Programs exist to help them achieve that goal

Monday, July 18, 2005
by Jessica Adler
Herald News

Clients at the North Jersey Friendship House, a non-profit rehabilitation center in Hackensack that offers behavioral health services, vocational training and employment support, generally have more than a few things in common. Many have mental disabilities - conditions such as bipolar, depression, and schizoaffective or anxiety disorders. Many have dual diagnoses of a mental disorder along with a learning disability or substance abuse problem. And many share one ambition.

"Of the people we see here, no matter how low their functioning - three-quarters of them, their goal is to someday work," says Mala Spivack, clinical director of the North Jersey Friendship House. "Clearly, across the board, it's an important value for people."

Last June, the Herald News reported that, of all U.S. cities, Paterson has the highest percentage of disabled residents. Nearly 30 percent of Patersonians receive disability benefits. Among working-age residents, rates are even higher - 35 percent of 21- to 64-year-olds are on disability for health conditions ranging from AIDS and cardiovascular disease to schizophrenia and depression.

Some of those receiving Social Security Disability Income (SSDI) want nothing more than to partake in the workforce, according to local service providers. In fact, some tailor part-time work schedules so they can do just that, while maintaining some of their benefits and much needed medical coverage.

But some people with mental illness find that the intricacies of "the system," coupled with their debilitating health condition, can make a job seem out of reach.

To some, "work incentive" programs, are either unknown or intimidating to ponder.

Friendship House aims to ease clients' transitions to work, tailoring goal-oriented treatment plans based on individual abilities and desires, which range from dog-grooming to clerical jobs, Spivack says. Last year, the agency placed 198 of its clients in jobs in the community.

"It gives them a place in society," Spivack says, "and it enhances self-esteem and self-worth."

But it takes self-esteem and self-worth to seek employment in the first place, something that can pose a challenge for some who have been contending with mental illness most of their lives.

"Some clients who have been in and out of state facilities or who haven't worked don't have the self-esteem," says Jeanne Metzger, an advocacy specialist at the Mental Health Association (MHA) in Passaic County.

"It's difficult for them to even think about going to work, let alone leaving the house. Clients who have worked in the past - they know what it was like and it may be easier to transition back."

Metzger, who has been diagnosed with depression, obsessive compulsive disorder and borderline bipolar disorder, draws from her personal experiences when counseling clients. She worked as a secretary and a bookkeeper for 20 years before suffering what she calls a "breakdown" in 1998.

While living in supported housing and attending an outpatient program for people with mental illness, she began receiving disability benefits.

Eventually, Metzger's counselor suggested she look for volunteer work.

In spite of Metzger's past professional experience, four years had passed since she held a job, and she felt overwhelmed.

"I didn't feel capable of even going on an interview," she says.

Finally, about six months after her counselor mentioned the idea of work, Metzger heard about an opening with the MHA, applied and got the job.

Not everyone has a similar success story.

"For some people, it's just so difficult, they'd rather stay away from it," says Joanne Green, executive director of the MHA in Passaic County.

People receiving benefits who want to work, either full- or part-time, face plenty of what-ifs, says Green.

They wonder if and when they should tell their employer that they have a mental illness. If they do tell, they fear either being stigmatized at work, or not getting the job at all.

Keeping their illness a secret, however, makes it hard to explain missing work if they feel ill or need to be hospitalized.

Often, above all else, says Green, one worry prevails: "A very big fear is about loss of benefits and medical insurance. It's not easy to get SSI and, sometimes, it takes many, many appeals for people to get it. The thought of then jeapordizing it is a big one."

Once Jeanne Metzger started working at the MHA, she found out about New Jersey WorkAbility, which allows certain employed people with permanent disabilities, whose earnings are too high for them to qualify otherwise for Medicaid coverage, to receive full state Medicaid benefits. (In some instances, people who qualify for the program may have to pay a monthly premium of $25 for one person or $50 for a couple.)

People often don't know about work incentive programs like NJ WorkAbility unless they hear about them through word of mouth.

Some fear that merely inquiring about such programs could put their benefits at risk.

"People get sort of afraid of maneuvering through the maze to find out what's available and what's not," says Lavonne Johnson, spokeswoman for the Division of Disability Services, which oversees NJ WorkAbility. "People need to know that these services are out there and not to be afraid."

"You don't lose anything by finding out the information," says Jasmin Rivera, a benefits specialist for New Jersey Work Incentive Network Support (NJWINS), a statewide program funded by the Social Security Administration which provides benefits planning assistance to those aiming to return to work.

Although SSI benefits may decrease according to income once someone is enrolled in NJ WorkAbility, Medicaid coverage is guaranteed.

The goal of the program, says Johnson, is to allow people with disabilities the freedom to take a job -- be it full- or part-time -- regardless of whether extensive medical insurance comes along with it.

Thanks to NJ WorkAbility, Jeanne Metzger works as much as she feels she can - between five and 15 hours per week - while still receiving the security of benefits and much needed medical coverage.

Whether or not someone is ready to return to work full- or part-time is a personal decision, she believes.

But now that Metzger is an advocate herself, she says, "It's important that I help my clients. I want to work and be able to help people with what they're going through by what I've learned and what I know."

Reach Jessica Adler at (973) 569-7169 or adler@northjersey.com.