Tunnels and Cliffs: A Guide for Workforce Development Professionals and Policymakers Serving Youth with Mental Health Needs (Short Cut)

No. 4, May 2008

The Challenge

Youth with mental health needs (MHN) often face unemployment, underemployment, and discrimination when they enter the workforce. Employment data show that individuals with serious mental illness have the lowest level of employment of any group of people with disabilities. As a result, large numbers of youth with both diagnosed and undiagnosed mental health needs who are transitioning into young adulthood, to the world of work, and to postsecondary education are likely to experience significant difficulties.

By the time youth are in their teens, it is important that they learn about career options and opportunities. Yet for many youth who need mental health services during this time period, this is not likely to occur.  One reason for this is that many youth with mental health needs end up falling through the cracks of an uncoordinated and inadequate network of service delivery systems.  These youth frequently do not receive the types of coordinated comprehensive individualized services and supports they need to be successful in the workplace or productively participate in their communities.  Rather, because most agency staff think primarily of the set of solutions available within their own system of service delivery, youth with mental health needs are frequently shunted down inappropriate service tunnels dictated by their point of entry.

In addition to service tunnels, youth encounter a “transition cliff” when they age out of youth systems and attempt to access adult services. Many youth systems end at age 18 and others when the youth reaches age 22, which means a youth could simultaneously be a youth in one system and an adult in another. The adult systems of education, mental health, Social Security, vocational rehabilitation, and workforce development often have different terminology, eligibility requirements, and service options than those of the corresponding youth systems. This disconnect can result in dire consequences such as termination of services and lost progress in career planning.

Youth service professionals in the workforce development system are responsible for supporting vulnerable youth; several of these targeted groups include many youth with mental health needs. Fortunately, there are a growing number of strategies and resources to support youth with mental health needs in achieving independence, self-sufficiency, and success in employment and postsecondary education.  For an in-depth discussion of this topic area see Tunnels and Cliffs: A Guide for Workforce Development Professionals and Policymakers serving Youth with Mental Health Needs.

The following serve as examples of emerging promising practices relating to career preparation and employment for youth with mental health needs: 

  • Bay Cove Academy, Boston, MA
    Bay Cove Academy (BCA) is a psychoeducational program that serves an urban adolescent population (ages 13 to 21) from the greater Boston area with severe emotional, behavioral, and learning disabilities.  The career development program (CDP) provides students with classroom and real-world employment skills training and community job placement, supported by employment training specialists.  CDP also provides age-appropriate life skills training, academic remediation, and the development of problem solving and reasoning skills. Students enroll in workforce entry skills courses and independent living skills courses to learn interviewing, résumé writing, and other transition skills. Skills learned in the classroom are transferable to the job and skills learned on the job are reinforced in the classroom
  • The Pennsylvania Community on Transition (PACT) Mental Health Practice Group
    The purpose of the Mental Health Practice Group is to promote the academic achievement and well-being of all Pennsylvania youth and young adults through the development of a comprehensive, cross-community, behavioral health support system.  The effort emphasizes the utilization of evidence-based school mental health services in conjunction with existing school-wide and community mental health programs.  The group also explores mechanisms to effectively assist youth in the smooth transition into needed adult services and supports.
  • Tucson Job Corps Center, Tucson, AZ
    The Fred G. Acosta Job Corps Center teaches marketable skills to youth ages 16 to 24 in a safe, residential setting.  The Center emphasizes early identification of disabilities and the development of a comprehensive accommodation plan that meets each youth’s needs.  A variety of course offerings, including basic education leading to a GED or high school diploma, vocational training in eight skill areas, basic computer skills, basic employment skills, health and wellness education, and training in cultural diversity, are available. During the first 60 days following enrollment, each student completes a career preparation program that includes leadership training. Through this program, each student develops a career plan. Students complete their training at their own pace. Students participate in work-based learning internships with area employers to get real-world experience in their area of vocational study.

What You Can Do to Help:  An Action Plan

Policymakers, workforce development staff, administrators, youth service providers, educators, advocates, the medical community, mental health professionals, community members, families, caregivers, youth, and others invested in improving outcomes for youth with mental health needs must make the coordination of services a cross-systems priority if the individual needs of youth with mental health concerns are to be met.  Here are some ways to make this happen: 

  • Engage state, regional, and local mental health stakeholders in resource mapping and strategic planning so existing resources can be identified and gaps in service can be addressed.
  • Develop Memoranda of Understanding (MOUs) among state, regional, and local agencies that include cost sharing for mental health service centers throughout the state and provide for comprehensive career preparation and work-based experiences.
  • Work with states to issue mental health policy guidelines that help regional and local entities effectively implement them.
  • Collaborate with states to promote comprehensive technical assistance and training for regional and local staff on global issues such as data-sharing and confidentiality, and on service delivery strategies such as accessing appropriate screening tools. 
  • Bring regional agencies together to offer leadership in coordinating services between partners, identifying qualified personnel to conduct screens, and making referrals when in-depth evaluations are necessary.
  • Assist local agencies with developing partnerships with agencies not covered by state or regional/local MOUs so certain assessment services can be provided, even if not offered by state service centers or local providers.
  • Work with local agencies to select unique screening instruments and formulate policies for screening referrals to in-depth evaluations not covered by state or local policy.
  • Collaborate with local agencies to offer training to parents and other caregivers on the various identification and eligibility criteria between youth and adult systems, accessing appropriate screens and evaluations, and navigating the cross-agency mental health service network.
  • Engage employers to promote competitive employment for youth with mental health needs and to provide opportunities for work-based experiences and career exploration.

General Resources on Effective Practices for Serving Youth with Mental Health Needs

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