Mental health occupational therapy and supported employment

Tawanda Machingura,Chris Lloyd

doi:10.1108/ijot-02-2017-0004

Abstract

Purpose The individual placement and support (IPS) model is an evidence-based approach to employment support for people with severe mental illness that functions by co-locating an employment consultant from the local disability employment service within a community mental health team to assist service users to find work. This paper aims to examine the unintended impacts of implementing IPS on occupational therapy practice and offer some suggestions. Design/methodology/approach The authors performed a narrative literature review on the IPS model, employment and occupational therapy. Authors then analysed and discussed impact on occupational therapy practice and concluded by making suggestions based on current evidence and practice. Findings The authors concluded that implementation of IPS has resulted in some unintended changes of practice in mental health with occupational therapists taking a less active role in enabling employment outcomes than previously. This paper concludes by calling upon occupational therapists to re-establish their role of enabling employment. Originality/value This paper offers an original viewpoint on employment and occupational therapy based on current evidence and authors’ expertise.

Highlights

Occupational therapy and employment Meaningful employment has been shown to improve self-esteem, increase personal empowerment and social contact, social identity and status (Marwaha et al, 2014)
This paper offers an original viewpoint on employment and occupational therapy based on current evidence and authors’ expertise
Despite the value that work has for people with a mental illness, competitive job tenure remains relatively brief

Summary

Introduction

Occupational therapy and employment Meaningful employment has been shown to improve self-esteem, increase personal empowerment and social contact, social identity and status (Marwaha et al, 2014). Clinicians need to encourage hope for recovery by being aware of the potentially damaging implications of one’s own lack of hope for the service user’s recovery, being someone who believes in recovery, facilitating access to narratives of recovery and providing new ways of understanding difficulties (Hobbs and Baker, 2012) This is important in the area of employment where traditionally many people with a mental illness were not supported in the area of finding work. Further work has been conducted in the area of disclosure, and McGahey et al (2016) conducted a research project which looked at the usefulness of the Personal Management Plan which gives people with a mental illness the opportunity to talk in detail about their abilities in the workplace, regardless of their insight into diagnosis This plan enables service users to maintain a sense of control over their own information and labelling of their experience. Occupational therapists have developed standardised assessment tools which may be useful in the provision of IPS services to better understand individual clients’ perspectives of psychosocial and environmental impacts on work (Martin et al, 2011)

Mental health occupational therapy

Recommended occupational therapy role

Advocate for people with a mental illness

Conclusion