Umeå University's logo

Individual Placement and Support is an evidence-based method created to support people with mental health problems reach vocational goals. The IPS-Y fidelity scale builds on IPS principles to reinforce a focus on young adults and their need for educational supports. Through 13 focus group interviews, this study explored practitioners’ considerations of program fidelity in relation to cultural and contextual issues regarding IPS-Y in Sweden. Findings suggest that various welfare contexts and organizational challenges impact service delivery. Practitioners were driven to better meet the individual needs of young adults, intentionally adapting their method and approach.

Offering supports for young adults with mental health problems in their educational and vocational pursuits promotes well-being, social inclusion, and self-sufficiency. It is therefore important that welfare actors offer services to this group. However, in Sweden, with a tradition of local self-governance and municipal autonomy, decisions regarding which services to offer may depend on perceptions of responsibility by managers. The aim of this study was to explore top-tier management’s perspectives on responsibility for young adults with mental health problems when offering vocational and educational support through municipal welfare services. The seven top-tier managers interviewed articulated the importance of offering this support, but at the same time expressed ambiguity regarding which welfare system organization should be responsible. The results suggest that these managers demonstrated key aspects of professionalism in prioritizing the needs of their clients over perceived organizational responsibility, thereby providing these young adults with opportunities that may not be available in other municipalities.

Purpose: Rural communities face specific challenges when attempting to implement evidence-based interventions, due to their size, distance from knowledge centers, and broad responsibility for the local population. The aim of this study was to investigate the utilization of an RPC (Research Practice Collaboration) initiative as a strategy for translation and implementation of EBPs in rural municipalities seeking to develop their services for individuals with serious mental illness.

Materials and Methods: Following a broad invitation consisting of a presentation of the newly produced National Psychiatry Guidelines, to four northern regions in Sweden, four municipalities participated in an RPC process that focused on the implementation of specific EBPs.

Results: In addition to confirming many of the challenges in rural areas, the participants reported that the RPC process helped them to understand the relevance of these methods to their own conditions and ambitions. They were able to recognize and build on their already existing strengths and achieve incremental steps toward EBPs.

Discussion: The collaborative nature of the structure and knowledge dissemination, requiring extremely tailored implementation strategies while considering the essential components in relation to local conditions, led to increased readiness to implement these practices as locally relevant.

Conclusion: Research practice collaborations may contribute to the implementation of EBPs in rural areas by increasing the accessibility and relevance of these methods in these challenging conditions. Identifying structures for sustainably supporting these types of collaborations is a challenge for national actors.

Background: Rural communities face specific challenges when implementing evidence-based practices (EBPs) due to their size, remoteness from knowledge centers, and broad responsibility for the local population. Studies indicate that these challenges can negatively impact the development of best practice for individuals with serious mental illnesses.

Purpose: The aim of this study was to investigate the utilization of an RPC (Research Practice Collaboration) initiative as a strategy for translation and implementation of psychiatric rehabilitation methods in rural municipalities.

Method:  With the starting point in form of a seminar where the updated National Psychiatry Guidelines were presented, four rural municipalities from the north of Sweden engaged in an RPC process, focusing on implementing specific recovery-oriented EBPs, including Individual Placement and Support and Shared Decision-Making.

Results: In addition to confirming challenges in rural areas, the RPC process helped the participants to understand the relevance of these practices to their own conditions and ambitions for individuals experiencing mental health problems. The municipalities were able to build on their already existing strengths and achieve incremental steps towards providing improved services.

Conclusions: The collaborative nature of the RPC structure, requiring locally relevant, tailored implementation strategies, while considering essential method components in relation to local conditions, led to increased readiness to implement these practices. Research practice collaborations may contribute to the implementation of methods based on best practice in rural areas by increasing their accessibility and relevance in these challenging conditions.

The integration of peer support workers (PSW) into the mental health services workforce has offered additional avenues to strengthen service provision. In Sweden, the availability of peer support workers has grown significantly over the past decade, yet there has been insufficient investigation into their organization and implementation. Consequently, there is a growing need for further research into the current state of peer support within the Swedish context. To examine stakeholders’ perspectives on the current state of peer support within the context of Swedish mental health services. In this qualitative study, a purposeful sampling method was employed in order to recruit 30 stakeholders, including peer support workers (n = 17) within mental health services, county council and municipal officials (n = 8), and representatives from user organizations (n = 5). The informants took part in focus groups or semi-structured individual interviews. The results highlight key factors from stakeholders for advancing peer support, providing PSWs with career paths and skill development, and advocating to top-level authorities. Organizational structures need to support sustainability, with Sweden's user organizations playing a crucial role to mitigate peer drifting. Long-term success relies on secure employment and a clear implementation strategy. The physical work environment shapes peer support implementation and requires clearly defined work roles. Navigating mental health services was viewed as challenging. According to the results, it requires stakeholders to balance perspectives and address feelings of inadequacy among PSWs, underscoring the need to legitimize the PSW profession in mental health care. To ensure genuine progress in the current organization of peer support, this work role must become a foundational aspect of service delivery, rather than merely an add-on, to foster the development of a more recovery-oriented mental health service in Sweden.

Mental health problems among young adults often lead to obstacles to completing higher education and becoming established in the labour market. It is important to offer support that can help these individuals realize educational and vocational goals in order to become self-sufficient and achieve social inclusion. Individual Placement and Support (IPS) and Supported Education (SEd) are two methods developed for supporting people with mental health problems in attaining competitive employment and reaching educational goals. These methods have not been widely implemented in Sweden, therefore making it interesting to study management perspectives in organizations offering IPS/SEd. The study aimed to explore the reasoning and strategies managers described in offering vocational and educational support to young adults with mental health problems. This study is based on 12 qualitative interviews with managers from six units in Sweden offering support through IPS/SEd. Results show a variety in interpretation of legislation and responsibility for young adults with mental health problems. The managers were positioned between policy and practice, having to navigate between the organizational restraints and their professional assessment in offering this support and pushing traditional boundaries in prioritizing long-term individual goals over short-term economic and political considerations. These managers demonstrate the possibilities for how IPS/SEd can be implemented and made to fit different organizational contexts, even within a highly sectorized welfare system as in Sweden. However, the methods might need to be adapted and adjusted to not only fit local organizational restraints, but also to fit into the Swedish welfare system.

Psykisk ohälsa är ett växande problem bland unga vuxna och att kunna studera trots denna utmaning är avgörande för framtida möjligheter och självständighet. Den här boken presenterar metoden Supported Education (SEd) som syftar till att ge individanpassat stöd för att unga vuxna med psykisk ohälsa ska kunna ta klivet in i studier och vidare i livet.

Objective: Supported education (SEd) provides individualized support to people with mental health problems to achieve their educational goals. Individual placement and support (IPS) has emerged as a model through which SEd may be efficiently delivered. However, the components and characteristics of educational support for these employment-focused services have not been fully explored. Building on earlier studies, we constructed a preliminary model of SEd components that integrated with the IPS model. The SEd model included the eight original principles of IPS, developed to reflect the SEd component, and two new principles were suggested. The aim of the study is to investigate these adapted principles by exploring the feasibility of applying them within established IPS programs providing both employment and educational services.

Methods: An organizational learning approach was taken, involving five IPS programs providing both employment and educational services to young adults with mental health problems. Data were collected through focus groups, interviews, and workshops with 19 IPS specialists.

Results: The results suggest that while the IPS principles provide a feasible and relevant structure for the development and provision of integrated services, adaptations that reflect the educational context were considered valuable when supporting young adults in pursuing their career-related goals. Conclusions and

Implications for Practice: The respondents confirmed that the SEd principles and the focus on support in educational contexts helped them to further develop their knowledge and strategies. While challenging, integrating SEd in IPS models shows good potential for supporting young adults as they struggle to reach longer term career-oriented goals. 

Mental health problems often appear at a young age. As the labour market places higher demands for education and competence, mental health services are focusing on young adults’ support needs for school and career opportunities. This study is a single case of an integrated supported education and employment unit in Sweden over an 18-month period. Multiple data sources illustrate the process of supporting careers and transition to school and work for young service users. This is a promising example of how careers can be supported through a flexible service that provides support for successful individual education and work trajectories among the youth. The service allowed for evolution of an identity process towards recovery through student and work roles.

Background: The purpose of this paper is to outline the protocol for the research program "UserInvolve", with the aim of developing sustainable, service user involvement practices in mental health services in Sweden.

Methods: This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022–2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice.

Results or conclusion: The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field.