Public Sector Supported Employment Programmes: What Works, What Doesn't, and Where Next
The Evidence Hierarchy
Not all supported employment models are equally effective. Decades of research have established a clear evidence hierarchy:
What Works: Individual Placement and Support (IPS)
IPS is the most evidence-based supported employment model, with over 30 randomised controlled trials demonstrating its effectiveness:
Core Principles of IPS:
- Competitive employment as the goal — not sheltered work, not volunteering, not "work readiness training" as an end in itself
- Zero exclusion — anyone who wants to work is eligible, regardless of disability severity
- Rapid job search — begin job searching within 30 days, not months of pre-employment training
- Integration with clinical services — employment specialists work within mental health/disability teams
- Attention to worker preferences — what the person wants, not what is available
- Individualised support — ongoing, not time-limited, available as long as needed
- Benefits counselling — help navigating the interaction between employment and disability benefits
Evidence:
- Meta-analysis: IPS achieves 55% competitive employment vs 25% for traditional vocational rehabilitation (Modini et al., 2016)
- Works across cultures: Positive RCTs in US, UK, EU, Japan, Hong Kong, Australia
- Cost-effective: Reduced hospitalisation and service use offset programme costs within 2 years
- Works for severe mental illness AND for other disability groups (learning disability, acquired brain injury, autism)