Supported employment: randomised controlled trial
- PMID: 20435968
- PMCID: PMC2862060
- DOI: 10.1192/bjp.bp.108.061465
Supported employment: randomised controlled trial
Abstract
Background: There 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.
Aims: To investigate the effectiveness and cost-effectiveness of IPS in the UK.
Method: Individuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673).
Results: Two 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.
Conclusions: There 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.
Comment in
-
An effective intervention delivered at sub-therapeutic dose becomes an ineffective intervention.Br J Psychiatry. 2010 May;196(5):341-2. doi: 10.1192/bjp.bp.109.073338. Br J Psychiatry. 2010. PMID: 20435955
-
Employment rates for people with severe mental illness in the UK not improved by 1 year's individual placement and support.Evid Based Ment Health. 2010 Nov;13(4):114. doi: 10.1136/ebmh.13.4.114. Evid Based Ment Health. 2010. PMID: 21036976 No abstract available.
References
-
- Lehman A. Vocational rehabilitation in schizophrenia. Schizophr Bull 1995; 21: 645–56. - PubMed
-
- Thornicroft G, Tansella M, Becker T, Knapp M, Leese M, Schene A, et al. The personal impact of schizophrenia in Europe. Schizophr Res 2004; 69: 125–32. - PubMed
-
- Marwaha S, Johnson S, Bebbington P, Stafford M, Angermeyer MC, Brugha T, et al. Rates and correlates of employment in people with schizophrenia in the UK, France and Germany. Br J Psychiatry 2007; 191: 30–7. - PubMed
-
- Bond GR, Drake RE, Becker DR. An update on randomized controlled trials of evidence-based supported employment. Psychiatr Rehabil J 2008; 31: 280–90. - PubMed
Publication types
MeSH terms
Associated data
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
