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TAY Mental Health programs are often asked to consider ways to integrate Career Development (Supported Education + Employment) into their programs. Sometimes this results in hiring a part-time Job Developer that has office hours every other Tuesday afternoon (or something similar). What if instead of asking how to best integrate “ancillary” career development into TAY programs, we reversed the question to how can we best integrate mental health services in TAY Career Development programs? What would TAY programs look like if they fully embraced the vision that one of their core purposes was to vigorously support youth with serious mental health conditions in assuming their rightful places in our schools and workplaces? How do we challenge this “soft bigotry of low expectations” approach where transitioning youth’s symptoms are treated, benefits established, and then discharged into a lifetime of poverty and disability?
If educational and employment outcomes were seen as primary indicators of high quality transition services, everything from staffing patterns to service philosophy, care planning and benefits counseling might begin to shift.
- Creating a hopeful program culture and context of urgency, rapid placement and continuous opportunity is crucial. Career development can’t wait until youth are symptom free and stable. (One youth commented that “pre-vocational means never.”) This includes ALL youth, whatever the level of impairment. Exposing struggling youth and young adults to opportunities to learn, train and earn money can provide the motivation to work hard to overcome and better manage their limitations and symptoms.
- Staffing patterns at many TAY programs may be top heavy with clinical specialists focused more on symptom reduction. Clinicians frequently outnumber peer supporters, generalist recovery coaches, and education and employment specialists. This ratio may need to be re-aligned to better support educational and employment goals.
- Care planning should always look to capture a youth-generated picture or vision of their preferred, future life. An important question to ask may be: “What would you be doing now or in the near future if you didn’t have these symptoms, barriers or problems?” The goal to reduce angry outbursts from 5 to 2 times per week may work for Medicaid, but it is not a very meaningful or inspiring objective for youth.
- Another area that should be included when promoting TAY Career Development is rigorous benefits counseling. With all good intentions, many TAY programs may seek to help the youth (and their families) qualify for SSI/SSA entitlements. On the one hand, SSI and SSA benefits provide the critical funds to meet basic survival needs such as food, housing and transportation. On the other hand, qualifying for these benefits by proving that one is “completely and totally disabled” can have a profound impact on the emerging identity of young adults and their career trajectory. Studies indicate that less than 1 percent of youth who go on SSI come off of it at a later date. Careful, ongoing benefit counseling that is up-to-date, hopeful and futures oriented is a must. Information on work and school incentives (Ticket-to-Work) should be offered to youth and families to keep career options at the forefront, and avoid cementing the disabled role.
The Recovery Model focuses on helping mature adults with psychiatric disabilities restore lost functioning, lost relationships and lost meaningful roles. TAY career development programs should focus on helping youth discover their passions and potentials, their grit, as well as their gifts.