Lack of participation in the open labor market is highly prevalent for people with a mental illness across countries, and the proportion of people who get some kind of sickness benefit because of mental illness is steadily growing in Europe.
Vocational rehabilitation through individual placement and support (IPS) model has been shown to be effective and is evidence-based for people with severe mental illness. In Sweden, the method is used but not scientifically evaluated. The aim was to investigate vocational and nonvocational outcomes at a 1-year follow-up and the relationships between these outcomes, at two different sites in the north of Sweden.
The study was designed as a follow-up of clients included in two SE services for people with a mental illness. Assessments were made at baseline, and at 1-year and 2-year follow-ups. In addition, service use and vocational situation were registered at 2-monthly intervals during the follow-up period. One of these services is situated in a town of 115,000 inhabitants, and the other team is situated in a town where 70,000 people live. Both teams are organized in the municipalities social service organization as time-limited projects. They are financed by a coordinating organization, where representatives of the employment office, social insurance bureau, psychiatric service and the local social service are members.
The participants were 65 men and women, mostly younger than 30 years of age and with a mental illness. Occupational situation, psychiatric symptoms, self-esteem, quality of life and psychosocial functioning were assessed. Assessments included vocational situation, psychiatric symptoms, self-esteem, quality of life and psychosocial functioning. The present paper includes results from the 1-year follow-up.
The clients were contacted by the first author as soon as possible after inclusion in the programme. The clients were given the opportunity to choose where the data collection would take place and this was usually at the SE office. However, but some interviews were held in the client‚ residence or in the first author‚ office at the university. In most cases, the data collection lasted for 60‚Äì90 minutes to complete the questionnaires.
Individual Placement and Support (IPS) model is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice.
There was no control or comparison condition.
The vocational outcome during 1 year was that 25% of the participants were employed, and 14% were in education. Most of the participants moved from unemployment to work practice for a prolonged time. Participants in employment, education or work practice at follow-up showed higher satisfaction with their occupational situation than those without regular activities outside home. Among the participants in work practice, improvements in psychiatric symptoms and global functioning were identified.
This attempt is the first to evaluate supported employment according to the IPS model for persons with mental illness applied in the Swedish welfare system. There is a need for a longer follow-up period to evaluate whether interventions such as further education and work practice actually will lead to real work.