Barriers in implementation of evidence‐based practice : Supported employment in Swedish context

Purpose – The aim of this paper is to identify initial barriers influencing implementation of supported employment (SE). SE, according to the individual placement and support (IPS) approach, has been recognised as an evidence‐based method to help people with severe mental illness to find regular employment. Design/methodology/approach – A systematic implementation evaluation of the first randomised controlled SE (IPS) trial in Sweden was conducted in August 2008 and August 2009. Data were collected on a regular basis from SE employment specialists, process heads, clients and representatives from mental health care units and vocational services (social insurance and public employment offices) using interviews, non‐participant observations and document analysis. Findings – SE employment specialists reported that existing regulations for social insurance and employment regulations presented major obstacles to implementation. Difficulties were reported in cooperation with handling officers at the vocational services. Scepticism towards persons with mental illness was common and employers expected to receive subsidies if they hired a person with mental illness. SE participants expressed fear of losing their social benefits. Originality/value – The results illuminate a collision between an innovative evidence‐based practice and the existing systems for social benefits and work rehabilitation.