies

Measures inconsistent across studies and vary
widely in effectiveness

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Drop-outs reported by Mowbray: 44%
Class enrollment rate 28% Mowbray; 83% Unger
study (includes San Mateo); 42% Cook
Course completion rate: 42% Mowbray; 90% Unger;
average of 3.6 courses, Cook
Reduced hospitalizations (Unger)
Evidence of success (cont.)
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Grade point average: 3.1 Unger
Received degree or certificate: 14% Cook, 21%
Unger
Quality of life and self-esteem improve in one site
(Mowbray), self-esteem alone (Cook), neither
improved (Unger)
Our Experience in California
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Accommodations and services required by students with
psychiatric disabilities are similar or identical to those
provided to students with other disabilities.
Students with psychiatric disabilities are neither prone to
crisis or disruptive to the campus environment.
As a result of participating in Supported Education program,
students experience improvements in work readiness, social
skills, and self-esteem.
The development of personal supportive relationships with
peers and other students is a key factor in the success of
students with psychiatric disabilities.
Most problems are related to the stigma of mental illness or
due to role confusion on the part of the college staff.
SUPPORTED EDUCATION &
EMPLOYMENT
Employment is Common among
Supported Education Participants

Many students also work
Unger: 49% worked concurrently
 Cook: 78% employed within 3 year study
period and half those employed at end
 Doughterty: 78% some employment in 18
month study period
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Employment after leaving school

San Mateo: 51% work, 69% of these as part
of MH system
School and Job Internships
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Boston University (2007):
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Kansas University (2005)
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Similar model but for peer counseling
At 6 months 63% employed
Housel (1993):
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Combined college classroom computer training with community
internship.
Baseline work 18%, at one year 64%
On-campus Aide Training. 13 of 15 hired as MH aides after
program
San Mateo
Programs providing supported education and
supported employment

An early model (Egnew 1993)
County MH contracted with one agency for
both services
 Preliminary counseling covers short/long
term and both employment and school
 Mobile approach used for both services
 School grads get special supported
employment intervention

Programs providing supported education
and supported employment (2)
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Nuechterlein(2005, 2008)
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Serve first break college drop outs
Adapted IPS for work or school
IPS Supported employment program also helped
with return to education, performing all
supported education functions
93% were successful returnees to:
• 36% School only
• 31% Jobs only
• 33% School and work
Getting to work!