Decision‐chain integrity and sustainment of the individual placement and support model: An embedded single case study in Finland

Abstract

AbstractThe individual placement and support (IPS) model is an evidence‐based practice proven effective in aiding individuals with mental disorders to achieve and maintain competitive employment. This study examines how policy and structural factors are perceived to influence the model's sustainment as routine practice after a national development project in Finland. We aim to identify critical dimensions related to decision‐making at the national, regional, and local organisational levels. We used a qualitative single‐case approach, analysing 21 stakeholder interviews and nine administrative documents. We conducted abductive thematic analyses. We report the results in compliance with the COREQ guideline. Our analysis identified three main external contextual influences affecting service sustainment: (1) System‐Level Planning—the coherence of formulation and execution of facilitative strategies across different administrative levels; (2) Political Decision Making—the recognition of inception points of policy change and the ability to set the IPS model on a broader policy agenda; and (3) Stakeholder Engagement and Collaboration—the need for mutual goals and collaborative platforms. Strategic planning, governance decisions, and stakeholder involvement affect local‐level decisions on the IPS model's sustained implementation. This research introduces the concept of ‘Decision‐Chain Integrity’, highlighting the alignment of strategies and their implementation across different levels of administration as a pivotal factor in producing sustained change in the service system.