Feasibility of a prototype for Individual Placement and Support (IPS) - Waitemata District Health Board (DHB)

This study is designed to pre-test and pilot the fidelity, reach and retention, activities and outcomes, and cutural fit of an Individual Placement and Support (IPS) prototype. IPS is a well specified integrated supported employment scheme for people with severe mental illness based upon eight principles: - Competitive employment is the primary goal; - Everyone who wants it is eligible for employment support; - Job search is consistent with individual preferences; - Job search is rapid: beginning within one month; - Employment specialists and clinical teams work and are located together; - Employment specialists develop relationships with employers based upon a person’s work preferences; - Support is time-unlimited and individualised to both the employer and the employee; - Welfare benefits counselling supports the person through the transition from benefits to work (Becker, Swanson, Reese, Bond, & Mcleman, 2015). Two employment specialists will work within a mental health team. On average each FTE can provide services to 25 clients at one time or 40-60 over a period of a year. The sessions will be face to face withthe employment specialist and will be tailored to the invidual. The frequency and duration of the individual sessions with the employment consultant will vary depending on the needs of the client, but will continue for up to niine months. Delivery will acknowledge and consider the situation of each participant and use an approach that is appropriate, individualised and delivered in a manner sensitive to participant needs. The service will be delivered in an environment that is positive and encourages achievement. Existing Provider care delivery processes will be utilised wherever possible. Employment specialists will have extensive local networks with support services, including counselling and budgeting services, employers, industry groups and training providers. They will source vacancies from their own employer networks or listed Work and Income vacancies. Activities will include regular face-to-face engagement with the participant, under-taking a work assessment, support with job development/job placement and providing job coaching and follow-along support Waitemata DHB plan to undertake a 'high fidelity' roll-out of IPS, focusing on people aged 18-35 years with severe mental health conditions who access mental health services at Waitemata DHB. The intervention will provide individual tailored support to people who experience a mental illness to assist them into employment. The approach tries to place people into the open labour market. People are placed quickly in normal work settings where they receive intensive on-the-job support. The theory of change for the IPS initiiative is that having imployment specialists integrated into a treatment setting maximises engagement with the focus on early job search activities. The intervention takes place in an integrated health care setting. The employment specialists and clinical teams work and are located together. Progress on participants will be regularly reviewed and data collected on attendance and participation. IPS supported employment programs help anyone who expresses the desire to work. All clients interested in working have access to IPS services regardless of job readiness factors, substance abuse, symptoms, history of violent behaviour, cognition impairments, treatment non-adherence, and personal presentation. Benefits advice, also called work incentives planning, is part of the employment decision-making process and will ensure that people understand the financial implications of employment in relation to their Work and Income benefit.. Employment specialists ensure that people are offered comprehensive and personalized benefits planning, which includes information about how work may affect their benefits and about work incentives in order to make informed decisions about job starts and changes. Employment specialists help people look for jobs soon after entering the program, instead of requiring extensive pre-employment assessment and training, or intermediate work experiences (for example, prevocational work units, transitional employment, agency-run businesses or sheltered workshops). Support from the employment specialist, and members of the mental health treatment team, continues as long as clients want assistance upt to a year after commencement. Job supports often occur outside of the work place and can include help from other practitioners, family members, coworkers, and supervisors. Jobs are seen as transitions. People commonly try several jobs before finding a job they want to keep. Each job is viewed as a positive learning experience. If a job is a bad fit for any reason, an employment specialist offers to help the person find a new job based upon lessons learned. IPS supported employment follows the philosophy that all choices and decisions about work and support are individualized, based on the person’s preferences, strengths, and experiences. In IPS, everyone is encouraged to carry out the job search and job performance as independently as possible, and employment specialists offer assistance as needed to support people in their working lives. Assistance with career advancement planning is offered. For some people, career development might focus on a different job that the person anticipates will be more enjoyable. For others, career development could include specific vocational training or education through credit-bearing or certified educational programs.