Impact of supported employment on service costs and income of people with mental health needs

Schneider, Justine; Boyce, Melanie J.; Johnson, Robyn; Secker, Jenny; Slade, Jan; Grove, Bob

doi:10.3109/09638230903111098

Cited by 21 publications

(19 citation statements)

References 12 publications

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“…Clients who do begin to work may experience an improvement in symptoms and self‐esteem , which might in turn reduce hospitalizations. Studies that have considered the effects of working on overall treatment costs do suggest that, in clients who enter into work (which IPS facilitates but does not guarantee), there are reductions in treatment costs , and these are largely influenced by inpatient use.…”

Section: Discussionmentioning

confidence: 99%

Supported employment: cost‐effectiveness across six European sites

et al. 2013

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A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n5312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost-effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost-benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost-effective than standard vocational services. Further analysis demonstrated cost-benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost-saving and almost certainly more cost-effective as a way to help people with severe mental health problems into competitive employment.

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Section: Discussionmentioning

confidence: 99%

Supported employment: cost‐effectiveness across six European sites

et al. 2013

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“…Finally, several recent studies have reported on the relationship between employment and treatment costs (28)(29)(30). The observed negative correlations between employment and treatment costs might be seen as evidence of a treatment cost offset effect of IPS-SE services, because IPS-SE has a track record of increasing employment (1,29).…”

Section: Other Cost Offsets Of Ips-se For Mental Health Treatmentmentioning

confidence: 94%

Social Costs of Expanding Access to Evidence-Based Supported Employment: Concepts and Interpretive Review of Evidence

Salkever¹

2013

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A recent policy analysis argued that expanding access to evidence-based supported employment can provide savings in major components of social costs. This article extends the scope of this policy analysis by placing the argument within a recently developed economic framework for social cost-effectiveness analysis that defines a program's social cost impact as its effect on net consumption of all goods and services. A total of 27 studies over the past two decades are reviewed to synthesize evidence of the social cost impacts of expanding access to the individual placement and support model of supported employment (IPS-SE). Most studies have focused primarily on agency costs of providing IPS-SE services, cost offsets when clients shift from "traditional" rehabilitation to IPS-SE, and impacts on clients' earnings. Because costs and cost offsets are similar in magnitude, incremental costs of expanding services to persons who would otherwise receive traditional services are probably small or even negative. The population served by an expansion could be sizable, but the feasibility of a policy targeting IPS-SE expansion in this way has yet to be demonstrated. IPS-SE has positive impacts on competitive job earnings, but these may not fully translate into social cost offsets. Additional empirical support is needed for the argument that large-scale expansion would yield substantial mental health treatment cost offsets. Other gaps in evidence of policy impacts include take-up rate estimates, cost impact estimates from longer-term studies (exceeding two years), and longer-term studies of whether IPS-SE prevents younger clients from becoming recipients of Supplemental Security Income or Social Security Disability Insurance

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“…In many studies, employment also correlates with short-term reductions in mental health costs (Bond et al, 1995;Burns et al, 2008;Clark, 1998;Henry, et al, 2004;Latimer, 2001;Perkins, Born, Raines, & Galka, 2005;Schneider et al, 2009). These savings can accumulate to large sums over time (Bush, Drake, Xie, McHugo, & Haslett, 2009).…”

Section: Non-vocational Outcomesmentioning

confidence: 99%

“…IPS generates two main cost offsets: reduced costs for mental health treatment and reduced participation in disability systems. Several studies demonstrate that supported employment services decrease mental health costs (Bond et al, 1995;Burns et al, 2008;Clark, Xie et al, 1998;Frey et al, 2011;Henry et al, 2004;Knapp et al, 2013;Latimer, 2001;Perkins et al, 2005;Schneider et al, 2009). While the preliminary evidence is encouraging for cost offsets exceeding the direct costs of IPS services, some economists remain cautious about overstating savings (Salkever, 2012).…”

Section: Cost Offsetsmentioning

confidence: 99%

Evidence-based supported employment for people with severe mental illness: Past, current, and future research

Luciano

Drake

Bond

et al. 2014

Journal of Vocational Rehabilitation

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BACKGROUND: Individual Placement and Support (IPS) is an evidence-based vocational rehabilitation intervention for people with severe mental illness. IPS emphasizes client choice, rapid job finding, competitive employment, team-oriented approaches, benefits counseling, and ongoing supports. OBJECTIVE: This paper summarizes 20 years of research on IPS, describes studies in the field now, and proposes priorities for future research. METHODS: To identify published and unpublished IPS research studies, we conducted an electronic search of qualitative and quantitative IPS studies, findings from recent reviews, and sought expert recommendation. RESULTS: Past research indicates that IPS supported employment is the most effective and cost-effective approach for helping people with psychiatric disabilities find and maintain competitive employment. Employment improves clinical, social, and economic outcomes. Current studies on IPS address several research gaps: IPS modification, generalizability, program settings, international dissemination, cultural awareness, and supportive technology. Looking forward, the field needs studies that report long-term outcomes, financing mechanisms, cost offsets, and standardized supported education models. CONCLUSIONS: While IPS is one of the most extensively studied of all vocational models, significant literature gaps remain.

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Impact of supported employment on service costs and income of people with mental health needs

Cited by 21 publications

References 12 publications

Supported employment: cost‐effectiveness across six European sites

Supported employment: cost‐effectiveness across six European sites

Social Costs of Expanding Access to Evidence-Based Supported Employment: Concepts and Interpretive Review of Evidence

Evidence-based supported employment for people with severe mental illness: Past, current, and future research

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