By Kathy McKee

For the last two years, a research project funded by the Canadian Education and Research Institute for Counselling (CERIC) has been underway in Nova Scotia, exploring what career practitioners need to know to support clients with mental health challenges. The project collected data from mental health consumers and career practitioners who provided a balanced perspective on the challenges faced in employment counselling. Through multiple consultations, the skills and knowledge career practitioners need were identified. However, the most profound results of the research have been the changes that have occurred within individual career practitioners. Education about stigma and discrimination has given career practitioners greater knowledge, created richer dialogue and has as a result, shifted internal beliefs and attitudes. This “change from within” is making a substantive difference in the way clients are understood and assisted.

Charting the Course: Mapping the Career Practitioner Role in Supporting People with Mental Health Challenges began as a seed planted by career practitioners in Nova Scotia who were puzzled by the complexity of working with people with mental health challenges and a feeling of inadequacy or lack of expertise in this area. Concern centered on the increasing number of clients who were disclosing that their mental health was a key barrier to their employment and the subsequent issues of capacity (do we have the time/training?), policy (are we allowed/contracted?) and fit (do we want to serve these clients?) were raised. The research consultations explored these topics, honing in on the central issues of who we are, what we believe, what we know and what we need to know to provide a superior level of service to mental health clients. The role of a career practitioner in the employment counselling realm can be that of gatekeeper; someone who can either open or shut the door of opportunity for clients. What are the factors that come into play when you see a client – what is your internal dialogue about the capacity of your organization and yourself?

The research confirmed that there is an increasing number of clients disclosing mental health problems and career practitioners do need training and education to increase success working with them. The research also uncovered that almost half of career practitioners themselves report as having mental health problems and surprisingly, these career practitioners are more likely to have stigmatizing and discriminatory attitudes towards clients on their journey to employment. Sociologically, this makes sense – we distance ourselves from those with who we differ a little more than from those who we differ a lot; we see ourselves in others and reject that vision or we make sure we are not identified with any group that is seen as ‘less than.” If we know that clients presenting with a mental health problem are left out of the workforce in much greater numbers than can be accounted for by their disability alone, then the career practitioner role is one where the seeds of success and failure are planted. The research highlighted that the limiting factor in our clients’ progress may be the career practitioner’s inability to see a limitless future for every client.

When this research began with local career practitioners, the discussions began with “what is wrong with people?” Discussions with and about clients seemed to focus on deficiencies – the clients were deficient in that they were not prepared for or did not accept help, and career practitioners were deficient in that we did not have the training or tools to properly address client needs. It was questioned whether clients with mental health challenges even belonged in our centres. Career practitioners did not feel particularly qualified to work in the mental health realm, which was viewed as specialized and separate. Because this work can be challenging, adding an additional layer of mental health concerns to client work was creating a desire to shed these clients as soon as possible. With one in five Canadians reporting a mental health problem it is abundantly clear that the issue is not about “us” and “them;” mental health is a moving target for everyone on any given day. The work began with the question “what is wrong with people?” which transitioned into “what is wrong with us?” Career practitioners must flex with societal norms that are more accepting of mental health disclosure and a client base that expects knowledgeable and responsive service in their communities.

Career practitioners have to be willing to examine core values about mental health and how this affects their work. There needs to be knowledge about stigma and discrimination in order to create a baseline of understanding of how our internal issues manifest themselves externally in the counselling relationship. Policies and standards may reward deficiency-based models where the sorting and labelling of clients occurs at the first ‘hello.’ All of us are on a journey to find a place where we can feel fulfilled and contribute in a meaningful way to our community. Everyone has a state of mental health, which may be different on any given day. I had once thought that there was a “normal” – now I know that there is no such thing.

So, what was my change from within? It began with discomfort. Neasa Martin, the mental health consultant on this project asked some pointed questions and allowed space for difficult discussions and for some significant life-changing moments to occur for staff. We all want our centres and our practices to offer the best services and help clients move forward on their life journey. My journey has been to understand that organizational models and operating systems rarely change unless individually held beliefs and actions force a new way of examining and questioning what is at hand. Ask yourself about your issues, how you feel about clients with mental health problems, examine what you have been taught and uncover what your values are about who warrants your time. Your answers will provide insight into how you can help us move towards a more caring and inclusive society.

The final report can be downloaded from CERICs website at: ceric.ca

To learn more about the project visit: chartingthecourse.nscda.ca

Kathy McKee was a project manager for the CERIC-funded and Nova Scotia Career Development Association (NSCDA) sponsored project: Charting the Course: Mapping the Career Practitioner Role in Supporting People with Mental Health Challenges. She is a Board member of the NSCDA and a long-time manager of a career resource centre in Windsor, NS. Neasa Martin, a mental health consultant at Neasa Martin & Associates, was the lead researcher.

See the article by Sharon Ferriss, the Director, Marketing, Web & New Media with CERIC, titled Career professionals a critical link to employment for clients with mental health challenges, for a summary of the project’s findings and recommendations.