Growing the availability of evidence based supported employment
| Published date | 01 November 2019 |
| Date | 01 November 2019 |
| DOI | https://doi.org/10.1108/MHSI-11-2019-062 |
| Pages | 145-148 |
| Author | Rachel Perkins,Julie Repper |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Rachel Perkins and Julie Repper
Growing the availability of evidence based supported employment
The majority of people with mental health challenges want to have a job (Rinaldi and Hill, 2000;
Secker et al., 2001) yet, among people using secondary mental health services, only 8 per cent
are in employment (see IPS Grow, 2018). It does not have to be this way. We know that there are
effective ways of supporting people with more serious mental health challenges to get and keep
real jobs in open employment. Developed in the 1990s in the USA (Becker and Drake, 1993;
Drake and Becker, 1996), at least 16 randomised controlled trials in different countries have
demonstrated that Individual Placement and Support (IPS) evidence based supported
employment is effective in enabling between 40 and 60 per cent of people with serious
mental health challenges to gain and sustain employment (see Bond et al., 2008). As a result the
2015 NICE quality standards for psychosis and schizophrenia[1] clearly indicate that this
evidence based supported employment support should be provided for everyone who wishes to
find or return to work. There is also increasing evidence that IPS is equally effective for people
experiencing what have been described as “common”mental health challenges like anxiety and
depression (Te Pou, 2014; Reme et al., 2018).
Despite the strong evidence base and NICE guidance the reality is that most people who wish to
work do not have access to the support they need to do so. Although the first IPS service in the
UK was established in 1999/2000 such services are available to very few people. The 2018
National Service User Survey in England (CQC, 2018) showed that only 23 per cent said they had
definitely received support to find or keep work –a significant fall from 27 per cent in the previous
year. At the same time, 47 per cent said they would have liked help but did not get it –a rise from
43 per cent in 2017.
But things are changing.
The Five Year Forward View Implementation Plan (NHS England, 2016) requires a doubling of
access to IPS from 10,000 people per year in 2017 to 20,000 in 2021 and additional (time limited)
funding has been provided to facilitate this. The NHS long term plan (2019) makes it clear that
this increase must continue:
Through increasing access to IPS, the NHS will support an additional 35,000 people with severe
mental illnesses where this is a personal goal to find and retain employment by 2023/24, a total of
55,000 people per year. This investment will support people to get back into or gain access to
employment. It will improve outcomes and recovery for people, meaning they spend less time in
hospital and live healthier, happier lives. By 2028/29, we aim to extend this to 50% of the eligible
population to benefit up to 115,000 people. (NHS England, 2019, p. 117)
It should be noted that this is not about forcing people into work with threats of withdrawal of
welfare benefits but ensuring that those whose “personal goal is to find and retain employment”
have access to the evidence based support they need to do so.
Across England many IPS services are being established all of which are based on 8 core,
evidence based, principles[2]:
1. It aims to get people into open competitive employment “real jobs”.
2. It is open to all those who want to work […] with no exclusions based on diagnosis, health
condition or benefits claim.
DOI 10.1108/MHSI-11-2019-062 VOL. 23 NO. 4 2019, pp. 145-148, © Emerald Publishing Limited, ISSN 2042-8308
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MENTALHEALTH AND SOCIAL INCLUSION
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Editorial
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