Are attitudes in employees of public employment service in line with the principles of individual placement and support? A questionnaire‐based survey

Abstract

A high proportion of people with severe mental illness (SMI) want to work, consider it essential for recovery, yet employment rates are low. Many employees in public employment services (PES) work according to traditional attitudes that people with SMI are unable to work and if they do, risk harm from work‐related stress. These attitudes conflict with principles in evidence based vocational models like individual placement and support (IPS) and probably contributes to the low‐employment rate. The aim of this study was to investigate attitudes towards the evidence‐based principles of IPS among PES employees with and without exposure to IPS. A case vignette describing a person with SMI and statements referring to this vignette was developed and administered to PES employees at two timepoints, 4 years apart. Respondents indicated their attitudes on a six‐point Likert scale to statements in accordance to the principles of IPS. Independent two‐tailed sample t‐tests were used to analyse differences between respondents in municipalities with IPS exposure, compared to municipalities without. Multiple linear regressions with attitudes as a dependent variable was used to test whether attitudes changed over time dependent on exposure to IPS. Attitudes were generally aligned with IPS principles compared to current PES practice. The municipality with IPS exposure had more favourable attitudes (p < 0.01). Changes in attitudes were minimal over time and did not differ between regions (p < 0.287). Attitudes of employees in PES are aligned with the principles of IPS and to a greater extent if exposed to IPS.

Implementing individual placement and support in Norway. From vocational rehabilitation to an employment scheme

“…Sveinsdottir et al (2020) provided an overview of research projects in Norwegian settings. Moe et al (2021) studied the implementation process as experienced by employment specialists, Butenko et al (2022) studied turnover rates in the implementation process, and IPS attitudes and practice within NAV have been studied, (Bakkeli, 2022; Bakkeli & Breit, 2021; Brinchmann et al, 2022; Gjersøe & Strand, 2021). These studies support our finding of IPS being embedded into routine practice in NAV.…”

The societal impact of individual placement and support implementation on employment outcomes for young adults receiving temporary health-related welfare benefits: a difference-in-differences study

“…Throughout the implementation, clinicians, NAV frontline staff and leaders were frequently brought together for education, training, and guidance about IPS and associated ways of working to counteract the traditional silos between services. To understand the impact of this, repeated testing of NAV staff attitudes towards IPS happened in 2013 and 2017 (Brinchmann et al, 2022).…”

“…Whilst health professionals' attitudes to individuals with mental illness gaining employment are well documented (Finne & Holt, 2023;Lettieri, Soto-Pérez, Díez, Bernate-Navarro, & Franco-Martín, 2022) it was important for the implementation team to understand the attitudes of NAV frontline staff as they are pivotal in the assessment, decision-making and trajectories of all WAA and Disability Pensions claimants. NAV frontline staff in Bodø were consistently more positive towards the evidence-based principles of IPS and associated ways of working compared to municipalities where IPS was not implemented (Brinchmann et al, 2022). Media (newspapers and social media) were actively used to frame the unemployment of individuals with mental illness as a community challenge.…”

Employment and mental health recovery: Revealing unused potential in multi-agency meetings

“…In Scandinavian countries, for example, mental health and welfare services are two completely different organisations with incompatible regulations, making inter-sectoral cooperation challenging. Although mental health and social welfare services regard it as a meaningful and innovative approach, IPS faces pressure to fit the common strategies in both services (Bonfils, 2021;Brinchmann, Rinaldi, Sandtorv, Moe, McDaid, Killackey, & Mykletun, 2022). As a consequence, therapists and social workers experience collaboration regarding the jobseekers' needs as challenging (Bonfils, 2021;Moen, Larsen, & Walseth, 2020a).…”