Working at the Interface Between Science and Culture: The Enablers and Barriers to Individual Placement and Support Implementation in Aotearoa/New Zealand

• Published in: Psychiatric rehabilitation journal 2020-03, Vol.43 (1), p.40-52
• Main Authors: Priest, Becki, Lockett, Helen
• Format: Article
• Language: English
• Subjects: Addiction; Assistance (Social Behavior); Culture; Employment; Employment Status; Employment, Supported; Evidence Based Practice; Female; Government Policy Making; Health Services Accessibility; Human; Humans; Implementation Science; Male; Mental Disorders; New Zealand - ethnology; Placement; Program Development; Psychiatric Rehabilitation; Rehabilitation, Vocational; Sociocultural Factors; Supported Employment
• ISSN: 1095-158X; 1559-3126; 1559-3126
• DOI: 10.1037/prj0000388

Objective: To identify the factors that help and hinder the implementation of individual placement and support (IPS) practices in the Aotearoa/New Zealand (Aotearoa/NZ) context. Methods: An examination of the conceptual and empirical literature on IPS implementation in Aotearoa/NZ and a prospective cohort study of people with mental illnesses and/or methamphetamine addiction participating in a newly established IPS program. Results: IPS programs have been operating in Aotearoa/NZ for more than 10 years, but coverage across the country is patchy and access inequitable. Previous public policy, contracting, and funding systems limited the availability of IPS programs, and in some cases operated as a barrier to the provision of integrated health and employment services. There is an opportunity for change, with a greater focus in government policy on mental health and addiction and achieving equity, a plan for cross-government policy solutions, and a recently established technical assistance organization to support new and existing IPS implementation. Facilitating implementation conditions include technical assistance, service integration, supportive contracting, and attention to culture. In 1 program where these conditions were in place from the outset, IPS fidelity reached 107/125; 41.1% of participants had commenced employment; and the program was achieving equity of engagement and outcomes for indigenous Māori people within 15 months of program establishment. Conclusions and implications for practice: Although IPS programs have been successfully implemented in Aotearoa/NZ, availability and access to them remains limited. Identifying the enablers and barriers to IPS implementation specific to the Aotearoa/NZ context could inform future IPS implementation and national program scale-up. Impact and Implications Individual placement and support (IPS) can be implemented in Aotearoa/NZ. IPS programs are particularly effective if combined with implementation support and practitioners pay attention to the needs of the indigenous Māori culture. This is demonstrated through a case example. Policy and contractual requirements also impact on successful IPS program delivery.