Vocational Outcomes of the Individual Placement and Support Model in Subgroups of Diagnoses, Substance Abuse, and Forensic Conditions: A Systematic Review and Analysis of Pooled Original Data

Hellström, Lone; Pedersen, Pernille; Christensen, Thomas Nordahl; Wallstroem, Iben Gammelgaard; Bojesen, Anders Bo; Stenager, Elsebeth; Bejerholm, Ulrika; Busschbach, Jooske van; Michon, Harry; Mueser, Kim T.; Rème, Silje Endresen; White, Sarah; Eplov, Lene Falgaard

doi:10.1007/s10926-021-09960-z

Cited by 13 publications

(23 citation statements)

References 34 publications

(100 reference statements)

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“…If in the long‐term IPS can achieve better mental (and physical) outcomes while reducing long‐term welfare dependency (Holmås et al, 2021) there are potential economic benefits to both the health sector and PES. Based on the efficacy of IPS for people with moderate to SMI, the approach is rapidly expanding into other client populations around the world (Hellström et al, 2021; Probyn et al, 2021). Research will be critical to the understand whether adaptations or adjustments to the existing IPS principles are needed for these populations.…”

Section: Implications For Policymentioning

confidence: 99%

Are attitudes in employees of public employment service in line with the principles of individual placement and support? A questionnaire‐based survey

et al. 2022

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A high proportion of people with severe mental illness (SMI) want to work, consider it essential for recovery, yet employment rates are low. Many employees in public employment services (PES) work according to traditional attitudes that people with SMI are unable to work and if they do, risk harm from work‐related stress. These attitudes conflict with principles in evidence based vocational models like individual placement and support (IPS) and probably contributes to the low‐employment rate. The aim of this study was to investigate attitudes towards the evidence‐based principles of IPS among PES employees with and without exposure to IPS. A case vignette describing a person with SMI and statements referring to this vignette was developed and administered to PES employees at two timepoints, 4 years apart. Respondents indicated their attitudes on a six‐point Likert scale to statements in accordance to the principles of IPS. Independent two‐tailed sample t‐tests were used to analyse differences between respondents in municipalities with IPS exposure, compared to municipalities without. Multiple linear regressions with attitudes as a dependent variable was used to test whether attitudes changed over time dependent on exposure to IPS. Attitudes were generally aligned with IPS principles compared to current PES practice. The municipality with IPS exposure had more favourable attitudes (p < 0.01). Changes in attitudes were minimal over time and did not differ between regions (p < 0.287). Attitudes of employees in PES are aligned with the principles of IPS and to a greater extent if exposed to IPS.

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Section: Implications For Policymentioning

confidence: 99%

Are attitudes in employees of public employment service in line with the principles of individual placement and support? A questionnaire‐based survey

et al. 2022

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“…Individualized support is perceived by people with mental illnesses seeking employment as an important facilitating factor, which is a challenging task for social workers and clinicians involved in IPS programs (77,78). The type of mental disorder can also affect program's efficacy for different outcomes (21). External emotional support from peers and family members is critical for rehabilitation and recovery (42,79).…”

Section: Barriers and Facilitators Of Successful Ips Implementation And Employmentmentioning

confidence: 99%

“…Type of the mental issue is also critical as it seems to be more effective in some disorders and less and in others (21,84). A systematic review of studies assessing IPS efficacy in individuals with substance use disorders found that episodic treatment of the disease and risk of relapse of the mental disease were among important barriers in implementing IPS (22).…”

Section: Barriers and Facilitators Of Successful Ips Implementation And Employmentmentioning

confidence: 99%

“…Reintegration into the employment market and building a social network is the central aspect of patient management, integrating work and therapy, which is led by an interdisciplinary team (18,19). A considerable amount of high-quality evidence from randomized controlled trials (RCT) supports the efficacy of this approach in providing improved employment, which has been validated in a number of countries and slowly becoming a standard of practice (18,(20)(21)(22)(23)(24). As such, aside from higher income and improved employment status, IPS was demonstrated to lead to enhanced job tenure, which is a key employment outcome for unemployed populations (18,(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Effects of the Individual Placement and Support Intervention on Employment Status: 6-Year Follow-Up of a Randomized Controlled Trial

et al. 2021

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People with mental illness often experience difficulties with reintegration into the workplace, although employment is known to assist these individuals in their recovery process. Traditional approaches of “first train, then place” have been recently replaced by supported employment (SE) methods that carry strategy of “first place, then train.” Individual placement and support (IPS) is one of the best-studied methods of SE, which core principles are individualized assistance in rapid job search with consequent placement in a paid employment position. A considerable amount of high-quality evidence supported the superiority of IPS over conventional methods in providing improved employment rates, longer job tenure, as well as higher salaries in competitive job markets. Nonetheless, our knowledge about the IPS-mediated long-term effects is limited. This non-interventional follow-up study of a previously published randomized controlled trial (RCT) called ZhEPP aimed to understand the long-term impact of IPS after 6 years since the initial intervention. Participants from the ZhEPP trial, where 250 disability pensioners with mental illnesses were randomized into either IPS intervention group or treatment as usual group (TAU), were invited to face-to-face interviews, during which employment status, job tenure, workload, and salaries were assessed. One hundred and fourteen individuals agreed to participate in this follow-up study. Although during the first 2 years post-intervention, the IPS group had higher employment rates (40% (IPS) vs. 28% (TAU), p < 0.05 at 24 months), these differences disappeared by the time of follow-up assessments (72 months). The results indicated no substantial differences in primary outcome measures between IPS and TAU groups: employment rate (36 vs. 33%), workload (10.57 vs. 10.07 h per week), job tenure (29 vs. 28 months), and salary (20.21CHF vs. 25.02 CHF). These findings provide important insights regarding the long-term effects of IPS among individuals with mental health illnesses. Further research is required to advance the current knowledge about IPS intervention and its years-long impact.

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“…Results indicated the beneficial effects of IPS for people with PTSD and SUD (Bond et al ., 2019). However, mixed indications of the effectiveness of IPS for people with CMD (including affective disorders) were found (Hellström et al ., 2021; Probyn et al ., 2021). The reasons for the diminished effectiveness of IPS for CMD are unclear, because a consistent definition of CMD is lacking.…”

Section: Introductionmentioning

confidence: 99%

Who benefits from individual placement and support? A meta-analysis

Winter¹,

Couwenbergh²,

Weeghel³

et al. 2022

Epidemiol Psychiatr Sci

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Aims Individual placement and support (IPS) is an evidence-based service model to support people with mental disorders in obtaining and sustaining competitive employment. IPS is increasingly offered to a broad variety of service users. In this meta-analysis we analysed the relative effectiveness of IPS for different subgroups of service users both based on the diagnosis and defined by a range of clinical, functional and personal characteristics. Methods We included randomised controlled trials that evaluated IPS for service users diagnosed with any mental disorder. We examined effect sizes for the between-group differences at follow-up for three outcome measures (employment rate, job duration and wages), controlling for methodological confounders (type of control group, follow-up duration and geographic region). Using sensitivity analyses of subgroup differences, we analysed moderating effects of the following diagnostic, clinical, functional and personal characteristics: severe mental illness (SMI), common mental disorders (CMD), schizophrenia spectrum disorders, mood disorders, duration of illness, the severity of symptoms, level of functioning, age, comorbid alcohol and substance use, education level and employment history. Results IPS is effective in improving employment outcomes compared to the control group in all subgroups, regardless of any methodological confounder. However, IPS was relatively more effective for service users with SMIs, schizophrenia spectrum disorders and a low symptom severity. Although IPS was still effective for people with CMD and with major depressive disorder, it was relatively less effective for these subgroups. IPS was equally effective after both a short and a long follow-up period. However, we found small, but clinically not meaningful, differences in effectiveness of IPS between active and passive control groups. Finally, IPS was relatively less effective in European studies compared to non-European studies, which could be explained by a potential benefits trap in high welfare countries. Conclusions IPS is effective for all different subgroups, regardless of diagnostic, clinical, functional and personal characteristics. However, there might be a risk of false-positive subgroup outcomes and results should be handled with caution. Future research should focus on whether, and if so, how the IPS model should be adapted to better meet the vocational needs of people with CMD and higher symptom severity.

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Vocational Outcomes of the Individual Placement and Support Model in Subgroups of Diagnoses, Substance Abuse, and Forensic Conditions: A Systematic Review and Analysis of Pooled Original Data

Cited by 13 publications

References 34 publications

Are attitudes in employees of public employment service in line with the principles of individual placement and support? A questionnaire‐based survey

Are attitudes in employees of public employment service in line with the principles of individual placement and support? A questionnaire‐based survey

Long-Term Effects of the Individual Placement and Support Intervention on Employment Status: 6-Year Follow-Up of a Randomized Controlled Trial

Who benefits from individual placement and support? A meta-analysis

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