By Jan Hutchinson

Last week I had the pleasure of meeting a group of staff and service users in Bedfordshire who have partnered with Centre for Mental Health in setting up an Individual Placement and Support (IPS) service with the East London Foundation Trust Community Mental Health Teams based in Luton and Bedfordshire. IPS is an approach to supported employment described by 25 statements, known as the fidelity scale, and robustly evidenced by more than 20 randomised control trials as the most effective approach to achieving paid work for people with mental health problems.

We were joined by Alistair Burt MP (the Minister with responsibility for mental health), who expressed his personal commitment to making it possible for everyone with mental health problems to return to work as soon as they feel it is right for them, as part of their recovery. Naturally Mr Burt has an interest in this particular service as it is based in his own constituency and is offering a solution to the widespread challenge of the effect of mental ill-health on unemployment. The significant numbers of people whose health conditions present major barriers to work, predominantly those with mental ill-health and musculo-skeletal issues, have warranted a new Government policy group focus, jointly headed by Mr Burt, known as the Health and Work Unit.

But back to IPS. The service model is, in some ways, a very simple idea - that people receiving specialist mental health care who want to return to work should be able to access personalised, knowledgeable and effective support to do so. The effectiveness of the service is ensured in two ways:

  1. by taking the skills, desires, needs and wishes of the individual at face value and having someone to help find work which will provide the right level of job satisfaction
  2. by ensuring that the Employment Specialist who provides that support is part of their client’s clinical team, knows their psychiatrist and community nurse or social worker, and therefore that employment, i.e. earning a wage for a job, is always one aspect of a person’s ‘recovery’ which includes self-management, symptom control and, crucially, an increase in quality and enjoyment of life.

Since the addition of an Employment Specialist within a clinical service is not complicated or (particularly) expensive – the salary being on a par with newly qualified nurses or occupational therapists – it is disappointing that we don’t see all NHS Trusts providing a similar service to the one supporting Mr Burt’s constituents, and run by ELFT. There are around 20 NHS Trusts who have committed to ensuring access to IPS for their service users, but this still leaves thousands of people without access to an Employment Specialist, at the time of their lives when they are least likely to be able to job search without support or to negotiate their way through Jobcentre services and their associated assessments and benefit rules.

Mr Burt met a group of people using an NHS service which had offered them return-to-work support immediately on entering specialist mental health services, and throughout their pathway of care. This, they told us, has given them additional hope for future opportunities and in itself has improved their mental health.

There are no better reasons for investing in an intervention than because it demonstrably improves health and achieves measurable savings on unemployment benefits. I am working towards the day when anyone in any Mental Health Trust in England will be offered the same.

More information on IPS and the NHS Trusts currently participating in Centre for Mental Health’s IPS Centres of Excellence network is available here