The Provision of Education and Employment Support At the Outreach and Support in South London (OASIS) Service for People at Clinical High Risk for Psychosis

Abstract

Clinical services for the early detection of individuals at clinical high risk of psychosis, such as Outreach and Support in South-London (OASIS), have been successful in providing psychological intervention and psychosocial support to young people experiencing emerging signs of serious mental disorders. Despite this, several studies have repeatedly shown that vocational and functional recovery in the clinical high risk for psychosis population is still low. This study aimed at evaluating the presence and nature of educational and employment focused interventions within the OASIS service, in order to inform research and clinical interventions aimed at supporting young people with early signs of psychosis on their path to vocational recovery. The specific objectives were to compare current practice i) to standards defined by the National Institute of Care Excellence guidelines; and ii) to principles defined by Individual Placement and Support (IPS). Nine standards of practice were derived. The OASIS caseload electronic records entered between January 2015 and January 2017 were manually screened. Data collected include sociodemographic, assessment of employment and educational status and support needs, interventions received, contacts with schools, employers and external vocational providers, employment, and educational status. Standards were considered as “met” if they were met for at least 90% of clients. Results suggest that, two out of nine standards were met while the remaining standards were only partially met. In particular, support provided was always focused on competitive employment and mainstream education and support was always based on people’s interest. Implications for clinical and research practice are discussed.

Public health primary prevention implemented by clinical high-risk services for psychosis

“…[ 17 , 27 , 28 , 30 , 36 , 51 , 55 , 59 – 61 , 63 , 64 ] Selective strategies and corresponding good mental health domains • Assessment of vocational history, goals and engagement, and cognitive functioning. [ 34 , 71 , 76 ] Academic/occupational performance, cognitive skills • Occupational or supportive therapy on vocational/occupational functioning. [ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ] Academic/occupational performance • Onsite vocational reintegration, including supported employment or IPS.…”

“…[ 34 , 71 , 76 ] Academic/occupational performance, cognitive skills • Occupational or supportive therapy on vocational/occupational functioning. [ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ] Academic/occupational performance • Onsite vocational reintegration, including supported employment or IPS. [ 34 , 35 , 54 , 55 , 73 , 76 , 80 ] Academic/occupational performance • Intensive networking with local/community stakeholders.…”

“…[ 11 , 34 , 36 , 42 – 44 , 50 – 52 , 55 , 57 , 58 , 77 – 79 ] Academic/occupational performance • Onsite vocational reintegration, including supported employment or IPS. [ 34 , 35 , 54 , 55 , 73 , 76 , 80 ] Academic/occupational performance • Intensive networking with local/community stakeholders. [ 19 , 28 , 34 , 38 , 41 , 74 , 77 ] Academic/occupational performance • Psychosocial support with housing and accommodation.…”

“…[ 34 , 35 , 54 , 55 , 73 , 76 , 80 ] Academic/occupational performance • Intensive networking with local/community stakeholders. [ 19 , 28 , 34 , 38 , 41 , 74 , 77 ] Academic/occupational performance • Psychosocial support with housing and accommodation. [ 11 , 19 , 33 , 74 , 77 ] QoL Neighbourhood Service characteristics • Presence in catchment areas with high levels of social deprivation.…”

A cross-sectional study addressing the importance of work and other everyday activities for well-being among people with mental illness: does additional vulnerability matter?

“…One group consists of people who develop psychosis at a young age and who as a consequence have fewer career opportunities than others of the same age. Their vulnerability also oftentimes includes being unable to proceed to higher education, and entrance to the labor market is made difficult [ 19 , 20 ]. They typically report low self-esteem, stigmatizing attitudes from others, and difficulties in identifying and achieving goals as hindering factors in relation to work and employment [ 21 ].…”