Road to Recovery – Ready, Willing, and Able To Work (full episode)

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Road to Recovery – Ready, Willing, and Able To Work (full episode)

Hello, I’m Ivette Torres, and welcome to another addition of The Road to Recovery  Today, we’ll be talking about obtaining and retaining employment for people in recovery Joining us in our panel today are David Berns, director, District of Columbia Department of Human Services, Washington, DC; Dr. Gary Bond, professor of psychiatry, Dartmouth Psychiatric Research Center, Lebanon, New Hampshire; Peggy Burns, EAP counselor, Employee Assistance Program, University of Maryland Medical System, Baltimore City, Maryland; Neli Vasquez-Rowland, president, A Safe Haven, Chicago, Illinois Of those individuals that are unemployed, there was about a 15.7 percent rate of drug dependency among them Of the ones that are employed with a drug dependency, there were 23.3 million people overall, and about 49.8 percent of them were employed And from the mental health community, there were 6 million people who were served by mental health authorities across the nation, and roughly 21 percent, or about, of the 6 million, were employed What does that tell us? What types of challenges, David, do these individuals present as they approach the employment marketplace? Well, that’s telling me that, actually, most people that are, that are served by my agency, which provides welfare or TANF services or homeless services, do not have mental health or substance abuse problems There- but the percentage is a lot higher than the general population So probably 20 percent of the people that we’re serving in TANF have substance abuse problems and a similar type for the homeless programs But, when they have both substance abuse and poverty issues, their problems are much, much higher and really need a much more concentrated effort Yeah, for them to get help And, Neli, for, for individuals who are dealing with substance use disorder, let’s take them first What do they present as they come into the marketplace? The underlying issue of drug and alcohol addiction is the underlying issue The real barrier as to employment are some of the criminal justice backgrounds that people have established along the way that prevent them from getting a job: their financial history, the fact that they may be homeless and don’t have a base to operate from, the fact that they might have children in tow And, you know, education can be a barrier, if, you know, there’s a very high likelihood of drug and alcohol addiction and failure to complete a formal education So the barriers, basically, just go on and on, with the underlying issue being drug and alcohol addiction So what we do at our program is, at A Safe Haven, is that we find out why people are in crisis, if it’s chronic or if it’s for the first time And if it is a drug and alcohol problem that’s keeping them from the workforce, let’s solve that first And then let’s move them through a continuum of care that’s going to be unique to their specific challenges so that we can really pave the way so once they do get employed, they’re going to be retained and they’re going to be successful And that’s, I think, at the end of the day what all employers want And, Gary, does this change much for those who have mental health problems? Well, I think the situation for people with severe mental illness, and by that I’m referring to schizophrenia and bipolar disorder But it includes a wide range of psychiatric disorders That their challenges certainly overlap with the, the two populations that, that Dave and Neli just mentioned And, oh, about half of them have substance abuse problems of the severe mentally ill group The, the challenges that they have are, are not what you might expect

The first thing that pops into people’s heads might be, or often is, that they have psychiatric symptoms that prevent them from working And that turns out not to be the biggest barrier There are a range of things that really interfere with their getting into employment They want to work The majority of them want to work Our statistics suggest over two-thirds want to work Even though, as you indicated earlier, a very small percentage, maybe as little as 10 percent in some of our surveys, are actually working at a given time There’s a big gap there And the reasons, the barriers, include the lack of encouragement and help from the mental health community, from mental health professionals And, certainly, we think of stigma as another big barrier, that the public and employers may have misconceptions about how violent people are with mental illness, even though, you know, they are, you know, the findings are way blown out of proportion by, you know, by the media And another huge barrier is fear of losing benefits Okay Folks with severe mental illness are living on the edge They’re living in great poverty, and they don’t want to lose their health care benefits and other benefits that- So let’s go a little bit into that That would mean that an individual is getting a specialized consideration on their X programs, and, if they became employed, they’re afraid of losing those benefits? That’s the number one reason that people with severe mental illness don’t look for work, and often it’s based on misconceptions So a big piece of this, as we’ll get to later, is how to intervene and how to get people accurate information about what really are their benefits and what are the consequences if they go back to work But I’d go back to the first point, and that is the importance of hope and optimism on the part of the individual who’s looking for work, having that belief that they can succeed, that is supported by the folks around them That’s so terribly critical And, Peggy, we’ve talked about substance use disorders We have talked about mental health problems What other, let’s take a look at your work within the EAP realm What other presenting issues have you faced, you know, as an EAP counselor? I work for a medical system and with medical professionals as well as everyone that’s employed by the system What often happens is we have nurses, doctors, who have an issue with substance problems, and then they’re in a position where it’s very easy to divert Then, if they get caught, and they usually do, they’ll come, via employee health, where they get a evaluation, and then the employee health sends them to EAP We assess the situation, evaluate, and then send them to a outpatient treatment center for further evaluation, and then follow with those recommendations as to whether or not they’re going to be sent to an inpatient facility or outpatient In most cases, it starts out with outpatient because of the different insurance companies that are out there are not ready, willing, or able to want to put someone in a 30-day program, or an inpatient program So which, which avenues, then, you’re talking a little bit about what one does once one identifies the problem that actually comes in But, in terms of the challenges that come before you, are, do they come because there’s individuals within the workplace that notice that someone is not really working up to par and then they bring them in? Or do they come because of a boss or a supervisor may have a concern? All of the above All of the above Plus, they also self-refer Rarely, but they do So usually, what happens is the manager or the supervisor will send them for a fitness-for-duty If their observation is that they’re not functioning; oftentimes they miss days, Mondays and Fridays particularly, and when they are on the job, there may be some physical impairment that can be observed I recently had a case where an R.N. was sent to me because she was falling asleep on the job, which is, of course, highly unusual And as the situation evolved, it turned out that she had a very serious problem with a prescription medication

So they come from all different angles, there’s no specific way And you, yourself, have an experience because you, you’re a person in recovery That’s exactly right Want to talk a little bit about your own experience? Yes I’ve been in recovery for a little over 33 years I was 34 years old when I came into recovery And when I came into recovery, at that time I was not employed outside the home I was at home, taking care of my children And this is a disease, and the disease continued to progress It’s also a family disease I come from a family where it’s not only, runs in the family, it gallops in my family, both sides All the way around I didn’t recognize that I had a disease called alcoholism until I went into an AA meeting right off the street And that’s how I got sober And you were employed at the time? I was not I was employed-well, I was, but not outside the home Okay I was employed in the home But as the years went on and I got involved in this field, I began doing a lot of work with women who were employed and who had issues, barriers to even looking to get treatment, seeking treatment Because of taking care of their children, that type of thing And, this is a question for the entire panel, let’s talk a little bit about why employment is such a critical factor in recovery David, we’ll start with you Okay And, of course, I work with unemployed people, that’s my focus, people who are in shelters, or receiving welfare benefits When we find out that they have substance abuse issues, then we find that the substance abuse is a barrier to the employment, but a lack of employment is a barrier to their recovery So a lot of times, you don’t start out with just getting somebody a job, but actually the first thing we find is getting them into safe and stable housing Because they can’t be successful with a job and they can’t be successful with treatment until they have a place So it’s an issue of housing first? It is an issue of housing first, but then the job that they often need is often just a part-time job, just to get them stabilized, get them a little extra money Give them some hope, some sense of self-esteem, and it gives them the resources then to maybe be able to take a class or two that will prepare them for a career So it’s get a job, get a better job, get a career And, at the same time, addressing all of their barriers, whether they’re mental health or substance abuse And, when we come back, we’ll be able to continue with the rest of the panel and get their views We’ll be right back The perspective, when a person in recovery, is seeking employment, is sometimes difficult People are sometimes concerned about whether they should be forthcoming with where they are in the process Lots of times they will have breaks in employment that they’ll need to explain I think, generally speaking, being honest and forthright about the situation, and being proud about being in recovery and where they are, and, and what they need to move forward, and the importance of the relevant employment, and the fact, frankly, that they’ve overcome the issues they’ve been struggling with, I think is a very important and positive thing to say when you’re seeking a job And, frankly, the more people who are willing to say they’re in recovery, the more people who are willing to say they’ve had these histories, I think is better for everyone When we are talking about the importance of employment and some of the complexities associated with getting a job, there is another alternative And that alternative is to volunteer What volunteering does, similar to a recovery job, it allows that person to offer service, to get to be known, to provide some skills, depending upon what skill set they bring to the situation, to demonstrate reliability, to be able to show that they can be accountable And to acquire personal references that can be of use to others in the community I had no idea it was going to be so hard I didn’t know what to expect You hear the stories, but I never took any of it seriously until I found myself here And then I realized I was going to have to work hard for my recovery If you or someone you know has a drug or alcohol problem,

you are not alone Call 1-800-662-HELP Recovery was the hardest job I ever had, and the most important Brought to you by the U.S. Department of Health and Human Services You do not have to be in recovery to be an effective counselor, I want to make that clear However, the fact that I am in recovery, and I’ve been counseling for over 30 years, it helps me because when I share and self-disclose with people who are sitting there filled with shame and guilt and remorse, and they don’t understand that they’re sick, and that they have a disease When I share with them that I’ve walked that walk, I’ve walked in their shoes, I know what it’s like, and I know that you can walk through it, they really listen They really pay attention Because they look at me and say, if she could do it, I can do it So, Gary, let’s continue Is employment a critical factor in the whole scheme of recovery? We say in the mental health field that work is the key to recovery And building what, what Dave said about substance abuse, many of the same themes you’ll see there, in terms of, of giving people a sense of self-worth, a sense of direction What are you going to do when you get up in the morning? You know, work really structures people’s lives It’s a normal adult role It gives great meaning to people’s lives And as we hear the stories of people who have recovered from mental illness or in recovery from mental illness, almost invariably one of the key ingredients is that they have found a way to find meaningful activity And most often that means competitive employment And so, we believe that supported employment, which is a program to help people get employment, is the best therapy around And actually the research shows it’s the most effective of any of the psychosocial interventions, any of the things that we do And more effective, actually, than medications And I’m not saying that we don’t need medications But if you look at a single ingredient that makes the biggest difference, it’s helping people find their niche in, in the workplace That’s one key ingredient to, you know, a meaningful life I want to come back to that supported employment because I want to really look at the, all the components of that And, Neli, when individuals come into your center for assistance, what do they really ask for, you know, in terms of do they primarily want to be retrained? Or do they, do they basically say just try and get me a job first? What is their initial contact? Well, the initial contact is really to get them a job And what’s different about A Safe Haven, and I agree with both of you, and it really was great to hear, you know, that housing is a, is a critical piece You know, you cannot begin the process of even looking, or having a job, without having a place to live And I do- I can imagine someone filling out an application and it says, you know, what is the address, and there’s no address Exactly I suspect, though, that someone might put a temporary housing for, you know, in terms of a halfway house or some other type of, of residence, but that is a residence Exactly And I agree with Gary, that, you know, work is definitely a critical piece However, where I disagree with both of them is that it’s part of the process You know, what we do at A Safe Haven is as people come to us and say we hear you get people jobs, we do But we assess the individual situation, and we tell people, at A Safe Haven, here you have an opportunity to reinvent yourself Let’s find out why you’re in the position that you’re in Is it chronic or is it for the first time? Is there education barriers? Is there drug and alcohol involved? Let’s solve those pieces first, and then let’s move you to the next steps So for an individual, for example, a woman coming out of the prison system that has been in and out of the prison system for years, or, you know, maybe for the first time, and her children are in the DCFS system A job would be nice, but first we’ve got to get her in a position to be stabilized, to be reunited with her children, and in our program can be reunited with her children, and then take on the responsibility of possibly taking on a job And, you know, taking the next step forward So, it really is individualized, you know,

people are not one dimensional, you know? And a job isn’t a solution for everybody At the end, goal is, you know, to get people a job The end goal is to get people permanent housing But for each individual, the path to getting there is different, you know, and that’s what we do is we look at the individual situation And by doing that, we literally achieve very high retention rates for people coming through our programs Just to give you an example, we’ve had a 3-year contract with the Department of Labor for job placement and retention, and our 3-year retention rate has been about 85 percent Very impressive And what’s great about that particular statistic is that that’s been with ex-offenders Very good Gary? If I could respond to a couple of points that Neli made I certainly agree that services need to be individualized, and you need to look at the whole person, and you need to look at housing, and you need to look at the family situation But in our supported employment model, the model that’s been adopted around the world I might add, we have looked at the timing of employment, and this is counterintuitive, many people wouldn’t think this would be true But we have a score of studies that show that when a person says I’d like to go to work, that you help them, that, what’s called a rapid job search approach You don’t wait until they stabilize, but you move ahead in looking for that search And that employment can be part of the recovery process for people with dual disorders, with mental illness and substance abuse That is, that their improvements and changes often come in the employment area before you see abstinence and some of the other important changes in their lives I think the trajectory for each individual is very different, but the key thing that I’m saying here is that you don’t go to somebody with schizophrenia who is, you know, struggling with a myriad of problems and say, well, listen, you have to go to day treatment for a while until we get you stabilized You don’t say that The evidence is very, very clear that you’re better off listening to what the person says they want and working around that, building the program, individualized, making some sensible decisions about housing and medications and other things as well That’s all terribly important and the mental health clinicians need to work closely with the employment people So that part is, I think, similar to what you’re saying But the key thing that I want to say is that we do not delay the search for employment based on any notion that we know best There is no evidence that clinicians know when somebody is ready for employment No evidence It’s been studied for 50 years, no evidence whatsoever If someone’s a substance abuser and they’re still drinking and you find them a job or assist them to get a job, what impact does that have on them being able to keep the job? I mean, I would think it would be a set up to fail, almost, in the substance abusing case If I went and got hired for a job and then I couldn’t get there or I was missing time Well, how we think about it is, and we’re certainly not opposed to people getting good help for their substance use That is part of the, of the whole package, the whole deal So that that certainly is not what I’m saying at all But in looking for a job, very much you depend on the natural consequences of passing the drug screens and you making some sensible, you know, decisions I was just going to say, Gary, because there are some, I mean, certainly SAMSHA has the workplace program where people are tested while they’re in the workplace Employers can avail themselves of these services and they provide not only help with assessing employees but they also certify the labs, etcetera, etcetera So there is a point where, in any job placement program, an individual has to be told, of course, you know, we will help you look for a job, but there’s some prerequisites in terms of what you will be facing as you enter that workforce Correct, Peggy? Yeah, that makes sense, perfect sense Well, when we come back, what I’d like to do is really, we already have the dynamics of, of the timing, of when someone ought to look for a job and some of the conditions, preexisting conditions that need to be in place But there’s also an aspect of some of the barriers that they will face as they go into that workplace, and that’s what we’re going to deal with when we come back We’ll be right back

Before, addiction and depression kept me from living my life And now, every step I take in recovery benefits everyone There are many options that make the road to recovery more accessible; it begins with the first step Join the Voices for Recovery For information and treatment referral for you or someone you love, call 1-800-662-HELP Brought to you by the U.S. Department of Health and Human Services If you can get up every morning to take the A, the B, or the C train to come down here, you can turn out to getting paid We have a lot of families that are living well, well below poverty line, and I believe that if we are able to give people jobs that they enjoy doing and they want to go to every day, they’ll go, they’ll succeed, and, hopefully, they’ll be able to make the money that they need to provide for their families And what happens is, when families are able to provide for their children, you’re helping someone to create self-esteem You’re helping someone to become more motivated So you want to be able to focus and being positive at all times All times, okay, never let that circle in front of you be negative, always got to be positive For somebody in recovery, you need to feel like you’re someone Like, this place is called WeCARE I care now You get people that care, you start caring, and when you start caring, it transposes to everything else in your life WeCARE stands for Wellness, Comprehensive Assessment Rehabilitation and Employment It’s a program under the Human Resources Administration of New York City, and it serves approximately 50,000 public assistance recipients each year-those who have indicated that they have some medical or mental barrier which prevents them from reengaging in the workforce Public assistance is meant to be temporary, it’s not meant to be something that is long term and lifetime, you know, so we’re hoping that as our clients come into our program they recognize the need and urgency to want to do better We work with our clients to provide job placements We work with them to get their GED, to help them get their resumes together, and we work with them to find the jobs that are suitable for them Whatever their skills are, we use their skills and look at their limitations and help them to apply for those specific jobs that are suitable for them Our mission is about respect and care, and it’s about making sure that all individuals become the best person that they can be, being able to become self-sufficient When a customer first comes into the WeCARE program, they go through a comprehensive, what’s called a bio-psycho-social assessment So all aspects of their medical and their mental health and their social environment are assessed to understand what are the key barriers preventing them from reengaging the workforce So that we can understand their entire health picture holistically Having these skills that you have in front of you right now is so important that some of us don’t even realize it That how listening skills is so important to us Individuals with mental health and substance abuse have many challenges The most important one that they encounter is generally that society tends to be very judgmental and stereotypical and think that people with mental health or substance use can’t be productive members of society, or that they can’t work Well, I chase this life now, probably even more so than I did my drugs, you know, because I want it, I really want it I want it just as bad as I wanted that heroin and that crack I want this life just as bad So now what I want you to do, I want you to type in, I am learning Microsoft Word 2000 I hope to learn at least one new thing in this training session Now, the only thing I know about a typewriter or computer was ASDF, JKL, semicolon I’m typing, in some cases, 20 words a minute and not looking at the keyboard People that recover from mental health and substance abuse, they really are an asset, and the asset is that you’re getting someone who’s going to be very committed And the reason is because they’ve been through a trying time in their lives Just ’cause we’re recovering addicts doesn’t mean that we don’t want to work We’re recovering addicts that want to work

You know, we want to be a productive member to society Whether it took us 35 years to do it, it really doesn’t matter But if somebody’s going to give me the opportunity to go out there and be productive, then let me do it You know, don’t judge me because of my past, you know, it’s not who I was, it’s who I am You will probably find that those clients are much more long lasting in those employment because they have owned something, they have something that they call their own They feel that they are of value to themselves They feel that they’re of value to their family and to the community on the whole My goal is to be a substance abuse counselor because what better job could I have, could I get? Not that I say I can’t work at some corporate place or be a porter or still, you know, whatever But, I mean, you know, how, why could I not give away what I have You know, I lived the life While the impact of the WeCARE program is significant in itself-we place over 2,000 people per year directly into employment-we can’t forget the larger economic benefit that the program has for the city Those 2,000 people are trusted employees of local businesses Those local businesses and those employees are returning tax dollars into the local economy So when you’re serving 50,000 people a year, when you’re placing 2,000 people a year, that has a significant economic impact on our local communities Where do you see yourself in a year from now? What would you say, class? Working. Working Right. Working. Right So, David, we’re, we’ve talked a little bit about what are some of the challenges for people coming in Talk to us about what is working What programs do you currently have that basically provide great opportunities for individuals who may have had a problem and, and are now in recovery? That’s a great question And the first thing we’ve discovered was that we didn’t even know who had the problems before So the first element is to do a much better assessment, screening, and to find out who has the problems The second is, we have moved away from the continuum of approaches where you start out with treatment and you go to some education to having much more of an array of approaches So a person might start out with a part-time job at the same time they’re in substance abuse treatment and going to some counseling for mental health issues and dealing with family problems All simultaneously And in order to do that, the third element of the approach is everybody seems to have, for our clients, about a half dozen or more case managers And so, I said, when I first came to this job, if they already have a case manager, that’s good enough for us And, and we will deputize other case managers in the city to be our TANF or our homeless case manager as long as they can continue to help the people along the road both to recovery and to self-sufficiency, and they can tap directly into our services and supports so that they can have help with housing, have help with education, have help with getting a job But maybe they’re bringing their expertise from substance abuse or mental health and the final element is the family or the individual chooses who their primary case manager is going to be and then we all support both that family and that primary case manager Excellent And, Peggy, in, in terms of, you see the whole realm of it You were just saying that earlier, during the break, that you deal not only with the individual but with the family And what things are the most successful, in your view, in terms of retention of good employees? Because, you know, as, as we were noting before, individuals that are in recovery, or individuals that have a problem, that need to go to treatment, are individuals that are, I suspect, very valuable to, to the employer Absolutely And what, what I think is the most important is that they develop support networks Both with the 12-step programs, as well as an EAP counselor, and the fact that I am in recovery adds a little bit more, that type of support to continually help them to be able to move forward University of Maryland Medical System, in the last couple of years, worked with the Helping Up Mission in Baltimore and a few other agencies And they had some service positions available, and they had these, whoever wanted to apply, apply for these service positions and they hired about 40 men And when the men came, they had to be monitored

and followed up by EAP And what we found was it was an exhilarating experience for the EAP counselors because we don’t normally deal with that population And what we found ourselves doing was helping them in every area that you can imagine, and, I mean, I had a young man who I helped to work on the computer I helped another one to get a sponsor, to get involved in the 12-step fellowships And they really did succeed Of the 40 plus that were hired, I don’t have the exact numbers, but I believe that there’s over 35 that are still employed What’s important about that is the ones that stayed and are still employed and still sober are the ones that stayed in residence with the Helping Up Mission during that particular time Very good Neli, let’s talk a little bit about partnerships and, I know, in Chicago, talk to us a little bit about the types of partnerships that you’ve been able to build with the business community to be able to get them to understand the value of hiring someone in, in recovery Oh, partnerships are a huge piece of what we do We are very engaged with various Chambers, you know, throughout the Chicagoland area Whether it’s the Chicagoland Chamber of Commerce, whether it’s the Hispanic Chamber of Commerce, I mean, you name it, we’re involved with them and they’re involved with us And the great news is we are a huge resource for them, essentially a staffing center at this point You know, we have been learned to be trusted, you know, so that as people are graduating from our programs, if they’re getting a referral from us, they know that this person’s not only been successful in the building the right type of foundation and getting the life skills and, you know, the job training and the things that they need to be successful but they also know how to follow through and execute on the jobs for an employer They become a very productive employee Just first hand, you know, to tell you, A Safe Haven is an employer of many of our graduates You know, we have about 180 employees, and I want to say at least 50 percent of our employees are graduates of our programs We have a very intense professional development training program So we train people that have gone through the system that have expressed an interest, and they have the propensity to help others We help them, you know, to get the certifications that they need to grow with us And that’s really important in terms of being able to get the street credibility with the residents that are coming through our programs To see that, you know, not only is our program successful for, you know, our graduates in terms of having literally turned into a job that they see someone, you know, working day to day, that’s successful but also, it’s an inspiration, you know, and it’s a role model and it’s a mentoring opportunity for us to offer the residents that come through our program So I can tell you that we have a very high retention rate of our own employees, and employers in the community have grown to trust us Very good Gary, how do you work with, in partnership with some of the folks that are sensitive and want to hire individuals who, with a mental health problem? Well, maybe, Ivette, the best way to explain this is to describe evidence-based supported employment, which is the approach that we’ve been studying for, and disseminating, for the last 20 years, a network of us at Dartmouth and around the country And, actually, around the world now So evidence-based, supported employment is an approach that has been endorsed by SAMHSA In fact, a lot of the early studies were done through SAMHSA funding But now there have been 16 rigorous studies, randomized control trials, the gold standard in drug research Sixteen studies of this evidence-based, supported employment, and every single one of them has shown an advantage to supported employment and helping people get competitive jobs, compared to other approaches, traditional approaches, that include stepwise approaches that involve counseling and transitional employment, and other things So overall, the employment rate from these studies is about 65 percent for people who enroll in supported, evidence-based supported employment, compared to about 23 percent in comparison groups The 23 percent is pretty close to the rate that you mentioned earlier for people who receive no services at all We have a couple of long-term studies We need more long-term studies But what is really exciting is that in these two long-term studies, 10 years after they enrolled in this supported employment program, over half of the people who initially enrolled were steady workers Which means they were working about half the time during the 10-year period So So tell me a little bit about what happens to a potential

employee that goes into a place that believes in supported employment Okay What happens, exactly, to them? They go in, do they get trained? Do they get special followup? What happens? The approach is based on eight principles They include one that I’ve already mentioned What we call rapid job search So we don’t have a lot of preparatory work before people go out looking for a job, if they say that they want to work And that’s a second principle here, which is that the only criterion for being in a supported employment program, aside from being a client with severe mental illness, is that you say that you want to work We don’t have any screening criteria because none of these predict whether somebody can work anyway And the objective of this program is competitive employment That is, getting a job that anybody can hold in the regular workforce and in integrated settings We’re very interested in people working alongside people without disabilities because so much of their lives often is, you know, embedded with ghettoes of people that share their condition We work very closely with the treatment teams That’s another core principle And then there is a principle of job development, which gets to the point of how do you interact with the employers It’s a matter of individual choice So if a person wants to disclose that they have a mental illness, you, you will work with- It’ll be their choice to disclose it That’s correct And you will work with the employer to try to explain, you know, who you represent and why this person would be good for your position So another principle is that of client preferences for jobs We try to find jobs for people that, you know, suit what their interests are, what their strengths are If they have a drinking problem, we probably would not advise them to work in a bar, for example And then long-term follow along, we know that’s another key ingredient to stay with them over the long term I mentioned earlier about benefits planning, or I alluded to it That’s another key ingredient To talk to people, what does it mean to your social security if you go to work? So, anyway, this model has now been disseminated We have what’s called a learning collaborative in 14 states and the District of Columbia Well, when we come back, I want to touch on some of the issues that will help us to place more people, and that’s dealing with the stigma associated with both mental health problems and addiction issues And we’ll be right back For more information on National Recovery Month , to find out how to get involved, or to locate an event near you, visit the Recovery Month  website at Every day, I seek a positive direction for my life through my accomplishments And now, with help, and support from my family and others, I own, I own, I own my recovery from addiction and depression Join the Voices for Recovery-it’s worth it For information on mental and substance use disorders, including prevention and treatment referral, call 1-800-662-HELP Brought to you by the U.S. Department of Health and Human Services Thank you for calling NAADAC, how could I help you? NAADAC is a membership association It’s made up of persons who focus on addiction services, whether that’s counseling, training, education, research Our mission is to advocate for the addiction profession To educate and train The training is on conflict resolution and relapse prevention NAADAC works with SAMHSA on a variety of workforce development projects and initiatives that help to bring people into this profession So that would indicate what? That I’m not making the best decisions You can’t watch all the bases at once And it’s very nice to have a resource organization that does It’s a vital, valid profession you can sink your teeth into, and it’s going to pay off The benefits to join NAADAC as an individual member is that you have the opportunity to grow as a professional NAADAC provides a variety of services Training is one of those hot spots that we provide Counselors need to have ongoing education, training specific to the new drugs that are coming out, and the new evidence-based practices So if you’re a student currently enrolled in our program,

you can qualify for this student membership We do also have online courses, webinars, that each month, that a person can access and for our members, those webinars are free For those nonmembers, it’s really offered at an extremely low discount I haven’t listened to her, I haven’t figured out what is, what is it, is it going to help her to feel comfortable and loved and part of this connected relationship? And then advocacy is one of those other really important things because our clients often can’t be their own voice We as the professionals become their voice What would be your response if I said it to you like that? Give me my drugs Give me my money Okay And so I love engaging with our volunteers, with our membership, with our certificants that we work with, because I see the effort being made by them How bad was it? We have listened to the profession In order for us to be able to offer what people need, not just what we presume that they need, but we’ve also looked at what is out there in terms of new evidence-based practices In this new age of electronic technology, we’re going to see more and more need for electronic health records HIT systems are going to be a godsend for our profession Being able to share that, that demographic information and treatment plans and progress notes is going to be very important to help that person move quicker in their recovery and get more comprehensive recovery If a recovering person can find employment early on in their recovery, it lends self-value It helps a person’s self-image to feel gainfully employed I like to tell employers, when I do employer training, that the thing about people in recovery is that you know what their issue is You don’t have to guess I believe it’s very important to the person in recovery, for a sense of self-responsibility and human dignity, and for the employer, in seeing that he has a workforce that’s largely untapped, that’s willing to work and will be loyal to the employer The reason why I got into this profession is because of my family history In my own recovery, I started using before the age of 10, and had a lot of medical issues as a result of early use This profession, literally, has saved my life I would not be still in recovery today I would not be alive today if I had not put myself into this profession If I’m talking with a person initially, I’ll let slip enough for them to figure out that I’ve been there and done that But after that, real treatment has to come in, and the real treatment is what pays off Treatment is effective and that recovery is possible, and that their life can change completely from what they knew when they were in the middle of their addiction or their mental illness, and now they can have a whole different life, the rest of their life Let’s take a look at, now, the governmental structures that are, are necessary to get some of these issues dealt with In the city of Washington, DC, for example, have there been special policies that have been presented related to this that foster a better understanding of the issue and that deal with a higher degree of participation from employers? Are they incentives? Because I know that within SAMHSA, the recovery support initiatives, which is one of the strategic initiatives of our agency, is taking a look at, indeed, not only housing, as you were mentioning, housing first But in addition to that, they’re taking a look at workplace to see and identify what kind of incentives can be made in order to encourage more people to hire Yeah We work with a variety of programs Our Department of Employment Services and vocational rehabilitation programs, substance abuse treatment programs So, we don’t do a lot of the direct placement or dealing with the stigma, but trusting and partnering with the other agencies to work with the families I think a big change is just having a sense of hope, and we have to get rid of our own stigma first, before the client can get rid of it So, if a client wants to disclose, then we help them with the messaging If they don’t, then we help them try to figure out a way to keep it as confidential as they can But it’s all individualized and it’s all working towards that own-one person’s best way and approach to overcoming both the stigma, the barriers, and, most importantly, building on their own strengths

And, Neli, have you had experience in terms of attempting to get your municipality or the state to develop initiatives? For employment, specifically for people in recovery, for example? No, no, we haven’t But I think that the political and economic realities are forcing, you know, everyone to rethink, you know, our approach I think the stigma is associated with the issues of drug and alcohol addiction has really been, you know, endemic Well, it’s discrimination It is discrimination, it’s been endemic, because of the way we’ve institutionalized this issue with the criminal justice system and the drug court system And, you know, that things like that As opposed to dealing with it as, you know, was mentioned earlier, as a disease, you know And people do successfully recover They live very successful, productive lives in recovery And, you know, just going back to our own issue in terms of when my family went through it My husband went through it We had the idea of starting A Safe Haven My husband, being in recovery, was a concern, personally, for ourselves, do we disclose, do we not disclose And it was my decision, and I asked my husband to please consider because it was something that, you know, was very personal to him, and it had to be his decision And I said, you know what, we just need to own it and we need to wear it like a badge of honor Absolutely Because truly this is something that we went through, we got through, and we came out on the, on the right side, and others can, too So I think that more and more people- And isn’t part of all that accepting responsibility? Exactly And I think and as more people that are successful, and there’s lots of them, you know, like Peggy, you know, come out and are willing to talk about it, I think that, you know, they inspire others, and at some point employers will value that, you know, as something that they want to see in their employees: someone that’s maybe overcome something and now has, you know, not, doesn’t have these issues Because when you’re hiring someone, you don’t know whether they do or they don’t Well, I think, I think one of the things that I want to clarify is that the drug courts, mental health courts, they are looking at addiction as a disease And I think that goes a long way to getting the broader society to be more accepting and to say, you know, if our criminal justice system is recognizing that individuals who come through the drug courts or special family drug courts, or now they’re even considering having youth drug courts, mental health courts, you know, where individuals, judges are knowledgeable about the dynamics of what goes on with the individual, what goes on with the families I think they’re definitely an arm of this field, and gaining a better understanding within the community And I love that that’s happening And that we’re starting to consider the idea of a diversion program, a no-entry program for people that do suffer from this disease What I’d like to see is the funding follow the treatment and support services that are necessary Gary, you wanted to add something? I just wanted to add a point about the underfunding SAMHSA reports that only 2 percent of people with severe mental illness actually have access to evidence-based supported employment And, and the, the mismatch between what we fund and what is effective What we know from some of our research is that in the long term, people who work use the mental health system less and so the savings, the cost savings can be phenomenal over the long term One area, which we really haven’t talked about a little bit is, individuals in recovery starting their own businesses And I know you mentioned your husband is in recovery, and you want to talk about how he got into business? Well, yes, he’s in recovery and, fortunately for us, it wasn’t out of necessity that we created our business of, you know, A Safe Haven It was out of a desire to help others that may be suffering from something that he went through, but didn’t have the resources to get the help that they need So we decided, as a charitable thing, to just open up, you know, a recovery home We became the first licensed recovery home in the state of Illinois, and the rest is history Today we have over 22 locations, we see over 4,000 people a year The vast majority of people do get reconnected to their families, to jobs, and to permanent housing And what has also happened as we have seen people face barriers to employment, we have created what we call social business enterprises So we have businesses that are-the intention is to create jobs for people that are graduating from our program, so, therefore, we overlook the background checks We already know they have a background And, but they’ve proven to us that they’re, you know, worthy of an opportunity, so we employ them within our own businesses

So we have a landscaping company, a culinary arts, catering service, a pest control company, a housekeeping company, a customer service, and sales training company So that is something that’s been basically an outgrowth of our success Thank you Gary, final thoughts? Well, I just want to reinforce the theme that all of us have been noting The importance of work is really the centerpiece of the recovery process I think we can all agree on that, and, you know, there are daunting challenges, but I think there are ways around them And we’ve heard some pretty encouraging case examples David? I like to think about a theory of abundance That even though there’s not enough money around, a lot of us, because we’re getting such poor outcomes, and that if we see our roles as prevention, even my agency is preventing deeper end services Everybody sees where their clients are coming from and where they’re going to, and if we keep people from getting deeper into the problems, and support the systems that keep them out of even our own programs, the good outcomes will be much cheaper than the bad outcomes we currently have Very good Peggy? In my position, as an employee assistance counselor, I work with several people who are working on developing better feelings about themselves so that they can sustain their, their job and feel really good And in terms of debunking the stigma, I have a little expression that I’d like to share that, that really helped me a lot when I first came into recovery And that is that we are sick people who can get well, we are not bad people who have to get good As sick people, we sometimes do bad things, it doesn’t make us bad people And I’ve said that a million times to many, many, many of my clients who are substance abusers, and that has really made a difference And, I want to remind our audience that September is National Recovery Month , and, as such, we want to encourage all of our listeners to conduct events, get together with their community coalitions, community organizations to plan activities during this month, so that we can continue to make headway into the, not only the area of employment but continue to get the millions of people who need help, the help they need so they can get into recovery from mental illness or addiction Thank you for being here, it was a great show For a copy of this program or other programs in the Road to Recovery  series, call SAMHSA at 1-800-662-HELP Or order online at and click multimedia [Music Playing] Every September,  National Recovery Month  provides an opportunity for communities like yours to raise awareness of substance use and mental health problems To highlight the effectiveness of treatment and that people can and do recover In order to help you plan events and activities in commemoration of this year’s Recovery Month  observance, the free online  Recovery Month kit offers ideas, materials, and tools for planning, organizing, and realizing an event or outreach campaign that matches your goals and resources To obtain an electronic copy of this year’s Recovery Month  kit and gain access to other free publications and materials related to recovery issues, visit the  Recovery Month  Web site at or call 1-800-662-HELP