Institutional work aimed at increasing employment orientation in mental health services

Abstract

Purpose – The importance of employment participation in recovery from mental health illness has led to broad recognition of the integration of employment-oriented support into mental health treatment. However, there is variation in the extent to which an employment orientation permeates healthcare services. This article explores how managerial-level actors in health and welfare services in Norway, who function as “change agents”, work to increase an employment orientation in mental health services.

Design/methodology/approach – The empirical material consists of 20 interviews with managerial-level actors, namely managers and advisors in health and welfare organisations. They work to implement a model – individual placement and support – for the integration of employment measures into healthcare services. The findings are analysed using the framework of “institutional work” to elucidate the strategies used by managers and advisors.

Findings – The findings underscore a consensus on the health advantages of employment and the place of employment-oriented support in mental health treatment. However, this concept requires further cultivation within healthcare services, with managerial-level actors playing a key role as change agents. Depending on the stage of the various organisations in the change process and the positions of the actors within the institutional context, the actors engaged in both creative and maintenance institutional work.

Originality/value – This article sheds light on the processes of integrating employment-oriented support into mental health services, the complexities of translating policy into practice and the critical role of managerial-level actors in this process.