Program gets Upper Valley residents with mental health issues into the workforce

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    Todd Balise, of West Central Behavioral Health, left, assists Nikki Kristl, 29, of Newport, right, as she studies a practice licensed nursing assistant exam in a supported employment appointment in Claremont, N.H., on Monday, Nov. 15, 2021. The program helped Kristl, who has multiple mental health diagnoses, prepare for employment as a cashier, and work toward her long term goal of training for and finding a job as an LNA in home health care. "I'm a success story," said Kristl. "I've never been this proud of myself." (Valley News - James M. Patterson) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — James M. Patterson

Valley News Staff Writer
Published: 11/19/2021 9:29:08 PM
Modified: 11/20/2021 6:34:14 AM

CLAREMONT — Nicole Kristl, a 29-year-old Newport, N.H., resident, has lived with various mental health conditions for decades.

In spite of her illness and with help from West Central Behavioral Health’s supported employment program, Kristl worked in recent months as a bagger at Shaw’s. That employment ended due to a flare-up of a non-work-related hand injury. Now, while she waits for her hand to heal, she is studying to become a licensed nursing assistant with West Central’s help.

“That’s my dream job, and we’re getting it going,” she said.

Kristl, who has been home from an inpatient mental health treatment program since February, is one of the approximately 40 participants in West Central’s supported employment program. The program, which first began in the 1980s, aims to help people with serious mental illness get and stay employed.

“We struggle if we don’t have something meaningful” to do, said Dr. Bob Drake, who was West Central’s medical director in the late 1980s.

At the time of the West Central program’s founding, New Hampshire officials were seeking to meet a demand from people with mental illness for help with employment, Drake said. Through research in New Hampshire and Washington, D.C., Drake found that supported employment, a model that comes from the developmental disabilities field, produced the best results.

“I think it works because it’s simple and commonsensical,” said Drake, who has since worked to help the model spread across the United States and to other parts of the world.

An employment specialist asks questions of clients to understand what type of job they would like and how many hours they would like to work. From there, the specialist looks for a match. Some especially creative matches Drake has encountered include a former heroin user who found work helping draw blood in people with difficult veins and a man, who often screamed due to his psychosis, who found work at a sawmill where employees all wore protective ear coverings.

“It’s all about finding the right job fit for the person (and) then supporting them on the job,” he said.

While jobs are currently available nearly everywhere, it’s “still just as difficult as it’s always been to get the right job,” Drake said. “Supported employment works because all of the effort that goes into making sure the person’s skills match the specific job.”

Kristl’s mental health diagnoses are many and varied, including schizoaffective disorder with bipolar traits; depression; anxiety; explosive personality disorder; obsessive-compulsive disorder; and post-traumatic stress disorder. To manage her illnesses, she receives regular treatment through West Central counselors, medication and group therapy. Her work with supported employment also plays a role.

“It makes me feel happy and proud of myself,” she said.

She meets with Todd Balise, a supported employment coordinator, once a week at one of West Central’s Claremont offices. There, they go over pretests and talk through strategies for how to navigate situations that might be difficult for her to navigate because of her illness.

Wendy Rastallis, Kristl’s mother and guardian, sometimes attends the sessions.

Balise helped Kristl find the bagging job and helped talk through any challenges she might face in advance.

“I think if any other employees or managers speak to her rudely, that’s very hard for her,” Rastallis said. It’s “hard work for her to handle that the right way.”

The goal is for Kristl to navigate such difficulties on her own as much as possible.

Balise said his job is to work to address clients’ individual needs, which can be highly varied. Some people struggle to find a suitable job or with job interviews, while others need support during onboarding. With clients’ permission, he will sometimes work with employers to help them understand how to support employees with mental illness.

Balise tries to help clients reach their goals, financial and otherwise.

“For someone like Nikki, (she’s) really trying to achieve some personal development and personal well-being,” he said.

So far, the program seems to be having that effect.

“I have come a long way,” Kristl said.

Once her hand has healed, Kristl plans to take a test and begin clinical work. Eventually, she would like to work in a nursing home, as she enjoys spending time with older people.

“I’m going to go and pursue my dream,” she said.

Nora Doyle-Burr can be reached at or 603-727-3213.

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