Employability West Cork: Implementation of the IPS model

1. Employability West Cork: Implementation of the IPS model Celine O’Donovan, Co Ordinator Employability Service West Cork BA(Sociology/Philosophy) MA (Sociology)

2. Supported Employment in Ireland • FAS funded model • Operation since 2001 • Free service • For people with mental health, intellectual, physical and sensory disabilities who are ‘job ready’ to enter or re enter mainstream work • Client led service • Job coach support • A support to both employer and client • 23 organisations in the country

3. 1 of 23 SUP organisations Remit: West Cork region from Castletownbere to Kinsale Population - 80,000 5 offices 125 clients on books 80% Mental Health clients, 10% Intellectual Disability Clients, 7% Physical Disability and 3% Clients Approximate clients in employment figure is 65% at any one time. Ran by Board of Voluntary Directors – from organisations West Cork Mental Health, CoAction, COPE, West Cork Development Partnership, RehabCare. Chairperson ES West Cork is Fiona Murray – Manager of National Learning Network (NLN) Employability Service West Cork

4. Achievements to date • One of the highest Achieving SUP organisations for past 5yrs (2006-2011) • Percentage of clients in work per month surpass FAS target per month • Presence in each major town, through external Offices • Patron - Lord David Puttnam • Inclusion MDT meetings

5. Unemployment figuresin West Cork 2007 and 2011 • Sept 2007 – 3093 • March 2011 – 8782 • Increased clients into work during this challenging time from 25% (2005) to 65% (2011) • HOW? • Business Consultant to upskill staff re sales in 2007 • Partnership Approach with other agencies ie NLN, Rehab Care, CoAction and COPE • Inclusion with MH services in MDT meetings

6. Not happening in isolation Mutual referrals between NLN (Employer Based Training) to ES West Cork – for next step. Referrals back to NLN, from ES West Cork if client needs more training for the work place. All three agencies work together = success for client NLN provide the Training process of IPS ES West Cork provide the employment process of IPS ES West Cork would not be as successful in finding work for clients, but for this relationship with NLN and WCMH. ES West Cork staff attended FETAC training on Mental Health Awareness. Tri Partnership WCMH/NLN/ES West Cork

7. Individual Placement and Support (IPS) integrates clinical and vocational services within mental health agencies. Goal – competitive integrated employment Job obtained directly. Employment Facilitators & mental health services merged. Employment Facilitators work directly with clinical teams to ensure coordinated services. Client Led The IPS model uses a "place-train" approach. Thus, based on the assumption that the job seeker benefits from learning on the job more than through pre-employment screening and training in sheltered work settings. All is being achieved within Supported Employment except that the vocational services are not being integrated with mental health agencies IPS Model

8. Vision for Change • Vision for Change (2006) • Revolutionary overhaul of existing services • Based on the ‘Recovery Model’ ethos. • Service-user at the heart of his/her own recovery journey. • Partnership approach between relevant agencies • Paid Employment seen as key to recovery • Martin (2008) “A best practice model needs to be developed and implemented with all the relevant parties on board, including the stakeholders. There is need for an innovative approach – a shift from the ‘whose client is it?’ approach towards a partnership approach where the client is placed in charge of his own recovery process” • Drake (1998) spoke about “ Employment Facilitators ‘integrating’ with mental health services and the establishment of formal and informal relationships between all the parties, including the job seeker in ‘shared decision making, co-ordinated planning”

9. Burns Research 2007 • Compared IPS with other vocational / rehabilitation services in six European countries. It was concluded: • IPS clients were twice as likely to gain employment and worked for significantly longer • individuals who gained employment had reduced hospitalisation rates.

10. Previous distant relationship on an ad hoc basis with Mental Health Services in West Cork 2% clients per year from WCMH (2001-5) Major client group who needed our service Decision to work closer with all referring organisations – especially Mental Health Services, with new team and co ordinator 2006 Mutual beneficial relationship between NLN and ES West Cork in terms of mutual referrals in client best interest, as mentioned earlier. Why ES West Cork implemented IPS Model

11. Meetings with Clinical Director WCMH Services and Director of Nursing, WCMH Services re objectives of closer relationship. Results achieved ensued more engagement from MH services, over the year (2006-7) Built up credibility. Invited to present to MDT meetings to outline on 6mthly basis to MH professionals in each geog area – who ES West Cork were. Having seen results of increased figures from 25% clients in work (01-05 – boom time years), to 65% figures in work (recessionary times) – easier to obtain access to meetings. Noticed lack of Us/Them relationship with MH services 2007/11 Invitation to sit in on MDT meetings, on regular basis to discuss mutual clients from 2007 with open communication from NH – with consent of client. On going plan to be a permanent feature on MDT meetings – re clients. How ES West Cork implemented IPS model

12. 90% of our clients embrace the PIPS model, for those who do, all be it anecdotal , the success rate for finding a job is far greater. The clients feel there is a group of people looking out for them not just one person. Feeling of support of joined up supports – the option of retraining with NLN, for example. Feeling of overall support Reaction of Clients

13. Joined up supports mean that the client’s needs are addressed, by all supports – health and employment in this case through communication Full disclosure given by client at outset Thus notification of ill health/improved health (MH Services) and job outcomes/successes by SUP organisation can be highlighted mutually, and thus, enhance SUP organisation abiliity to obtain work for client and MH service to be up to date on outside agencies work and outcomes with that clients – all = benefit for client 2% referrals from MH Services in 2005 to 45% in 2010/11 to ES West Cork. Clients in Work – 2001/5 – 25% Clients in Work – 2010/11 – 65% Effectiveness of IPS model

14. Dr Pat Bracken, Clinical Director of West Cork Mental Health Services “In my opinion, employment and occupation are very often of crucial importance when it comes to mental health. I have found the inputs from Employability West Cork fantastic! They provide vital support for individuals who are struggling to get back on their feet and who are seeking access to the jobs market. The work they do is tremendous" (Bracken, 2011)

15. Kevin O’Hanlon - Clinical Nurse Specialist – West Cork Mental Health Services ‘I have only had excellent feedback from the many clients that I have mutually referred to ESWC and worked with within the MDT meetings. ESWC has provided a dignified, sensitive, and helpful service where clients with mental health issues have been treated with the respect they are worthy of from the coordinator and all of the job coaches I have dealt with. . Pivotal to its success I believe, is its organizational culture at local level, and especially its staffs positivity, helpful, and personable attitude which is so hard to quantify and yet so easy to recognize.’

16. Maintaining presence at MDT meetings - we are still at the early stages. We are still attending MDT meetings, to discuss mutual clients, re employment To keep this relationship going We are a long way from the ideal of an employment specialist being part of the Multi Disciplinary Team, as in the UK. However, having researched amongst all SUP organisations in the country, ES West Cork are the only organisation with a consistent presence within the MDT meetings, or any presence within MDT meetings. Challenges

17. To maintain our own close relationship with the Mental Health Services - there is a long way to go until we will become part of their Multi Disciplinary Team – we have come as close as possible to the ideal so far. We are presently sitting in on MDT meetings – the only Supported Employment Organisation in the country to do so. We want a closer involvement nationally, for SUP organisations to be part of multi disciplinary teams. There are Employment Specialists in 11 out of 23 South West London Community Mental Health Teams (Rachel Perkins presentation) This is not happening in Ireland. ES West Cork is coming close to it, at a local level. This needs to be happening at National Level – as the Vision For Change document advocated: The Vision For Change document advocated a revolutionary overhaul of existing services and is primarily based on the ‘Recovery Model’ ethos. The fundamental characteristic of the recovery model is the positioning of the service-user at the heart of his/her own recovery journey. It encompasses partnerships between all the relevant parties in this journey towards wellness. Accessing paid employment is considered to be a fundamental ingredient of an individual’s recovery journey Future Plans