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toward peace of mind: mental health in b.c.

Ruth MacLennan, of the Canadian Mental Health Association, says counsellors prepare people to re-enter the workforce.Darryl Dyck/The Globe and Mail

Part three of Toward Peace of Mind: Mental Health in B.C., our four-part series on the state of the mental health system. Part two, on how police forces across British Columbia are revolutionizing the way they deal with calls involving the mentally ill, can be read here.

Lyle Richardson would love full-time work with all its trappings, but says his main career these days is managing his schizoaffective disorder.

He does get paying work such as temp jobs, and helps at conferences held by the Canadian Mental Health Association, but most of the 39-year-old's income comes through social-assistance from the province – $900 a month. He hasn't worked full time since he was diagnosed about 17 years ago when he was a junior executive assistant with a venture capital firm in Vancouver.

The New Westminster resident regards a full-time job with the intrigued fascination some might focus on retirement. "There is something about paying my way that seems appealing – being a participant in society rather than on the receiving end," Mr. Richardson says.

He has a five-year goal of moving into full-time work in advertising or copywriting after removing sources of stress that causes his illness to emerge. "If I can have less of stressful experience, I can accommodate more work."

Many suggest that work can be a boon for those with mental-health issues. Health Minister Margaret MacDiarmid notes that some cannot work, but recalls patients when she was a practising physician who became employable and gained from the experience. "They would say, in retrospect, they started out thinking, 'I couldn't possibly do that. It's not possible for me to do that,'" she said in an interview.

While many programs provide and facilitate work experiences for the mentally ill, Mr. Richardson has his eye on Individual Placement Support (IPS), which Vancouver Coastal Health and Fraser Health have embraced as a premium measure for streaming the mentally ill into full-time jobs.

The program adds an employment-focused case worker to the patient's mental-health treatment team, which can include a social worker or psychiatric nurse, a psychiatrist and occupational therapist. The IPS counsellor helps get the client into the workplace.

"For the person that wants to work, that's all we do," says Ruth MacLennan, program manager for rehabilitation and recovery with the Vancouver and Burnaby branch of the Canadian Mental Health Association, which employs some Lower Mainland counsellors in the program. She also helps some IPS counsellors in their work with clients.

IPS counsellors prepare the client, but also canvas prospective employers. Ms. MacLennan says counsellors her organization has retained have worked with warehousing firms, the hospitality sector, retail, offices and service stations, among other businesses.

She says IPS workers cannot always match clients with the kind of work they had before their diagnosis, but that that is consistent with anyone who has had an "interrupted career."

About 500 clients go through the program each year at Coastal Health. The success rates are 55 to 60 per cent – better than the 50 per cent average for programs, says Andrew MacFarlane, mental health and addictions director for coastal health. Vancouver Coastal Health has used the program for about a decade, and lately doubled the number of caseworkers to eight.

Fraser Health has been providing IPS programming in Delta, the TriCities, Burnaby, Surrey and New Westminster since 2011. Each of about six staff have 33 clients with a 50 per cent employment rate in the first year and an average employment rate of 64 per cent, according to an overview of the program provided to The Globe and Mail.

Jim, a 65-year-old man in the Fraser region who told his story on condition his last name not be used, was diagnosed schizophrenic in 1969, and became interested in a full-time job again last year after working for the Salvation Army as a store detective and attending to a kettle. At the time, it had been 10 years since he had worked full time. His psychiatric nurse referred him to an IPS caseworker, who helped him write a résumé, among other counselling. She even drove him around to hand it out.

For about six months last year, Jim worked in a warehouse scanning merchandise bar codes. The $20 an hour was good, he said, but not entirely the point because he had some income from his pension and old-age security. "I had a feeling of accomplishment. I was helping a modern economy," he said.

He was laid off, but is staying in touch and hopes to get hired back.

Not all do, said Ms. MacLennan. "Not everyone chooses to return to work who has a mental illness. … A lot struggle with other things in their lives."

Mr. Richardson says his absence from the work force over the past decade has been hard to explain, but the IPS would deal with the issue of establishing clarity with employers about his health so the dialogue could go beyond it to deal with his suitability for a job.

"I think that program is actually a great avenue to allowing people to avoid the whole difficulty and stigma of letting an employer know you're mentally ill. If an employer already knows that, it makes the transition a lot easier and less stressful," he said.