Abstract
Vocational rehabilitation for people with severe mental health problems is poorly developed in the UK. Although a high proportion state they would like to work, few actually do. This paper reports a pre and post design comparing the outcomes of two vocational services in the UK: an Individual Placement and Support (IPS) service and a non-integrated pre-vocational service in addition to employment outcomes, we report fidelity ratings, service costs and findings from a survey of user experiences of mental health services two years after implementing IPS. The study shows that high fidelity IPS was significantly more effective in enabling people with severe mental health problems to gain and retain open employment. After two years of full IPS implementation a significantly greater proportion of service users reported that they received help with vocational needs with decreased unmet vocational need in comparison to the non-integrated pre-vocational service. In addition, service user expectations to gain open employment appeared to increase in comparison to the non-integrated pre-vocational service. The IPS service was 6.7 times financially more efficient in terms of delivering open employment outcomes than the non-integrated vocational service.