Challenges in implementing individual placement and support in the Australian mental health service and policy context
Yolande Stirling A B , Kate Higgins C and Melissa Petrakis A B DA St Vincent’s Hospital Melbourne, Mental Health Service, Hawthorn Community Mental Health Service, 642 Burwood Road, Hawthorn East, Vic. 3123, Australia. Email: yolandestirling@gmail.com
B Monash University, Department of Social Work, Faculty of Medicine, Nursing and Health Sciences, PO Box 197, Caulfield East, Vic. 3145, Australia.
C Wellways Australia, PO Box 359, Clifton Hill, Vic. 3068, Australia. Email: khiggins@wellways.org
D Corresponding author. Email: melissa.petrakis@monash.edu
Australian Health Review 42(1) 82-88 https://doi.org/10.1071/AH16093
Submitted: 7 May 2016 Accepted: 9 December 2016 Published: 20 January 2017
Abstract
Objective Although Australia’s service and policy context differs from that of the US, studies have highlighted potential for individual placement and support (IPS) to support competitive employment outcomes for people with severe and persistent mental illness. The aim of the present study was to explore why the model is not yet widely available.
Methods A document analysis was conducted to discern reasons for challenges in implementation of IPS practice principles within the Australian service context.
Results The document analysis illustrated that although policy acknowledges the importance of increasing employment rates for people with severe and persistent mental illness, consistent measures, change indicators, direction and time frames are lacking in policy and strategy documentation. Further, IPS principles are not consistently evident in guiding operational documentation that government-funded Disability Employment Services (DES) programs are mandated to adhere to.
Conclusions For IPS to be readily implemented, it is necessary for government to offer support to agencies to partner and formal endorsement of the model as a preferred approach in tendering processes. Obligations and processes must be reviewed to ensure that model fidelity is achievable within the Australian Commonwealth policy and service context for programs to achieve competitive employment rates comparable to the most successful international programs.
What is known about the topic? The IPS model has been established as the most efficacious approach to support people with severe and persistent mental ill health to gain and sustain employment internationally, yet little is known as to why this model has had very limited uptake in the Australian adult mental health service and policy context.
What does this paper add? This paper provides an investigation into the achievability of IPS within DES philosophical and contractual arrangements.
What are the implications for practitioners? Mental health practitioners are typically skilled in their understanding of individual or micro-level challenges faced by consumers in achieving vocational goals: working with symptoms, medication side effects, motivation and anxiety. The present study was designed to offer practitioners an increased understanding of service-level factors, because these present considerable challenges to achieving sustained employment. This paper is a call for greater advocacy towards better integration of employment and mental health service delivery in the Australian policy and practice context.
Additional keywords: consumers, clinical services, health services research, health care reform, supported employment.
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