Scoping review exploring vocational rehabilitation interventions for mental health service users with chronic mental illness in low-income to upper-middle-income countries

Chimara, Munyaradzi; Niekerk, Lana van; Biljon, Hester M van

doi:10.1136/bmjopen-2021-059211

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…As demonstrated by Chimara et al, the prevailing institutional model of mental health services in LMICs often leads occupational therapists to prioritize service provision within institutions rather than in community settings. [7]. In contrast, social workers and psychologists displayed greater motivation to engage, learn, and participate in our program.…”

Section: Implementation Challenges and Solutionsmentioning

confidence: 93%

“…Despite nearly 60% of patients with severe mental illness in the United States expressing a desire to work, less than 2% have access to this evidence-based service [3]. While IPS has been developed and implemented in some Western countries, its development in the Middle East is limited [7]. In Iran, a developing country with an unemployment rate of 9.0% (amar.org.ir), the employment rate among people with severe mental illness is not well-documented.…”

Section: Introductionmentioning

confidence: 99%

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

Mirsepassi,

Tabatabaee,

Panahi

et al. 2024

Preprint

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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.

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Section: Implementation Challenges and Solutionsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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

Mirsepassi,

Tabatabaee,

Panahi

et al. 2024

Preprint

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“…The latter study in particular also points out that ‘No individual studies were identified for rehabilitation of speech and language disorders or cognition from LMICs’ given that 67% of stroke patients experience cognitive consequences. Finally, in a very recent review (Chimara et al, 2022), the authors describe the use of vocational rehabilitation only for chronic mental diseases in LMICs.…”

Section: Partmentioning

confidence: 99%

Cognitive evaluation and rehabilitation in high‐ and low‐income countries

Mazzucchi

2023

Journal of Neuropsychology

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Starting from her own personal experience, in the First Part of the article, the author reconstructs how the specialized sectors of cognitive evaluation and rehabilitation evolved in Western countries (Europe, the United States, Canada, and Australia, in particular) during the second half of the last century and the first decades of this century. In the Second Part, she describes her personal experience in setting up a rehabilitation centre dedicated to traumatic brain‐injured subjects and her commitment to international cooperation (Bolivia, Rwanda, Myanmar, Tanzania) in the field of cognitive evaluation and rehabilitation in favour of people with congenital and acquired cerebral pathology, especially in the paediatric age, since there is an almost total lack of diagnostic, but above all, rehabilitative procedures for cognitive functions in low‐middle income countries. In the Third Part of the article, the author carries out an extensive review of the international literature on the differences in access to cognitive diagnostic evaluation and cognitive rehabilitation in middle‐ and low‐income countries – but not only – underlining the urgent need to launch a major international collaborative effort to reduce and eliminate these discrepancies.

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“…Despite all the research done there remains limited knowledge of supported employment interventions in LMICs. Although a scoping review has synthesised the existing evidence of vocational rehabilitation interventions being offered at institutions in LMICs [ 49 ], there is a dearth of evidence on support employment interventions in LMICs. This review, therefore, seeks to synthesize the existing literature pertaining to supported employment interventions in LMICs and document their impacts on persons with mental disabilities in the open labour market.…”

Section: Introductionmentioning

confidence: 99%

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

Mavindidze,

Nhunzvi,

Van Niekerk

2023

PLoS ONE

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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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Scoping review exploring vocational rehabilitation interventions for mental health service users with chronic mental illness in low-income to upper-middle-income countries

Cited by 5 publications

References 27 publications

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

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

Cognitive evaluation and rehabilitation in high‐ and low‐income countries

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

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