Leadership in sustainment of Individual Placement and Support model: a comparative case study in Finland

Individual Placement and Support is an evidence-based practice designed to assist individuals with psychiatric disorders in gaining employment. Contextual factors such as policies, funding, and organizational structures are widely acknowledged as barriers and facilitators to the sustainment of evidence-based practices. This study focuses on leadership's role in driving the sustainment process and navigating the dynamic interplay between internal and external contexts following a national development project in Finland.

We used qualitative data from semi-structured interviews. Participants included outside experts such as trainers and researchers (n = 4), leaders from the implementing sites, including medical directors, nursing directors, administrators (n = 11), project managers and team leaders (n = 6), and frontline workers (n = 8). We performed an abductive thematic analysis to identify patterns and themes within the data.

We identified three Leadership Approaches for IPS Model Sustainability that differentiated agencies with more robust sustainment strategies from those with less robust ones. The Visionary Approach included championing recovery-oriented principles to foster organizational readiness and aligning IPS with organizational goals. The Proactive Approach was characterized by early and deliberate planning to minimize challenges, leveraging IPS fidelity evaluations for quality improvement. Leaders employing the Collaborative Approach emphasized effective facilitation within governance structures, including the integration of IPS into the strategies of administrative units.

The study presents three leadership approaches that differentiate implementing agencies with more robust IPS model sustainment strategies from those with less robust ones. It introduces and empirically explores a conceptual model that can be used both in research and practice.