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Mental health, social inclusion and the development of vocational services in the NHS – what can be learnt?

Mark Bertram (Vocational Services, South London and Maudsley NHS Trust, London, UK)

Mental Health Review Journal

ISSN: 1361-9322

Article publication date: 8 July 2019

Issue publication date: 8 July 2019




The purpose of this paper is to describe the learning from a historical NHS vocational service development that focused on: mental health, employment and social inclusion – in an inner city area – involving service users, staff and commissioners.


It is a descriptive case study. A range of historical documents was content analysed and described through a first-person narrative: service user consultations, service specifications, audit records, outcome frameworks, internal service evaluations and published literature.


When vocational NHS service developments are grounded in what service users say helps them (person-centred, networked and co-ordinated approaches) the evidence indicates people can achieve their vocational goals.

Research limitations/implications

The range of documents described is factual, although the learning insights from some of the service developments are based on personal judgements. The author was the responsible manager – personal bias is high. There is not enough robust evidence to warrant generalisation.

Practical implications

When employment and social inclusion are prioritised, as core business in NHS, outcomes and health impact can increase. Greater detail is needed from healthcare policy makers – focusing on who exactly should undertake this work and what the key commissioning social inclusion performance indicators are.


The bulk of literature on employment support focuses on promoting evidence from one model: individual placement and support. Evidence here indicates a broader range of activity (education, training and volunteering) can have value and health impact.



The author thanks all the people who courageously voted with their feet and made these journeys. People who helped out are: Patrick Gillespie, Denis O’Rourke, Shaun Williams, Sarah McDonald, Kevin Poulton, Robin Harrison, Manju Rajput, Kate Reaney, Paul Goddard, Joan Kennedy and Venus Caesar.


Bertram, M. (2019), "Mental health, social inclusion and the development of vocational services in the NHS – what can be learnt?", Mental Health Review Journal, Vol. 24 No. 2, pp. 133-143.



Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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