Individual Placement and Support; Service Development and Implementation of an Evidence-based Practice in Iran

Abstract

Background Individuals with severe mental illness (SMI) often face challenges in obtaining and maintaining employment, resulting in low occupational rates. The Individual Placement and Support (IPS) program has been proven effective in promoting employment for people with SMI. However, its implementation in low-resource settings is limited. This study aims to share the experience of developing and implementing IPS in Iran and discuss the encountered challenges. Methods An interdisciplinary team was formed, including academic members and experts in providing occupational services. Employment specialists were trained through workshops and supervision sessions. Stakeholders, including hospital administrators and psychiatrists, were engaged to promote the adoption of IPS. The study included individuals with SMI who accepted the invitation to participate. The IPS fidelity scale was utilized to assess the quality of the service. Results During the 36-month study period, 40 clients were referred, with a majority being male and having a diploma or university degree. The IPS fidelity scale scores indicated good fidelity at 6 months and exemplary fidelity at 12 months. However, a significant dropout rate was observed, with the majority occurring during the first and third steps of the IPS process. Conclusion The implementation of IPS in Iran faced challenges, including limited resources and high dropout rates. Despite these challenges, the study demonstrates the feasibility of developing and implementing IPS in a low-resource setting. Efforts to secure funding and engage stakeholders were crucial for the sustainability of the service. This study highlights the need for comprehensive evidence-based occupational programs for individuals with SMI in Iran and similar settings. Further research and interventions are warranted to address the identified challenges and improve employment outcomes for individuals with SMI.