Implementing individual placement and support (IPS): the experiences of employment specialists in the early implementation phase of IPS in Northern Norway. The IPSNOR study

BMC Psychiatry

David McDaid¹  Oda Lekve Brandseth²  Line Rasmussen²  Beate Brinchmann³  Arnstein Mykletun⁴  Cathrine Moe⁵  Marit Borg⁶  Eóin Killackey⁷  Miles Rinaldi⁸ 

[1]Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK

[2]Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway

[3]Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway

[4]Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway

[5]Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway

[6]Department of Community Medicine, UiT – The Arctic University of Norway, Tromsø, Norway

[7]Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway

[8]Division for Health Sciences, Norwegian Institute of Public Health, Oslo, Norway

[9]Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway

[10]Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway

[11]Nordland Hospital Trust, Centre for Work and Mental Health, Bodø, Norway

[12]University of South-Eastern Norway, Drammen, Norway

[13]Orygen, Melbourne, Australia

[14]Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia

[15]South West London and St George’s Mental Health NHS Trust, London, UK

关键词: Early phase;    Employment specialist;    Implementation;    Individual placement and support;    Mental illness;    Rural;    Supported employment;    Vocational rehabilitation;    Work;   

DOI  :  10.1186/s12888-021-03644-x

来源: Springer

【 摘 要 】

BackgroundFor decades there has been a continuous increase in the number of people receiving welfare benefits for being outside the work force due to mental illness. There is sufficient evidence for the efficacy of Individual Placement and Support (IPS) for gaining and maintaining competitive employment. Yet, IPS is still not implemented as routine practice in public community mental health services. Knowledge about implementation challenges as experienced by the practitioners is limited. This study seeks to explore the experiences of the front-line workers, known as employment specialists, in the early implementation phase.MethodsQualitative data were collected through field notes and five focus group interviews. The study participants were 45 IPS employment specialists located at 14 different sites in Northern Norway. Transcripts and field notes were analysed by thematic analyses.ResultsWhile employment specialists are key to the implementation process, implementing IPS requires more than creating and filling the role of the employment specialist. It requires adjustments in multiple organisations. The new employment specialist then is a pioneer of service development. Some employment specialists found this a difficult challenge, and one that did not correspond to their expectations going into this role. Others appreciated the pioneering role. IPS implementation also challenged the delegation of roles and responsibilities between sectors, and related legal frameworks related to confidentiality and access. The facilitating role of human relationships emphasised the importance of social support which is an important factor in a healthy work environment. Rural areas with long distances and close- knit societies may cause challenges for implementation.ConclusionThe study provides increased understanding on what happens in the early implementation phase of IPS from the employment specialists’ perspective. Results from this study can contribute to increased focus on job satisfaction, turnover and recruitment of employment specialists, factors which have previously been shown to influence the success of IPS. The greatest challenge for making “IPS efficacy in trials” become “IPS effectiveness in the real world” is implementation, and this study has highlighted some of the implementation issues.

【 授权许可】

CC BY