Advanced

An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study

Prior, Susan ; Maciver, Donald ; Aas, Randi W. ; Kirsh, Bonnie ; Lexen, Annika LU ; Van Niekerk, Lana ; Irvine Fitzpatrick, Linda and Forsyth, Kirsty (2020) In BMC Psychiatry 20(1).
Abstract

Background: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from... (More)

Background: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p <.001. Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. Trial registration: NCT04083404 Registered 05 September 2019 (retrospectively registered).

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Employment, Enhanced Individual Placement & Support, Model of human occupation, Severe mental illness
in
BMC Psychiatry
volume
20
issue
1
article number
361
publisher
BioMed Central (BMC)
external identifiers
  • pmid:32641009
  • scopus:85087691727
ISSN
1471-244X
DOI
10.1186/s12888-020-02745-3
language
English
LU publication?
yes
id
884ab218-2726-4b7d-b977-362193b760f2
date added to LUP
2020-07-22 08:33:43
date last changed
2020-07-29 06:16:37
@article{884ab218-2726-4b7d-b977-362193b760f2,
  abstract     = {<p>Background: Employment is good for physical and mental health, however people with severe mental illness (SMI) are often excluded from employment. Standard Individual Placement and Support (IPS) is effective in supporting around 55% of people with SMI into employment or education. Current research considers enhancements to IPS to improve outcomes for those requiring more complex interventions. Clinicians need to better understand who will benefit from these enhanced IPS interventions. This study offers a new enhanced IPS intervention and an approach to predicting who may achieve successful outcomes. Methods: This prospective cohort study included people with SMI who participated in an enhanced IPS service and had prolonged absence from employment. Secondary data analysis was conducted of data gathered in routine clinical practice. Univariate analysis coupled with previous research and clinical consultation was used to select variables to be included in the initial model, followed by a backward stepwise approach to model building for the final multiple logistic regression model with an outcome of successful or unsuccessful goal attainment (employment or education). Results: Sixty-three percent of participants in the enhanced IPS successfully attained employment or education. Significant relationships from bivariate analyses were identified between outcomes (employment or education) and seven psychosocial variables. Adapting Routines to Minimise Difficulties, Work Related Goals, and Living in an Area of Lesser Deprivation were found to be significant in predicting employment or education in the final multiple logistic regression model R2 = 0.16 (Hosmer-Lemeshow), 0.19 (Cox-Snell), 0.26 (Nagelkerke). Model χ2(7) = 41.38 p &lt;.001. Conclusion: An enhanced IPS service had a 63% rate success in achieving employment or education, higher than comparable studies and provides an alternative to IPS-Lite and IPS-standard for more complex populations. Motivational and habitual psychosocial variables are helpful in predicting who may benefit from an enhanced IPS intervention supporting people after prolonged absence from employment. Trial registration: NCT04083404 Registered 05 September 2019 (retrospectively registered). </p>},
  author       = {Prior, Susan and Maciver, Donald and Aas, Randi W. and Kirsh, Bonnie and Lexen, Annika and Van Niekerk, Lana and Irvine Fitzpatrick, Linda and Forsyth, Kirsty},
  issn         = {1471-244X},
  language     = {eng},
  month        = {07},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Psychiatry},
  title        = {An enhanced individual placement and support (IPS) intervention based on the Model of Human Occupation (MOHO); a prospective cohort study},
  url          = {http://dx.doi.org/10.1186/s12888-020-02745-3},
  doi          = {10.1186/s12888-020-02745-3},
  volume       = {20},
  year         = {2020},
}