PATHWAYS TO WORK AND WELLBEING: EMPLOYMENT PREDICTORS AND CHANGES IN HEALTH AND WELLBEING IN INDIVIDUALS PARTICIPATING IN THE INDIVIDUAL PLACEMENT AND SUPPORT PROGRAMME

Background: IPS (Individual Placement and Support) programme is an evidence-based practice to promote the employment of people with severe mental health disorders in the competitive labour market. There is already a considerable body of research evidence on the employment outcomes of the IPS programme, but more knowledge is needed about the factors that contribute to successful employment. Further, more understanding is needed on potential of the IPS programme to also promote, besides employment, the health and wellbeing of programme participants. Objectives: The present study aims, firstly, to determine the factors that predict employment among IPS programme participants, and secondly, to investigate the changes in health and wellbeing in individuals participating in the IPS programme. Materials and methods: The study sample consisted of 249 individuals participating in the IPS programme in Finland, all of them diagnosed with a mental illness, most of them with psychotic disorders. The data were collected through questionnaires from programme participants at baseline and at one-year follow-up, and from IPS employment specialists at the end of the programme. The questionnaire for the participants included several validated scales measuring, e.g. self-esteem, mental health symptoms and experience of social inclusion. The data used for the study also included IPS client documentation in terms of employment. Results: Of the programme participants, 49% found employment in the competitive labour market at least once. Educational attainment and factors related to clientcoach relationship (client’s level of engagement, the presence of a trustworthy client-coach relationship and the frequency of meetings between client and employment specialist) emerged as the primary predictors of employment. Neither participants’ sociodemographic characteristics nor health and wellbeing related factors statistically significantly explained employment outcomes. At the one-year follow-up, health and wellbeing of programme participants had improved in terms of self-rated health, perceived social inclusion, self-esteem and mental health symptoms. These changes were primarily statistically significant among the participants who gained employment. Nevertheless, self-rated health showed improvement irrespective of employment status. Conclusion: The study highlights the crucial role of the quality of the client–coach relationship within the IPS programme as a central mechanism of getting employed. The findings also challenge the traditional assumptions about who is “ready” for employment and highlights the inclusive potential of IPS, which emphasizes motivation and relational support over clinical or diagnostic thresholds. Positive changes in the health and wellbeing of IPS programme participants seem to be primarily related to employment, supporting the assumption that work can support recovery from mental illness and promote social inclusion.