All Change Is Difficult, No Matter How Long You Put It Off: Making Mental Health Systems of Care "High Performers" in Employment Outcomes

This article reviews the state-employment-system design work resulting in the creation of the High Performing States model of analysis. We apply this analysis to the work needed to improve mental health systems' ability to create structures, funding, and policies to promote employment. We derive recommendations from this analysis on how best to ensure these policies and improve funding mechanisms to obtain better employment outcomes for people experiencing serious mental illnesses. Policy changes cannot stand the test of time without concomitant leadership, training, advocacy, enthusiasm, and high expectations from all parties involved.