Skip to main content Accessibility help
×
Home

Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual

  • Eóin Killackey (a1), Henry J. Jackson (a2) and Patrick D. McGorry (a3)

Abstract

Background

Unemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.

Aims

To examine whether a vocational intervention - individual placement and support (IPS) - which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.

Method

A total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).

Results

The IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.

Conclusions

Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual
      Available formats
      ×

Copyright

Corresponding author

Dr Eón Killackey, ORYGEN Research Centre, 35 Poplar Road, Parkville, Victoria 3052, Australia. E-mail: eoin@unimelb.edu.au

Footnotes

Hide All

Declaration of interest

This research was supported by a National Health and Medical Research Council Program Grant (ID: 350241) and an unrestricted study grant from Bristol Myers Squibb. ORYGEN Research Centre is supported by the Colonial Foundation.

Footnotes

References

Hide All
1 Killackey, EJ, Jackson, HJ, Gleeson, J, Hickie, IB, MCGorry, PD. Exciting career opportunity beckons! Early intervention and vocational rehabilitation in first episode psychosis: employing cautious optimism. Aust N Z J Psychiatry 2006; 40: 951–62.
2 Secker, J, Grove, B, Seebohm, P. Challenging barriers to employment, training and education for mental health service users: the service user's perspective. J Ment Health 2001; 10: 395404.
3 Wu, EQ, Birnbaum, HG, Shi, L, Ball, DE, Kessler, RC, Moulis, M, Aggarwal, J. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry 2005; 66: 1122–9.
4 Carr, V, Lewin, TJ, Neil, AL. What is the value of treating schizophrenia? Aust N Z J Psychiatry 2006; 40: 963–71.
5 Crowther, RE, Marshall, M, Bond, GR, Huxley, P. Vocational rehabilitation for people with severe mental illness. Cochrane Database Syst Rev 2001; (2): CD003080.
6 Becker, DR, Drake, RE. A Working Life For People With Severe Mental Illness. Oxford University Press, 2003.
7 Bond, GR. Supported employment: evidence for an evidence-based practice. Psychiatr Rehabil J 2004; 27: 345–59.
8 Turton, N. Welfare benefits and work disincentives. J Ment Health 2001; 10: 285300.
9 Killackey, E, Waghorn, G. The challenge of integrating employment services with public mental health services in Australia: progress at the first demonstration site. Psychiatr Rehabil J in press.
10 Ventura, J, Lukoff, D, Nuechterlein, KH, Liberman, RP, Green, MF, Shaner, A. Brie Psychiatric Rating Scale (BPRS) Expanded Version (4.0). Scales, Anchor Points, and Administration Manual. UCLA Department of Psychiatry and Behavioral Sciences, 1993.
11 Andreasen, NC. Scale for Assessment of Negative Symptoms (SANS). University of Iowa, 1984.
12 Eaton, WW. Centre for Epidemiologic Studies Depression Scale - Revised (CESD-R). In Innovations in Clinical Practice: A Source Book (eds Vande Creek, L, Jackson, T): 295–7. Professional Resource Exchange, 2001.
13 First, MB, Spitzer, RL, Gibbon, M, Williams, JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). Biometrics Research, New York State Psychiatric Institute, 2001.
14 Heinrichs, DW, Hanlon, TE, Carpenter, WT. The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10: 388–98.
15 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). American Psychiatric Association, 1994.
16 Becker, DR, Smith, J, Tanzman, B, Drake, RE, Tremblay, T. Fidelity of supported employment programs and employment outcomes. Psychiatr Serv 2001; 52: 834–6.
17 Jenkins, R, Lewis, G, Bebbington, P, Brugha, T, Farrell, M, Gill, B, Meltzer, H. The national psychiatric morbidity surveys of Great Britain - initial findings from the Household Survey. Int Rev Psychiatry 2003; 15: 2942.
18 Knapp, M, Mangalore, R, Simon, J. The global costs of schizophrenia. Schizophr Bull 2004; 30: 279–93.
19 SANE Australia. Schizophrenia: Costs. An Analysis of the Burden of Schizophrenia and Related Suicide in Australia. SANE Australia, 2002.
20 Andlin-Sobocki, P, Rössler, W. Cost of psychotic disorders in Europe. Eur J Neurol 2005; 12: 74–7.
21 Löthgren, M. Economic evidence in psychotic disorders: a review. Eur J Health Econ 2004; 5 (suppl 1): s6774.
22 Long, M. How Young People are Faring: Key Indicators 2005. Dusseldorp Skills Forum, 2005.
23 McGorry, PD, Hickie, IB, Yung, AR, Pantelis, C, Jackson, HJ. Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 2006; 40: 616–22.
24 Dooley, D. Unemployment, underemployment and mental health: conceptualizing employment status as a continuum. Am J Community Psychol 2003; 32: 920.
25 Mitchell, DP, Betts, A, Epling, M. Youth employment, mental health and substance misuse: a challenge to mental health services. J Psychiatr Ment Health Nurs 2002; 9: 191–8.
26 Birchwood, M, Fiorillo, A. The critical period for early intervention. Psychiatr Rehabil Skills 2000; 4: 182–98.
27 McGorry, P. ‘Every me and every you’: responding to the hidden challenge of mental illness in Australia. Australas Psychiatry 2005; 13: 315.
28 Killackey, E, Yung, AR. Effectiveness of early intervention in psychosis. Curr Opin Psychiatry 2007; 20: 121–5.
29 Rosenheck, R, Leslie, D, Keefe, R, McEvoy, J, Swartz, M, Perkins, D, Stroup, S, Hsiao, JK, Lieberman, J; CATIE Study Investigators Group. Barriers to employment for people with schizophrenia. Am J Psychiatry 2006; 163: 411–7.

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Vocational intervention in first-episode psychosis: Individual placement and support v. treatment as usual

  • Eóin Killackey (a1), Henry J. Jackson (a2) and Patrick D. McGorry (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *