Background: Employment is a vital source for experiencing well-being and lowering the risk of long-term social marginalisation and poverty. For persons with alcohol and drug addiction, it may also improve sobriety. However, the unemployment situation for this group reflects the knowledge gap in effective interventions to support employment. While Individual Placement and Support (IPS) is recognised as evidence-based supported employment for those with serious mental health problems, no scientific evidence for the target group of addiction exists to date. The aim of the present IPS for Alcohol and Drug Addiction in Sweden (IPS-ADAS) trial is to study whether IPS has an effect on gaining employment for this group. Methods: The IPS-ADAS trial is a multisite, pragmatic, parallel, and single-blinded, superiority randomised controlled trial (RCT). Participants (N = 330) will be randomly assigned (1:1) and participate in IPS plus treatment as usual within Addiction Services (IPS + TAU) or Traditional Vocational Rehabilitation (TVR) available plus TAU (TVR + TAU) for 12 months. The principle of intention-to-treat (ITT) will be applied. The hypothesis is that a significantly larger proportion of IPS + TAU participants will be employed for > 1 day (primary outcome), reach employment sooner, work more hours and longer periods of time, and have a higher income as compared to TVR + TAU participants at 18-month follow-up. We further anticipate that those who benefit from IPS + TAU will use less alcohol and drugs, experience better health, and use less care and support, including support from the justice system, in comparison to TVR + TAU participants, at 6, 12, and 18 months. A supplementary process evaluation, using the IPS Fidelity Scale (25 items) and adhered interviews will address delivery and receipt of the IPS as well as contextual hinders and barriers for coproduction and implementation. Working age (18-65), willingness to work, unemployment, participation in an information meeting about the RCT, treatment for addiction diagnosis, and being financially supported by welfare, constitute eligible criteria. Discussion: A primary study on the effectiveness of IPS on employment for the new target group of addictions will add to the international IPS knowledge base and inform national policy to include the underrepresented group in working life.

Research shows that resistance to change might occur in organisations that implement new evidence-based practices (EBP). Formal and informal structures may work to retain traditional interventions, potentially counteracting the implementation process. Little is known about the de-implementation of traditional practices to leave room for and enhance the implementation of EBPs. This study uses implementation structures as a theoretical framework with the aim of analysing implementation and de-implementation factors among Swedish municipalities that provide support to vulnerable clients through the Housing First (HF) or Individual Placement and Support (IPS) interventional programmes. This cross-sectional study is based on a digital survey and collects descriptive and qualitative data from three organisational levels in each responding municipality in Sweden. The descriptive statistics and qualitative texts were analysed using content analysis. The results show the incidence of HF and IPS, if and to what extent the interventions are going to be developed further, and partially, describe the organisational settings of HF and IPS. Organisational factors shown to have a negative impact on the implementation of HF and IPS were identified. The mapping of professional experiences from the intersection between HF or IPS and organisations such as the Swedish Health Insurance Office, the social services, and other similar welfare organisations, indicates that the realisation of HF and IPS requires expanded collaboration, which raises the consideration as to whether it is necessary to de-implement broader frameworks and guidelines in these organisations to provide the prerequisites that enable the implementation of EBPs.

In recent decades, Sweden has seen extensive change in its housing policy, with emphasis shifting from "good housing for all" to marketisation and the supposed benefits of private ownership (Bengtsson, 2013; Grander, 2018). Consequently, Swedish society is now facing increasing homelessness rates, including whole new groups of social service clients due to housing shortages and people's difficulties accessing the housing market. This article examines the complexities emerging from diverging institutional frames and points specifically to a dividing line between those who can access housing independently and those who need support from the social services. The article describes how such a categorical division/dividing line is institutionalised in the organisation of the social services' work with homelessness and points to causes and effects of this situation. The case study is based on interviews and documents. The interviewees are staff from the municipal social services and the municipal public housing company. Our theoretical point of departure is Tilly's (1999) "categorical inequality," using exploitation, opportunity hoarding, emulation, and adaptation to explain how homelessness is (created and) maintained in our case study. The results show the dependency of social services on external actors and demonstrate the problematic consequences both for those referred to social services and for the practical work within them, including a requirement to stringently control clients. The results further show how it is possible for the social services to maintain collaboration with (public) housing companies at the same time as the most vulnerable clients are permanently denied housing.

The aim of this article is to develop theory and generate knowledge about the challenges and possibilities of co-producing change in a social housing programme. The purpose of the project was to implement the Housing First philosophy in the social housing programme in the city of Helsingborg, Sweden. The aim was also to create opportunities for service user involvement. Several innovative measures were implemented in order for these changes to occur from autumn 2016 to summer 2017. The social services commissioned a university course on which social workers and their clients studied together on equal terms to create project plans for the further development of their own workplace. A "Future" workshop was held by the researchers with representatives from all the different housing options (the shelter, transitional housing, category housing, Housing First apartments), both clients and social workers. Repeated dialogue meetings were conducted at the different housing options to discuss how service user involvement could be developed and to discover new ways of participation. This article is based on a strengths-based perspective using the theoretical discussions on social traps, as well as the concepts of enabling and entrapping niches. We show the importance of social workers identifying and supporting missing heroes-service users who want to participate and be involved in co-producing change. We also show that if an organisation is not prepared for the initiated changes, there is a risk of disappointment due to awakened expectations that are not fulfilled. Building trust is also an important component to emerge from the material, but we also found that change processes can be initiated that continue and have impact beyond the initial project's goals.

The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.

The number of homeless people has increased in Sweden. More and more families with children are turning to thesocial services for help but are referred to temporary and short-term emergency assistance. The reason for this isthat they are defned as structurally homeless and are consequently not considered to be part of the target group forsocial services. Based on on-going and up-to-date research, we highlight examples of how diferent municipalitieshandle this problem. Furthermore, we highlight the consequences for children’s health, well-being and life chances.We also discuss the shortcomings which we see in the Swedish system and what needs to be changed in order forchildren to be insured the right to a safe home in the future.

Rapporten redovisar resultat från en fördjupad studie av det bostadssociala programmet i Helsingborg åren 2017 och 2018. Studien anlägger ett brett angreppssätt då det bostadssociala programmet är komplext. Det hanteras inom ett samarbete mellan fyra av förvaltningarna i Helsingborg stad.Tre av dem: Socialförvaltningen, Arbetsmarknadsförvaltningen och Vård- och Omsorgsförvaltningen arbetar med och ger stöd åt många människor och där några av dessa behöver hjälp med att få en bostad. Den fjärde, Fastighetsförvaltningen, arbetar dels med att samla in och registrera tillgängliga bostäder bland stadens fastighetsägare, dels med att matcha det remitterade behovet från de tre andra förvaltningarna mot dessa bostäder. Det är ett komplext arbete och det tar tid att förstå, åtminstone övergripande, hur arbetet i och mellan de fyra förvaltningarna går till.

Målet är att alla fastighetsägare med hyresfastigheter i Helsingborg ska vara anslutna till det bostadssociala programmet. Programmet syftar till att människor som står utanför den ordinarie bostadsmarknaden ska kunna få en bostlad med ett eget kontrakt.

De övergripande frågorna i studien är: Hur arbetar man inom det bostadssociala programmet dels i den egna förvaltningen, dels tillsammans med de övriga förvaltningarna samt AB Helsingborgshem? Hur organiserar man sig? Vilka bostadsresurser har man? Vad är det som gör att människor som inte har stora skulder eller missbruk hamnar utanför den ordinarie bostadsmarknaden?

The gap-mending concept is an analytical tool that helps teachers and researchers in social work to reflect upon what, in their practice, increases, maintains or mends gaps between professionals and service user groups. The article suggests a theoretical background on how gaps in social work practice can be challenged. This includes theories about power and recognition. It then moves on to describe the development of gap-mending strategies in research and education at the School of Social Work at Lund University. Lund University was one of three partners that took the initiative to the international network PowerUs that has focused on gap-mending strategies in social work education. The authors have been working over 10 years in collaboration with service user participation in the education of social workers and in different research projects. In the article, they give examples of gap-mending practices and of challenges that they have faced. The first example is an experimental course that has been given since 2005 where social work students study together with students from service user organizations in a university course. The second example is an attempt to combat homelessness in several Swedish municipalities. Supported by researchers, the development project has been a collaboration between homeless groups, politicians and social workers.