Supported Employment for the Reintegration of Disability Pensioners with Mental Illnesses: A Randomized Controlled Trial

Abstract

Work is beneficial for the recovery from mental illness. Although the approach of individual placement and support (IPS) has been shown to be effective in Europe, it has not yet been widely implemented in European health care systems. The aim of this randomized controlled trial was to assess the effectiveness of IPS for disability pensioners with mental illnesses new on disability benefits in Switzerland. In the study at hand, 250 participants were randomly assigned to either the control or the intervention group. The participants in the intervention group received job coaching according to IPS during 2 years. The control group received no structured support. Both groups were interviewed at baseline and followed up every 6 months (baseline, 6, 12, 16, 18, 24 months) for 2 years. Primary outcome was to obtain a job in the competitive employment. IPS was more effective for the reintegration into the competitive employment market for disability pensioners than the control condition. Thirty-two percent of the participants of the intervention group and 12% of the control group obtained new jobs in the competitive employment. IPS is also effective for the reintegration into competitive employment of people with mental illness receiving disability pensions.

A meta‐regression of the impact of policy on the efficacy of individual placement and support

“…Hoffmann et al and Howard et al and Heslin et al report the efficacy of IPS for the same patient population at two follow‐up periods, so we only included the latter study from both in our meta‐analysis. The meta‐analysis is based on 27 studies (Fig. ).…”

“…The variation in control conditions in the included trials is another limitation. The control conditions are all labelled as traditional vocational rehabilitation, but there is diversity between high quality supported TAU and possibility of vocational support .…”

A structured mixed method process evaluation of a randomized controlled trial of Individual Placement and Support (IPS)

“…Although IPS has consistently proved effective, the majority of participants do not obtain employment [12][13][14][15][16][17]. Perhaps more thorough process evaluations or implementations studies could shed light on speci c barriers and facilitators to be targeted in order to enhance employment outcomes.…”

Los Centros de Rehabilitación Laboral y el Trastorno Mental Grave: la Experiencia y el Seguimiento de los Usuarios en la Comunidad de Madrid

“…En 2011 se publicó la revisión de la Cochrane Collaboration (Crowther, Marshall, Bond y Huxley, 2001) en la que señalaba el empleo con apoyo como la metodología más efectiva. A partir de ese momento, numerosos estudios controlados (Bejerholm, Areberg, Hofgren, Sandlund y Rinaldi, 2015;Bond et al, 2015;Hoffmann, Jäckel, Glauser, Mueser y Kupper, 2014;Michon et al, 2011;Oshima, Sono, Bond, Nishio e Ito, 2014;Viering et al, 2015;Waghorn, Dias, Gladman, Harris y Saha, 2014), revisiones y metaanálisis (Marshall et al, 2014;Modini et al, 2016) se centraron en el estudio del empleo con apoyo refrendando los hallazgos previamente mencionados. Entre estas investigaciones cabe mencionar la llevada a cabo por Burns et al (2007) en la que, tras un periodo de intervención de 18 meses, encontraron que un 55% de las personas que recibieron un programa de empleo con apoyo obtuvieron trabajo.…”

“…Estos efectos positivos también han sido encontrados en diferentes países y bajo condiciones económicas diferentes (Modini et al, 2016). Ejemplo de esto son los estudios llevados a cabo en Australia (Waghorn et al, 2014), Japón (Oshima et al, 2014), Holanda (Michon et al, 2011), Suecia (Bejerholm et al, 2015) o Suiza (Hoffmann et al, 2014;Viering et al, 2015). Incluso, cuando el crecimiento del producto interior bruto es menor al 2%, el empleo con apoyo muestra aun mayor diferencia en cuanto a su eficacia respecto al entrenamiento prelaboral (Modini et al, 2016).…”