Sunday, May 4, 2008


More people today than ever hold university degrees and college diplomas than before in our educational history. It is said that at some point in the future, 70% of all jobs will require some type of post-secondary education. More than one in five Ontarians have at least one university degree, and approximately one third completed training at a community college level. Students graduating from post-secondary institutions are fraught with problems of student debt. Others have trouble finding work in their field.

At the same time, we hear about employers crying out about a so-called 'skills shortage'. We hear that hundreds of thousands of civil servants, professionals, tradespersons, etc. are all going to be retiring in the next ten years and somebody has to replace them! The facts look grim. People are having less children. That means there will be fewer workers to support those who end up retiring in the years to come. Skills development is a major issue with many employers in both the public and private sectors. However, how come many services continue to provide what is at best mediocre responses to these problems?

For some of this, I blame the situation on 'consumerism'. In the past twenty-five years, consumers of a variety of types of services, ranging from addictions, to social services, to mental health to employment supports, have wanted and deserved a greater say in how these services are shaped and delivered. In fact, during the 1990's the move went to the point of hiring unqualified consumers to actually provide many of these same services that we generally expect to received from trained individuals. Consumers who were unable to succeed academically have decried what they referred to as 'credentialism' and pushed for the emphasis on 'life experience' as an actual criteria upon which to make hiring decisions, as opposed to actual skills for the job. People who lived in poverty can best help others who live in poverty. People with mental health problems can best help others with mental health issues, and the list goes on.

When somebody with any type of credential accidentally slips through the hiring process, movement leaders soon try to find a way to get rid of them, on the grounds that somebody with a disability that actually has legitimate credentials couldn't really be disabled or really couldn't be truly disadvantaged. While it is true that a lower percentage of persons with disabilities, for example, have completed college and university than their non-disabled peers, but the numbers among persons with disabilities are not insignificant. So throughout the 1990's, consumers were hired in a broad range of jobs to provide support services to other consumers, counselling, advocating on their behalf and to set up consumer-run initiatives, like drop-in centres and such. However, most of these programs -- though funded -- were not successful in capturing true consumer representation at the political level, or developing programs that truly met the needs of the whole population of consumers they were to serve.

Please do not take this as an anti-consumer rant, as the concept of hiring consumers in various positions is a good one, but required skills, qualifications and expectations of these positions should not differ whatsoever from the requirements for positions open to non-consumers. In discussing this with various consumer leaders in Ontario, I have still not ascertained from any of them how "life experience" can be measured objectively in a way to contribute to one's candidacy for a paid position. What about your "life experience" itself makes you more qualified to be an accountant? What about "life experience" and how it applies to your capability in handling a multi-million dollar budget and programming objectives? If you were a recovering alcoholic, does this make you more capable of running a large residential program for addiction treatment services?

In any kind of job, we set out what we require the worker to do on a regular basis and some tasks that may be done on an infrequent basis, and what types of skills or training we might expect in the individual at the minimum to fill these duties. For example, if you are looking for an administrative assistant for your non-profit organization that provides supportive housing to people, what skills and qualities might you look for in such an individual? I would expect that this person have excellent oral and written communication skills, significant skills in organization, training and experience in working with Windows business applications, good listening skills, and the ability to use accounting software and to manually re-check figures down to a monthly trial balance. A radical consumer perspective would say this person must be homeless or have been homeless, which to me is not as important as having those other above skills.

Why is it important to consumer groups that people have "been there"? They want people who have empathy and understanding toward their client group. They do not want to have people serve them that have bad attitudes and prejudice against people in their 'group'. Empathy is an important trait to have, but empathy does not necessarily come strictly from "being there" and even among those who have been there, this does not make them necessarily "empathetic". I have been in positions of authority that involved the hiring of personnel, as well as dealing with personnel issues and policies. In one agency where I was in charge of human resource issues, I successfully made an argument to the board to create a job sharing arrangement for the position of its executive director. This type of arrangement was practically unheard of at the time, as the board naturally would want a full-time executive to oversee its $2.5 million budget and 14 ongoing initiatives. The existing executive director wanted to temporarily reduce her hours as she had young children at home and the person with whom she would share her duties was somebody who was seeking greater challenges within the organization. At the time, I had no children. However, this executive director was a fine worker and did have children and it was important for her psychologically to seek a better 'work-life' balance. This would lead to her 'in office' hours to be even more productive, knowing that she had more time for her family.

I remember long after this initiative passed and she since returned to her full-time duties. She wondered why I was able to understand her needs, when I had no children at the time and wasn't concerned about daycare issues and so forth. I responded that as chair of human resources my responsibility is to our employees and to maximize their productivity and support a 'work-life' balance. For her, the issue was children. For somebody else, it may be the care of an elderly parent. For another person, it may be a disability issue. I do not have LIVE these issues in order to understand how they relate to that person's happiness and productivity within the organization. As human resource chair, I took the term resource seriously. How an organization sets up, designs and designates its human resources effects how services are delivered to those in need.

In another example, I have experience as a person with a disability. I know how it affects me, as well I know how I am best accommodated regardless of the type of job I am doing. However, a colleague of mine may also have experience as a person with a disability; her experience may have reflected even more negatively on her life or more positively than my issues did on mine. How does a potential employer of either of us justify hiring one or the other of us based on "life experience" as the primary factor when indeed both of our perspectives, while both valid, differ substantially from one another? Even two people with the same disability deal with their issues in completely different ways ... I've met many examples of the "angry blind man", as well as the "passive user of a scooter" (that didn't think social issues were important to her life). Again, both perspectives are important, but neither addresses how much skill either of these people have in doing a particular job.

What this "life experience" issue does is politicize the positions and make them open to a form of favourtism and bias, based solely on the opinions and political views of those doing the interviewing and hiring. I have heard from women who did marvellous work in the community for victims of rape and post-traumatic stress disorder, but who were turned away from prospective positions on a board or on staff because they did not believe Karla Homolka was completely innocent of her crimes, or that they did not share the sexual orientation of the key leader in the organization. I have nothing against persons with different political opinions or people with different sexual orientations; it is just that none of these things determine whether you can do or not do a particular job. People in these situations certainly do have a right to an opinion, but an opinion does not equal expertise.

For example, there was once a program where people who dropped out of high school were solicited to sit on a panel and write a report on how to keep people in school until they graduate. I don't think it is necessary to be a high school drop-out to provide expertise in this area, although I do feel high school drop-outs can contribute their opinions and experience to an expert panel that has training and knowledge in educational and curriculum matters to explain how their school experience could have been made different for them to encourage them to stay. Then the experts can translate that experience, while continuing to consult with the drop-outs and others with an interest in the issue, to re-formulate the school experience to make it better for everybody.

But unfortunately, this is not what we're getting. We have untrained mental health consumers providing counselling to other mental health consumers, many of whom could be quite fragile at that point in their lives. Some consumers do not believe in psychiatry and medicine, for example, for the treatment of mental health issues ... while this belief is not necessarily without grounds, it is risky to pursue this option with somebody who may be better in an environment where trained professionals can work with them. These same untrained consumers go to boards, councils and policy meetings to try to get more money for theirs and other similar organizations by trying to make the argument that consumers have some kind of "preference" to work with other consumers. This assertion is of course not backed up by research, but should be considered suspect once in funder's hands ... although it is never questioned in the way it should be, or are funders pushing for any kind of quality control.

Again, I am not saying people who have problems should not be delivering services to people of the same experience. Many independent living centres have developed a broad range of services for persons with disabilities and at least half of their staff must be persons with disabilities. From the want ads for many jobs in the independent living centre, they do expect some type of credentials as well as some "direct experience in working with persons with disabilities". Boston University's Centre for Psychiatric Rehabilitation has as its director a person who is trained as a Psychiatrist, but he has also been diagnosed as having schizophrenia. Jean Campbell runs a large consumer-controlled research and evaluation network and she is endowed with a PHd, as well as being a consumer herself. Mary Ellen Copeland has written a number of books on coping with various mental health issues, and has herself advanced to a Master's Degree. However, this does not seem to be the case here in Ontario, where anti-education and anti-credentialism continue to rule the roost.

This does not only apply at the local level but also at the provincial and federal level as well. An experiment people can try is to ask the paid leadership of consumer-based organizations what levels of education they have and if they claim nothing beyond high school (or even nothing beyond grade ten or eleven), ask again how they feel they developed the skills to do the work they are doing. If they are doing legal research, this takes training. If they are doing financial management and budgetary planning, this also takes training. If they are doing public relations and advocacy, this also takes training. If they are developing a skills-based course, and are attempting to evaluate its effectiveness, this also requires training. No amount of "personal life experience" in the world is going to teach people how to do these essential elements of a job.

One does not need to look very far to learn that many (though not all) of these organizations provide mediocre services and advocacy work. I personally do not feel I am represented as a person with a disability by any of the mental health and most of the cross-disability groups although a few of the cross-disability groups are starting to "get it" and understand what a democratic process is about and what inclusion really means. For example, I enjoy working with ODSP Action Coalition, Citizens with Disabilities - Ontario, Canadian Association of Professionals with Disabilities, as well as a few more traditional groups that are attempting to develop and broaden their democratic processes. The leadership of these organizations structure themselves into committees which everybody with a disability can join and everybody's voice gets heard on a near consensus basis. While not a disability organization, but utilizing a 50% structure of persons with disabilities on all committees, the work being done on the Accessibility for Ontarians with Disabilities Act is also very broad-based, representative and has the set-up to bring in broad public input into its deliberations.

But what is mediocrity? Mediocrity is a consumer offering 'self-help' group meetings, where the facilitator often does not show up and if they do, they do not know how to truly facilitate discussion and maintain confidentiality of their proceedings. I once managed a small consumer group here in the Niagara Region that was set up for both families and consumers and some of my members attended meetings and events held by other groups, both in the region and the province. In the small meetings, discussions tended to go off course. People's private information somehow accidentally gets disclosed or discussed in other groups. At the provincial level, a workshop on board development ended up to be a rant on how the gays and lesbians empowered themselves, as the facilitator for this workshop walked around the room smoking a cigarette. I've also heard of cases where people were seeing these consumer leaders for "counselling", often coming back more confused ... often they were told they should be going off their drugs or seek so-called "naturopathic therapies". While I have nothing against these choices, these choices need to be delivered and explained by a professional person and monitored as they are chosen.

People who are paid to facilitate these groups must have training in human behaviour, as well as how to deal with people who may be in deeper need than what the group situation can offer. Psychologists and social workers that operate these types of groups have this training. Others do as well, but most "consumer" leaders don't. Just as I, as a Licensed Paralegal, has to know the difference between the type of work I can competently assist or represent a client with ... and what work I either should or must refer to another Licensed Paralegal or Lawyer. As part of being licensed, regulated and accountable, you are ensuring that a consumer of service is receiving the right type of service and is getting it from the most competent provider. For example, many of my colleagues in the legal profession - Paralegal or Lawyer - know very little about human rights law, so they refer to me. I, in turn, refer them work in provincial offences or bankruptcy matters. Other times, economics rules and Lawyers refer to Paralegals that specialize in certain areas because the law office cannot complete a certain type of file economically (e.g. an accident benefit claim that does not have a tort component, a landlord/tenant issue).

I also speak up a lot at Coalitions, meetings, councils, position papers, etc. While I do not disclose private or confidential matters of clients, I generally speak of how people are affected by a certain law or policy. I talk to my clients too on important matters and register their concerns. For example, many of my clients cannot work at all, so I do talk a blue streak about how this group of disabled persons is being discriminated against. This does not include me, as I consider myself in the labour force, just not happy being self-employed (though the work I do is fine). I continue to speak of single people with disabilities, even though I am married with children. I speak of those with additional income sources, such as private pensions, EI, etc. and how unfairly they are treated. For me, I only push the CAP-D agenda and the need for more accountable services.

In employment, for example, our only national mental health consumer group thinks it is fine to replicate a program of somebody else's creation, BUILT Network, and develop and enhance its growth across the province. But, did any of you who have mental health problems ever get asked by anybody about the type of work you want to do? Of course not. BUILT Network, while suitable for mildly disabled individuals who are job ready and possibly high school educated who may know their way moderately around a computer, is not suited for everyone. This will not get people with higher education and professional qualifications into their careers. It will not help those for whom only self-employment is an option, nor will it help people that require a substantial amount of job coaching. For those entering call centre type careers, this is high risk ... most of those jobs have high turnover and for many employees in this type of work, they find it stressful - particularly somebody with problems to begin with.

Did anybody ask ME what I wanted? Of course not. Nor is there a detailed evaluation of the program carried out by an external body with no interest in the results. BUILT Network is not the only program that is guilty of mediocrity and promotion of mediocrity; many job programs are developed so that participants do not enter jobs that pay more than $8 - $10/hour. BUILT Network is just following where the money is, as opposed to what consumers really want and need, much like other programs. I said the same about the Job Bus, ODSP, Ontario Works, etc. It is easier to put your eggs in one basket and not challenge the status quo by truly improving the lives of your consumers. A large component of these programs must be advocacy, but unfortunately, this is sadly lacking - possibly because many of these organizations are based as charities, or because the people running them do not know how to effectively "bite the hand that feeds them, but still get fed".

But unfortunately, as long as the public and those served by the various programs passively accept less than satisfactory and services that are not consumer-based, individualized services, the majority of people needing these types of supports will continue to be without service or receiving ineffective service. It is important now to look at what qualifications these jobs require, hire better trained and skilled staff and invite professionals with disabilities, skilled immigrants, older persons with significant experience in these areas, and our labour market needs will be more than met ... until then, we are wasting too many people who are now wasting their lives on OW, ODSP or in low-paid jobs that do not take their skills into account or even pay their bills ... while some others continue to work in jobs that are well over their heads and remain accountable to nobody.

1 comment:

Dog Meat said...

A mental Health Consumer Provider's experience working on two Programs of Assertive Community Treatment

After an accident I was disabled for five years. During this time I received Social Security Disability Income and counseling. I joined a club house in Newton Massachusetts for vocational counseling. After volunteering there I got a temporary employment placement. I did janitorial work on two days each week for two hour shifts at some group homes. On one night each week I attended a vocational support group to discuss issues related to the job. After this I found a part time telemarketing job. This independent employment was a step in the right direction. I had an excellent college education and had difficulty getting hired. I thought this could be related to having been disabled. Employers are careful in hireling people and this can exclude people who can do the job but have been unemployed. I was grateful that a program was available in my community to help disabled people get jobs. Being excluded from the work force creates a unique poverty of the soul. I vowed that someday I would help disabled people with finding jobs.

A year and six months into my recovery I got a residential counselor job working with individuals called mentally retarded. I slept overnight three nights. This was an excellent situation for someone with depression. I got off public assistance and was self supporting, productive and responsible member of society. After you worked for a year at the agency you were eligible for tuition reimbursement. I took advantage of this and enrolled in the U Mass Boston's Rehabilitation Counseling program.

After taking one course a semester for a few years I moved into a therapeutic community where I worked as a counselor with mental health clients. Working in a supportive environment as a counselor and learning about mental health counseling helped me grow as a person and nurture the growth of people I worked with. I worked in this position and studied rehabilitation counseling for five years. After I earned a Masters in Counseling I got certified as a rehabilitation counselor.

Then I took a job with a Program of Assertive Community Treatment (PACT) in central Massachusetts. I was able to advocate for clients and help them with a lot of problems. I liked the fact that we did outreach and helped clients where ever they were. This type of work brought me to homeless shelters, schools, work places, hospitals, jails and client's homes. The psychiatrist and staff were supportive. Because the program was associated with a University teaching and learning were emphasized. I received good performance reviews over my four years of employment. I handled numerous crisis situations effectively. I helped clients to find jobs.

After four years I was offered a better paying position at another PACT. I had twelve years experience and not one complaint on my record. I moved near to Malden take a position as a Vocational Counselor with a PACT in Malden at Tri-City Mental Health Center (TCMHC). The company was merging with Eliot Community Mental Health (ECMH). This was because TCMHC had committed fraud in billing Medicaid and the director of rehabilitation stole from clients. I understood that the company was in transition. I was confident in my ability to help clients and I knew I had a good work ethic and thought that would be enough to succeed. No one new I had a disability when I took the job. I had the experience of being on an effectively operated PACT. This experience was needed because the program had problems.

After taking the job I saw that clients were not getting services they needed with housing and employment. Clients needed help. Staff would say that clients were to "symptomatic" to benefit from help with these important issues. Staff treated clients in a condescending manner. I raised my concerns about client treatment with Aaron Katz the new program director. A Katz did not have the required credentials or experience to manage the program. This program was designed to serve the most disabled and vulnerable mental health consumers in the area. The response I got was "mind your own place and business". I could see his approach to management was to bully subordinates, use intimidation and push people around. For example he and another manager would co supervise a counselor while A Katz sat at a computer taking notes like it was a disposition. You never knew what was being written. I asked if I could take notes during a meeting but was told this was not allowed. I do not respond well to this approach by a manager.

In my first month of employment I was asked to take a client to get a toxicology screen. The test results could get the client in legal trouble. I thought that this task was a bad idea for our first meeting. I found out latter this client had been charged with attempted murder. I was not told about his background but just to take him to get tested. I refused to do this. This is just one example of a number of problems where clients and staff were put at odds because of poor management. (Reports to DMH never told what was going on.) In a PACT program clients are often under court order to get treatment and have the program manage their money. The only way to be sure clients are not coerced and staff is acting ethically is for there to be effective communication between all staff and management. However this was not possible at the ECHS PACT all communication was one way. Aaron Katz gave orders and expected staff to obey his orders without question. It was as if the clients weren’t people but animals to be feed anti-psychotic medications. A Katz the program director would say "I have to micromanage everything". If a team meeting was going on counselors were expected to raise there hand and ask permission to go to the bathroom. We were in team meetings ten hours a week.

The work place became hostile. I think it was because other staff saw that I advocated for clients in meetings and management felt threatened. I got the "you aren't fitting in talk" from the manager. Then I got a written warning that threatened termination. This was for late paper work. Some of the paper work was the program directors (A Katz) responsibility. I explained that I had dyslexia and I asked for some extra time to complete the paper works. I advocated for my self and asked for the accommodations that I am entitled to under the American's with Disabilities Act. Other than this minor issue I had demonstrated leadership in important matters. I helped client's find jobs and housing. I managed crisis situations. My request for more time to do paper work was denied by a Katz.

Then after a client in crisis did not get help from management in a timely manner a blame game started. I had brought the client in crisis to meet the manager. I got blamed because this client who needed to be hospitalized ended up driving in Malden. This happened after I warned the manager that he needed help. A staff person from the day program was in his car. He could have crashed his car into someone. But I was blamed for this management neglect. I filed two grievances with the SEUI union. Management ignored them. I developed health problems as a result of the stress I was under. The management created a hostile work place. I even got treatment for job related stress. I let A Katz and M Mathews a senior manager know I was being treated for job related stress. The work place got more hostile. I requested time off but this was denied. Even though I had a doctors note as evidence that I had job related stress and both vacation and personal time.

Basically I was thrown out like the trash. The reason was because I advocated for clients, workers rights and would not accept unethical behavior by management. ECHS management contested my unemployment claim. At hearings M Mathews and Aaron Katz committed perjury. After four hearings the Massachusetts Department of Employment and Training found I had an urgent and compelling reason for ending the job. I was paid unemployment compensation. ECHS management also refused to pay me for my last two weeks work. I went to small claims court and named Pam Burns the Human Resources Director in my complaint. I had an excellent case but the hearing officer was a Malden court clerk named Paul Burns. Without considering the facts I lost my case.

Because of all this I lost my health insurance and couldn't continue treatment. Now, I can not get a good job because I do not have a reference from my last employer. My health problems have not been treated. I am applying for Social Security Disability. I found management's main interest was in misleading the Massachusetts Department of Mental Health about how the PACT was operated. Ethical issues were not to be discussed. Dishonesty and hostility were the foundations of management's practice. They treat counselors like dogs and laugh at the SEUI union.

Dog Meat