Training and employment of consumer provider employees in Dutch mental health care.

OBJECTIVE: This article describes the results of a qualitative study on the training and employment of consumer provider employees in Dutch mental health care. METHODS: The authors used semi-structured interviews with students, graduates/employees, teachers, team managers, colleagues and clients to assess their experiences with the college program. RESULTS: The college program succeeds in preparing the consumer students for their role as consumer provider employees in mental health teams. In the peer support and recovery program and supervision, students learn to develop their recovery story, to apply their experiences in practice, and to deal with challenges. CONCLUSIONS: Coaching and supervision are essential to help consumer providers in their specific role, to deal with dilemmas and to facilitate open dialogue. Teams need to be adequately prepared by informing them on the requirements of the college program and the role of consumer providers.

Enhancing systematic implementation of skills training modules for persons with schizophrenia: three steps forward and two steps back?

OBJECTIVE: This brief report addresses the systematic implementation of skills training modules for persons with schizophrenia or related disorders in three Dutch mental health agencies. METHODS: Information on barriers, strategies and integration into routine daily practice was gathered at 0, 12 and 24 months through interviews with managers, program leaders, trainers, practitioners and clients. RESULTS: Overall implementation of the skills training modules for 74% of the persons with schizophrenia or related disorders was not feasible. Implementation was impeded by an incapable program leader, organizational changes, disappointing referrals and loss of trainers. The agencies made important steps forward to integrate the modules into routine daily practice. CONCLUSIONS: A reach percentage of 74% in two years time is too ambitious and needs to be adjusted. Systematic integration of the modules into routine daily practice is feasible, but requires solid program management and continuous effort to involve clients and practitioners.

A multisite study of implementing supported employment in the Netherlands.

OBJECTIVE: This article reports on the implementation of the individual placement and support model of supported employment in four Dutch regions. METHODS: The authors used structured site visits, employment data, and semistructured interviews to assess fidelity, employment outcomes, and facilitators of and barriers to successful implementation. RESULTS: At 24 months, the four sites reached a mean+/-SD fidelity score of 4.1+/-.3 (possible scores range from 1 to 5, with higher scores indicating closer adherence to the model). Of the 316 persons with mental illnesses, 57 (18%) obtained competitive jobs. Barriers to implementation included lack of organizational standards, loss of vocational staff, funding problems, insufficient time for program leaders, and inadequate cooperation between the involved organizations. Important facilitators were the skills and commitment of the vocational team members and the integration of vocational and mental health staff. CONCLUSIONS: To implement evidence-based supported employment in the Netherlands will require changes in financing, organizational structures, attitudes, cultural beliefs, and labor and disability regulations.