Employer and employment agency attitudes towards employing individuals with mental health needs

Background: The positive benefits of paid employment for individuals with mental health needs are well known yet many still remain unemployed (Perkins & Rinaldi, (2002). Unemployment rates among patients with long-term mental health problems: A decade of rising unemployment. Psychiatric Bulletin, 26(8), 295–298.).\ud \ud Aims: Attitudes of employers and employment agencies that may provide short-term contracts to individuals with mental health needs are important to understand if these individuals are to be given access to paid employment.\ud \ud Methods: A mixed methods approach was used to investigate this phenomenon comprising of interviews and a follow-up survey. Interviews were conducted with 10 employment agencies and 10 employers. The results of these interviews then informed a follow-up survey of 200 businesses in Gloucestershire.\ud \ud Results: The findings demonstrated that employment agencies would consider putting forward individuals with previous mental health needs to employers. However, employers had a high level of concern around employing these individuals. Employers reported issues of trust, needing supervision, inability to use initiative and inability to deal with the public for individuals with either existing or previous mental health needs.\ud \ud Conclusions: The findings of this research suggest a need for employers to have more accurate information regarding hiring individuals with mental health needs

Employer and employment agency attitudes towards employing individuals with mental health needs

Background: The positive benefits of paid employment for individuals with mental health needs are well known yet many still remain unemployed (Perkins & Rinaldi, (2002). Unemployment rates among patients with long-term mental health problems: A decade of rising unemployment. Psychiatric Bulletin, 26(8), 295–298.). Aims: Attitudes of employers and employment agencies that may provide short-term contracts to individuals with mental health needs are important to understand if these individuals are to be given access to paid employment. Methods: A mixed methods approach was used to investigate this phenomenon comprising of interviews and a follow-up survey. Interviews were conducted with 10 employment agencies and 10 employers. The results of these interviews then informed a follow-up survey of 200 businesses in Gloucestershire. Results: The findings demonstrated that employment agencies would consider putting forward individuals with previous mental health needs to employers. However, employers had a high level of concern around employing these individuals. Employers reported issues of trust, needing supervision, inability to use initiative and inability to deal with the public for individuals with either existing or previous mental health needs. Conclusions: The findings of this research suggest a need for employers to have more accurate information regarding hiring individuals with mental health needs

An audit of clinical practice in an ACT team against NICE guidelines in schizophrenia

Aims and method: We audited the caseload of an Assertive Community Treatment (ACT) team against National Institute of Clinical Excellence (NICE) guidelines in the treatment of schizophrenia. Care coordinators rated the work carried out by the team on an audit tool. Results were compared to a case note audit completed 2 years earlier. Results: 61 patients had a primary diagnosis of schizophrenia. Rates of compliance with NICE guidelines varied from 0% (provision of advance directive) to 85% (written information given, no antipsychotic polypharmacy). Compliance was greater than in the earlier audit. Discussion: When refusal, lack of capacity or indication were taken account of, guidelines were generally adhered to. Although a useful benchmarking process and an opportunity to identify skill deficits in the team, our findings raised concerns about simplistic notions of guideline implementation, as a means to improve practice. Patient choice is an important consideration

What survival benefits are needed to make adjuvant sorafenib worthwhile after resection of intermediate- or high-risk renal cell carcinoma? Clinical investigators' preferences in the SORCE trial

Background: Decisions about adjuvant therapy involve trade-offs between possible benefits and harms. Objective: We sought to determine the survival benefits that clinical investigators would judge as sufficient to warrant treatment with adjuvant sorafenib in the SORCE trial after nephrectomy for apparently localised renal cell carcinoma (RCC). Methods: A subset of clinical investigators in the SORCE trial completed a validated questionnaire that elicited the minimum survival benefits they judged sufficient to warrant one year of adjuvant sorafenib in scenarios with hypothetical baseline survival times of 5 years and 15 years, and baseline survival rates at 5 years of 65% and 85%. Results: The 100 participating SORCE investigators had a median age of 42 years, and 74 were male. For one year of sorafenib versus no therapy, the median benefits in survival times the investigators judged sufficient to warrant treatment were an extra nine months beyond five years and an extra 12 months beyond 15 years; the median benefits in survival rates were an extra 5% beyond baseline survival rates of both 65% and 85% at five years. The patients recruited in the SORCE trial by these investigators judged smaller benefits sufficient to warrant adjuvant sorafenib for both survival rate scenarios (p≤0.0001). The survival benefits the investigators judged sufficient to warrant one year of adjuvant therapy with sorafenib for RCC were similar to those of other clinicians considering three months of adjuvant chemotherapy for lung cancer, but smaller than those of clinicians considering six months of adjuvant chemotherapy for breast cancer. Conclusion: SORCE investigators judged larger benefits necessary to warrant adjuvant sorafenib than their patients. The benefits required by the investigators were similar or smaller than those other clinicians considered sufficient to warrant adjuvant chemotherapy for other cancers. Clinicians should recognise that their patients and colleagues may have preferences that differ from their own when considering the potential benefits and harms of adjuvant treatment