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:

1. Competitive employment as the goal — not sheltered work, not volunteering, not "work readiness training" as an end in itself
2. Zero exclusion — anyone who wants to work is eligible, regardless of disability severity
3. Rapid job search — begin job searching within 30 days, not months of pre-employment training
4. Integration with clinical services — employment specialists work within mental health/disability teams
5. Attention to worker preferences — what the person wants, not what is available
6. Individualised support — ongoing, not time-limited, available as long as needed
7. 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)