Barriers and facilitators of the implementation of Individual Placement and Support (IPS) for patients with offending histories in the community:: the UK experience

Abstract

Introduction: we aimed to identify the barriers and facilitators to the implementation of a high fidelity IPS service in a community forensic mental health setting.

Method: in-depth interviews were conducted with clinical staff (n=11), patients (n=3), and employers (n=5) to examine barriers and facilitators to implementation of a high fidelity IPS service. Data was analysed using thematic analysis, and themes were mapped onto IPS fidelity criteria.

Results: barriers cited included competing interests between employment support and psychological therapies, perceived patients’ readiness for work, and concerns about the impact of returning to work on welfare benefits. Facilitators of implementation included clear communication of the benefits of IPS, interdisciplinary collaboration, and positive attitudes toward the support offered by the IPS programme among stakeholders. Offences, rather than mental health history was seen as a key issue from employers’ perspective. Employers regarded disclosure of offending or mental health history as important to develop trust and to gauge their own capacity to offer support.

Conclusion: implementation of IPS in a community mental health forensic setting is complex and requires robust planning. Future studies should address the barriers identified and adaptations to the IPS model are needed to address difficulties encountered in forensic settings.

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Identifiers

ORCID for Dawn-Marie Walker: orcid.org/0000-0003-2135-1363

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