Mental health, social inclusion and the development of vocational services in the NHS – what can be learnt?
| Published date | 02 July 2019 |
| Date | 02 July 2019 |
| DOI | https://doi.org/10.1108/MHRJ-09-2018-0027 |
| Pages | 133-143 |
| Author | Mark Bertram |
| Subject Matter | Health & social care,Mental health |
Mental health, social inclusion and the
development of vocational services in the
NHS –what can be learnt?
Mark Bertram
Abstract
Purpose –The purpose of this paper is to describe the learning from a historical NHS vocational
service development that focused on: mental health, employment and social inclusion –in an inner city
area –involving service users, staff and commissioners.
Design/methodology/approach –It is a descriptive case study. A ran ge of historical document s
was content analysed a nd described through a first-person narrat ive: service user cons ultations,
service specifications, audit records, outcome frameworks, internal service evaluations and
published literature.
Findings –When vocational NHS service developments are grounded in what service users say helps them
(person-centred, networked and co-ordinated approaches) the evidence indicates people can achieve their
vocational goals.
Research limitations/implications –The range of documents descri bed is factual, althoug h the
learning insights fro m some of the service devel opments are based on pers onal judgements. The
author was the responsible manager –personal bias is high. There is not enough robust evidence to
warrant generalisation.
Practical implications –When employment and social inclusion are prioritised, as core business in NHS,
outcomes and health impact can increase. Greater detail is needed from healthcare policy makers –focusing
on who exactly should undertake this work and what the key commissioning social inclusion performance
indicators are.
Originality/value –The bulk of literature on employment support focuses on promoting evidence from
one model: individual placement and support. Evidence here indicates a broader range of activity (education,
training and volunteering) can have value and health impact.
Keywords Employment, Mental health, Social inclusion and employment
Paper type Case study
Introduction
Literature that describes the development and role of vocational services in secondary mental
healthcare systems is largely non-existent. These services remain –at best, random and
patchy –despite there being research evidence that participation in work, education or training
can improve and sustain peoples well-being.
This paper describes a historical NHS service development, from the perspective of a
manager. In my experience, vocational services are always very different. Their type, size and
aims are determined by the personalities, priorities and beliefs of local management teams, and
what commissioners will support. Here, I tell a story by describing what we did during (2006–
2012) as a large inner city NHS mental health trust –in partnership with commissioners, service
users and staff. Ke y aspects of learning from facilitati ng and evaluating an integrated rang e of
vocational services are highlighted –as a whole system –that achieved a wide range of social
inclusion outcomes.
Received 4 September 2018
Revised 29 April 2019
Accepted 24 May 2019
The author thanks all the people
who courageously voted with their
feet and made these journeys.
People who helped out are:
Patrick Gillespie, Denis O’Rourke,
Shaun Williams, Sarah McDonald,
Kevin Poulton, Robin Harrison,
Manju Rajput, Kate Reaney, Paul
Goddard, Joan Kennedy and
Venus Caesar.
Mark Bertram is based at
Vocational Services, South
London and Maudsley NHS
Trust, London, UK.
DOI 10.1108/MHRJ-09-2018-0027 VOL. 24 NO. 2 2019, pp. 133-143, © Emerald Publishing Limited, ISSN 1361-9322
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MENTALHEALTH REVIEW JOURNAL
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