The challenge of integrating employment and treatment services to support people with severe mental illness to gain occupation

    Publikation: Konferencebidrag uden forlag/tidsskriftAbstraktForskning


    People with severe mental illness are one of the most marginalized groups at the labour market. According to OECD (2012), the unemployment rates are 3-6 times higher for people with severe mental disorder than for people with no mental disorder. One of the main challenged to support people with mental health problems to gain employment is the mismatch between their needs and the services that are provided. Often, the mental health and the employment sector operate independently of each other’s, with different objectives and approaches, and under different government authorities. This further marginalize people with mental illness. Hence, OECD call for a policy transformation that integrate the two services to improve the labour market inclusion of people with mental health problem (OECD 2015). In recent years the Nordic Countries have addresses this challenge through a more inclusive employment policy and emphasized a support system based on evidence-based supported employment methods (Marktröm et al. 2015). One example is the Individual Placement and Support (IPS) approach, developed in the US in the 1980’s, and introduced in the Nordic employment services through the last few years. IPS is a supported employment program targeted towards people with severe mental illness. Integration between employment services and mental health treatment teams is a central part of the program. This presentation focuses on the implementation of IPS in a Danish welfare context. The paper examines how institutional logics theory can be applied to the implementation process (Thornton et al. 2012). Within the organisations involved in the process of implementation, institutional logics determine what practices and symbolic constructions are acceptable or unacceptable. Insight from institutional logic theory can explain factors facilitating or challenging the implementation of IPS. The study is a multiple case study from four IPS Danish settings, and builds on document-analysis and interviews with stakeholders. Empirical data have been analysed using content analysis. The study shows how the implementation is challenged by institutional complexity of the Danish welfare system. The IPS method’s “place-train” logic is contested by the traditional employment services “train-place” logic. Furthermore, traditional employment services support methods that are more generic, which challenge the sustainability of a specialised employment service such as IPS. The integration of IPS in the mental health services is faced by a treatment logic based on lean techniques. Time spend on IPS activities are at risk of being defined as waste that should be removed. The informal relationship between IPS specialist and members of the clinical team facilitates the integration of IPS in the treatment of people with severe mental illness. The findings illustrate how the institutional complexity of the Danish welfare system challenge the shift towards a more inclusive employment policy.
    StatusUdgivet - 2018
    BegivenhedNordic Work Life Conference NWLC 2018 - OsloMet – Oslo Metropolitan University, Oslo, Norge
    Varighed: 13 jun. 201815 jun. 2018


    KonferenceNordic Work Life Conference NWLC 2018
    LokationOsloMet – Oslo Metropolitan University