title: A multisite study of implementing supported employment in the Netherlands.
abstract: OBJECTIVE
  This article reports on the implementation of the individual placement and support model of supported employment in four Dutch regions.
  
  
  METHODS
  The authors used structured site visits, employment data, and semistructured interviews to assess fidelity, employment outcomes, and facilitators of and barriers to successful implementation.
  
  
  RESULTS
  At 24 months, the four sites reached a mean+/-SD fidelity score of 4.1+/-.3 (possible scores range from 1 to 5, with higher scores indicating closer adherence to the model). Of the 316 persons with mental illnesses, 57 (18%) obtained competitive jobs. Barriers to implementation included lack of organizational standards, loss of vocational staff, funding problems, insufficient time for program leaders, and inadequate cooperation between the involved organizations. Important facilitators were the skills and commitment of the vocational team members and the integration of vocational and mental health staff.
  
  
  CONCLUSIONS
  To implement evidence-based supported employment in the Netherlands will require changes in financing, organizational structures, attitudes, cultural beliefs, and labor and disability regulations.
authors.affiliation: Research Unit of Reintegration, Trimbos Institute, P.O. Box 725, Utrecht 3500 AS, the Netherlands. nerp@trimbos.nl
authors.forename: Nicole H J
authors.initials: NH
authors.lastname: van Erp
authors.forename: Femke B M
authors.initials: FB
authors.lastname: Giesen
authors.forename: Jaap
authors.initials: J
authors.lastname: van Weeghel
authors.forename: Hans
authors.initials: H
authors.lastname: Kroon
authors.forename: Harry W C
authors.initials: HW
authors.lastname: Michon
authors.forename: Deborah
authors.initials: D
authors.lastname: Becker
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: McHugo
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
mesh_terms: D000328:Adult; D019992:Databases as Topic; D004059:Diffusion of Innovation; D016832:Employment, Supported / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009426:Netherlands