CHOICES II-8 - Impediments to Acceptance 1G

Robin Cunningham Health Guide

    My last blog presented a hypothetical hiring scenario which put us into the role of the employer, forcing us to look at the trade-offs employers encounter when considering a job applicant with a mental illness.


    I'm pleased to report that Jim Blaha [jjbgeneva] made an excellent suggestion about how the employee assigned to do the hiring could handle the situation.  You should look at his solution to the specific problem presented.  Don Fraser responded by expanding on the original dilemma I posed, which has raised some interesting questions. [See the replies to CHOICES II -7 Impediments to Acceptance 1F posted Sunday, 17 November 2008.]

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    In this blog, we will discuss one of the issues raised by Don in his reply.  Here is an excerpt from his comment -


    . . . here's a twist:  suppose the company is sympathetic toward the disabled and is more likely to hire candidate A because he has schizophrenia.     I know this may sound contrived or far-fetched but in the community where I live it actually does happen. . .


    I have seen what Don is describing.  It does happen from time to time.  I think he's saying that it is a community wide phenomena, which I believe is highly unusual.  Don is fortunate to live in such a community.


    In my experience, the deliberate hiring of persons with mental illness is usually the policy of a single company [large or small] within the community and this policy is set by the CEO.  [I have in fact instituted this policy in the companies I have run.]  The effect of such a policy is marvelous.  Regular workers learn that they can't really tell who has a mental illness and who does not, that they can work effectively side by side with a person with mental illness.  It injects a powerful anti-stigma message into the workplace and, in Don's situation, even the entire community.  The only problem is that this is unusual.  It is not the norm.


    In recent years, one of the U.S. states, which will remain nameless, was cited by the federal government for its wholly inadequate programs and facilities for the treatment of the mentally ill and was ordered to correct the situation.


    The cost of providing acceptable treatment had been one of the reasons the state's programs were found inadequate.  The state had refused to spend the money to provide satisfactory treatment.  Naturally, cost was also a very important issue in the new programs and delivery systems developed by the state to meet Federal standards.


    I first heard of this in the proceedings at a NASMHA conference.  The state in question was giving a workshop extolling the benefits of the new mental health care delivery system it had developed to meet Federal Standards.  It was, in fact, bragging about the fact that they had found a way to deliver excellent treatment at relatively low cost.  This was something in which all those attending the conference were interested, thinking it might be a way of improving their services within the limits of their state budgets.


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    The state went on to describe the how the key ingredient of their new innovative systems was the employment of peer counselors to deliver good care.  They explained that this approach was so effective that the resultant increase in the cost of their new system was manageable within their budget restrictions.  They vigorously advocated for the use of peer counselors.


    This made sense to me.  I could see how the firsthand experience of someone in recovery from a mental illness who had been properly trained could be more effective in providing counseling to someone who was now experiencing these same agonies.  Still, something about the state's presentation gave me an uneasy feeling.  There was something they weren't telling us.  My suspicions grew stronger when they indicated that their old counselors had been replaced one for one by peer counselors.

    To make a long story short, most of the cost savings provided by their newly designed mental health care delivery system resulted from the fact that they were paying their peer counselors less than half of what they had paid their previous counselors


    The question I have for you is - Was this state taking advantage of consumers in recovery by paying them so much less for the same work that had been done others?  Is this was a shocking case of exploitation?  Or was it a means of providing gainful employment to consumers in recovery, employment that seemed to benefit everyone?


    I'm eager to hear what you all have to say.

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    Please remember, this writing reflects my own experience and opinions.  If you, or a loved one, are experiencing the symptoms of schizophrenia, or any other mental illness, you should seek professional assistance.


Published On: November 23, 2008