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Supported employment: randomised controlled trial

  • Louise M. Howard (a1), Margaret Heslin (a1), Morven Leese (a1), Paul McCrone (a1), Christopher Rice (a1), Manuela Jarrett (a1), Terry Spokes (a1), Peter Huxley (a2) and Graham Thornicroft (a3)...
Abstract
Background

There is evidence from North American trials that supported employment using the individual placement and support (IPS) model is effective in helping individuals with severe mental illness gain competitive employment. There have been few trials in other parts of the world.

Aims

To investigate the effectiveness and cost-effectiveness of IPS in the UK.

Method

Individuals with severe mental illness in South London were randomised to IPS or local traditional vocational services (treatment as usual) (ISRCTN96677673).

Results

Two hundred and nineteen participants were randomised, and 90% assessed 1 year later. There were no significant differences between the treatment as usual and intervention groups in obtaining competitive employment (13% in the intervention group and 7% in controls; risk ratio 1.35, 95% CI 0.95–1.93, P = 0.15), nor in secondary outcomes.

Conclusions

There was no evidence that IPS was of significant benefit in achieving competitive employment for individuals in South London at 1-year follow-up, which may reflect suboptimal implementation. Implementation of IPS can be challenging in the UK context where IPS is not structurally integrated with mental health services, and economic disincentives may lead to lower levels of motivation in individuals with severe mental illness and psychiatric professionals.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (http://creativecommons.org/licenses/by-nc/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Corresponding author
Correspondence: Louise M. Howard, PO31 Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, UK
Footnotes
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*

The results given here have been presented in part at the 2008 Krakow ENMESH meeting.

Declaration of interest

None.

Footnotes
References
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Supported employment: randomised controlled trial

  • Louise M. Howard (a1), Margaret Heslin (a1), Morven Leese (a1), Paul McCrone (a1), Christopher Rice (a1), Manuela Jarrett (a1), Terry Spokes (a1), Peter Huxley (a2) and Graham Thornicroft (a3)...
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