Evidence-based Supported Employment

There are broadly two models used to help people with mental health problems who are not working get jobs:

  1. Training, development and sheltered work to prepare and then place the person in paid employment: 'train then place'.
  2. Get people into competitive employment first with training and support on the job: 'place then train'.

The benefits of 'place then train'

'Place then train' is not a magic bullet. But it overcomes many of the drawbacks of traditional approaches such as the loss of motivation and confidence over time and the tendency for health care systems to assume that once someone is ready for work they are better and no longer in need of support.

'Place then train' models not only improve employment outcomes, they also improve people's mental and physical health status over long periods of time.

They are also consistently less expensive than traditional approaches and may bring some cost savings in mental health services and welfare benefits.

The evidence, therefore, provides strong support for the substitution of 'place then train' services for traditional day centres and employment programmes, especially for young people with first episodes of mental illness.

This does not negate the value of social firms and social enterprises that offer 'protected employment' but in the form of real jobs for real pay in genuine businesses.

The potential of 'place then train'

While it has yet to be adopted widely in the UK, 'place then train' is recommended in current commissioning guidance for mental health services. We believe that the principles of 'place then train' have potential for other groups who have low levels of employment or are otherwise disadvantaged by the labour market, including:

  • People who have become disabled and long term unemployed as the result of common mental health problems such as depression and anxiety
  • Prisoners and other offenders.
  • People with a 'dual diagnosis' of mental ill health and a substance use problem: for which evidence of the benefits of IPS is now available.
  • Young people with mental health problems or complex needs.

Individual Placement and Support (IPS)

The most well-established method of 'place then train' in mental health is Individual Placement and Support (IPS). Read more about IPS here.