Vocational support in mental health service delivery in Australia

Scand J Occup Ther. 2019 Dec;26(7):535-545. doi: 10.1080/11038128.2018.1498918. Epub 2018 Oct 9.

Abstract

Background: Individuals experiencing severe and persistent mental illness report a desire to gain and sustain work. Individual Placement and Support (IPS) is an evidence-based approach to vocational rehabilitation to support competitive employment outcomes.

Aim/objective: This study aimed to evaluate whether a joint-governance management partnership, between a clinical adult mental health and an employment service, could deliver a sustained IPS program in Australia.

Materials and method: The methodology entailed a Clinical Data Mining approach, to examine records from seven years of implementation of IPS in one setting within an Australian public mental health service context.

Results/findings: Despite the prevalence of schizophrenia spectrum diagnoses and an older mean age (39 years), indicating that a large proportion of the cohort had experienced serious mental illness for over twenty years, findings were that 46.3% of participants achieved employment.

Conclusions: This is an excellent result and is comparable to the only randomised control trial, with adult services, in the Australian context, which found a 42.5% employment rate possible under IPS compared with just 23.5% with referral to external employment services.

Significance: More extensive trialling of IPS across clinical services is required, in Australia and internationally, including fidelity protocols, for knowledge translation to be achieved.

Keywords: Individual Placement and Support; Mental health services; health care reform; mental illness; outcomes; supported employment; vocational rehabilitation.

MeSH terms

  • Adult
  • Australia
  • Employment, Supported / organization & administration*
  • Female
  • Humans
  • Male
  • Mental Disorders / rehabilitation*
  • Mental Health Services / organization & administration*
  • Middle Aged
  • Rehabilitation, Vocational / methods*
  • Young Adult