1. Working Your Way Through Recovery
Maria Hilditch, Specialist OT
Jan McGall, Lead OT

2. Objectives
Provide an overview of current mental health policy and drivers for change in Northern Ireland and United Kingdom
Review the link between employment and mental health recovery
Provide an overview of the supported employment initiatives within the Belfast Health and Social Care (BHSCT) for mental health service users

3. Outcomes Gain a greater understanding of
the impact of mental ill-health on the worker role
Recognise the necessary change in policy and
service provision in supporting employment;
Gain an understanding of mental health care priorities in Belfast in ensuring employment is a realistic recovery goal for service users

4. Where are we now?
32% of people with a disability are in employment in Northern Ireland
Mental and behavioural disorders make up the largest diagnostic category for Employment Support Allowance
Long term unemployment and increased risk of mental health problems
Unemployment: increased risk of suicide

5. Drivers for Change
Research shows that those in paid employment are 5 times more likely to achieve functional remission than those who are unemployed or in unpaid employment
Recovery and Work
Recovery: an ethos to guide practice and also a personal journey for individuals
Benefits of work in recovery

6. Policy Perspective
Dame Carol Black: Working for a Healthier Tomorrow 2008
The Review of Mental Health and Learning Disability (Northern Ireland) June 2005: The Bamford Report
Recovering Ordinary Lives, The Strategy for Occupational Therapy in Mental Health Services

7. Key Service Changes Where have we come from?
Principle that work is important in in everyone’s life has always been there
50 years ago, large psychiatric institutions on the outskirts of city which were self sustaining in many ways but with many issues around individual rights
Move towards community care and reintegration and need to develop real employment initiatives reflective of individual skills

8. Key Service Changes How has this developed: Recovery focused
Individualised
No ceiling on what you can and cannot do
Continuum of options – voluntary work, paid work, part-time etc with a value on productive roles, including homemaking

9. Overview of Supported Employment Initiatives in BHSCT
Individual Placement and Support (IPS)
Exemplar Employer
Acute Care Job Clinic

10. Where we started from
Images supplied courtesy of

11. Video

12. Why IPS Zero exclusion Competitive employment is the goal
Specialist integrated within the mental health team
Rapid job search
Individual job preferences
Employment specialists develop relationships with employers based upon a person’s work preferences
Ongoing time-unlimited support
Personalised benefits counselling

13. Barriers to employment
Stigma (3 components – ignorance, prejudice and discriminatory practices)
Over protective families/professionals
Self stigma (negative past experience, low self efficacy)
Benefits trap
Resources for employability
Side effects of medication

14. IPS Process and Implementation
Referral received
Initial joint meeting with client within one week
Service explained – OT role and ES role
Job search initiated – clinical needs addressed in parallel
Key worker remains involved
Ongoing support from ES and OT for client and employer

15. Roles within IPS Role of Employment Specialist
Role of Occupational Therapist

16. Where are we going?
Increase in the employment rate for our service users
Work is firmly on the agenda
Independent evaluation
Chairman’s Award
Implementation across Recovery and Early Intervention Teams

17. Exemplar Employer Rationale – BHSCT Process Ring fenced posts
Support of Workable and other partnership working
Outcomes

18. Acute Care Job Clinic
Ethos
Location
Outcomes / Formative Evaluation

19. Summary