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Philanthropy In Action

Turbocharging Recovery

By Gary Snyder

Wendy Thayer, a mechanic in Mounds View, Minn., is one of many people who have been helped by a new model of mental health treatment developed by Geisel researchers.

Leaving the well-tread path sometimes leads to a remarkable discovery.

For Wendy Thayer, her physical and mental health brightened when—after a series of menial jobs and unemployment—she took the first step toward a non-traditional career.

For Robert Drake and Deborah Becker, it took breaking away from the ineffective traditional model of treatment for patients with serious mental illness to create a new model. Their pioneering approach, called individual placement and support (IPS), helps people with mental illness and other disabilities acquire employment via training, job-search assistance, and placement services. IPS emphasizes that meaningful work is an essential part of the recovery process, not a far-off goal to be pursued months or years after treatment.

In the 1980s, Drake began to question why only 10 percent of individuals with serious mental illness were working in mainstream jobs despite the fact that 70 percent said that they wanted to be working. He unearthed two major findings: First, the model of providing employment opportunities to developmentally disabled individuals through sheltered, non-mainstream jobs was also being used for people with mental illness, and this approach was failing badly.

The second finding opened Drake's eyes to new possibilities. "We were astounded but delighted to discover that when people go to work, it helps them manage their mental health symptoms, they move out of the mental health system, and they feel better about themselves," says Drake, a Geisel professor of psychiatry and of community and family medicine. "Functioning in the world is what people want from the mental health system. They don't want more and more treatment. And functioning in the world helps them take care of the other problems they're facing."

Having a job I love makes me feel like I'm contributing to society and not just a burden. . . . My kids are very proud of me.

Working with Becker, a research associate professor of psychiatry and of community and family medicine at Geisel, Drake developed IPS, which has now been implemented in every state as well as a number of other countries. The success of the program hinges on having a supportive team of vocational rehabilitation, mental health, job placement, and medical professionals to guide participants to a job that fits their preferences and skills.

That type of multidisciplinary team changed Wendy Thayer's life. Thayer was struggling with mental illness and long-term unemployment, with "no light in her eyes," as employment consultant Lori Clauson puts it. With the help of the IPS team, Thayer completed an auto mechanic training program—becoming the first woman to graduate from the program—and landed a job as a mechanic at Rydell Auto Outlet and Garage in Mounds View, Minn. She celebrated her first year at Rydell in April and is now studying for her eight-part master mechanic certification.

"There's a huge difference in the way I feel, the way I act now," Thayer says. "Having a job I love makes me feel like I'm contributing to society and not just a burden. I feel normal. . . . I don't feel like an outsider. It means a lot to come home from work and be able to pay the bills. . . . My kids are very proud of me."

Although Becker and Drake devised the groundbreaking model, the IPS approach only took off nationally when the Johnson & Johnson Foundation called in 2001 and offered to help support the spread of IPS across the U.S. and the world. That funding has allowed for large IPS demonstration projects, the success of which is now getting the attention of Congress and federal agencies as they look for proven ways to keep people with mental illness healthy and productive while managing costs. It has also helped transform the lives of people like Wendy Thayer, says Becker.

"The philanthropic support from Johnson & Johnson is really making a difference in the lives of people who are living with these horrible illnesses."

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Geisel School of Medicine at DartmouthDartmouth-Hitchcock Medical CenterWhite River Junction VAMCNorris Cotton Cancer CenterDartmouth College