NDEAM: Recovery, Success, and the Value of Work

All feelings of Monday morning ambivalence (or reluctance) aside, work provides most people in the United States not just with a necessary source of income, but also with a sense of purpose and a compelling reason to get up in the morning. Each October National Disability Employment Awareness Month (NDEAM) encourages us to recognize the role supported employment plays in the life of a person with a disability or mental illness, with the goal of fostering a more inclusive workforce, one where every person is recognized for his or her abilities.

The National Alliance for Mental Illness (NAMI) published a report in 2014, which explored the current state of mental illness and employment in the United States. The organization found that “many people with mental illness are either unemployed or underemployed. Bouts of illness, difficulty concentrating, trouble communicating with co-workers, medical appointments and absences from work can make getting and keeping a job difficult. Stigma and discrimination can also be great barriers to overcome.” Individuals who are not engaged in the workforce are enormously costly to society: they often require public assistance, may strain their social networks, and incur exorbitant health care and justice system costs. In contrast, the value of supported work in the recovery process for people living with mental disorders is outstanding.

The Substance Abuse and Mental Health Services Administration (SAMHSA) asserts that “every person with a serious mental illness is capable of working competitively in the community if the right kind of job and work environment can be found.” To that end, the Administration has developed a toolkit from evidence-based practices to help stakeholders build such a program. A number of successful models providing supported employment also exists across the country.

In 1948, Fountain House was founded in New York City, to change the general public’s perceptions of people living with mental illness, allow members to support one another through “life’s challenges,” and prevent social isolation. As the organization demonstrated growth and success in reducing hospitalizations and increasing members’ employment opportunities, the Fountain House design was expanded to form the Clubhouse model, which has spread, over the course of several decades, into other cities and countries across the globe. Today, Clubhouses provide a launching pad for people experiencing mental illnesses to reach greater self-sufficiency, a tighter community, and a fulfilling life through both transitional and independent employment programs.

Among others, organizations like Greyston Bakery and DC Central Kitchen provide opportunities for people with high barriers to employment, like histories of substance abuse, homelessness, mental illness, or incarceration, to receive job training, find work, and move on to self-sufficiency.

Some models include both housing and graduated employment strategies. The Doe Fund in New York City partners with a range of local entities to provide a stable path to employment through their Ready, Willing & Able program in coordination with supportive housing sites throughout the city. Colorado’s Boulder Bridge House is home to 44 individuals returning from homelessness, and helps them get back on their feet with job training; substance use, mental health and primary medical treatment; case management, and a path to stability.

According to Maslow’s Hierarchy of Needs, the path to self-actualization cannot happen before needs like hunger, housing, and community are met. Each of us knows the meaning and value work brings to our lives, including its ability to help us meet our own basic needs. Communities and businesses all across the country should actively create and promote programs like those mentioned above, to bring opportunities for supported employment to those with special needs, disabilities, and mental illnesses in our communities.


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