196 3457 3 Mental health service users' experiences of returning to paid employmentResearch into mental health and employment has focused largely on people who are unemployed. This paper reports the experiences of 20 clients of employment support agencies who had succeeded in returning to work. A number of barriers to getting back to work were identified, but receiving employment support could enable people to overcome them. There was consistency with previous studies of factors associated with high and low levels of job satisfaction. Even those participants who were less satisfied with their jobs identified benefits and none described any negative effects. The quality of the employment support provided was important, including advice and counselling during the job search, enabling informed choice about disclosure, and support in work.Job retention targets are required for funding programmes in addition to placement targets. Further research into the timing and processes of disclosure and into occupation health screening processes would be helpful. AcknowledgementThe study on which this paper is based was financed by the European Social Fund (http:www.sesami.org.uk) and six supported employment agency partners made contributions in kind. The authors gratefully acknowledge the participation of interviewees and agency staff in this study, and also the constructive contributions made by Miles Rinaldi.
Background: The UK government is advocating the use of supported employment to help people on incapacity benefits back to work, with an emphasis on Individual Placement and Support (IPS) models. However there is little UK-based evidence on the key ingredients of effective support. Aim: To ascertain service users' views of what they found helpful about supported employment. Method: Interviews were carried out with 182 people with severe and enduring mental health problems who were actively engaged with one of the six supported employment agencies included in the study. Results: Three themes emerged: emotional support, practical assistance and a client-centred approach. Conclusion:The findings highlight the importance of the quality of support, particularly through interpersonal dynamics, which go beyond the organizational features emphasized in the IPS model. Declaration of interest:The study was financed from Higher Education European Social Fund Objective 3 resources and the six partner agencies made contributions in kind.
This paper assesses the extent to which the Individual Placement and Support (IPS) approach is currently adopted in England. Interviews based on the Supported Employment Fidelity Scale were conducted with staff from five of the leading providers of supported employment. One provider obtained a good IPS adherence score, three a fair score and one a non-adherence score. Constraints influencing providers' capacity to provide an IPS service related to funding, values and organizational policy. The authors discuss the implications of these constraints in relation to the recent commissioning guidance for vocational services in the UK.
In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group. One hundred and fifty-five users of six English agencies were followed up for 1 year (2005-2006). Information was collected about their employment status, job-seeking behaviour, perceived obstacles to work, self-esteem and hope, and the employment support received. Eighty-two per cent of those working at baseline were still in work a year later. The support agencies helped 25% of unemployed clients into work, a statistically significant increase in the proportion of clients in employment. Gaining employment was associated with improvements in financial satisfaction and self-esteem. There was a trend towards working half time. People who had been out of work longer were less likely to secure employment. No significant associations were found between getting a job and personal characteristics, the quantity of employment support given, nor the recipient's rating of the support offered. The odds of moving into work were nearly four times higher for those people who visited a job centre prior to the start of the study. Clients of specialist agencies rated their provision more highly than clients of pan-disability agencies. These results demonstrate the benefits of working for this group and support the development of employment services with an individualised, rapid placement approach, linked to job centre advice and expert mental health service input. This is consistent with the Individual Placement and Support model, and highlights in addition the importance of job centres for its implementation in England.
Background: A 12-month study of UK supported employment providers found that 77 (54.6%) of the participants in the study remained unemployed, 32 (22.7%) got jobs and 32 (22.7%) retained the jobs they held at the outset. Aims: To explore the impact of moving into employment on service use, earnings, benefits and tax allowances claimed. Methods: Service use and frequency were measured at baseline and 12 months. Comparisons paid particular attention to the differences between people entering work and those who remained unemployed. Costs were analysed from a government perspective (excluding earnings) and a societal perspective (excluding welfare benefits and taxes). Results: People who entered work reduced their consumption of mental health services (p<0.001). However, use of supported employment increased (p=0.04), in contrast to falling use by people who remained unemployed (p<0.001) and those who had been working for more than one year (p=0.002). The increase in earnings for those entering work (p=0.02) was not offset by a similar reduction in benefits. Conclusion: This indicates that mental health services may make savings as a result of their clients engaging in paid work. It raises questions about the optimal nature and organization of employment support for this service user group.
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