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Dissemination of IPS in Italy Problems and opportuinities

Dissemination of IPS in Italy Problems and opportuinities. A. Fioritti, R. Sabatelli, Manchisi D., Piegari D., Dell’Alba N., Trono V. WPA Congress, Buenos Aires, 21.9.2011. Content. Background Italy and work Italian community psychiatries and work

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Dissemination of IPS in Italy Problems and opportuinities

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  1. Dissemination of IPS in ItalyProblems and opportuinities A. Fioritti, R. Sabatelli, Manchisi D., Piegari D., Dell’Alba N., Trono V. WPA Congress, Buenos Aires, 21.9.2011

  2. Content • Background • Italy and work • Italian community psychiatries and work • Strategies and policies for employment by MI • Current approaches and outcomes • Innovative approaches and IPS • Experiences of IPS in Italy • EQOLISE in Rimini and after • TIPS in Bologna and Emilia-Romagna • Future developments

  3. Italy and work • “L’Italia è una repubblica democratica fondata sul lavoro”, Costituzione della Repubblica, art. 1. • Work as a citizens’ right (and “due”) • Social responsibility in ensuring work to individuals • High level of protection for workers • How long will it last?

  4. Italian Community Psychiatries • 1904: law on mental hospitals • 1965: pilot CMHC (secteurs) • 1968: pilot experiences (Gorizia, Trieste, Reggio) • 1978: National Health System – Psychiatric Reform Law n.180 • 1995: MH plan, standards for CMHTeams • 1999: Devolution • 2009: Regional MH Plan (DGR 313/09)

  5. Social responsibility Specialization Institutional Reservation Welfare Protection Train and place Strategies for employment Personal initiative Mainstreaming Responsibilization Empowerment Support Motivation Place and support

  6. Social responsibility TEG (A, B, C…) Free attendance, training contracts Cooperative B Simulazione e creazione d’impresa Collocamento obbligatorio (l. 68)‏ Strategies for employment Personal initiative Personal research Counselling Transient job agencies (Adecco) Supported Employment Individual Placement and Support Microcredit

  7. Currently • Most resources dedicated to social responsibility programs • Prevalence of pre-vocational, vocational training and cooperatives programs • Increase in less disabled population with higher expectations • Trends of: • Deregulation of labour market • Decommodification of social services

  8. Dipartimento di Salute Mentale e Dipendenze Patologiche - Area CSMPercorsi d’inserimento formativo - lavorativo

  9. Dipartimento di Salute Mentale e Dipendenze Patologiche - Area CSMPercorsi d’inserimento formativo - lavorativo

  10. Dipartimento di Salute Mentale e Dipendenze Patologiche - Area CSMInserimenti lavorativi in Cooperative Sociali di tipo BITR Borse Lavoro e Assunzioni

  11. Dipartimento di Salute Mentale e Dipendenze Patologiche - Area CSMInserimenti lavorativi in Cooperative Sociali di tipo BITR Borse Lavoro e Assunzioni

  12. Totale complessivo (6 regioni) = 3.273 persone inserite

  13. 4.294 persone sostenute nei PilDSM

  14. EQOLISE • 6 centers: • Londra (UK)‏ • Rimini (I)‏ • Ulm (D)‏ • Zurich (CH)‏ • Groeningen (NL)‏ • Sofia (BUL)‏

  15. Worked at least for one day

  16. Table 16: Worked in informal labour market n (%) of those who obtained employment Service London n=16 Ulm n=25 Rimini n=24 Zurich n=14 Groningen n=16 Sofia n=33 Total n=128 IPS 0 (.0%)‏ 1 (7.1%)‏ 6 (37.5%)‏ 0 (.0%)‏ 1 (11.1%)‏ 8 (36.4%)‏ 16 (18.8%)‏ Vocational 0 (.0%)‏ 0 (.0%)‏ 7 (87.5%)‏ 0 (.0%)‏ 3 (42.9%)‏ 5 (45.5%)‏ 15 (34.9%)‏

  17. EQOLISE in Rimini • Continuously effected by three IPS specialists since 2003 • More than 180 clients treated • Replication of standard outcomes (>40% of clients in treatment work) • Seminars across Italy • Preparing TIPS project

  18. PROGETTO TIPS TRAINING ON INDIVIDUAL PLACEMENT SUPPORT

  19. IPS Training

  20. Time schedule • 9/6/2010 – Start-up meeting • 16-18/9/2010 – Full immersion residential training in Rimini • 1/10/2010 – Starting recruitment. Monthly meetings of supervision and sharing of experiences. • 31/12/2010 – End of recruitment • 30/6/2011 – Midterm evaluation • 1/12/2011 – Final evaluation workshop

  21. Regional Policies

  22. Regional Policies and IPS • Regione Emilia-Romagna (DGR 313/09) • Sicily Region (2011) • Rome Province • Some Veneto Departements

  23. IPS in Italy - Opportunities • Users’ dissatisfaction with traditional vocational rehabilitation • Awareness among professionals of more empowering opportunities (self help, supported accomodation, IPS…) • Social welfare cuts, labour market «deregulation» • Interest in evidence based practices (FEP, ACT, Psychoeducation…)

  24. IPS in Italy - Problems • IPS specialist: project vs. program. • What is «team approach»? • Are we bound to instability? • IPS and informal work. • Are we supporting workers exploitation by blackmarket employers? • PseudoIPS: the «we are already doing this» issue. • Ensuring fidelity and reasonable adaptation

  25. Dartmouth-J&J Int’l learning coll. • Good opportunity for: • Linking with international network of experiences • Access to training and research material • Improving training and fidelity locally • Better coordination of local practice • Provide training to other centers/regions • Participating in international research and training activities

  26. Thank You!

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