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>> In this demonstration, we see part of a mental health treatment team meeting.
>> For the purposes of this demonstration, we will only show discussions of clients
in supported employment services.
>> During typical Fidelity visits, we have individual interviews
with mental health treatment team members as well.
>> Well, thanks everyone for being here.
As we talked about in the meeting last week, we have a couple of guests
that are here to observe our meeting.
They are here for our Fidelity review for supported employment
and I thought we'd just get things started with some introductions.
So I'll start, I'm Nicole Richardson [assumed spelling], I'm the team leader
of the mental health team here at Great Lakes.
>> Jenny Frasier [assumed spelling], employment specialist.
>> Jeff Weis [assumed spelling], mental health case manager.
>> Hello, Deborah Howard-Frye [assumed spelling], also a case manager.
>> Hi, Rochelle [assumed spelling], case manager.
>> I'm Ann, I'm the nurse on the team.
>> Hi and I'm Sandy Reese [assumed spelling] and I'll be here observing you today,
hope you don't mind if I take a few notes.
>> And I'm Sandy's colleague, Galen Smith [assumed spelling],
thank you guys for letting us spend some time in your team meeting.
>> Sure.
>> You're welcome.
[ Inaudible ]
>> Okay. Well, let's get started.
Jeff, why don't you tell us what's been going on with Karl.
>> All right.
Well, you know Karl tends to stay in his apartment almost all the time,
really hard to get out, come out to social activities or to the agency for anything
but today he said he's interested in work.
>> Oh wow.
>> Great.
>> So I got a little excited about that and --
'cause we've been tossing around ideas about work for a few weeks.
He said he's struggling with his time, free time, what to do with it.
And I see a lot of potential in Karl so I brought out the supported employment brochure
and we went over and it and he said he's interested in the program.
He's a little anxious though about taking the next step but he,
you know, he says he want to do that.
So, Jenny, I thought maybe we could arrange for an appointment for me to introduce him to you.
>> Sure. Now we've been talking about Karl for a couple of weeks so I'm anxious
to get going and starting to work with him.
So whenever the three of us can get together, that'd be fine.
>> Well, I see him again Friday at 3 p.m. and I want to make sure I call and ask Karl
if it's all right for you to come along.
>> Well, I'll just leave that time open and you just let me know if he's okay
with me meeting him and I hope he does.
>> I do too.
I'll call Karl and get back to you.
>> Okay.
>> Great. Well, you guys have a good plan going I think with Karl.
Why don't we check in with Roger.
Jenny, you've been working with him recently, what's been going on with Roger?
>> Well, I need some help.
We were doing his vocational profile and we were talking about the kind of jobs he wanted
and hours and transportation and he came across really adamant about not wanting
to use the subway and of course that's going to be a problem 'cause the subways are
so much more available in this city.
I mean he's okay with the bus and so we'll go with that but he wouldn't get into why
and so I just needed some help to kind of understand that.
>> Well, I don't know if Roger's told you this
but he actually does have some pretty severe panic attacks and tends to get worse when he's
in a closed off space and he can't see an exit and in case something would happen.
And I think it actually gets more complicated in a noisy place, like the subway.
>> Okay. Yeah.
So that makes -- that puts it in perspective for me because he was talking about as far
as preferences that he wanted a job outside.
He said he would be inside if it was a large building that was not too noisy so now
that I know that, that kind of gives me some direction on that -- on the job hunt.
But, you know, Rochelle, if you're working on anything that helps him manage that anxiety,
if there's anything you can tell me so that I can reinforce it
at my end, that would probably help Roger.
>> Well, let me think about it and then maybe we can talk later.
>> Oh, sure.
Not a problem.
Okay.
>> Let me review his medications.
Up to this point, Roger's just kind of handled his anxiety by avoiding the situations.
Now that he's looking for work, it seems like we need another strategy.
It may be time to add an anti-anxiety agent so let's get him
in with the doctor this week and, you know, see what we can do.
>> Okay.
>> Well, you guys I got to tell you about Patty.
I feel really bad about this, her employer called yesterday
and he just said she's been off work sick for too long, it's his busy season
and he just can't hold her job anymore so Patty's lost her job.
>> Are you serious, Jenny?
>> Yeah, I know.
>> Oh my goodness.
I know she's going to be terribly disappointed and I was afraid
that something like this was going to happen.
But, you know, I will be visiting with her tomorrow, well talk about this.
>> You'll talk to her about it then?
Okay.
>> [inaudible] about this and I will talk to her about using this
as an opportunity to focus on her treatment.
She doesn't have to worry about being stressed about looking for another job,
that when she feels as though she has her symptoms in control, then we'll start talking
about other employment opportunities.
>> All right.
>> We may even want to talk to her former employer.
>> So I can do that.
>> Yeah about, you know, her returning because they did like her,
she was a very good employee so, you know, we may want to look
at that as an opportunity as well.
>> I think that's a good idea at this point, I mean she loved the job, she loved the work
but she's really struggling right now so give her some time, let her get her symptoms
under control and then, you know, then jump back into the job search.
>> Okay. So I'll wait to hear from you when you think Patty's symptoms have improved
and you think she's ready to start looking for work again.
>> Thanks, Jenny, I really appreciate it.
>> That's really cool to see everybody working together to help our clients get jobs.
Great. Do you folks have any questions for us before we wrap things up here?
>> Thanks Nicole, I have just one question for your team, how do you decide which clients
to refer to your supported employment program?
>> Well, I usually like to ask at the annual treatment plan review,
I'll see if they're interested in joining our employment program
and having someone help them get a job they'd be interested in.
And if at that point they say no or I'm not sure, then I'll usually bring it
up again the next year at the next treatment plan review.
So.
>> And I usually bring up work from time to time with the clients when I meeting with them,
usually when they say they're feeling lonely or they're out of money or they're bored.
So I try to focus on short term conversations just now and then.
I keep supported employment brochures in my office, I've had good response
about the rapid job search and then the other areas, the benefits counseling.
[ Inaudible ]
Which helps them, you know, decide what type of job is best suited for them.
>> Jeff, that's great.
I really like the way you take an opportunity to talk about work.
I think that that's a big part of the recovery process.
When clients are in control of their symptoms, they're managing their apartment,
everything seems to be okay, that's when we can really start asking them about work.
>> Sandy, that's the only question I had.
Do you have any?
>> No, I don't think so.
I think you covered it all.
Thank you very much.
>> Thank you for coming.
>> Sandy, what did you hear in this meeting?
>> Well, I thought it was great that the case manager [inaudible] employment specialist go
out together to meet clients in the community, that is an excellent way
to engage a new person in supported employment.
>> We also witnessed some good team problem solving in this meeting.
The nurse practitioner said she would review the client's medications to see
if it would help reduce his anxiety so he has better access to public transportation,
that would help him have more employment choices.
Also, we'll check to see if employment specialists attend these meetings
on a regular weekly basis, all of these are important points
for the Fidelity item integration through frequent team member contact.
>> I was a little concerned that the team was so quick to decide that the client
who was experiencing increased symptoms take a break from the employment process.
I heard the client was going to be disappointed and still wanted to work so it seems
like the team is making the decision for the client, rather than asking the client
if she wants to continue with supported employment.
This is an important piece of information to consider
when scoring the Fidelity item zero exclusion.
>> Some case managers are asking clients about their interest work frequently
and one case manager is only bringing up the topic of employment once a year,
while another case manager is only discussing work
after she feels the client's symptoms and housing are stable.
>> That was a good example of how different team members can be at different places even
when they're on the same mental health treatment team.
This will be useful information to include in our summary report.
>> Okay, Sandy, next on our agenda, we're off to another meeting.
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