Guidelines for Supervisors of Consumer Employees

Trained consumers who are employed to provide direct services to other mental health consumers can bring many strengths to the workplace. Adding consumer providers to clinical teams can also challenge many of the agency's formal and informal practices, as well as present significant supervisory challenges. In the best possible situation, consumers should receive their clinical services from a different agency or at a different location than the one where they are employed. The reality in Virginia at this time is that most consumer employees work and receive their ongoing psychiatric care from the same agency. Generally, supervisors and co-workers "know too much" about the life and history of consumer employees, which can make supervisory situations much more complicated.

In hiring consumers to work for a mental health agency, administrators and supervisors need to be clear in several specific areas: knowing how to balance the agency's needs with employee needs (and what are the priorities); understanding the ways in which consumer employees (or any employee living with a disability) are the same and how they may bring unique issues to the workplace as an employee group; and developing clear ethical boundaries in supervising all employees.

This document was developed by supervisors, staff, and consumers who attended the VA-IAPSRS Conference in November, 2002. It is intended to be a guideline for "best practice" in the supervision of consumer employees and is based on knowledge and experience currently available. It is expected that these guidelines will be revised and improved as additional successful supervisory experience is gained in Virginia.

General Agency/Organizational Issues

1. In the workplace, consumer employees are employees first and consumers second. All employees should be held accountable for knowing the policies and procedures that pertain to their work and the general mission of the agency.

2. Thorough orientation should be provided to all employees.

3. Complete and specific job descriptions should be developed for each agency position. There should be clarity around which duties are "essential functions" of the job (that can be performed with or without accommodations), and which duties are marginal functions that can be compromised or adjusted.

4. Clear and specific agency policies need to be developed for any areas involving safety, risk, or legal issues. Accommodations/compromises should not be made in these areas for any employee.

5. New employees (and particularly new consumer employees) should be trained by skillful, experienced supervisors.

6. Leave and scheduling policies/practices should be flexible enough to accommodate employee needs to keep appointments, or obtain required medical services.

7. All supervisors should be oriented to the agency's responsibilities under the Americans with Disabilities Act. Additional information concerning the ADA and possible accommodations for mental health problems can be obtained from Virginia's Human Services Training Center (VHST) at (434)970-2148.

Supervising Consumer Employees

1. Maintain a stance of supervisor, not of therapist, with consumer employees. Keep the focus on job performance issues and upon meeting the needs of the team's clients rather than on the possible mental health needs of the employee. When performance on the job is not adequate, that issue should be discussed directly in supervision, with a plan of correction developed.

2. As with all employees, be clear about standards/expectations of conduct and performance on the job.

3. Create a favorable working atmosphere for all employees. Supervisors and co-workers should treat all employees with dignity and respect.

4. Like any new employee, consumer employees will benefit from individual supervision during the first six months of employment. Pairing new employees with a mentor (another staff member on the team) can also be helpful. A list of "back-up" people/staff needs to be available to the employee for consultation in the event of the supervisor's unavailability.

5. Communication should be honest, clear, and direct. In order to avoid confusion, it may helpful to put important points in writing.

6. Be sure supervisory actions and expectations are fair and impartial.

7. The issue of where/from whom the consumer employee will receive ongoing services needs to be resolved before beginning employment.

Performance Issues/ Establishing Accommodations

1. Where issues of risk, client safety, and legal issues are involved, there can be no compromise or accommodation.

2. In other situations, when accommodations are necessary or requested, the supervisor should work with the employee to develop these accommodations and provide them. Resources or assistance in developing "reasonable accommodations" is available from job coaches within the agency, from the Human Resources or Personnel Department, as well as counselors at the Department of Rehabilitative Services. Another resource is The Job Accommodation Network (800/526-7234), which provides free telephone consultation regarding employment and accommodation issues.

Privacy Issues

1. If a consumer employee is receiving services at the same agency where they are employed, special consideration must be taken to limit general staff access to that staff member's medical record. This may mean that the record is stored in a different or separate area from those of other consumers. This consideration should extend to all information about a staff member's physical condition, lab reports, or any other information that will be stored in their chart.

2. Consumer employees should have the same access to the medical records of the clients with whom they work as do other staff members on the team, i.e., only on a need-to-know basis. All employees are expected to adhere to the agency/employer's highest standards of confidentiality concerning client information. All employees should only have access to records that are required for completion of their work.

Integration into the Workplace

1. All staff, supervisors, and administrators should support and encourage the development and adjustment of new employees within the agency, focusing on capabilities rather than disabilities. Team work and peer support should be fostered, encouraged, and modeled.

2. Supervisory plans should be made for dealing with patronizing or excluding behavior by co-workers. Intentionally preparing the workforce for the entry of consumer providers and clarifying staff roles and performance expectations will help insure positive results.