Position Statement 25: Standards for Work Performed by Patients in State Mental Health Facilities
Introduction
Mental Health America opposes the practice of exploiting work performed by patients in mental health facilities. Mental Health America approves the use of work as an important component of an individualized and integrated treatment plan designed by an interdisciplinary team (IDT) of mental health professionals to assist patients in achieving a level of independence and an enhanced quality of life. Work performed by patients in mental health facilities is generally categorized under psychiatric rehabilitation services on an in-patient basis and vocational rehabilitation services in the community and thus is required to meet accreditation standards by such regulatory bodies as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). All patient work should be compensated in accordance with applicable state and federal laws.
Work as Part of an Individual Treatment Plan and Rehablitation Plan
Typically, a referral is made by the patients’IDT to a qualified specialist for a screening and an additional assessment if the team determines that the patient will benefit from structured work situations. If the assessment indicates potential benefits, the IDT will develop a coordinated and integrated treatment plan, which will take into considerations the patient’s level of functioning, cognition, vocational and educational history and interests.
Work programs include a wide range of programs designed to help patients achieve a level of self-sufficiency and an improved quality of life. Strong emphasis is placed on coordinating and integrating mental health treatments and work programs. The various programs may include development of job skills for competitive employment, supportive employment, and sheltered employment for long-term work. A qualified specialist must supervise such work to ensure its therapeutic and rehabilitative value.
Application of Wages
Patients should be compensated in accordance with the minimum wage laws of the National Fair Labor Standards Act (29 U.S.C. 206.) All work that is assigned by the treatment team must be a) part of an approved individual treatment plan and b) inherently compensable. Payments to a patient performing compensable work will not and should not be applied to costs of treatment. Noncompensable work is only that work which is a) undertaken by a patient voluntarily and without coercion or b) the result of chore-sharing within a consumer group as part of the treatment setting (e.g., as in a residential treatment setting).
Institutional Maintenance Work
A patient may perform vocational training work involving the operation or maintenance of a mental health facility, or contract work if the work is a part of the patient’s individualized treatment plan approved by the patient’s IDT with the work supervised by a qualified specialist to ensure its rehabilitative function.
A qualified specialist should supervise all work activities on a regular and periodic basis as circumstances warrant.
Housekeeping Tasks
Staffing of the mental health facility should be sufficient to provide for the adequate care of all patients.
Patients should perform personal housekeeping tasks and assist in the care of other patients as would be expected in a family or residential school setting. Tasks of a personal housekeeping nature should not be considered to be compensable work.
Effective PeriodThe Mental Health America Board of Directors approved this policy on March 11, 2000. It will remain in effect for five (5) years and is reviewed as required by the Mental Health America Executive Committee. However, this policy was reviewed on December 10, 2005 and extended for an additional three (3) years. Expiration: December 10, 2008 |
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