© 2000 Evidence-Based Mental Health
Individual placement and support led to more competitive employment than did enhanced vocational rehabilitation for severe mental disorder
Drake RE, McHugo GJ, Bebout RR, et al. A randomized clinical trial of supported employment for inner-city patients with severe mental disorders. Arch Gen Psychiatry 1999 Jul;56:627–33.
QUESTION: In people with severe mental disorder (SMD), is individual placement and support (IPS) better than enhanced vocational rehabilitation (EVR) for increasing competitive employment?
Randomised (unclear allocation concealment*), unblinded*, controlled trial with 18 months of follow up.
A community agency in southeast Washington, DC, USA.
152 unemployed, inner city patients (mean age 39 y, 61% women, 83% African–American) who had SMD (schizophrenia spectrum 67%, bipolar disorder 14%, depressive disorders 16%, other Axis I disorder 3%) and no memory impairment or illness that would affect participation in study. Patients were recruited from an agency that serves patients with SMD who need intensive case management. Follow up was 99% at 18 months for vocational outcomes.
After stratification for work history, patients were allocated to IPS (n=76) or EVR (n=76). In the IPS group, 3 employment specialists helped clients to search rapidly for jobs and provided individualised follow up once clients were employed. IPS was implemented according to a manual. EVR consisted of vocational rehabilitation services provided by community agencies with the support of an
McMaster University Hamilton, Ontario, Canada
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