Challenges of integrating employment services with mental health services as part of the ‘Individual placement and support’ approach

Abstract

ABSTRACT One of the main challenges in supporting people with mental health problems in gaining employment is the mismatch between their needs and the services provided. Often, the mental health and the employment sector operate independently of one another, with different objectives and approaches, and under different government authorities. Individual Placement and Support (IPS) is an evidence-based approach to helping people with severe mental illness achieve competitive employment. A central principle in IPS is the integration of IPS with mental health services. This paper examines the challenges of integrating IPS and mental health services (MH) in a cross-sectoral setting in Denmark. Four IPS units and collaborating MH services were studied over a period of four years. The paper focuses on the MH managers’ experiences of cooperation with IPS employment specialists. Semi-structured interviews with 12 managers from MH services were conducted and analysed using a combined ‘pattern matching and pattern inducing’ technique. Findings were interpreted using an institutional logic approach, focusing on the material and symbolic aspects of the cooperation. The institutional logic approach conceives of IPS as a logic that organizes the time and space of daily activities, and motivates and legitimizes these practices as evidence-based. MH managers regarded IPS as a parallel service that supplemented treatment, and they valued the work of the IPS specialists as meaningful for the client’s recovery. They emphasized the informality in the cooperation with IPS specialists, while IPS was expected to fit into the existing organization of the treatment service.