Delivering results through IPS: using IPS to improve job outcomes for people with severe mental...
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Transcript of Delivering results through IPS: using IPS to improve job outcomes for people with severe mental...
Delivering results through IPS:
using IPS to improve job outcomes for people with severe
mental health problems
Jan Hutchinson – Centre for Mental Health
Becky Priest – Centre for Mental Health
Jonathan Allan – Shropshire Council
Dean Atkinson – Coventry City Council
Individual Placement and Support
Jan Hutchinson Director of ProgrammesCentre for Mental Health
The question....
How do we provide effective support for people with mental
health problems to return to work?
The Individual Placement and Support approach
8 evidence-based principles:
1. Eligibility for the service is based on individual choice;
2. Employment support is integrated with treatment;
3. Open ‘ordinary’ employment is the goal;
4. Job search begins rapidly (within 4 weeks);
5. The job finding action plan is individualised;
6. Employers are approached with individuals in mind;
7. Follow-along supports are multiple and not time-limited;
8. Financial planning is provided.
IPS Service Provider
Benefits advice
Rapid job search
Long term employee support
Psychiatric Support and Medication
Psychological Support and CBT
Care coordination and self management support
ReferralsEmployer engagement
It would be nice to have
a job...
Employment support and benefit advice
Integration of IPS
Research Studies
Compare IPS with the best alternative
Many US studies
European study – EQOLISE (2007) London site
Percentage who obtained competitive employment
Elements of fidelity
20-25 clients per Employment Specialist
Do not provide any ‘general’ on employment support
Make 6 face-to-face employer contacts per week
Spend 65% of time out of the office
Integration of employment support with clinical care and treatment
NHS top level support for IPS
Linking with Job Centre and Work Programme
Accurate benefits advice
Planned disclosure of mental health history
Tailoring support for ‘in employment’, not ‘before employment’
Finding jobs according to individual preferences
Support continues for as long as necessary to achieve steady employment
UK Centres of Excellence
Centre for Mental Health carried out independent fidelity reviews and recognises the quality of services in:
Turning evidence into outcomes: The Sussex Experience
Becky Priest, Clinical Specialist OT, Sussex and Associate of Centre for Mental Health,
Sussex
Population of 1.55 million, mix of coastal, urban and rural townsSupports 10,000 people with a mental health problem every year across 3 local authorities 32 clinical teams (including early intervention and assertive outreach)19 employment specialists, employed by Southdown supported employment a not for profit organisationAttached to and embedded within clinical teamsEvery mental health team has a vocational champion
Regional trainer
Modelled on state trainer programmeSuccessful results in 13 states over ten yearsTranslates the research into practical ‘on the ground’ advice Accelerates implementation and therefore outcomes
The role of a UK trainer
Fidelity reviews, preparing, conducting and action planningDemonstrate a learning culture, targeting specific staff groups ‘Lets talk about work’ training- how to ask and just askRegular meetings with senior leaders utilising data such as NI150Internal magazine articlesReports to Trust exec boardField mentoring
Paid work outcomes against targetApr 2010-Oct 2011
Introduction of the Regional Trainer in November 2010
Reproduced with permission of Southdown Supported Employment
Additional outcomes
Profile for employment has been raised across the Trust and in specific staff groupsFurther embedded partnership Positioning the role in the Centre for Mental Health helped with thisEnsuring employment is everyone's business not just the ESDeveloping real employment focused health care
“I’m a bit embarrassed really. When (the employment specialist) first came to our team I thought, what are they hear for? We work with people who are really ill, you know? I refer people now who say they want to work even if I think it’s impossible for them to ever get a job as I’m constantly proved wrong.”
Community Psychiatric Nurse, Sussex
The IMPROVE Projectdeveloping IPS in the West Midlands
Jonathan Allan, Enable Supported Employment Service,
Shropshire Council
enable
Enable
• Provided a mental health employment service for 17 years
• Shropshire is an IPS Centre of Excellence as part of the Centre for Mental Health’s CoE programme
• LD employment • Other disability / substance misuse
employment via personal budgets
enable
The Improve Project 2011 - 12
• Regional project in partnership with the Centre for Mental Health
• IPS Regional Development Manager = UK version of State Trainer in the US
• Working with 6 services to improve performance and quality in mental health employment using IPS
• Coventry, Birmingham, South Staffordshire, Worcestershire, Walsall & Dudley, Shropshire (south)
• Provided training in theory and practice of IPS, self assessment, employment engagement, training and mentoring and Fidelity Reviews (via CfMH).
enable
Key Objectives
• Act as IPS lead in the West Midlands (with CfMH)
• Work with frontline mh services in the W. Midlands to develop their IPS services through coaching and training
• Work with senior managers in NHS Trusts and local commissioners
• Commission the CfMH to varry out Fidelity Reviews
enable
Areas covered
• Walsall / Dudley• Coventry• Worcester• South Staffordshire• Birmingham• Shropshire (south))
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Implementation
• Introduction: getting to know the teams, agreements, data
• Self assessment against FR criteria and action planning
• Regional IPS leads project meetings• Training of staff• Individual and team coaching• Fidelity Reviews by CMH
enable
Role of regional trainer in W.Mids
• Previously supervised Enable’s IPS service in Shropshire
• Putting IPS theory into practice – working with service users, employer engagement, disclosure, working with clinical teams, marketing IPS ,barriers to employment, Caseloads, supervision
• Challenges – variation in services, service barriers, commitment levels, mh services change, economy
eable
Lessons learned, progress made• Raising performance - average job starts increased
by 73%• Increasing quality: 5 services FR: originally: 2 “not SE”, 3 “Fair” went to : 2 “Fair” and 3 “Good” (C of E)• Five years to establish a full working IPS service – we
made these improvement s in 9 months• Staying close to Fidelity is crucial
enable
For more information
Jonathan AllanTel: 01743 276900
www.shropshire.gov.uk/enablemarketing
enable
www.coventry.gov.uk
The Employment Support Service (TESS)
Implementing IPS in Coventry
Dean Atkinson
www.coventry.gov.uk
Overview of TESS
Started in March 1993
Client groups
Supported Employment
Part of the Council’s Employment Team
Partnership with Adult Social Care & Health
www.coventry.gov.uk
Some of the challenges
• Research project
• Changing practices
• Increasing employer engagement
• Gaining commitment
• Changing attitudes
• Resources
www.coventry.gov.uk
Our journey
• Part of the Improve project• Fidelity self-assessment & plan• Focus purely on paid employment• To disclose or not to disclose?• Work with health and social care
colleagues• Greater integration• The Fidelity Review
www.coventry.gov.uk
Being part of the Improve Project
• Information & guidance
• Training
• Mentoring & support
• Fidelity Review
www.coventry.gov.uk
Progress so far
• Moved from Fair to Good Fidelity
• Increased client and employer contact time
• Increased job outcomes
• Increasing integration into CMHT’s
• Centre of Excellence
www.coventry.gov.uk
• Remain focused on IPS
• Further investment
• Develop stronger partnerships
• Ongoing review
• Share what we are learning
• Promote success and learn from the rest!
www.coventry.gov.uk
Thank you