Creating a culture of employability in mental health
| Published date | 05 March 2014 |
| DOI | https://doi.org/10.1108/MHSI-03-2014-0007 |
| Pages | 29-34 |
| Date | 05 March 2014 |
| Author | Naomi Boycott,Justine Schneider,Michael Osborne |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Creating a culture of employability in
mental health
Naomi Boycott, Justine Schneider and Michael Osborne
Dr Naomi Boycott is a Clinical
Psychologist, based at
CLAHRC-NDL,
Nottinghamshire Healthcare
NHS Trust, Nottingham, UK.
Professor Justine Schneider is
based at School of Sociology
and Social Policy, Institute of
Mental Health, University of
Nottingham, Nottingham, UK.
Michael Osborne is a Service
User Representative,
based at CLAHRC-NDL,
Institute of Mental Health,
Nottingham, UK.
Abstract
Purpose – The purpose of this paper is to draw out the lessons learned from the implementation of the
Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental
health teams; one “standard”CMHT, and one early intervention in psychosis (EIP) team.
Design/methodology/approach – These inferences are based on the evidence from a four-year studyof
IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to
run a RCT looking at the impact of psychological input as an adjunct to IPS alone.
Findings – In attempting to introduce IPS to mental health teams in Nottingham the authors came across
numerous barriers, including service reorganisation, funding cuts and the wider context of recession.
Differences were observed between mental health teams in the willingness to embrace IPS. The authors
argue that this variability is due to differences in caseload size, recovery priorities and client profiles.
The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS
fidelity reviews can make a positive difference to the implementation process.
Practical implications – The experience suggests that setting up an IPS service is possible even in the
most challenging of times, and that EIP services may be a particularly fertile ground for this approach.
The authors also discuss potential barriers to implementing new services in mental health teams.
Originality/value – This paper will be of value to service development and the science of implementation in
mental health.
Keywords Implementation, Employment, EIP, IPS, Psychological support, Severe mental illness
Paper type Viewpoint
Introduction
In the landmark study Marienthal: The Sociography of an Unemployed Community, Marie
Jahoda et al. (1972) describe a culture of unemployment in the early 1930s, following factory
closures on an Austrian village. This research has influenced our understanding of history in
that part of Europe, as well as affecting policy on poverty, ill-health and deprivation. In addition,
Marienthal signposted the direct effects of unemployment on people of working age.
The authors describe the residents’ unlimited free time as “a tragic gift” (p. 66) and say that “no
longer under any pressure, they undertake nothing new and drift gradually out of an ordered
existence”. This loss of structure to the day (which appeared mainly to affect the men) together
with the loss of social contact at work (which appeared mainly to affect the women) had
detrimental effects over and above the economic pressures, while the entire population
manifested psychological ill-effects that today we might characterise as depression. During her
illustrious academic career as a sociologist, Jahoda went on to elucidate five “latent” benefits of
employment over and above financial rewards: time structure, social contact, collective effort or
purpose, social identity or status, and regular activity. These canbe seen as human needs that
are normally met at work.
For a person with the social identity of “psychiatric patient” – which is stigmatised and negative,
regular activity, time structure and social contact may have psychological benefits, and there is
DOI 10.1108/MHSI-03-2014-0007 VOL. 18 NO. 1 2014, pp. 29-34, CEmerald Group Publishing Limited, ISSN 2042-8308
j
MENTAL HEALTH AND SOCIAL INCLUSION
j
PAGE 29
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