Vocational support in mental health service delivery in Australia

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:

• Mental health services
• mental illness
• health care reform
• supported employment
• outcomes
• Individual Placement and Support
• vocational rehabilitation

Acknowledgements

The researchers acknowledge the data extraction assistance of Tony Pinzoni, and the management support of champions Bridget Organ, at St Vincent’s Hospital (Melbourne), Mental Health Service, and Laura Collister, and previously Tracey Swadling, at MI Fellowship (now called Wellways) in Australia.

Disclosure Statement

No potential conflict of interest was reported by the authors.