Search

Background: A 12-month study of UK supported employment providers found that 77 (54.6%) of the participants in the study remained unemployed, 32 (22.7%) got jobs and 32 (22.7%) retained the jobs they held at the outset. Aims: To explore the impact of moving into employment on service use, earnings, benefits and tax allowances claimed. Methods: Service use and frequency were measured at baseline and 12 months. Comparisons paid particular attention to the differences between people entering work and those who remained unemployed. Costs were analysed from a government perspective (excluding earnings) and a societal perspective (excluding welfare benefits and taxes). Results: People who entered work reduced their consumption of mental health services ( p < 0.001). However, use of supported employment increased ( p = 0.04), in contrast to falling use by people who remained unemployed ( p < 0.001) and those who had been working for more than one year ( p = 0.002). The increase in earnings for those entering work ( p = 0.02) was not offset by a similar reduction in benefits. Conclusion: This indicates that mental health services may make savings as a result of their clients engaging in paid work. It raises questions about the optimal nature and organization of employment support for this service user group. [ABSTRACT FROM AUTHOR]

Background: The UK government is advocating the use of supported employment to help people on incapacity benefits back to work, with an emphasis on Individual Placement and Support (IPS) models. However there is little UK-based evidence on the key ingredients of effective support. Aim: To ascertain service users' views of what they found helpful about supported employment. Method: Interviews were carried out with 182 people with severe and enduring mental health problems who were actively engaged with one of the six supported employment agencies included in the study. Results: Three themes emerged: emotional support, practical assistance and a client-centred approach. Conclusion: The findings highlight the importance of the quality of support, particularly through interpersonal dynamics, which go beyond the organizational features emphasized in the IPS model. Declaration of interest: The study was financed from Higher Education European Social Fund Objective 3 resources and the six partner agencies made contributions in kind. [ABSTRACT FROM AUTHOR]

The thrust of this paper is to argue that Habermasian theory can provide useful insight and understanding to inform participatory research in the area of forensic mental health care. Habermasian theory about communication, participation, and democracy is used to explore retrospectively the relatively free discussions that took place within a user-led research project evaluating forensic mental health care. We (the academics within the research project team) first describe the stages of the research project, outlining how it opened up space for discussion about service users' experiences of the forensic mental health care they had received. Habermas's distinction between 'strategic action' (orientated towards getting things done) and 'communicative action' (interaction orientated towards freely agreeing consensual understanding) is then explored in a re-analysis of users' accounts of the interactions they recalled having with service providers. We then offer an account of interactions between service user researchers presenting their work at academic forums and their audiences of service providers. In particular, we look at the communication that occurred and, again using Habermasian theory, consider the issues that arose about open discussion and similarities and differences between therapy and participatory research. [ABSTRACT FROM AUTHOR]