Supported Education
Trevor J Manthey, MSW, Ph.D.
ACTIVITY/Discussion
What was
YOUR
experience
like attending
school?
In Oregon 4.6 percent of adults (79,000) have experienced a
mental illness (2012).
Onset usually occurs in early adulthood.
A serious mental illness diagnosis must meet 3 criteria:
• A diagnosis which can include schizophrenia, bi-polar
disorder, depression and other psychiatric disorders
• Disability: significant role impairment
• Duration: extended involvement with mental health systems
Introduction
Unemployed and Underemployed
• Only 10 to 15% of people with serious mental illness are
competitively employed.
• That is less than half the 33% of other disability groups.
• Those working are at or near minimum wage and/or parttime jobs without benefits.
• They are overrepresented in unskilled occupations in the
service industries and laborers.
Educational attainment predicts higher lifetime earnings and
other positive employment outcomes in people with mental
illness even more strongly than in the general population.
• Over 30% of people with mental illness have not
completed high school.
• Income in the U.S. without a high school diploma or
equivilant is less that $20,000.
• Median income increases 33% with a high school
diploma and more than triples with a college degree.
Benefits of Education
People who choose to pursue their education often
encounter these barriers:
• Psychiatric symptoms
• Finances
• Stigma
• Mental health professional who view coursework as
stressful
Barriers to Pursuing Education
“Because of my illness, I can’t concentrate, I can’t
focus long enough to read, and I often don’t buy
books. I used to like to go to the library. And now I
can’t focus long enough to read, so I don’t know if
I’ll ever be able to go back to school. I don’t know if
I’ll ever be able to work….and I mean at [a
bookstore] people go, “wow, she must be a fast
reader! She’s scanning a book.” No, it’s because I
can’t read it. I can’t sit down and read it. So that
would be the biggest barrier, was I can’t comprehend
a whole book. I mean I can’t memorize.”
Real Quotes
(Manthey et al., under review)
Supported education is individualized, practical assistance
to help people with psychiatric disabilities pursue their
educational goals. It includes:
• Clarifying education goals
• Finding education programs consistent with the goals
• Navigating the application process
• Securing financial support
• Finding education supports and accommodations to help
insure student success in meeting academic requirements
One Solution:
Supported Education
An intervention
model designed
to assist
individuals with
psychiatric
disabilities to
complete
educational goals.
Oregon began implementing a supported employment and
supported education model in 2000 as Individual Placement and
Support.
It began at Options in Grants Pass and is now offered in 31
community mental health settings serving 33 Oregon counties.
In the second quarter of 2015, 1587 individuals were enrolled.
Most programs provide limited supported education services as
as element of IPS supported employment.
Only 81 of the 1587 (5%) of clients in IPS SE received
education supports from April-June 2015.
The Oregon Experience
In 2006 three Oregon pilot projects (Cascadia, Lifeworks, and
Options) were funded. By years 2 and 3 students were
matriculated in community college vocational certificate and 2
year associates degree programs and 4 year degree programs.
A new SEd program at Jackson County Mental Health began in
2014.
Oregon SEd Programs
The low rate of participation in supported education programs
has been largely due to:
• Medicaid liability concerns as the SE Medicaid code did not
clearly include education supports in the description of
covered services,
• Uncertainty about how to provide supported education
services.
Barriers
New Medicaid Modifier
Available
Starting July 1, 2015, a modifier is now available to use
with the Medicaid supported employment code to denote
supported education service provision.
The Medicaid service description for this code has been
revised to include supported education.
Implementation, funding and technical assistance to:
Collaborate with present consultants (Karen Unger and Trevor Manthey) and others to develop a crosswalk
from the 25 items of the IPS SE fidelity scale to an equivalent 25 item best practice SEd fidelity scale.
Develop technical assistance to train SE staff and managers in SEd service model, IPS fidelity for SEd and
outcome data collection.
Incorporate SEd technical assistance into individual annual IPS program technical assistance plans.
Modify the existing IPS program fidelity review process to include concurrent and annual review of SE and
SEd services.
Provide on-going technical assistance to participating agencies.
Review SE and SEd services concurrently incorporating a 25 item SEd fidelity scale, resulting in one fidelity
score for the IPS program being reviewed.
Proposed Service Delivery Model
ACTIVITY/Discussion
What would
you need to
move closer to
implementing
SEd?
•
• “I don’t look at [my symptoms] as obstacles anymore. I
look at them as opportunities for growth. I may have a
setback now and then, but I know that I’ll work through it
and recover, and then I’ll be stronger on the other side
than I was going in.”
• “My diploma is going to mean everything. When I put
that thing up on my wall, I’m going to be able to look at
this thing every day. Every damn day…”
Real Quotes
(Manthey et al., under review)