Sussex Early Intervention Employment Services. Case Study

Transcription

1 Sussex Early Intervention Employment Services Case Study Page 1 of 9

2 Could you provide relevant facts about the service you provide (numbers of people supported, incl young people; how long you ve provided it for; what type of service it is; who commissions it; who you work with in partnership etc.) Southdown s Employment Services provides Individual Placement and Support (IPS) and Retention employment support to individuals with severe and enduring mental health across Sussex. Southdown has been commissioned to provide these services in Brighton & Hove by the Clinical Commissioning Group, in East Sussex by the East Sussex County Council and the Clinical Commissioning Group and in West Sussex by the Joint Commissioning Unit. Each of these three services operates independently of each other and all have slightly varying remits although the main objective of providing IPS support; closely following all of the eight principles of IPS: 1 Every person with severe mental illness who wants to work is eligible for IPS supported employment. 2 Employment services are integrated with mental health treatment services. 3 Competitive employment is the goal. 4 Personalized benefits counselling is provided. 5 The job search starts soon after a person expresses interest in working. 6 Employment specialists systematically develop relationships with employers based upon their client's preferences. 7 Job supports are continuous. 8 Client preferences are honoured. All three services work in partnership with the Sussex Partnership NHS Foundation Trust (SPFT). Southdown s Employment Specialists and Team Managers are fully integrated and based within the SPFT Mental Health teams. Southdown and the Sussex Partnership Foundation Trust have a signed Memorandum of Understanding which has aided in the implementation of this working partnership. Funding History Brighton & Hove Commissioned to provide vocational support to clients with severe and enduring mental health using the IPS model 2013 Commissioned to include IPS support within the Early Intervention service (EIS) by providing one FTE employment specialist to work within the EIS team. The employment team consists of one team manager and five FTE employment specialists. East Sussex 2009 Commissioned to provide IPS support to clients with severe and enduring mental health across the whole of East Sussex; including one FTE employment specialist to work within the EIS team. The employment team consists of one team manager and seven employment specialists Page 2 of 9

3 West Sussex Commissioned to provide IPS support to clients with severe and enduring mental health across the whole of West Sussex; including one FTE employment specialist to work within the EIS team. The employment team consists of one team manager and 7.5 employment specialists Southdown Caseload Southdown provides support to an average of 1100 individuals per year with active caseloads of 500 individuals on average at any given time. Southdown has supported an average of 150 EIS clients per year supported since 2013 with an active caseload of 80 EIS clients at any given time. Page 3 of 9

4 EIS Caseload Southdown has experienced a steady increase since in the number of EIS clients accessing employment support across Sussex, accounting for 17% of the total number of individuals the Employment Services supported in What are the main success factors for the work you ve done on YP w MH needs? The main success factors of providing employment support to EIS clients begins with the working partnership with the SPFT and the EIS teams, which has provided consistency in the message and practice with employment being an equally important part of the recovery process. This has been achieved in part with team meetings to reinforce staff roles in implementing employment support, information sharing and the sharing of examples of success. The EIS teams are commonly smaller than non-eis teams which facilitate employment support integration positively. Referrals to the employment service occur at an earlier stage of the client s recovery plan than compared to Southdown s non-eis services. The clinical staff within the EIS teams are better vocational orientated and provide direct support to clients to achieve education and voluntary placements thus allowing the employment specialists to focus on paid employment during support. Integration of this standard has translated to wider benefits, by the increased understanding and trust between SPFT and Southdown leading onto efficient service delivery and improved outcomes. Having a dedicated EIS employment specialist is another main success factor to the efficiency of the service, as these dedicated positions have allowed individuals to access employment support on average 38 days earlier than non-eis clients as one example. Page 4 of 9

5 Another example of efficiency is with the length of service use/delivery which is 69 days less for EIS clients compared to non-eis Clients Client motivation is another success factor with EIS clients with 81% of clients referred to Southdown s employment services commencing the service compared to 63% of non-eis referrals commencing service. What have been the main barriers to the work you ve done on YP w MH probs? A significant barrier for EIS clients is the fact they are often coming straight from an education background, such as college, and have not had previous work experience and therefore can be viewed as having a lack skills and experience needed to secure employment. Clients can at times have an unrealistic perspective of time frames required to achieve their employment ambitions. Often with the experience of psychosis there is a period of profound low self-esteem which brings a challenge for the employment specialist to maintain momentum, as well as building resilience as a fear of relapse is a huge source of stress and a continuation of symptoms, contributing to stress vulnerability. Page 5 of 9

6 Support networks are often void and these are essential to recovery. Southdown works with the clinical team to support clients in this situation. Employment specialists have also at times included EIS client family members in the clients support plan. Clients have disclosed that they have experienced negative peer pressure, Southdown s employment specialist work closely with the clinical teams to support the client to overcome this. Criminal convictions and an understanding of the law around disclosure can also be barriers. What difference has your work made? This could be either for individuals (i.e. a story) or more generally. If you have any data/figures that might help draw out this success a bit, then that would be great Across Sussex we have provided employment support to 150 young people on average per year. This accounts for approximately 28% of the total amount of young people accessing EIS services in Sussex. EIS clients achieved a total of 99 paid outcomes during the past 23 months (April 2013 to Feb 2015) which accounts for 16% of Southdown s total paid outcomes achieved. The paid job outcome rate for the EIS client group in (12 months) was 26% of all EIS clients achieving a paid outcome. The paid outcome rate for the period Apr 14 Feb 15 (11 months) was 22%. The table below compares these figures to the non-eis client group. Apr-13 to Mar-14 (12 months) Apr-14 Feb 15 (11 months) EIS Non-EIS 26% 23% 22% 16% Page 6 of 9

7 These outcomes lead to increased annual earnings of 4,299 per person, compared to people using other mental health services. 1 Southdown s EIS clients have expressed positives experiences with the EIS employment service; contributing to clients gaining a positive sense of self identity and confidence, building stronger relationships and networks, financial independence which increases their social capital. Being part of the EIS service has allowed us to be an active part of the EIS model and most importantly, the client s mental health recovery. Additional EIS Data (2014) Vocational Outcomes Other vocational outcomes such as Education and Voluntary account for 26% of the total outcomes achieved. In Southdown s non-eis other vocational outcomes account for 38% of all outcomes. This supports the vocational orientation displayed by the EIS clinical team. 1 Andrews A, Knapp M, Parsonage M, McCrone P, Effective interventions in schizophrenia; the economic case. London School of Economics and Political Science Page 7 of 9

8 Paid outcomes 33% of all paid outcomes achieved were for positions over 16 hours a week and 45% of all paid outcomes were for permanent positions. Age Ranges Page 8 of 9

9 Employment Specialist Case study Before requesting employment support I had never had full time work. I volunteered in a charity shop and delivered newspapers for cash in hand. Although these jobs were enjoyable, I wanted something a little more steady, more challenging and with a higher wage. Also having experience of Mental Healthcare services myself I was keen to look into that line of work and these are the topics we discussed when Lorna and I first started meeting. After highlighting what I wanted to do in terms of work we began more actively searching. As well as the health care service, working for a cleaning company seemed appealing in the shorter term so we began to write my CV and look at efficient ways to search and apply for jobs. What was really helpful with my Employment Specialist is that I would understand myself better through talking to her. It became clear I had the skills and confidence to get these jobs, Lorna really helped me see that. It wasn t long before I found a job with a cleaning company and was earning a wage I was pleased with. What was also great was having stability and a routine from day to day. With some work experience under my belt a few months later I was successful in receiving a job offer for a Healthcare Assistant role at Millview Hospital. I was delighted with this as I had been wanting to give something back to the community that had helped me turn my life back around, especially Lorna and her indispensable support. My advice to others would be to remember there is a lot more to a person than their experiences with mental health problems. Also since finding work my mental health has really improved as these things are all interlinked. Relax, take your time and by working to small targets, it becomes easier to enter into positive cycles. Page 9 of 9