Mental Health and Employment in TVR Work

Building on Our Strengths as Tribal Programs

Medical Model

Medical Model v. Traditional Perspective

FOCUS ON INDIVIDUAL INCAPACITY

DIAGNOSIS RATHER THAN FUNCTIONING

LOOKS AT PEOPLE AT WORST TIMES IN THEIR LIVES

PERSON INDEPENDENT FROM ENVIRONMENT AND SUPPORTS

WESTERN MEDICINE VALUES CURE OVER MINIMZATION OR REMEDIATION OR ADAPTABILITY

Medical Model Traditional Perspective

Medical Model v. Traditional Perspective

VR Considerations

Mental Illness Defined Mental illness refers to a wide range of mental

health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

Indigenous View Lack of traditional acknowledgement of

mental illness

Often not looked at as illness causing disconnect and inability to identify

Things viewed as broken in the medical model are at odds with traditional medicine beliefs (visions and channeling others emotions)

The more we accept the medical model the further we get away from the traditional teachings

RECOVERY VALUES IN WORKING WITH PEOPLE W. MI

CULTURE OF CLIENT BENEFIT – LIVING, WORKING, RELATIONSHIPS

PEOPLE HAVE RIGHT TO CONTROL THEIR LIVES, THEIR TX, & KINDS OF HELP THEY RECEIVE. STAFF SHOULD INFLUENCE.

ALL PEOPLE NEED HOPE & SUPPORT

PEOPLE W. MI DO GET BETTER --- > 60%

SYMPTOMS NOT PREDICTIVE IN OTHER AREAS

PEOPLE CAN WORK, SO THEY SHOULD WORK

PEOPLE W. MI BEST SERVED IN COMMUNITY

COMMUNITY/ PEER/ FAMILY SUPPORTS + PROS

Is there room for our IDENTITY?

Merging the Western and Traditional

Preparing for Employment…Assessment

PERSON

ABILITIES - CAN DO?

TOLERANCES - WHERE DO?

VALUES - WANT/ NEED TO DO?

EMPLOYER JOB

NEEDS ABILITIES

VALUES TOLERANCES

JOB MATCH

IF YOU THINK WORK IS BAD FOR

PEOPLE WITH MENTAL ILLNESS,

THEN WHAT ABOUT POVERTY,

UNEMPLOYMENT, AND

SOCIAL ISOLATION?

The Importance of Focusing on Wellness

How Has the Non-Native World Influenced Your Consumers?

LIZZIE BORDEN SYNDROME

LINE MANAGER -- S.F.

“ I CAN’T IMAGINE HIRING SOMEONE

WITH A PSYCHOLOGICAL

PROBLEM. “

RECRUITER -- BALTIMORE

“ I’D MUCH RATHER DEAL WITH THOSE WITH

PHYSICAL CHALLENGES. SIMPLY BECAUSE THEIR

WORK ETHIC IS BETTER & THEY’RE LESS LIKELY TO

STAB YOU TO DEATH.”

STIGMA REDUCTION:ABILITY TO CHANGE BEHAVIOR THROUGH

EDUCATION IN THIS AREA IS NEGLIGIBLE

IF YOU THINK WORK IS BAD FOR

PEOPLE WITH MENTAL ILLNESS,

THEN WHAT ABOUT POVERTY,

UNEMPLOYMENT, AND

SOCIAL ISOLATION?

IF YOU THINK WORK IS BAD FOR

PEOPLE WITH MENTAL ILLNESS,

THEN WHAT ABOUT POVERTY,

UNEMPLOYMENT, AND

SOCIAL ISOLATION?

What to Expect When Working With Consumers

ResistanceDeflectionProjection

Theory of Change Model

HELPING PEOPLE CHANGE:

HOPE,

HELP,

AND

HASSLING

(What does “hassling” mean for different cultures?)

HELPER’S RESPONSIBILITY TO ENGAGE & MOTIVATE

HOPE VS. OPTIMISM? ---

PAT ON BACK VS.

COMMUNICATING THAT: YOU CARE

YOU UNDERSTAND

YOU WILL BE THERE

YOU HAVE IDEAS & HELP TO OFFER

People don't resist change. They resist being changed.

~ Peter Senge

NO MOTIVATION(DO YOUR CLIENTS GET LABELED WITH THIS?)• FEAR OF FAILURE• NO SELF - CONFIDENCE• POOR EXPERIENCES• LOSS OF BENEFITS• LACK OF INFORMATION• LAZINESS • ? OTHERS

MOTIVATIONAL INTERVIEWING

•Express empathy•Develop discrepancy•Avoid argumentation•Roll with resistance•Support self-efficacy

Miller, W. & Rollnick, S. (1991).

Group Discussion

How do you incorporate tribal values, beliefs and teachings into the VR process?

What is working?Where are the disconnects?

Thank You

Lanor Curole, DirectorUnited Houma Nation Vocational Rehabilitation Services

(985)223-3093lanor.curole@unitedhoumanation.org

Joe MarroneUniversity of Massachusetts Institute for Community Inclusion