The IPS fidelity scale as a guideline to implement Supported Employment

Objective: Despite the wish of many people with SMI to work in a competitive job, employment rates are low. IPS is more effective than other vocational rehabilitation methods in achieving employment and its use should be extended to bridge the gap between user wish and reality. This study measures possibilities to implement IPS in Flanders, by investigating current use, barriers and facilitators across a wide range of services. Method: Semi-structured interviews with 17 vocational rehabilitation agencies were conducted, using the IPS Fidelity Scale and a list of open-ended questions on perceived barriers and opportunities. Results were analyzed via thematic analysis. Results: Results show an overall lack of implementation of IPS in Flanders, especially on the four core elements for which most evidence exists. An external style of attributing barriers to environment factors or client characteristics is apparent which could lead to a sense of resignation among counselors. Conclusions: The use of the IPS fidelity scale and open-ended questions has provided concrete levers to prepare for implementation: a strong leadership in the agencies to encourage optimism towards regular employment for people with SMI; closer co-operations between employment agencies, care agencies and employers; and a more facilitating legislation concerning using IPS.