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Whitworth A, Baxter S, Cullingworth J, Clowes M. Individual Placement and Support (IPS) beyond severe mental health: An overview review and meta-analysis of evidence around vocational outcomes. Prev Med Rep 2024; 43:102786. [PMID: 38975284 PMCID: PMC11225006 DOI: 10.1016/j.pmedr.2024.102786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
Objective To provide an overview review of international evidence of vocational outcomes in Individual Placement and Support (IPS) interventions for populations other than severe mental health. Methods An overview of reviews published in English since 2000 reporting vocational outcomes (job entry, work sustainment, earnings, work hours, time to job entry) against counterfactuals of IPS interventions for population groups other than severe mental health. The overview review maximises data from individual studies and includes additional recent primary studies. DerSimonian-Laird random effects meta-analysis was performed. Results Thirteen eligible studies were identified from five reviews and five more recent individual studies were also identified. IPS studies covered a range of groups with a concentration towards mental health. For the primary vocational outcome of job entry all IPS studies showed superior job entry rates compared to control groups with an overall weighted odds ratio of 1.78 [1.42,2.22]. Substantial heterogeneity was identified by study size and the overall weighted odds ratio of 1.32 [1.2,1.46] estimated from the large and medium sized studies seems a more plausible estimate of the likely effects of scaled-up IPS interventions in groups beyond severe mental health. Secondary vocational outcomes including job sustainment, total earnings, average weekly hours worked and time to job entry were typically superior in IPS services than control groups. Conclusions IPS services are consistently more effective in supporting diverse population groups into sustained employment compared to business-as-usual employment services. The evidence is limited by unclear terminology, small sample sizes, incomplete intervention fidelity, intervention contamination and inconsistent measurement.
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Affiliation(s)
- Adam Whitworth
- Strathclyde Business School, University of Strathclyde, 199 Cathedral St, Glasgow G40QU, UK
| | - Susan Baxter
- University of Sheffield, School for Health and Related Research, Regent Court, Regent Street, Sheffield S14DA, UK
| | - Jane Cullingworth
- School of Social and Political Sciences, Adam Smith Building, University of Glasgow, G128RT, UK
| | - Mark Clowes
- University of Sheffield, School for Health and Related Research, Regent Court, Regent Street, Sheffield S14DA, UK
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Mavindidze E, Nhunzvi C, Van Niekerk L. Supported employment interventions for workplace mental health of persons with mental disabilities in low-to-middle income countries: A scoping review. PLoS One 2023; 18:e0291869. [PMID: 37733732 PMCID: PMC10513264 DOI: 10.1371/journal.pone.0291869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To review the evidence of supported employment interventions in low-to-middle income countries, documents their impact for persons with mental disorders in the open labour market and well as support decision making for its wider implementation in the workplace. DESIGN The scoping review is conducted following guidelines in the Arksey and O'Malley (2005) Framework. DATA SOURCES AND ELIGIBILITY Eleven databases which are PubMed, Scopus, Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Humanities International Complete, Web of Science, PsychInfo, SocINDEX, Open Grey and Sabinet were searched for articles published between January 2006 and January 2022. Both peer-reviewed articles and grey literature were eligible if they were on supported employment interventions in low-to-middle income countries. Only articles published in English were included. STUDY APPRAISAL AND SYNTHESIS Articles were screened at title, abstract and full article levels by two independent teams with the use of Rayyan software. Deductive thematic analysis was used to synthesize evidence on the supported employment interventions implemented in LMICs, capturing evidence of their outcomes for persons with mental disabilities securing competitive work. RESULTS The search yielded 7347 records and after screening by title and abstract, 188 studies were eligible for full article screening. Eight studies were included in this scoping review. Thematic descriptions of the findings were based on the availability of supported employment interventions within the context, the type of supported employment interventions as well as mental health and vocational outcomes in the workplace. CONCLUSIONS There is limited evidence of supported employment interventions in low-to-middle income countries despite the promising potential it has as an intervention to address mental health problems in the workplace and facilitate work participation by persons with mental disabilities.
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Affiliation(s)
- Edwin Mavindidze
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Occupational Therapy Programme, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Clement Nhunzvi
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Occupational Therapy Programme, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Lana Van Niekerk
- Faculty of Medicine and Health Sciences, Division of Occupational Therapy, Stellenbosch University, Cape Town, Western Cape, South Africa
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Drake RE, Bond GR. Individual placement and support: History, current status, and future directions. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e122. [PMID: 38867819 PMCID: PMC11114326 DOI: 10.1002/pcn5.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 06/14/2024]
Abstract
Over the past three decades, Individual Placement and Support (IPS) has emerged as a robust evidence-based approach to helping people with severe mental illnesses, such as schizophrenia, bipolar disorder, and major depression, to obtain and succeed in competitive employment. This review addresses the history, principles, research, and future directions of IPS. It covers current evidence on employment outcomes, cost-effectiveness, and nonvocational outcomes. It also describes current attempts to extend IPS to new populations. The authors provide an overview of numerous systematic reviews and meta-analyses of randomized controlled trials involving people with serious mental illness. For studies addressing nonvocational outcomes and new populations, the review uses best available evidence. Published reviews agree that IPS enables patients with serious mental illness in high-income countries to succeed in competitive employment at a higher rate than patients who receive other vocational interventions. Within IPS programs, quality of implementation, measured by standardized fidelity scales, correlates with better outcomes. Employment itself leads to enhanced income, psychosocial outcomes, clinical improvements, and decreased mental health service use. As IPS steadily spreads to new populations and new settings, research is active across high-income countries and spreading slowly to middle-income countries. IPS is an evidence-based practice for people with serious mental illness in high-income countries. It shows promise to help other disability groups also, and emerging research aims to clarify adaptations and outcomes.
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Affiliation(s)
- Robert E. Drake
- Department of PsychiatryColumbia University Vagelos College of Physicians and SurgeonsNew York CityNew YorkUSA
- Westat CorporationRockvilleMarylandUSA
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Adams WE, Rogers ES, McKnight L, Lynde D. Examination of Adaptations to the Evidence Based Supported Employment Model: Individual Placement and Support. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023:10.1007/s10488-023-01267-w. [PMID: 37162603 DOI: 10.1007/s10488-023-01267-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/11/2023]
Abstract
Individual Placement and Support (IPS) is a long-standing and innovative employment service for individuals with mental illness with dozens of clinical trials demonstrating effectiveness. Little is known, however, about intentional adaptations to IPS, especially those outside of the context of research studies. Using an implementation science framework, we conducted an exploratory study to better understand the characteristics of stakeholder-reported adaptions to IPS, the impetus for their development, and perceived impacts. We conducted qualitative interviews to analyze and describe these adaptations. Numerous adaptations of IPS were found that address the needs of new and underserved populations both within and outside of the mental health field. Programs reported adapting IPS because of the dearth of other evidence-based employment services, to serve diverse populations in need, and based on financial incentives. Benefits of adaptations were weighed against impacts on fidelity. As evidence-based practices (EBPs) are adapted, developers of EBPs should determine how fidelity of a program or service can be assessed or preserved in light of adaptations. This is critical with the increase in different service delivery methods, new populations, new service recipient needs, and new settings in need of EBPs.
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Affiliation(s)
- Wallis E Adams
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
- Department of Sociology, California State University, East Bay, Hayward, USA
| | - E Sally Rogers
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Lauren McKnight
- Center for Psychiatric Rehabilitation at Boston University, 940 Commonwealth Avenue, Boston, MA, 02215, USA
| | - David Lynde
- Independent Mental Health Consultant, Concord, NH, USA
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Cook JA, Steigman PJ, Swarbrick M, Burke-Miller JK, Laing TB, Vite L, Jonikas JA, Brown I. Outcomes of Peer-Provided Individual Placement and Support Services in a Mental Health Peer-Run Vocational Program. Psychiatr Serv 2022; 74:480-487. [PMID: 36254454 DOI: 10.1176/appi.ps.20220134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to determine whether staff at a peer-run agency could deliver supported employment services with high fidelity to the individual placement and support (IPS) model and whether employment outcomes of peer-delivered IPS plus work-specific health promotion were superior to usual supported employment services. METHODS Two teams from a vocational program of a large peer-run agency were studied from July 2015 to July 2017. One team received training and supervision in delivering IPS plus employment-focused physical wellness support and mentoring. The other team continued providing usual supported employment services. Study data included vocational outcomes from 348 clients served by the two teams (IPS, N=184; comparison condition, N=164) and the results of IPS fidelity reviews of the IPS team at study baseline, midpoint, and end. The authors modeled the primary outcome of competitive employment with random-effects logistic regression and adjusted propensity scores for age, gender, race, ethnicity, education, and months of service receipt. RESULTS Following training, the IPS team demonstrated acceptable and increasing fidelity to the IPS model, achieving "good fidelity" by the end of the 25-month observation period. Among IPS recipients, 43% achieved competitive employment versus 21% of comparison recipients (p<0.001). Multivariable analysis indicated that IPS recipients were significantly more likely to achieve competitive employment than individuals in the comparison group (OR=4.06, p<0.001). CONCLUSIONS Providing training in IPS along with health promotion to the behavioral health peer workforce may help address the severe shortage of IPS services and enhance the competitive employment outcomes of people served by peer-run programs.
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Affiliation(s)
- Judith A Cook
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Pamela J Steigman
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Margaret Swarbrick
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Jane K Burke-Miller
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Taina B Laing
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Laurie Vite
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Jessica A Jonikas
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
| | - Isaac Brown
- Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Cook, Steigman, Burke-Miller, Jonikas); Collaborative Support Programs of New Jersey, Freehold (Swarbrick); Center of Alcohol and Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers, the State University of New Jersey, New Brunswick (Swarbrick); Baltic Street Advocacy, Employment, and Housing (AEH), Inc., New York City (Laing, Vite, Brown)
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