Navigating the gap between policy and practice: frontline and second-tier management perspectives and strategies in offering vocational and educational support to young adults with mental health problems

Mental health problems among young adults often lead to obstacles to completing higher education and becoming established in the labour market. It is important to offer support that can help these individuals realize educational and vocational goals in order to become self-sufficient and achieve social inclusion. Individual Placement and Support (IPS) and Supported Education (SEd) are two methods developed for supporting people with mental health problems in attaining competitive employment and reaching educational goals. These methods have not been widely implemented in Sweden, therefore making it interesting to study management perspectives in organizations offering IPS/SEd. The study aimed to explore the reasoning and strategies managers described in offering vocational and educational support to young adults with mental health problems. This study is based on 12 qualitative interviews with managers from six units in Sweden offering support through IPS/SEd. Results show a variety in interpretation of legislation and responsibility for young adults with mental health problems. The managers were positioned between policy and practice, having to navigate between the organizational restraints and their professional assessment in offering this support and pushing traditional boundaries in prioritizing long-term individual goals over short-term economic and political considerations. These managers demonstrate the possibilities for how IPS/SEd can be implemented and made to fit different organizational contexts, even within a highly sectorized welfare system as in Sweden. However, the methods might need to be adapted and adjusted to not only fit local organizational restraints, but also to fit into the Swedish welfare system.