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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]

This paper assesses the extent to which the Individual Placement and Support (IPS) approach is currently adopted in England. Interviews based on the Supported Employment Fidelity Scale were conducted with staff from five of the leading providers of supported employment. One provider obtained a good IPS adherence score, three a fair score and one a non-adherence score. Constraints influencing providers' capacity to provide an IPS service related to funding, values and organizational policy. The authors discuss the implications of these constraints in relation to the recent commissioning guidance for vocational services in the UK. [ABSTRACT FROM AUTHOR]

A comprehensive GPS velocity field along the Dead Sea Fault System (DSFS) provides new constraints on along-strike variations of near-transform crustal deformation along this plate boundary, and internal deformation of the Sinai and Arabian plates. In general, geodetically derived slip rates decrease northwards along the transform (5.0 ± 0.2 to 2.2 ± 0.5 mm yr−1) and are consistent with geological slip rates averaged over longer time periods. Localized reductions in slip rate occur where the Sinai Plate is in ∼N–S extension. Extension is confined to the Sinai side of the fault and is associated with prominent changes in transform geometry, and with NW–SE striking, left-lateral splay faults, including the Carmel Fault in Israel and the Roum Fault in Lebanon. The asymmetry of the extensional velocity gradients about the transform reflects active fragmentation of the Sinai Plate along the continental margin. Additionally, elastic block modelling of GPS velocities requires an additional structure off-shore the northern DSF segment, which may correspond with a fault located along the continental margin, suggested by prior geophysical studies. [ABSTRACT FROM AUTHOR]

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]

In the context of UK policy to promote employment for people with disability as a means to greater social inclusion, this study investigated how people with severe mental health problems fare in existing supported employment agencies. The aim of the study was to identify factors associated with successful placement in work and to test the impact of working on psychological well-being in this group. One hundred and fifty-five users of six English agencies were followed up for 1 year (2005–2006). Information was collected about their employment status, job-seeking behaviour, perceived obstacles to work, self-esteem and hope, and the employment support received. Eighty-two per cent of those working at baseline were still in work a year later. The support agencies helped 25% of unemployed clients into work, a statistically significant increase in the proportion of clients in employment. Gaining employment was associated with improvements in financial satisfaction and self-esteem. There was a trend towards working half time. People who had been out of work longer were less likely to secure employment. No significant associations were found between getting a job and personal characteristics, the quantity of employment support given, nor the recipient's rating of the support offered. The odds of moving into work were nearly four times higher for those people who visited a job centre prior to the start of the study. Clients of specialist agencies rated their provision more highly than clients of pan-disability agencies. These results demonstrate the benefits of working for this group and support the development of employment services with an individualised, rapid placement approach, linked to job centre advice and expert mental health service input. This is consistent with the Individual Placement and Support model, and highlights in addition the importance of job centres for its implementation in England. [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]