Innovative Policy 2013 on Employment
UK’s individual placement and support system
|Beneficiaries targeted||Persons with mental health conditions in (primary and) secondary care.|
|Responsible body||Department of Health, National Health Services, Department for Work and Pensions|
|Stakeholders||Public sector (National Health Services)|
Piloted in the UK in 1998, Individual Placement and Support (IPS), also known as evidence-based supported employment, addresses the problem that the majority of mental health service clients do not receive help with finding paid work. Based on the rationale that everyone is capable of working in the open labour market if the right work is found, the programme, most importantly and unlike the traditional sequential rehabilitation approach, embeds employment specialists in clinical treatment teams so that clinical treatment and employment support are integrated and occur in parallel. The generalizability of IPS has been demonstrated.
Focusing on abilities
The overriding philosophy of IPS is that anyone is capable of working competitively in the community if the right kind of job can be found and the right kind of support provided.
Adherence to a principled methodology
Principles include competitive employment as the primary goal, employment support along with clinical treatment and respect of the individual’s choice.
Sustainable use of financial resources
The savings for inpatient costs, over an 18-month period, were calculated at around £6,000 per person, with evidence suggesting that further, long-term savings could accrue.
Sixteen randomised controlled trials have demonstrated that IPS achieves far superior outcomes across varying social, economic and welfare contexts.
Individual Placement and Support is a proven methodology, developed in the USA in the ‘80s, whereby employment specialists are integrated into mental health teams to support service users to return to work. In 1998, a pilot programme in the National Health Service trust of South West London was implemented and proved its successfulness, which led to the introduction of IPS into a series of policy documents recommending its use: the Mental Health and Social Exclusion Report of the Social Exclusion Unit of the UK Office of the Deputy Prime Minister in 2004, the Commissioning Guidance of the UK Department of Health in 2006, as well as the Action Plan for Social Exclusion of the Prime Minister’s Strategy Unit of the UK Cabinet Office in 2006. Most importantly, in 2007, the number of secondary mental health services users in employment became a national indicator on which all mental health trusts needed to report data. In 2009, an independent review of the Department for Work and Pensions reiterated the IPS Guidance to Commissioners, which was reaffirmed by the Government’s strategy No Health without Mental Health and its supporting document, where IPS was recommended as an effective vocational support and skills development service. The next step was to set up the centre of excellence (2009) and a programme to train employment specialists at the London Metropolitan University.
«By revolutionizing traditional thinking, Individual Placement and Support is a compelling bridge for most people with psychosocial disabilities who have always wished to find and retain employment. »
Individual Placement and Support helps persons with psychosocial disabilities in (primary and) secondary care to get open, competitive employment, commensurate with their interests and preferences as quickly as possible, and provides all the support, (ideally) as long as necessary, that both the individuals and their employers need to make a success of the employment. IPS consists of the adherence to seven principles. The most important principle is, unlike the traditional sequential approach, to embed employment specialists in clinical treatment teams so that clinical treatment and employment support are integrated and occur in parallel. The other principles include competitive employment as the primary goal, rapid job search consistent with individual preferences, time-unlimited and individualized support to both the employer and employee, and benefits counselling. A typical IPS case management process follows five steps: firstly, building an understanding of the service user’s needs; secondly, developing a clear vocational profile; thirdly, setting up of a vocational action plan; fourthly, early job search and placement; and, finally, giving support ensuring the individual sustains employment.
IPS cannot be imposed on mental health trusts because of the decentralized National Health System. Attitudinal barriers amongst mental health staff and lack of funding limit the IPS’s potential.
Nominated by: Ms. Marion WILKINSON, National Disability Authority