Individual Placement & Support (IPS) Martin Dominy Head of Mental Health Recovery Services

1. Individual Placement & Support (IPS) Martin Dominy Head of Mental Health Recovery Services Southdown Kate Bones Director of Occupational Therapy & Recovery Practice Sussex Partnership NHS Foundation Trust

2. IPS –Individual Placement & Support An evidence based supported employment approach which aims to enable people with severe and enduring mental health needs to gain and maintain competitive employment.

3. Individual Placement and Support (IPS) • Focus on competitive employment as a primary goal • Eligibility to the service Zero exclusion • Rapid job search and minimal pre-vocational training • Integrated into the work of the clinical team • Attention to client interests preferences • Availability of time unlimited support • Access welfare benefits counselling • Employer Engagement

4. The Evidence 16 Randomised control trails internationally IPS - 50% increase outcomes of other models Dartmouth Research Centre USA Principles and Fidelity framework Centre for Mental Health IPS Centre of Excellence Programme NICE Guidance for Schizophrenia 2014 National Development Team for Inclusion Commissioning Guidance 2014

5. Employment Rates 80% of people with severe and enduring MH needs want to work 55% would like active support to find work Only 8% of people with serious mental illness being seen in secondary care are in work 80% of General Population – approx Compare to physical and sensory disability employment rate of 48%

6. Sussex Overview

7. Sussex Area population of 1.5 million, Trust supports 10,000 people with a severe and enduring mental health problems each year. 28 clinical teams (including 4 early intervention and 4 additional assertive outreach teams). 22 (20 FTE) Employment Specialists across the area, all employed by Southdown, a local not-for-profit organisation, but attached to & embedded in the clinical teams within the area. Every community team has a vocational champion – usually an Occupational Therapist

8. Contracts Summary Brighton and Hove have commissioned IPS services since 2008 East Sussex since July 2009 West Sussex May 2010 Contracted to support people with severe and enduring mental health issues Annually supporting over 1138 people 450 at any one time 2013/2014 - Last years paid outcomes 298 2014/2015 - Target of 334 Paid Outcomes 12% increase expected

9. Rinadi, Miller & Perkins 2010 4 key barriers to implementation of IPS fear on the part of professionals, individuals and their families; a culture of low expectations; a failure to provide the support that we know works, the global ‘credit crunch’ recession.

10. The suggestion to engage with employment was a key part of my recovery. If I’d waited until I felt ready to go to work I might still be waiting, but since Dr D, and my OT believed I could benefit from talking to the employment specialist, then I was willing to try. Person using employment support

11. Tony Wilson, Policy Director at Inclusion ‘The Work Programme ……..is still a long way below expectations for those who are on benefit because of a health condition or disability. For this latter group, just one in 25 participants is getting into sustained employment within a year. There is no sign of any improvement in performance for these participants, and the nature of the Work Programme means that lower employment is leading to fewer “outcome” payments and in turn less funding being made available. The government needs to look urgently at its targets and funding rules for these groups.’