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Harkko J, Sipilä N, Nordquist H, Lallukka T, Appelqvist-Schmidlechner K, Donnelly M, Kouvonen A. External context in individual placement and support implementation: a scoping review with abductive thematic analysis. Implement Sci 2023; 18:61. [PMID: 37946209 PMCID: PMC10636871 DOI: 10.1186/s13012-023-01316-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/15/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Context including the external context may considerably affect the adoption, implementation, sustainment, and scale-up of evidence-based practices. We investigated external contextual features by conducting a scoping review of empirical research regarding the implementation of an evidence-based psychiatric or mental health vocational rehabilitation service called Individual Placement and Support (IPS). METHODS The protocol for the scoping review was registered with the Open Science Framework. We used the methodology by Joanna Briggs Institute for conducting the scoping review and reported it according to the PRISMA-ScR checklist. We searched 12 databases for research regarding 'Individual Placement and Support' or 'Evidence-Based Supported Employment'. We retained peer-reviewed empirical studies investigating external contextual factors and their impact on IPS implementation outcomes. We extracted data from the eligible articles and conducted descriptive and thematic analyses. RESULTS Fifty-nine original research papers met our eligibility requirements and were retained after reviewing 1124 titles and abstracts and 119 full texts. The analysis generated two main themes: (1) external contextual determinants of service delivery and (2) external systems influencing the evidence-to-practice process. The first main theme encompassed policies and laws, financing, and administratively instituted support resources, and organizational arrangements associated with external stakeholders that may facilitate or hinder the local implementation. The second main theme comprised strategies and actions used by different stakeholders to facilitate implementation locally or scale-up efforts at a system level. DISCUSSION Our scoping review illustrates the important role that external contextual factors play and how they may facilitate or hinder the implementation and scale-up of the IPS model across mental health services in different countries. Consideration of these factors by decision-makers in mental health and welfare services, planners, providers, and practitioners is likely to facilitate the development of effective strategies for bridging the evidence-practice gap in implementing the EBPs. Finally, the scoping review identified gaps in knowledge and offered suggestions for future research. TRIAL REGISTRATION Open Science Framework.
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Affiliation(s)
- Jaakko Harkko
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
| | - Noora Sipilä
- The Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Kotka, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
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Stengler K, Bechdolf A, Becker T, Döring A, Höhl W, Jäckel D, Kilian H, Theißing A, Torhorst A, Wirtz G, Zeidler R, Riedel-Heller S. [Implementation of the principle of supported employment in Germany : Position paper of a task force of the DGPPN]. DER NERVENARZT 2021; 92:955-962. [PMID: 33570685 DOI: 10.1007/s00115-020-01038-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 11/29/2022]
Abstract
The effects of mental diseases on the employment and working situation can be substantial. They are one of the main reasons for inability to work and reduced earning capacity. Against this background the question arises about suitable occupational reintegration measures for people with severe mental illnesses. In recent years, the principle of supported employment has been internationally shown to be increasingly more successful. In this context mentally ill people are primarily placed at a position of the first employment market and supported on-site by a job coach. This concept is inclusive, individual and evidence based. Despite proven effectiveness, it has so far been insufficiently implemented in German-speaking regions. In the future it will be a matter of considering the individual needs for assistance of mentally ill people more intensively than previously and to respond with functional and in a best-case scenario, multiprofessional and flexible offers.
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Affiliation(s)
- K Stengler
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie, Helios Park-Klinikum Leipzig, Leipzig, Deutschland
| | - A Bechdolf
- Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - T Becker
- Klinik für Psychiatrie und Psychotherapie II, Bezirkskrankenhaus Günzburg, Universität Ulm, Günzburg, Deutschland
| | - A Döring
- Fachausschuss Psychiatrie, Deutscher Verband der Ergotherapeuten e. V., Karlsbad, Deutschland.,Referat "Gesundheitsfachberufe", DGPPN, Berlin, Deutschland
| | - W Höhl
- arbeit & integration e. V., Düsseldorf, Deutschland
| | - D Jäckel
- Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Akademische Lehrkrankenhäuser, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - H Kilian
- Bundesarbeitsgemeinschaft Beruflicher Trainingszentren e. V. (BAG BTZ), Berlin, Deutschland
| | - A Theißing
- beta89, Verein für betreuendes Wohnen und Tagesstrukturierung psychisch Gesundender e. V., Hannover, Deutschland
| | - A Torhorst
- RPK Bad Tölz und München, ReAL Holding AG, Bad Tölz, Deutschland
| | - G Wirtz
- SRH Rehabilitationseinrichtung für psychisch Kranke Karlsbad GmbH, Karlsbad, Deutschland
| | - R Zeidler
- DGPPN-Geschäftsstelle, Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde e. V. (DGPPN), Reinhardtstraße 27 B I, 10117, Berlin, Deutschland.
| | - S Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Leipzig, Deutschland
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Pelizza L, Ficarelli ML, Vignali E, Artoni S, Franzini MC, Montanaro S, Andreoli MV, Marangoni S, Ciampà E, Erlicher D, Troisi E, Pupo S. Individual placement and support in Italian young adults with mental disorder: Findings from the Reggio Emilia experience. Early Interv Psychiatry 2020; 14:577-586. [PMID: 31642590 DOI: 10.1111/eip.12883] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 08/26/2019] [Accepted: 09/24/2019] [Indexed: 01/26/2023]
Abstract
AIM Individual placement and support (IPS) has a considerable body of evidence for its effectiveness in helping people with mental disorder to achieve and maintain competitive jobs. However, little data in young adult populations are currently available, especially in Europe. Aim of this study was to assess the effect of IPS in Italian young adults with moderate-to-severe mental illness, examining the main competitive employment outcomes and drop out rates during a 3-year follow-up period. METHODS Participants (n = 54) were recruited from patients receiving psychiatric treatment in one of the seven adult Community Mental Health Centers of the Reggio Emilia Department of Mental Health. Together with drop out rates, we investigated job duration (total number of days worked), job acquisition (employment in the labour market for at least 1 day during the follow-up), total hours per week worked, and job tenure (weeks worked on the longest-held competitive job). RESULTS A crude competitive employment rate of 40.7% and a crude drop out rate of 22.2% over the 3-year follow-up period were found. However, 66% of 42 clients who remained in the program over 3 years gained competitive employment at some time during the 3-year period. CONCLUSIONS This research shows the feasibility of an IPS intervention model in the public mental health care system in Italy, especially for a young adult target population.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, Italy
| | - Maria L Ficarelli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Vignali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simona Artoni
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria C Franzini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Serenella Montanaro
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria V Andreoli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | - Elisa Troisi
- School of Psychiatric Rehabilitation Techniques, University of Modena and Reggio Emilia, Modena, Italy
| | - Simona Pupo
- Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Anesthesia and Resuscitation Service, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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Pelizza L, Ficarelli ML, Vignali E, Artoni S, Franzini MC, Montanaro S, Andreoli MV, Marangoni S, Ciampà E, Erlicher D, Troisi E, Pupo S, Fioritti A. Implementation of Individual Placement and Support in Italy: The Reggio Emilia Experience. Community Ment Health J 2020; 56:1128-1138. [PMID: 32157515 DOI: 10.1007/s10597-020-00603-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/06/2020] [Indexed: 01/26/2023]
Abstract
Individual placement and support (IPS) is an evidence-based intervention helping people with mental illness to obtain competitive jobs. In the last decade, European mental health leaders were interested on its implementation. Aim of the study was to assess the IPS feasibility in Italian patients with moderate-to-severe mental illness. To date, no evaluation of IPS has been conducted exclusively in Italy. Participants (n = 95) were clients of community mental health centers of the Reggio Emilia Department of Mental Health. In addition to drop-out rates, we calculated job acquisition, job duration, and total hours per week worked. A crude competitive employment rate of 41.1% and a crude drop-out rate of 30.5% were found over 42-month follow-up period. Using a Kaplan-Meyer survival analysis, the cumulative employment rate increased up to 44% at 12 months and 61% both at 24 and 42 months. This study documents the feasibility of an implementation strategy for introducing the IPS model in the public mental health care system in Italy.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy. .,Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Centro "Santi", Via Vasari n.13, 43100, Parma, PR, Italy.
| | - Maria Lorena Ficarelli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Elisabetta Vignali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Simona Artoni
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Maria Cristina Franzini
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Serenella Montanaro
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Maria Vittoria Andreoli
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Sara Marangoni
- E.N.A.I.P. Foundation, Via D'Arezzo n. 14, 42123, Reggio Emilia, RE, Italy
| | - Elizabeth Ciampà
- E.N.A.I.P. Foundation, Via D'Arezzo n. 14, 42123, Reggio Emilia, RE, Italy
| | - Diana Erlicher
- E.N.A.I.P. Foundation, Via D'Arezzo n. 14, 42123, Reggio Emilia, RE, Italy
| | - Elisa Troisi
- School of Psychiatric Rehabilitation Techniques, University of Modena and Reggio Emilia, Via Università n.4, 44121, Modena, MO, Italy
| | - Simona Pupo
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS Di Reggio Emilia, Via Amendola n.2, 42100, Reggio Emilia, RE, Italy
| | - Angelo Fioritti
- Department of Mental Health and Pathological Addiction, Azienda USL di Bologna, Via Castiglione n.29, 40124, Bologna, BO, Italy
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Khalifa N, Talbot E, Barber S, Schneider J, Bird Y, Attfield J, Bates P, Walker DM, Völlm B. A Feasibility Cluster Randomized Controlled Trial of Individual Placement and Support (IPS) for Patients With Offending Histories. Front Psychiatry 2020; 10:952. [PMID: 31998164 PMCID: PMC6970337 DOI: 10.3389/fpsyt.2019.00952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/02/2019] [Indexed: 11/18/2022] Open
Abstract
Objective: To examine the feasibility of conducting a fully powered randomized controlled trial (RCT) of Individual Placement and Support (IPS). IPS is a form of supported employment which aims to put people into open employment quickly and in accordance with their preferences. It is delivered by employment specialists collocated within clinical teams, and provides time unlimited support for the individual and their employer, along with welfare benefits counselling. Method: A feasibility cluster RCT of treatment as usual (TAU) plus IPS versus TAU alone was conducted over 12 months among patients with offending histories in a community forensic setting in the UK. The feasibility criteria were to achieve 50% recruitment rate; 50% completion rate for IPS; 50% completion rate of all outcome measures; and 80% acceptability rating for IPS. The primary efficacy outcome was the proportion of people in open employment at 12 months. The secondary outcomes were other vocational and educational activities; Brief Psychiatric Rating Scale; Rosenberg's Self-esteem Scale; Client Service Receipt Inventory; quality of life using the SF12-v2 and EQ5-D3; Social Functioning Questionnaire; Work Limitation Questionnaire; and reoffending. Results: Participants' mean age was 39.2 years. The majority were male (88.9), White British (72.2), and single (72.2%). Over 72% had no higher qualification beyond secondary education; mean years in education was 10.4. Over one third had schizophrenia, one fifth had depression, and the rest had personality disorder as their primary diagnosis. Participants had a lifetime average of 7.5 convictions for 15.5 offences. The recruitment rate of all referrals was 38.3% (IPS n = 11; TAU n = 7). Completion rate for IPS was 54.5, with 45.5% acceptability rating. Completion rates for outcome measures for the groups at baseline and 12 months ranged from 22.2 to 100%. The proportion of people in open employment at 12 months were 9.1 and 0% for IPS and TAU respectively. Conclusion: It is not feasible to conduct a full RCT of IPS in community forensic settings in the UK owing to recruitment and retention difficulties. Conducting a trial of this kind requires a large pool of patients from multiple sites and longer IPS implementation and recruitment periods than those of this study. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02442193.
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Affiliation(s)
- Najat Khalifa
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
- Wells Road Centre, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Emily Talbot
- DOCS contracted partner of Amgen, Cambridge, United Kingdom
| | - Shaun Barber
- Clinical Trials Unit, University of Leicester, Leicester, United Kingdom
| | - Justine Schneider
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | - Yvonne Bird
- Wells Road Centre, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Julie Attfield
- Corporate Services, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Peter Bates
- Public and Patient Involvement, The Institute of Mental Health, Nottingham, United Kingdom
| | - Dawn-Marie Walker
- Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Birgit Völlm
- Department of Forensic Psychiatry, Universitätsmedizin Rostock, Rostock, Germany
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6
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Vukadin M, Schaafsma FG, Westerman MJ, Michon HWC, Anema JR. Experiences with the implementation of Individual Placement and Support for people with severe mental illness: a qualitative study among stakeholders. BMC Psychiatry 2018; 18:145. [PMID: 29793455 PMCID: PMC5968490 DOI: 10.1186/s12888-018-1729-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 05/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individual Placement and Support (IPS) is an evidence-based approach to help people with severe mental illness achieve competitive employment. This article provides insight into an organizational and a financial implementation strategy for IPS in the Netherlands by exploring the perceived facilitators and barriers among participating stakeholders. The goal of this multifaceted strategy was to improve IPS implementation by improving the collaboration between all organizations involved, and realising secured IPS funding with a 'pay for performance' element. METHODS A qualitative, explorative study among practitioners (n = 8) and decision makers (n = 7) in mental health care and vocational rehabilitation was performed using semi-structured interviews to collect rich information about the possible facilitators and barriers with regard to the organizational and financial implementation strategy for IPS. RESULTS Important perceived facilitators were the key principles of the IPS model, regular meetings of stakeholders in mental health care and vocational rehabilitation, stakeholders' experienced ownership of IPS and collaboration, the mandate and influence of the decision makers involved and secured IPS funding. Important perceived barriers included the experienced rigidity of the IPS model fidelity scale and lack of independent fidelity reviewers, the temporary and fragmented character of the secured funding, lack of communication between decision makers and practitioners and negative attitudes and beliefs among mental health clinicians. Changes in legislation were experienced as a facilitator as well as a barrier. CONCLUSIONS The results of this study suggest that the collaboration and IPS funding were experienced as improved by applying an organizational and a financial implementation strategy. However, considerable effort is still necessary to overcome the remaining barriers identified and to make the implementation of IPS a success in practice.
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Affiliation(s)
- Miljana Vukadin
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. .,Research Center for Insurance Medicine: collaboration between AMC- UMCG - UWV - VUmc, Amsterdam, the Netherlands.
| | - Frederieke G. Schaafsma
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands ,0000000404654431grid.5650.6Research Center for Insurance Medicine: collaboration between AMC– UMCG – UWV – VUmc, Amsterdam, the Netherlands
| | - Marjan J. Westerman
- 0000 0004 1754 9227grid.12380.38Department of Health Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
| | - Harry W. C. Michon
- 0000 0001 0835 8259grid.416017.5Trimbos Institute, The Netherlands Institute of Mental Health and Addiction, Da Costakade 45, 3521 VS Utrecht, the Netherlands
| | - Johannes R. Anema
- 0000 0004 0435 165Xgrid.16872.3aDepartment of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands ,0000000404654431grid.5650.6Research Center for Insurance Medicine: collaboration between AMC– UMCG – UWV – VUmc, Amsterdam, the Netherlands
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Watson DP, Adams EL, Shue S, Coates H, McGuire A, Chesher J, Jackson J, Omenka OI. Defining the external implementation context: an integrative systematic literature review. BMC Health Serv Res 2018; 18:209. [PMID: 29580251 PMCID: PMC5870506 DOI: 10.1186/s12913-018-3046-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/20/2018] [Indexed: 11/27/2022] Open
Abstract
Background Proper implementation of evidence-based interventions is necessary for their full impact to be realized. However, the majority of research to date has overlooked facilitators and barriers existing outside the boundaries of the implementing organization(s). Better understanding and measurement of the external implementation context would be particularly beneficial in light of complex health interventions that extend into and interact with the larger environment they are embedded within. We conducted a integrative systematic literature review to identify external context constructs likely to impact implementation of complex evidence-based interventions. Methods The review process was iterative due to our goal to inductively develop the identified constructs. Data collection occurred in four primary stages: (1) an initial set of key literature across disciplines was identified and used to inform (2) journal and (3) author searches that, in turn, informed the design of the final (4) database search. Additionally, (5) we conducted citation searches of relevant literature reviews identified in each stage. We carried out an inductive thematic content analysis with the goal of developing homogenous, well-defined, and mutually exclusive categories. Results We identified eight external context constructs: (1) professional influences, (2) political support, (3) social climate, (4) local infrastructure, (5) policy and legal climate, (6) relational climate, (7) target population, and (8) funding and economic climate. Conclusions This is the first study to our knowledge to use a systematic review process to identify empirically observed external context factors documented to impact implementation. Comparison with four widely-utilized implementation frameworks supports the exhaustiveness of our review process. Future work should focus on the development of more stringent operationalization and measurement of these external constructs. Electronic supplementary material The online version of this article (10.1186/s12913-018-3046-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dennis P Watson
- Department of Social and Behavioral Sciences, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA.
| | - Erin L Adams
- Department of Psychology, Indiana University Purdue University-Indianapolis, 420 N Blackford St, Indianapolis, IN, 46202, USA
| | - Sarah Shue
- Indiana University-Purdue University Indianapolis, School of Health and Rehabilitation Sciences, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Heather Coates
- Indiana University-Purdue University Indianapolis, University Library, Center for Digital Scholarship, 755 W. Michigan St, Indianapolis, IN, 46202, USA
| | - Alan McGuire
- Richard L. Roudebush VA, 1481 W. 10th St, Indianapolis, IN, 46202, USA
| | - Jeremy Chesher
- Department of Environmental Health Sciences, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Joanna Jackson
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
| | - Ogbonnaya I Omenka
- Department of Health Policy and Management, Indiana University Richard M. Fairbanks School of Public Health, 1050 Wishard Blvd, Indianapolis, IN, 46202, USA
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Talbot E, Bird Y, Russell J, Sahota K, Schneider J, Khalifa N. Implementation of individual placement and support (IPS) into community forensic mental health settings: Lessons learned. Br J Occup Ther 2018. [DOI: 10.1177/0308022618756593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Assessment of the effectiveness of individual placement and support in forensic mental health settings is a relatively new field of research despite evidence demonstrating its effectiveness in generic mental health settings. Method IPS was implemented into a community forensic mental health setting within a large National Health Service trust in the United Kingdom over 6 months. Using the Consolidated Framework for Implementation Research this paper describes the lessons learned from implementing individual placement and support into such settings. Results Our findings suggest that implementation of individual placement and support in forensic mental health settings is complex and requires robust planning and collaboration with internal and external agencies. Barriers to implementation included staff attitudes, difficulty engaging employers and lack of employment related performance indicators, and facilitators included the support of service managers and outside groups. Adaptations to the IPS model were made to address challenges encountered, including difficulty starting rapid job searches, concerns about stigma, lack of confidence, uncertainty around employment opportunities, offence restrictions and lack of interest from potential employers. Conclusion This paper adds to the limited literature in the field. Findings are relevant to practitioners and service providers who wish to implement individual placement and support services for people with mental disorder and offending histories.
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Affiliation(s)
- Emily Talbot
- Clinical Trial Associate, Amgen Ltd, Cambridge, UK
| | - Yvonne Bird
- Community Forensic Services Manager, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Jo Russell
- Occupational Therapist, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Karan Sahota
- Employment Advisor, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Justine Schneider
- Professor of Mental Health and Social Care, Faculty of Social Sciences, University of Nottingham, UK
| | - Najat Khalifa
- Associate Professor and Consultant Forensic Psychiatrist, School of Medicine, University of Nottingham, UK
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Khalifa N, Talbot E, Schneider J, Walker DM, Bates P, Bird Y, Davies D, Brookes C, Hall J, Völlm B. Individual placement and support (IPS) for patients with offending histories: the IPSOH feasibility cluster randomised trial protocol. BMJ Open 2016; 6:e012710. [PMID: 27449894 PMCID: PMC4964185 DOI: 10.1136/bmjopen-2016-012710] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 05/23/2016] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION People with involvement in forensic psychiatric services face many obstacles to employment, arising from their offending, as well as their mental health problems. This study aims to assess the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of individual placement and support (IPS), in improving employment rates and associated psychosocial outcomes in forensic psychiatric populations. IPS has been found consistently to achieve employment rates above 50% in psychiatric patients without a history of involvement in criminal justice services. METHODS/DESIGN This is a single-centre feasibility cluster RCT. Clusters will be defined according to clinical services in the community forensic services of Nottinghamshire Healthcare NHS Foundation Trust (NHCT). IPS will be implemented into 2 of the randomly assigned intervention clusters in the community forensic services of NHCT. A feasibility cluster RCT will estimate the parameters required to design a full RCT. The primary outcome is the proportion of people in open employment at 12-month follow-up. Secondary outcome measures will include employment, educational activities, psychosocial and economic outcomes, as well as reoffending rates. Outcome measures will be recorded at baseline, 6 months and 12 months. In accordance with the UK Medical Research Council guidelines on the evaluation of complex interventions, a process evaluation will be carried out; qualitative interviews with patients and staff will explore general views of IPS as well as barriers and facilitators to implementation. Fidelity reviews will assess the extent to which the services follow the principles of IPS prior, during and at the end of the trial. ETHICS AND DISSEMINATION Ethical approval was obtained from the East Midlands Research Ethics Committee-Nottingham 1 (REC reference number 15/EM/0253). Final and interim reports will be prepared for project funders, the study sponsor and clinical research network. Findings will be disseminated through peer-reviewed journals, conferences and event presentations. TRIAL REGISTRATION NUMBER NCT02442193; Pre-results.
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Affiliation(s)
- N Khalifa
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottingham, UK
| | - E Talbot
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - J Schneider
- University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottingham, UK
| | - D M Walker
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - P Bates
- Patient and Public Involvement Lead, Nottingham, UK
| | - Y Bird
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - D Davies
- Leicestershire and Rutland Probation Trust, Leicestershire, UK
| | - C Brookes
- Leicester Clinical Trials Unit, University of Leicester, Leicester, UK
| | - J Hall
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - B Völlm
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottingham, UK
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Schneider J, Akhtar A, Boycott N, Guo B, Latimer E, Cao Z, McMurran M. Individual placement and support versus individual placement and support enhanced with work-focused cognitive behaviour therapy: Feasibility study for a randomised controlled trial. Br J Occup Ther 2016. [DOI: 10.1177/0308022615619184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Employment is a key goal for many people with long-term mental health issues. Evidence-based individual placement and support is a widely advocated approach. This study explored whether individual placement and support outcomes could be enhanced with work-focused counselling. Method The study was designed as a pragmatic randomised controlled trial comparing the cost-effectiveness, in severe mental illness, of work-focused intervention (intervention) as an adjunct to individual placement and support compared to individual placement and support alone (control). Results The original sample (330) proved impossible to attain so the design was revised to a pilot study from which information on feasibility of a full trial could be drawn. Twenty-five individuals out of 74 found paid work but no difference was found in the mean number of hours in paid employment between the intervention and control groups. Conclusion Results demonstrate that delivering work-focused counselling in tandem with individual placement and support is feasible and acceptable to service users. The study observed that, even during a period of recession (2010–13), individuals with mental health problems succeeded in obtaining paid employment. Any additional benefit of counselling over individual placement and support alone could not be ascertained, due mainly to the high drop-out rate from this study.
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Affiliation(s)
- Justine Schneider
- Professor of Mental Health and Social Care, School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Athfah Akhtar
- Lecturer in Applied Psychology, Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - Naomi Boycott
- Psychologist, Collaboration for Leadership in Applied Health Research and Care East Midlands, University of Nottingham, Nottingham, UK
| | - Boliang Guo
- Assistant Professor in Medical Statistics, Faculty of Medicine, University of Nottingham, Nottingham, UK
| | - Eric Latimer
- Research Scientist, Douglas Mental Health University Institute, Montreal, Canada
- Professor, Department of Psychiatry, McGill University, Montreal, Canada
| | - Zhirong Cao
- Statistical Analyst, Douglas Mental Health University Institute, Montreal, Canada
| | - Mary McMurran
- Professor of Personality Disorder Research, Institute of Mental Health, University of Nottingham, Nottingham, UK
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