BackgroundThere is evidence from North American trials that supported employment
using the individual placement and support (IPS) model is effective in helping
individuals with severe mental illness gain competitive employment. There have
been few trials in other parts of the world.AimsTo investigate the effectiveness and cost-effectiveness of IPS in the
UK.MethodIndividuals with severe mental illness in South London were randomised to
IPS or local traditional vocational services (treatment as usual)
(ISRCTN96677673).ResultsTwo hundred and nineteen participants were randomised, and 90% assessed 1
year later. There were no significant differences between the treatment as
usual and intervention groups in obtaining competitive employment (13% in the
intervention group and 7% in controls; risk ratio 1.35, 95% CI
0.95–1.93, P = 0.15), nor in secondary outcomes.ConclusionsThere was no evidence that IPS was of significant benefit in achieving
competitive employment for individuals in South London at 1-year follow-up,
which may reflect suboptimal implementation. Implementation of IPS can be
challenging in the UK context where IPS is not structurally integrated with
mental health services, and economic disincentives may lead to lower levels of
motivation in individuals with severe mental illness and psychiatric
professionals.