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))

enable

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

jonathan.allan@shropshire.gov.uk

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

Thank you

Any questions? jan.hutchinson@centreformentalhealth.org.uk

becky.priest@centreformentalhealth.org.uk

dean.atkinson@coventry.gov.uk

jonathan.allan@shropshire.gov.uk