BackgroundThis policy brief examines Individual Placement and Support (IPS) in Aotearoa New Zealand since 2019, within wider health, welfare, and labour market settings.AnalysisUsing a macro (policy, funding), meso (organisational and services) and micro (practitioner level) framework, IPS availability and implementation quality are examined. The IPS workforce has doubled in 5 years to 113 full-time equivalent employment specialists across 13 of 19 health districts. However, service quality, as measured by fidelity score is variable, and access is uneven.Policy optionsIPS already exists, the workforce and implementation infrastructure exists, and outcomes have been demonstrated. New Zealand has solved the effectiveness problem, but not the authorisation one. Clear accountability for investing in evidence-based employment services for people in contact with specialist mental health and addiction services is needed from government agencies. Drawing on research, fidelity reviews, and national policy, recommendations are made to support equitable scale-up.ConclusionIPS employment support is simultaneously an employment and a mental health intervention, as well as a mechanism to address systemic inequities. There is ample, robust evidence that IPS works in New Zealand. What is needed is a system that is accountable for delivering it at scale.
BackgroundCare farming in Europe, traditionally provided to children and youth with intellectual disabilities, expands to serve older adults due to demographic shifts, providing an alternative to nursing homes and helping farms diversify for sustained businesses. There is a lack of policies which systematically interweave the public health and agricultural sectors. The article provides policy insights for informed decision-making in this transformation.AnalysisCare farming with older adults involves activities like feeding animals or preparing meals showing positive effects on physical, emotional, and cognitive health, including with dementia, and contrasts sharply with the history of abuse tied to involuntary farm placements.Policy OptionsFor intersectoral complexity, a transdisciplinary approach allows to integrate diverse stakeholders across health and agriculture. Policymakers facilitate dialogue to align objectives like production goals versus care farming services.ConclusionSustainable policies must acknowledge complex intersectoral influences by systematically collaborating between health and agriculture sectors through a transdisciplinary approach. Robust practices and models are vital for heterogeneous populations aged 65 and older. A mindset of experimentation and integration among stakeholders supports implementing care farming in a graying society.
Public health crises are increasingly becoming diplomatic events. They require leaders to navigate scientific uncertainty while negotiating political, economic, social, and community interests. Yet public health preparedness continues to treat communication primarily as an individual leadership skill rather than as an institutional capacity for negotiation, consensus building, and trust. The COVID-19 pandemic exposed the consequences. Leaders were expected to communicate evolving evidence while absorbing public anger over difficult tradeoffs involving health, economic disruption, education, individual freedom, and equity. This commentary argues that crisis communication should be understood as public health diplomacy: a structured process through which leaders build trust, make values and tradeoffs transparent, engage diverse stakeholders, and adapt decisions as evidence changes. We propose three institutional practices: transparent decision-making frameworks, predefined reassessment checkpoints, and cross-sector advisory structures. We further argue that leadership turnover and chronic vacancies should be treated as indicators of system instability and emergency preparedness. Building public health diplomacy into training and crisis infrastructure can distribute responsibility for difficult decisions, strengthen institutional resilience, and better prepare leaders to protect health and trust when the next crisis arrives.
BackgroundIndividual placement and support (IPS) is an effective vocational rehabilitation programme for people with mental illness. This article analyses national policies that directly promote IPS and broader employment-related policies on mental health in 13 European countries.AnalysisIPS alone cannot address the broader workplace and policy conditions that influence sustainable employment. Therefore, creating mentally healthy working conditions also requires action by employers, healthcare systems, and policymakers.Policy optionsRecurring barriers and facilitators were identified across countries, alongside variation in governance and implementation contexts. IPS services often operate in isolation, with limited access to consistent training, data, and cross-sector coordination. A national infrastructure for IPS is therefore needed to offer implementation support, intersectoral collaboration should be strengthened and employers need to be supported to advance equity, diversity and inclusion. IPS practice will benefit from policies addressing poor mental health conditions in the workplace, and policies endorsing a recovery-oriented mental healthcare system.ConclusionIPS can build a solid bridge between mental healthcare and employment when integrated into recovery-oriented services and supported by policies that promote inclusive, mentally healthy workplaces.
ObjectivesTo examine the use of process mapping (PM) in clinical healthcare settings in low- and lower-middle-income countries (LLMICs).MethodsA scoping review was conducted. Full-text empirical studies published from 2014 to 2024 were identified from MEDLINE, Embase, Web of Science, and CINAHL databases.ResultsTwenty-six articles were included. Deductive and inductive content analysis was performed. Applications have included process- and quality-improvement initiatives (n = 12), health system process analysis and assessment (n = 7), health systems tools design, implementation and evaluation (n = 4), and costing (n = 3). Observations, workshops and interviews were applied, with 65% using a single method (n = 17). PM was predominantly researcher-led (n = 17), with local healthcare workers participating in the majority of studies (n = 21); none involved patients. Gaps in reporting and documentation of PM activities were identified (n = 16).ConclusionPM demonstrated significant potential as a versatile and adaptable method for improving clinical processes. Future PM studies should adhere to reporting guidelines, promote locally led PM activities and incorporate diverse perspectives, particularly those of patients.
