Individual placement and support: History, current status, and future directions

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.

Individual placement and support: A qualitative investigation of carers' experiences supporting someone experiencing mental illness into employment

“…IPS, if adhering to the core principles, addresses most of the issues raised by carers. Specifically, IPS has been developed to successfully support individuals with severe mental illness and functional impairment into work (Drake & Bond, 2023). The study findings emphasise the significance of ensuring that carers understand IPS supports and that clinicians and Employment Specialists understand the benefits of the additional assistance carers provide, so reducing caregiver stress and enhancing the psychosocial benefits of issue sharing (Department of Social Services, 2022;Gühne et al, 2015).…”

Supported employment interventions for workplace mental health of persons with mental disabilities in low-to-middle income countries: A scoping review

“…Rusch and Hughes [ 61 ] explain that supported employment is a group of interrelated work intervention models that emphasise integrated paid work with ongoing support. The most widely researched model of supported employment intervention model is the IPS [ 25 , 41 , 62 – 64 ]. ISE was developed in Hong Kong in response to the contextual limitations on implementing IPS to fidelity and to improve job tenure and sustaining employment outcomes [ 28 , 65 ] Supported employment interventions have increasingly integrated other interventions and services such as cognitive interventions, social skills interventions, clubhouse approaches, sheltered employment and occupational therapy to improve outcomes for persons with mental disabilities and in response to contextual realities [ 66 ].…”

“…The most common model among supported employment interventions is the Individual Placement and Support (IPS) model [ 23 , 25 ], IPS focuses on ensuring rapid job search and placement of clients in competitive work settings of their choice, while continuing to provide support to accessing clinical services and counselling for an unlimited time [ 23 ]. Other models of supported employment interventions, such as Integrated Supported Employment (ISE), follow similar principles as IPS, and either combine IPS with other psychological interventions or embed it into another models [ 25 – 27 ]. ISE integrates occupational therapy services together with supported employment interventions which can take various forms including embedding work-related social skills training (WSST) into an IPS model [ 25 , 26 ].…”

“…Other models of supported employment interventions, such as Integrated Supported Employment (ISE), follow similar principles as IPS, and either combine IPS with other psychological interventions or embed it into another models [ 25 – 27 ]. ISE integrates occupational therapy services together with supported employment interventions which can take various forms including embedding work-related social skills training (WSST) into an IPS model [ 25 , 26 ]. WSST, IPS and ISE are defined in Table 1 .…”

Supported employment interventions with people who have severe mental illness: Systematic mixed-methods umbrella review

“…They have since been adapted for individuals with SMI, with a core emphasis on open competitive employment, e.g., provision of support to secure a job and maintain employment in the open job market concurrent with mental health or other treatments [ 25 – 27 ]. Individual Placement and Support (IPS), first developed and tested in US populations, is one of the most commonly known models of supported employment for SMI, incorporating rapid job search, tailored support services, and the integration of mental health and employment services [ 28 , 29 ]. IPS appears to be the most extensively studied model [ 30 ], exhibiting notable enhancements in work-related achievements, quality of life, clinical outcomes, and demonstrated cost-effectiveness [ 31 – 33 ].…”