The societal/economic case for individual placement and support implementation in northern Norway

A-La PARK1,2,3, David MCDAID1, Sina WITTLUND2, Thomas LORENTZEN 4, Beate BRINCHMANN2, Arnstein MYKLETUN 2,3

1London School of Economics , London, United Kingdom
2Centre for work and mental health, Nordland Hospital trust, Bodø, Norway
3Department of Community Medicine, UiT– The Arctic University of Norway , Tromsø, Norway
4Institute of Sociology, University of Bergen, Bergen, Norway

Introduction: Facilitating opportunities for competitive employment can be an important element in promoting recovery and inclusion for people with lived experience of mental health conditions. One evidence-based, supported-employment approach, Individual Placement and Support (IPS) has been shown in multiple contexts to help promote employment for individuals, but less is known about its broad cross-sectoral societal impacts.  This analysis estimates the economic benefits to society of the implementation of IPS at a municipality level in northern Norway.



Methods: Economic modelling analysis, making use of Norwegian registry data in a longitudinal interrupted time series quasi-experimental design, that estimated the difference in differences for number of additional workdays associated with IPS over a four year period.  IPS implementation, in the Bodø municipality of Norway, was compared to ten control municipalities where IPS had not been implemented. Detailed monitoring data on resources/costs associated with implementation of IPS in Bodø were collected, with resource use and costs of usual employment support elsewhere in Norway obtained from published contracts and documentation. The economic analysis modelled the impacts of changes in employment on housing and welfare support needs. 



Results: There was a positive economic return on investment, with implementation costs more than covered by societal gains from the implementation of IPS. This was driven by a significant, positive, causal effect on employment outcomes, equivalent to 12.7 years of increased work per year for the total study population in Bodø, compared to municipalities without IPS. This economic case is strengthened further if expected reduced use of menta and physical health services is taken into account.



Conclusion: In looking at the economic case for investing in IPS, it is important to identify multi-sectoral impacts in addition to changes in health outcomes. These positive economic benefits in Norway for IPS were made possible by effective multi-sectoral collaboration and dedicated financing.