People with severe mental illness receive twice the benefit from an IPS (Individual Placement Support) program at establishing themselves in competitive employment, when compared to vocational services*, according to an article in The Lancet, this week’s issue.

IPS involves job searching based on the patient’s preference. It provides the patient and employer with continuing support from an employment specialist who works for the local mental health service.

Professor Tom Burns, Department of Psychiatry, University of Oxford, UK, and team carried out a study involving 312 patients across six centers – London, UK; Ulm-Guenzburg, Germany; Rimini, Italy; Zurich, Switzerland; Groningen, Netherlands; Sofia, Bulgaria. 156 of them received IPS while 156 received vocational services. They were followed up for 18 months. The researchers measured the difference between the percentages of patients who entered competitive employment from the two groups.

Here are some of the results:

– 55% of IPS patients worked for at least one day
– 28% of vocational services patients worked for at least one day

– 13% of IPS patients dropped out of the service
– 45% of the vocational services patients dropped out of the service

– 20% of IPS patients were readmitted to hospital
– 31% of vocational services patients were readmitted to hospital

The researchers say that the varying IPS success rates were directly influenced by local unemployment rates in the different centers.

“Our demonstration of the effectiveness of IPS in widely differing labor market and welfare contexts confirms this service to be an effective approach for vocational rehabilitation in mental health that deserves investment and further investigation,” the researchers concluded.

“Further progress will inevitably require new international partnerships, funding from a wide variety of sources, different research designs, a long-term focus to track vocational recovery, and inclusive communities prepared to restore equal rights of citizenship and value human strengths over deficits. Equally important will be the need for researchers to produce evidence for immediate use in developing policy and in sponsoring local evidence based programs,” wrote, Dr Geoff Waghorn, Queensland Centre for Mental Health Research, University of Queensland, Australia and Dr Paul Gold, University of South Carolina, USA, in an accompanying Comment.

*Vocational services are the standard psychiatric rehabilitation services that aim to train people to return to work (i.e. train and place as opposed to place and train). They use structured training such as IT training, interview training, time-skills and practice in sheltered settings. They are often day programs.

thelancet