Psychological Wellbeing and Work Feasibility (RAND) pilot IPS in IAPT

Transcription

1 Psychological Wellbeing and Work Feasibility (RAND) pilot IPS in IAPT Jan Hutchinson Centre for Mental Health Martin Dominy Southdown Donna Johnson Southdown Donna Swinden Talking Changes

2 What is IPS? An approach to supported employment developed in the 1990s in USA by Dr Robert Drake Characterised by full integration of employment support with the person s mental health care and treatment Focuses on paid employment only and aims to find work for people quickly Case loads are very small maximum 20 per full-time worker Type of job, location and hours are sought to suit the individual Job-seeking begins almost immediately without the stepping stones of work preparation activities Employers are contacted in order to find the hidden jobs Intensive and ongoing in-work support is provided.

3 One of the RAND Europe pilots This was one of four pilots commissioned by Department of Health and Department for Work and Pensions following the 2014 report from RAND Europe Psychological Wellbeing and Work: Improving Service Provision and Outcomes IPS in IAPT pilot ran from June 2014 to December 2014 in four sites in England New referrals stopped on 31 st October 2014

4 What were we testing? Targeted support for people with mental health needs claiming ESA Jobcentres identify appropriate people and offer them a referral to IAPT (and IPS) Translation of IPS into a primary care context Testing the feasibility of setting up a more robust trial in the future

5 Who could be referred? Participation in the project was voluntary offered to people claiming ESA for common mental health conditions: ESA WRAG, with a prognosis of months, who have not yet been referred to the Work Programme ESA WRAG returning from the Work Programme the assessment phase waiting for the Work Capability Assessment On 5 th August eligibility was extended to include any claimant in the above groups with a mental health problem as their secondary condition.

6 Review of the Sussex Pilot Context 5 Way Partnership Coordinated Approach High amount of Referrals What Worked Partnership relationships/buy in Flexibility of the Referral Model / triage Data management / Reporting Responsive Employment Support

7 Review of the Sussex Pilot Challenges Implementation Time High numbers of closed at referral High amount of referrals not eligible for IAPT due to complex needs Waiting lists for IAPT Short time to deliver IPS support Recommendations

8 What were the challenges for the pilot in Durham? Lower numbers of referrals than expected IPS staff recruitment People not ready for IPS support with job search Developing relationships with Job Centre staff What did we learn?

9 Evaluation The Work Foundation carried out independent evaluation PHQ9/GAD7 Job Search Self-Efficacy (JSSE) scale number of referrals received Number of people who engaged number of IPS/IAPT sessions clients have attended. Proportion of people with better mental health Number of applications and interviews Number of people who achieved paid work

10 Role of the Employment Specialist He could see what I was looking for. And he sort of got ideas in his head of jobs that would suit what I was looking for. It s almost like he had a list of jobs in his head, I don't know, as I was talking you could almost hear the cogs working as he put me and the job together. Service User

11 Outputs and outcomes 413 people referred to the four sites 173 declined to take up the opportunities = 240 participants 166 consented to take part in the evaluation 15 service users found paid employment 183 job applications made 39 interviews attended Improved job search self-efficacy scores Improved health & wellbeing scores from GAD & PHQ

12 Improved health and wellbeing Average Job Search Self-Efficacy score at start (range) Avg JSSE score at end (range) Change 24 (13-44) 31 (15-45) +7 GAD GAD GAD PHQ PHQ PHQ at start at end change at start at end change Average score

13 What didn t work so well Inability to provide parallel IPS and IAPT service delivery Low levels of feedback to the Jobcentres about the customers I have been disappointed by the way this pilot was run. We had some information at the start but felt let down quite early on when most customers we referred were either declined for the IAPT part or told there was a long waiting list. Customers were told they could not access IAPT before we were told, but feedback has not been given as to why someone could not access the IAPT part. JCP ESA Work Coach

14 Recommendations for future trials of IPS and IAPT Increase time for the pilot to set up, embed and wind down Take action to ensure parallel provision of IPS and IAPT services Improve communications and partnership working with Jobcentre Plus Assign a local project/service manager to be assigned to each pilot site Broaden eligibility criteria

15 The last word I think [the IAPT] totally do get it. it s very much with employment being the outcome for them as well. We all know as professionals, we all know the benefits of work. Employment Specialist I can t tell you how much it s helped me actually, I ve come on more in the past few weeks, for the past eight weeks, than I ever would have if I hadn t had [service name] behind me. I would still be where I was eight weeks ago because I had nowhere to turn So I can t say enough how much help it s been. Service User

16 Questions For more information please contact: Tel