Does Individual Placement and Support really ‘reflect client goals’?

Abstract

Individual placement and support (IPS) is considered the only evidence-based practice available for providing vocational support within secondary mental health services. Clients are supported into and during competitive employment, with proponents claiming IPS 'reflects client goals' because most service users want to work. The idea that work improves mental health is also involved in promoting IPS in the U.K. This paper examines the evidential basis for these claims in policy documents and cited research. It additionally draws upon qualitative research in representing the value, meaning and challenges of working described by service users, while briefly considering the U.K. socio-economic context for IPS implementation. Statistical claims that most unemployed service users want to work are found misleadingly applied to IPS because only a minority say they want competitive employment. Discussion centres on the power interests such statistics serve and their role in underpinning the relevance of IPS randomized control trials. Assertions that work improves mental health are found confusing as a result of use of a dual continua model of mental illness and mental health. The internalized moral basis for work acting as a seemingly healthy 'normalization' experience is suggested as paradoxically feeding self-stigma in those who feel they cannot work.