The Effectiveness of Supported Employment in People With Dual Disorders

Abstract

Objective This study compared the effectiveness of the Individual Placement and Support (IPS) model of supported employment to control vocational rehabilitation programs for improving the competitive work outcomes of people with a severe mental illness and co-occurring substance use disorder. Methods A secondary data analysis was conducted drawing from four randomized controlled trials comparing IPS supported employment to conventional vocational rehabilitation programs for severe mental illness, and focusing on the 106 clients with a recent (past 6 months) substance use disorder. Competitive work outcomes were tracked across an 18-month follow-up period. Analyses compared the IPS and comparison vocational programs on cumulative work over the 18 months, including attainment of work, hours and weeks worked, job tenure, wages earned, and days to first job. Results In the total study group, clients who participated in IPS had better competitive work outcomes than those who participated in a comparison program, with cumulative employment rates of 60% vs. 24%, respectively. Among clients who obtained work during the study period, those receiving IPS obtained their first job significantly more quickly and were more likely to work 20 or more hours per week at some point during the 18-month follow-up. Conclusions The IPS model of supported employment is more effective than alternative vocational rehabilitation models at improving the competitive work outcomes of clients with a dual disorder.

Health and well-being of homeless veterans participating in transitional and supported employment: Six-month outcomes

“…It should also be noted that IPS does not have a large evidence base for improving employment in a largely substance using, homeless population and research has primarily focused on clients with SMI. There is some evidence that IPS helps individuals with co-occurring mental health and substance use diagnoses achieve better employment outcomes than other vocational services [60][61]; however, IPS may be less advantageous for the population studied here, offering a possible explanation for the lack of significant findings in non-vocational outcomes between the groups. These findings may have also been influenced by the 70-72 percent follow-up rates, leading to a potential selection bias; differences may have gone unmeasured because of attrition, which may have confounded the comparison of groups.…”

Drinking trajectories among HIV-infected men who have sex with men: A cohort study of United States veterans

“…A recently published randomized controlled trial demonstrated that individual placement and support (IPS) programs (i.e., individualized rapid job searches, community-based job placement) were effective at increasing competitive employment among veterans with PTSD (Davis et al, 2012). Another study demonstrated that the IPS model improves work outcomes of dually diagnosed veterans (Mueser et al, 2011). More research is needed to determine whether employment-based programs can have positive effects on other health outcomes among veterans, including reductions in alcohol use.…”

Simulations Test Impact Of Education, Employment, And Income Improvements On Minority Patients With Mental Illness

“…We consider a potential effect of reducing the present unemployment rate by 60% based on the estimated effect as reported by Mueser et al 10 For instance, if the pre-effect unemployment rate of a minority group is 20%, the post-effect unemployment rate becomes 0.4*20%=8%.…”