Michon Harry, van Busschbach Jooske T, Stant A Dennis, van Vugt Maaike D, van Weeghel Jaap, Kroon Hans
Trimbos Institute, Department of Reintegration and Community Care.
University of Groningen, University Medical Center Groningen.
Psychiatr Rehabil J. 2014 Jun;37(2):129-36. doi: 10.1037/prj0000061.
Whereas in the U.S. and Canada the Individual Placement and Support (IPS) model has proven to be highly effective in enhancing employment perspectives for persons with severe mental illnesses, the evidence base is less abundant in countries with a different socioeconomic climate. The aim of this study was to examine the effectiveness of IPS in the Dutch socioeconomic context.
A multisite randomized controlled trial was performed following 151 persons with severe mental illnesses expressing an explicit wish for regular employment, comparing IPS with traditional vocational rehabilitation (TVR). Primary outcome was the proportion of persons who were competitively employed over a period of 30 months. Secondary outcomes were self-reported quality of life, self-esteem and mental health. Additionally, the impact of being engaged in competitive employment on these secondary outcomes was examined.
In 30 months, 44% of IPS participants found competitive work, compared with 25% of participants supported by TVR. No direct effect of IPS on mental health, self-esteem or quality of life was found. Being competitively employed before follow-up measurements was significantly associated with an increase in mental health, self-esteem and quality of life.
This study strongly confirms that IPS is an effective method in helping people with severe mental illnesses find competitive work also in countries characterized by a relatively protective socioeconomic climate putting up unintended barriers to employment. The implementation of IPS on a larger scale seems warranted, and new studies are needed on the mechanisms through which IPS works.
在美国和加拿大，个人安置与支持（IPS）模式已被证明在提高重症精神疾病患者的就业前景方面非常有效，但在社会经济环境不同的国家，相关证据较少。本研究的目的是检验IPS在荷兰社会经济背景下的有效性。
对151名明确希望获得固定工作的重症精神疾病患者进行了一项多地点随机对照试验，将IPS与传统职业康复（TVR）进行比较。主要结局是在30个月内获得竞争性就业的人员比例。次要结局是自我报告的生活质量、自尊和心理健康。此外，还研究了从事竞争性就业对这些次要结局的影响。
在30个月内，44%的IPS参与者找到了竞争性工作，而接受TVR支持的参与者这一比例为25%。未发现IPS对心理健康、自尊或生活质量有直接影响。在随访测量前获得竞争性就业与心理健康、自尊和生活质量的提高显著相关。
本研究有力地证实，在社会经济环境相对保护、存在意外就业障碍的国家，IPS也是帮助重症精神疾病患者找到竞争性工作的有效方法。似乎有必要更大规模地实施IPS，并且需要对IPS起作用的机制开展新的研究。
