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Health services and the Norwegian Labour and Welfare Administration (NAV) are responsible for getting people into work, including those with serious mental health problems.

Financial insecurity may force people out of the workforce

"Health services and the Norwegian Labour and Welfare Administration need to collaborate better to help people with mental health problems return to work and improve their mental health," a researcher believes.

Many with severe mental health problems want to participate in the workforce. However, only between 10 and 20 per cent of them have paid work.

Individual Placement and Support (IPS) is a method to help people in this group get a job. In short, it involves participants going straight into employment and receiving task-specific training and support on the job. 

This method is widespread both in Norway and around the world.

“Studies show that more people find work through IPS compared to other services for people with severe mental illness,” says Ellen Ånestad Moen.

She has studied the collaboration between participants, healthcare personnel, and the Norwegian Labour and Welfare Administration (NAV) counsellors on individual placement and support.

A need for improvements 

Another way of providing work training has been to train individuals in sheltered workshops. According to Moen, this has proven to be less effective since the training often lacks transferable value to other jobs.

“It can take up to a year for any of us to get used to the routines of a new job. A severe mental illness may make it more difficult to both learn work tasks and navigate social interactions with colleagues. Therefore, it's important to focus our efforts where the skills will be applied,” says Moen.

Although individual placement and support is the most effective rehabilitation approach for severely ill people, many individuals do not receive this service and remain unemployed or leave their jobs soon after starting.

“There is a need for improvements,” the researcher says.

“I found that financial security is an essential starting point to be able to focus on mastering a job,” says Ellen Ånestad Moen, who has earned a doctorate on individual placement and support.

She conducted a systematic literature review, observed 16 collaboration meetings between jobseekers, therapists, social workers, and counsellors from NAV. 

She also interviewed several of the participants. A total of 291 jobseekers, 107 employment specialists, 21 therapists, and 19 NAV counsellors participated in the research.

“What struck me as a little odd was that initially, it seemed like everyone was in favour of IPS. The therapists were happy that their patients had this opportunity, and NAV counsellors thought it was a great service. However, during the meetings, both groups were very quiet and passive,” says Moen.

Underestimate their importance 

But why is that the case? It has a lot to do with the participants having different expectations for the meetings. In practice, they were essentially in different meetings, according to Moen's research.

For jobseekers, their financial situation was the most important, yet the most uncertain. Many of them worried about what would happen to their NAV support should they not master the job they got through IPS.

“Jobseekers are very clear that they turn to NAV to secure their financial situation, and financial insecurity can make them give up trying to find a job, which means that they end up receiving disability benefits,” says Moen.

This group thus wanted financial clarification from NAV and hoped that the social worker or therapist accompanying them at the meeting could help them.

However, NAV counsellors were not attentive enough to the significance of financial security and felt somewhat disconnected from IPS. The accompanying therapists meanwhile emphasised that this was the patients' meeting and refrained from speaking too much due to their duty of confidentiality.

“Both therapists and NAV counsellors underestimate their importance in the meeting. There is little knowledge about the everyday life of therapists and social workers at NAV, and little knowledge about the everyday life of NAV counsellors among therapists and social workers,” says Moen.


Moen, E.Å. Sammen om individuell jobbstøtte: En kvalitativ studie av deltakelse og opplevelser fra deltakelse i Individual placement and support (Together on individual job support: A qualitative study of participation and experiences from participation in Individual Placement and Support), Doctoral dissertation at the University of Agder, 2024.


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