Abstract
To provide increased understanding about how work applicants, employment specialists, social workers in the welfare service and clinicians in mental healthcare service experience participating in individual placement and support (IPS). We searched in several databases and identified 17 studies published from 2007 to 2017 in Sweden, USA, Canada, UK, Australia and Denmark, and applied meta-ethnographic reinterpretation and synthesis. The employment specialists followed the core ideas of IPS, where work is seen as a way to recover. They saw the work applicants' preferences and needs as important for health and well-being, and crucial for successful work rehabilitation. In order to reach these goals, they offered a personal relationship to the work applicants. Work applicants clearly appreciated this personalised recovery-oriented mindset. Furthermore, work applicants needed the employment specialists as culture brokers between health-related questions and the expectations met in the labour market. Social workers lacked resources to such personalised support, and they were under demand of welfare regulations made for a 'train then place' model, which conflicts with the view that work leads to recovery as IPS sees it in their 'place then train' model. The scarce knowledge of the clinicians' experiences in the present study suggests that they are sceptical to work as a way to recover, which is in conflict with IPS. The work applicants highlighted the significance of the individualised support they received. Social workers and some clinicians found it difficult to provide this important personalised support towards work. Conflicting mindsets between the traditional gradual work rehabilitation paradigm and the IPS approach as a way of recovering might explain these frustrations and distance. Recommendations for practice. An improvement of IPS may depend on more cooperation based on an acceptance of the recovery-oriented mindset, which for some will mean an acceptance of new knowledge.
Highlights
Employment is a priority and an important part of recovery for many people with severe mental illness (SMI) (1)
This change depends on an acceptance of the recovery-oriented mindset, which for some will mean an acceptance of new knowledge
The work applicants highlighted the significance of the individualised support they received
Summary
Employment is a priority and an important part of recovery for many people with severe mental illness (SMI) (1). IPS follows a strict manual consisting of a 25-item fidelity scale, guiding implementation (8). This manual emphasises the importance of coupling vocational assistance with mental health treatment (9). Employment specialists collaborate with practitioners in the mental health treatment team as well as social workers in the local welfare and employment service (9). This last-mentioned service has a ‘welfare-to-work orientation’ and exists in many European countries, such as Denmark, Norway, the UK, Finland, Germany and the Netherlands (10). In a fully implemented IPS service, employment specialists and mental health clinicians work for the same agency and share office space. Together with social workers in the welfare and employment service, they develop strategies to help the work applicants to find jobs, and they share responsibilities in supporting the person who is working
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