South Carolina Department of Mental Health

Consumer Employment Program

Updated September 17, 2012

"Consumers are beginning to ask for more than a survival, maintenance, stay-out-of-the- hospital concept of life. Consumers are now asking for hope-that life will be of quality, productive, and based on equality." (Colleen Jasper, M.A., Consumer Advocate, Michigan Dept. Of Mental Health)

Supported Employment Annual Report
July 1, 2010-June 30, 2011

Consumer Employment Program

Among persons with serious mental illness, unemployment rates are unjustifiably high. Compared to individuals with other types of disabilities whose, unemployment rate is around 67%, the unemployment rate for people with psychiatric disabilities is 85% to 92% (Anthony et al., 2002).

In South Carolina, most recent employment data reveals that 84% of the persons served by the South Carolina Department of Mental Health (SCDMH) are unemployed.  Many factors contribute to unemployment among consumers, including the complex, highly idiosyncratic nature of mental illness itself.  Most mental illnesses are episodic and unpredictable in nature (Rutman, 1994).  Active symptoms, such as hallucinations and erratic behavior, may be difficult to manage, and negative symptoms-such as reduced motivation and cognitive problems of attention-can interfere with performance and success on a job (Ridgway & Rapp, 1988).

In addition, the educational deficits of consumers can affect employment outcomes.  Onset of symptoms during adolescence or early adulthood may interrupt a consumer’s education.   Between 52% and 94% of persons with serious psychiatric disabilities are high school graduates, and 15% to 60% of those go on to college (Anthony et al., 2002). In South Carolina, only 34% of consumers with severe psychiatric disabilities served by SCDMH have graduated from high school.

The societal stigma about mental illness is another barrier to employment.  Distortions and sometimes frightening portrayals of mental illness continue to occur in film, television and the news media; this reinforces employer bias and unfounded, fears that most people with mental illness are violent (Diksa & Rogers, 1996).

The mission of SCDMH is to assist people in their recovery of mental illnesses.  Employment has long been viewed as an essential component to helping people recover from their mental illness. “Employment helps define who we are; gives us a sense of community involvement and offers hope in our recovery”.  There is empirical evidence that work can positively affect psychiatric symptoms.  Mueser, Becker, et al (1997) found that people with psychiatric disabilities who were working tend to have lower symptoms, higher Global Assessment Scores, better self-esteem, and more satisfaction with their finances.   

Through partnerships with the South Carolina Vocational Rehabilitation Department (SCVRD) and Work-in-Progress, counselors and job coaches help people with mental illness seek, obtain, and maintain competitive employment.

Individual Placement and Support Programs (IPS): The IPS program is an evidence-based best practice program that places 44-58% of its referrals into competitive employment in an integrated, community setting.  This program serves individuals with the most severe mental health diagnoses known as Severe and Persistent Mental Illness (SPMI).  These diagnoses include schizophrenia, bi-polar disorder and major depression.  The IPS teams have SCVRD mental health employment specialists who spend 100% of their time focused on employment activities.  They are dedicated to assisting individuals with SPMI in obtaining competitive employment in an integrated setting.

SCVRD Employment Specialists perform the following duties:

  • Assessments
  • Counseling and guidance to address psychiatric symptoms and the impact on employment
  • Job seeking and job survival skills
  • Assertive engagement activities
  • Job development and placement
  • On-the-job supports
  • Job coaching

IPS staff provide unlimited time and support to help individuals with SPMI maintain competitive employment in the community.  IPS is an evidence-based best practice model developed and tested by Dr. Robert Drake and his associates at the Dartmouth College Psychiatric Center.  The IPS model currently has the largest body of empirical evidence supporting it.

Work-In- Progress – WIP is an independent employment agency that serves people with the most severe diagnosis of SPMI. These WIP staff consist of employment coach services to eligible individuals with chronic mental health illness as jointly determined by the SCDMH and SCVRD.  In addition, the employment coaches work as a member of the IPS Team at the SCDHH Center to provide employment profiles, assessments, and screening to identify appropriate SCDMH/SCVRD clients for program participation; provide job skills training on the work site to clients ensuring adequate adjustment to require duties and according to employer expectations; and provide support services to enable clients to be competitively employed at a minimum wage or above. 

Mental Health Job Coaches:  These DMH staff work with individuals with SPMI to provide pre-vocational activities to assess work readiness and begin the process of work preparation.  Activities may include placement in sheltered employment such as enclaves, mobile work crews and temporary employment.  DMH Job Coaches work closely with SCVRD Counselors to identify and refer individuals interested in pursuing competitive employment.

SCVRD Counselors:  On a regular basis, SCVRD Counselors meet with representative from each of the 17 Community Mental Health Centers to identify individual who wish to pursue competitive employment.  SCVRD counselor provide an array of services, including but not limited to: counseling and guidance, vocational assessment, job skills development, job placement, on-the –job supports and job coaching.  SCDMH provides long-term supports following successful placement into competitive employment.

The SCDMH efforts to track the employment pattern of consumers with mental illness and implementing evidence-based best employment practices in every Community Mental Health Center are ongoing.  Information on rates and IPS implementation will be posted in the employment website.

If you are interested in more information about Consumer Employment Services in your area, please contact:

Demetrius Henderson, Director of Consumer Employment
Phone: 803-898-4275
E-mail: DDH17@scdmh.org

Diksa, E., & Rogers, S. (1996). Employers concerns about hiring persons with psychiatric disability: Results of the Employers Attitude Questionnaire. Rehabilitation Counseling Journal, 40 (1), 31-43

Emery, B. (1997, Winter). “The impact of welfare reform on employment of persons with psychiatric disabilities.” Networks, 1-17

Rutman, I. (1994). How disability expresses itself as a barrier to employment.  Psychosocial Rehabilitation Journal, 17 (3), 31-43

Individual Placement and Supports (IPS) Implementation Progress

IPS implemented in the following SCDMH Community Mental Health Centers:

  • Santee-Wateree-1995

  • Columbia-2002

  • Florence-2002

  • Charleston-2002

  • Waccamaw-2003

  • Berkeley-2003

  • Aiken-2004

  • Anderson-2004

IPS implementation Plan in SCDMH Community Mental Health Centers

  • Greenville-2005

  • Lexington-2005

  • Aiken-2005