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What does it mean to say there's an evidence base for supported employment? One approach, known as Individual placement and support or IPS for short, has been extensively evaluated and proven to help high numbers of people with severe mental health problems into work. But there is still little evidence of this approach being put into practice here in the UK. This article recalls a visit this year to the UK by Professor Bob Drake and colleagues from Dartmouth, New Hampshire, USA where the approach was developed, and explains the principles of supported employment and what it can mean for service users, staff, families and employers.

Evidence accumulated over many years illustrates the benefits of work for mental health, including that of mental health service users. Despite strong evidence of the effectiveness of the individual placement and support (IPS) approach in enabling this group to find and keep paid employment, employment rates among mental health service users remain low, and IPS is not widely implemented in the UK. This paper reviews recent evidence for IPS, describes the key features of the approach and compares these with service users' accounts of the kind of support that they find helpful. The current situation regarding implementation of IPS is then considered, together with the barriers hindering implementation. It is clear that the barriers are multifaceted, and action will be required at a number of levels if mental health service users are to be enabled to achieve their employment goals.

Around 90 per cent of offenders have a mental health problem, personality disorder or addiction, and most have two or more such problems. One of the most effective ways of preventing reoffending and improving the life chances of an offender is through achieving and maintaining employment, however very few people leaving prison will have employment on release from prison. This paper aims to focus on these issues.

The paper describes an investigation conducted by the Centre for Mental Health into employment opportunities for offenders with mental health problems on release from prison.

The investigation revealed that, although offenders with mental health problems are less likely than other prisoners to be included in employment programmes, evidenced‐based approaches such as individual placement and support offer huge potential. The investigation identified five principles for employment programmes supporting this group: employers should play an instrumental role in creating opportunities; recruitment should be pragmatic, based on attitude and “character” rather than qualifications or health status; support should be offered to employees and their employers/managers for as long as they need it; opportunities for “pre‐ employment” and “in work” skills development should be linked to real employment opportunities; and criminal justice and other statutory agencies should facilitate effective pathways to real work and skills development.

There is a need to develop more employment programmes for offenders with mental health problems that incorporate evidenced‐based approaches such as individual placement and support, and a number of key principles identified in this investigation.

The investigation that this paper describes is the first to consider as its main focus evidence‐based employment interventions for people with mental health problems leaving prison or engaged with other parts of the criminal justice system.

Although work has a fundamental role in the individual’s psychological well-being, the vast majority of mental health service users are not in employment. This is the result of various barriers that impede their work re-integration process despite their desire to work. Apart from the illness’ symptoms, these barriers are strongly associated with the negative effects of long-term unemployment, the negative stereotypes and attitudes towards mental health service users and the fear of losing disability benefits. There are several occupational intervention models aiming at vocational rehabilitation of mental health service users. Arguably, the Individual Placement and Support (IPS) model of supported employment has proved to be more effective compared to other models. This chapter presents an innovative career counselling approach that combines elements from the IPS model and from the newly emerged career theories that have been developed to address today’s world of work challenges. This model was developed by the Pan-Hellenic Association for Psychosocial Rehabilitation and Work Integration (PEPSAEE) in Greece during the recent major economic crisis. Further implications of the model’s implementation regarding vocational rehabilitation of mental health users as means for social inclusion are discussed.

Commissioners of adult health and social care services in the London Borough of Camden are keen to see the spread of evidence‐based practices in mental health and employment services. Jobs in Mind, a trusted third sector provider already delivering employment support services in the borough since 1999, was uniquely placed to expand its service delivery into a partnership with the local NHS trust to deliver an innovative individual placement and support (IPS) pilot. A Life in the Day went to Camden to find out how it is going.

Individual Placement and Support (IPS) is an evidence-based employment model, effective in supporting individuals with severe mental health difficulties to gain competitive employment. Irish mental health policy recognises its value and IPS is being rolled out in a national programme. Employment is recognised an important contributor to mental health recovery and social inclusion. However, research on IPS has tended to focus on competitive job outcomes. The purpose of this study was to explore the non-vocational outcomes of IPS in an Irish context.

A qualitative research approach was used to interview participants taking part in IPS within community mental health teams. Twelve interviews were included in the data analysis process which was informed by a thematic analysis approach.

Participants experienced increased confidence and positivity, both within a work context and whilst job seeking. More purposeful time use, participation in activities and engagement with society were also experienced by those employed and those at the job search stage of IPS.

This study contributes to the literature about the non-vocational benefits of IPS within an Irish context, highlights the mental health recovery benefits of taking part in IPS and supports the need for ongoing development of IPS throughout mental health services in Ireland.

The purpose of this paper is to provide the personal accounts of the journey back to work from the perspective of both the person entering employment and the Employment Specialist who assisted them.

Two people with mental health problems who received help into employment from an employment service in a London Mental Health Trust were asked to give write their accounts of their journey. The Employment Specialists who assisted them in this journey were also asked to write their accounts.

Reflective accounts – no findings presented.

Much has been written about the effectiveness of Individual Placement and Support evidence-based supported employment, but little has been published about the lived experience of this approach from the perspective of both the person endeavouring to return to work and the employment specialists who support them. This paper presents two such accounts.

Significant unemployment among adults with serious mental illness (SMI) is a well-documented problem. Estimates suggest that as many as 85% of adults with SMI are unemployed at any one time (Anthony & Blanch, 1987; Milazzo-Sayre, Henderson & Manderscheid, 1997; Rogers, Walsh, Masotta & Danley, 1991). Recent years have seen advances in the development and dissemination of a variety of supported employment services for adults with disabilities. When people with SMI are enrolled in services with a specific employment focus, they achieve employment outcomes (e.g. job placement rates, job tenure) superior to those achieved by people receiving standard mental health services such as day treatment (Bond et al., 2001; Cook, 2003). Supported employment is now considered an “evidenced-based” practice (Bond et al., 2001). Although supported employment approaches vary, evidence-based services share common principles, including (1) prioritizing client preferences for type and timing of work; (2) providing in-vivo and follow-along supports as long as needed; (3) viewing work attempts as part of a learning opportunity; (4) having a commitment to “competitive” employment as an attainable goal; and (5) not relying on pre-vocational training, day treatment or sheltered workshops (Bond et al., 2001; Mowbray, Leff, Warren, McCrohan et al., 1997; Ridgeway & Rapp, 1998).

The purpose of this paper is to explore the economic benefits of Individual Placement with Support programmes commissioned by NHS North in the North West and Yorkshire and Humber regions.

A literature review was conducted and data collected from supported employment programmes in four localities. An econometric analysis was performed to evaluate likely savings for local commissioners and return on investment for the Treasury.

Integration of employment support within mental health services is central to success. Econometric analysis showed that local commissioners could save £1,400 per additional job outcome by commissioning evidence-based interventions and there is a positive return on investment to the Treasury for every £1 spent there is a return to the Treasury of £1.04.

This paper demonstrates the economic and social value of evidence-based supported employment for people with severe mental illness. The economic data generated could be helpful in encouraging investment in effective employment support in other areas. The work, views and perspectives contained in this paper are those of the authors. It does not necessarily reflect the views of the organisations for whom the authors work.

A feasibility study of cognitive-behavioural therapy (CBT) as an adjunct to individual placement and support (IPS) with adults with severe mental illness showed that fewer people who received CBT dropped out and more obtained jobs. The purpose of this paper is to investigate how the adjunct CBT programme worked. CBT used a problem-solving approach to address common psychological barriers to employment.

Baseline and six-month follow-up scores were compared on measures of problem solving, executive functioning, fear of negative evaluation, self-esteem, and stigma.

At baseline, the majority of the 23 participants scored within the normal range on measures. Around half of the participants showed improvement in social problem solving, executive functioning, and fear of negative evaluation. General improvements in self-esteem were seen. Change in the expected areas according to module choice was evident, however this was inconsistent.

Many participants were within normal ranges on the measures at baseline. Offering participants a choice of topics led to some people having few sessions, possibly too few to produce benefits. Although the modules on offer targeted commonly experienced problems, they may not have been the most important to these participants.

CBT does appear to enhance IPS but the mechanisms by which this occurs is unclear. To improve adjunct CBT, there is a need to clarify the most beneficial targets and identify the mechanisms by which CBT may augment IPS.

This study begins to identify the processes by which CBT can enhance IPS for adults with severe mental illness.