Analysis of barriers and facilitators of existing programs in Belgium for the purpose of implementing individual placement and support (IPS).

Abstract

Objective:The goal was to build a strategy before implementing individual placement and support (IPS) in the country, leveraging existing facilitators and mitigating, as much as possible, identified barriers. Methods: A qualitative study called "group analysis" was conducted: Over 2 days, two groups of stakeholders were invited for a whole-day workshop to collect information on facilitators and barriers faced by existing programs. Results: Many perceived facilitators were related to some guidelines or key principles of the IPS model. Main barriers were lack of long-time job support, lack of funding, lack of communication between stakeholders, social or financial insecurity of the beneficiary, denial of their own disease, high hiring selectivity, and on-the-job requirements by employers looking to maintain a competitive workforce. The four points of divergence between participants in relation with IPS were (a) the (dis)advantages of internships and trainings compared to standard work contracts, (b) the risk associated with the communication of a medical diagnosis and the disclosure issue, (c) the best time to start a job search or to return to work, and (d) whether priority should be given to the search for an adapted job or the adaptation of existing jobs to the specific needs of the beneficiaries. Conclusion: The IPS model appears as a potential solution to many issues faced by stakeholders in Belgium in charge of helping people with moderate to severe mental illness to find a job. A stronger legal framework could help to achieve the integration of such model. Impact and ImplicationsThe group analysis method is a useful method to predict how an employment programindividual placement and support (IPS)-will be received. In the case discussed in this article, the method enabled the identification of points of convergence between participants and points of tension that could persist after the implementation of the IPS program. The confrontation of points of view also helped to get deeper insights on certain themes than in individual interviews. This has the advantage of allowing decision makers who wish to initiate change not only to see how to build on existing strengths but also to analyze how to reduce the identified weaknesses.

Sustainable employability in Supported Employment and IPS interventions in the context of the characteristics of work and perspectives of the employers: a scoping review protocol

“…The sustainable employment outcomes and cost-effectiveness of SE and IPS have been well reported 10 15–17. Besides the effectiveness of these approaches, research has focused on the quality criteria for the implementation of the SE/IPS method and in diverse work life and social security contexts 18–22. Also, various target groups like people with severe mental illness, spinal cord injury and affective disorders have been in the focus of the research 5 6 16.…”

External context in individual placement and support implementation: a scoping review with abductive thematic analysis

“…The policy of allocating decision-making and management of services to local authorities was reported to hinder adoption due to low prioritization at the local level [41]. Laws and regulations related to sharing client information and access to data and mandated use of multiple information systems were reported to complicate the implementation of IPS [44,57,58]. Legally mandated limitations on using data could be circumvented by strategic actions by the administrative authorities or local leaders [18,44].…”

“…Payment models that were based on specific medical diagnoses rather than outcomes [62,63] and separate or divided sources of funding [18,41,42,51] hindered the implementation. Set or predefined funding duration to funding [41,46,57,59,64], restrictions on financing employment services as health services [51,65], and rules that penalize short employment contracts [51] were also perceived to impact the quality of implementation negatively. Funding contracts covering a broader set of programs could include criteria conflicting with the IPS fidelity criteria [50,63].…”

Long-Term Effects of the Individual Placement and Support Intervention on Employment Status: 6-Year Follow-Up of a Randomized Controlled Trial

“…Often, the ethical part of the mental disease is not considered. Qualitative analysis by de Greef showed that the risk of disclosure of the medical diagnosis might represent a potential issue for people with mental conditions seeking employment (85). Lastly, since the spread of the IPS model, different variants and types were invented to fit the needs of specific population groups (50,86,87), explaining the individualistic approach to the implementation of this strategy and an opportunity for further development improvements and developments (88).…”