Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Mar;141(3):206-220.
doi: 10.1111/acps.13129. Epub 2019 Dec 19.

A meta-regression of the impact of policy on the efficacy of individual placement and support

B Brinchmann  1   2 , T Widding-Havneraas  3 , M Modini  4   5 , M Rinaldi  6 , C F Moe  1   7 , D McDaid  8 , A-L Park  1   8 , E Killackey  9   10 , S B Harvey  11 , A Mykletun  1   2   3   12
Affiliations
Meta-Analysis

A meta-regression of the impact of policy on the efficacy of individual placement and support

B Brinchmann et al. Acta Psychiatr Scand. 2020 Mar.

Abstract

Objective: Individual placement and support (IPS) has shown consistently better outcomes on competitive employment for patients with severe mental illness than traditional vocational rehabilitation. The evidence for efficacy originates from few countries, and generalization to different countries has been questioned. This has delayed implementation of IPS and led to requests for country-specific RCTs. This meta-analysis examines if evidence for IPS efficacy can be generalized between rather different countries.

Methods: A systematic search was conducted according to PRISMA guidelines to identify RCTs. Overall efficacy was established by meta-analysis. The generalizability of IPS efficacy between countries was analysed by random-effects meta-regression, employing country- and date-specific contextual data obtained from the OECD and the World Bank.

Results: The systematic review identified 27 RCTs. Employment rates are more than doubled in IPS compared with standard vocational rehabilitation (RR 2.07 95% CI 1.82-2.35). The efficacy of IPS was marginally moderated by strong legal protection against dismissals. It was not moderated by regulation of temporary employment, generosity of disability benefits, type of integration policies, GDP, unemployment rate or employment rate for those with low education.

Conclusions: The evidence for efficacy of IPS is very strong. The efficacy of IPS can be generalized between countries.

Keywords: disability benefits; employer regulations; employment; individual placement and support; mental illness; meta-analysis; meta-regression; supported employment; systematic review; unemployment.

PubMed Disclaimer

References

    1. Summergrad P. Homeless and impaired: the burden of serious psychiatric illness. Acta Psychiatr Scand 2015;131:238-239.
    1. Marwaha S, Johnson S, Bebbington P et al. Rates and correlates of employment in people with schizophrenia in the UK, France and Germany. Br J Psychiatry 2007;191:30-37.
    1. Kooyman I, Dean K, Harvey S, Walsh E. Outcomes of public concern in schizophrenia. Br J Psychiatry. 2007;191:29-36.
    1. OECD. Sick on the job? Myths and realities about mental health and work. OECD,2012.
    1. OECD. Fit Mind, Fit Job.: OECD, 2015.

Publication types

LinkOut - more resources