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Individual Placement and Support in Sweden-A randomized controlled trial.

Bejerholm, Ulrika LU ; Areberg, Cecilia LU ; Hofgren, Caisa LU ; Sandlund, Mikael and Rinaldi, Miles (2015) In Nordic Journal of Psychiatry 69(1). p.57-66
Abstract
Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered... (More)
Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Nordic Journal of Psychiatry
volume
69
issue
1
pages
57 - 66
publisher
Informa Healthcare
external identifiers
  • pmid:24983382
  • wos:000346342500008
  • scopus:84918521389
ISSN
1502-4725
DOI
10.3109/08039488.2014.929739
language
English
LU publication?
yes
id
7ec99ea4-dd40-4e39-b0b4-4508ad124c49 (old id 4583752)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24983382?dopt=Abstract
date added to LUP
2014-08-06 22:45:45
date last changed
2017-10-01 03:00:26
@article{7ec99ea4-dd40-4e39-b0b4-4508ad124c49,
  abstract     = {Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment.},
  author       = {Bejerholm, Ulrika and Areberg, Cecilia and Hofgren, Caisa and Sandlund, Mikael and Rinaldi, Miles},
  issn         = {1502-4725},
  language     = {eng},
  number       = {1},
  pages        = {57--66},
  publisher    = {Informa Healthcare},
  series       = {Nordic Journal of Psychiatry},
  title        = {Individual Placement and Support in Sweden-A randomized controlled trial.},
  url          = {http://dx.doi.org/10.3109/08039488.2014.929739},
  volume       = {69},
  year         = {2015},
}