Disability Employment Systems and Change

It is the season of change or rather the expectation of change within the disability employment systems, but first, a bit of background.

?In 2012, I, Dr Peter Smith started the initial research for my PhD, focusing on the factors that underpin successful employment for people with intellectual and developmental disabilities. Unlike writing a paper for peer review, there is scope for looking a lot deeper into a subject. One outcome of this should be and often is that unexpected issues are discovered. After all, a PhD is about extending the knowledge base in a field, not simply replicating someone else’s work. Using the ideology that research and knowledge creation should also extend to research methodology, I undertook extensive consultations on this aspect with the methodologies' founders and moved that along a bit.

?One of the earliest findings was how unfit the current systems are for their purpose. In 2012, I proposed a new systems model inspired by Bronfenbrenner’s system work. I presented it overseas not long after, and it created an interesting debate among the audience members. The most controversial piece was where I placed the family in the ecosystem. That particular outcome was the result of extensive consultation with families and, in a way, influenced by my experience working with families.

?The system model (Fig 1) became known as the Equilibrium Systems Model of Employment (ESME) and is now part of a larger body of work being undertaken. I'm not an artist so that the image will evolve over time.

?Fig 1.

?I put that part of the research aside to focus on the main event, but once again, something else popped up. That was the way we measure the success of the service delivery, which we will all acknowledge doesn't reflect much about how the people the system serves actually feel about the outcomes. What we currently measure isn't outcomes but outputs.

?Outputs are system efficiency; outcomes are actual meaningful long-term jobs. Anyone looking at the long-term employment rate for people who have been in the system will see that it isn't that spectacular after twelve months but worse after two years. We aren't measuring the right things. Again, this is not the focus of my PhD, so I was asked to put that aside. Fast-forward a few years, and I was offered the opportunity to work on the outcome measure at Cornell University. It was an excellent opportunity and experience, cut short in some ways by Covid, but that's life. The outcome has been the initial outcome measure framework being peer-reviewed and published. It is known as the Personalised Inclusive Employment Outcome Measure (PIEOM) (https://doi.org/10.33700/jhrs.2.1.61) and is underpinned by four pillars: Social Inclusion, Social Cohesion, Self-Determination and Socioeconomic Security. Disturbingly, much of what we talk about as though it is settled is, in fact, not settled, and there are significant variations in understanding to the point that a discussion about the same thing may not be about the same thing. Think context and culture.

?The next stage of this development is slowly moving forward with active engagement from the community.

?Currently, I’m focusing on our joint venture research with a US institution, which is looking at aspects of disability employment practice in the USA and Australia. Practice in Australia is changing as a result of the NDIS and its influence on families and their expectations. In our boutique disability employment practice, Work First, we use a different practice model that has proven successful. That model is about extending the evidence base, which is one of our advantages as researchers and active practitioners who are engaged in service delivery daily.

?We are about to undertake a comparative study using a small set of case studies from both countries to compare the work of disability employment professionals in the USA with that of our staff.

?Staff in the US program are starting to see the need for what we deliver, and it will be interesting to see what we find, given that they are using different practice models and settings. It’s all about extending the evidence base for practice that supports the professionalism of disability employment.

?Where am I heading with this? We're in the midst of an evolution spurred in part by the Disability Royal Commission, the NDIS Review and the re-invention of DES. In that sense, the entire disability employment ecosystem is in flux, and I do not doubt that expectations are high.

?We aren't heading for the Big Bang many people would like. Our systems are complex, and in reality, no government, present and past, has ever been brave enough to take a big swing at it and start from scratch. That piece of work would take years and a significant investment; even the proposed Centre of Excellence won't solve that. It will have to deal with the realities of competing agendas from so many parties all vying for influence and a slice of the pie. This may have the effect of making it a small “c” centre if the government isn’t brave enough to ensure that it focuses on life’s reality for the broader community and not simply be a conduit for influence collectors.

?The DRC, the NDIS Review, etc., are just the latest chapters in a long line of reviews that go back to the New Directions Report and probably beyond. Systems are complex, and the disability employment system is no less so. They are nuanced and require a nuanced approach in order to be effective nationally. At the moment, our systems are a big brush at a time when we need an artist's approach.

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