Pichler Eva-Maria, Stulz Niklaus, Wyder Lea, Heim Simone, Watzke Birgit, Kawohl Wolfram
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.
Psychiatric Services Aargau, Windisch, Switzerland.
Front Psychiatry. 2021 Oct 12;12:709732. doi: 10.3389/fpsyt.2021.709732. eCollection 2021.
People with mental illness often experience difficulties with reintegration into the workplace, although employment is known to assist these individuals in their recovery process. Traditional approaches of "first train, then place" have been recently replaced by supported employment (SE) methods that carry strategy of "first place, then train." Individual placement and support (IPS) is one of the best-studied methods of SE, which core principles are individualized assistance in rapid job search with consequent placement in a paid employment position. A considerable amount of high-quality evidence supported the superiority of IPS over conventional methods in providing improved employment rates, longer job tenure, as well as higher salaries in competitive job markets. Nonetheless, our knowledge about the IPS-mediated long-term effects is limited. This non-interventional follow-up study of a previously published randomized controlled trial (RCT) called ZhEPP aimed to understand the long-term impact of IPS after 6 years since the initial intervention. Participants from the ZhEPP trial, where 250 disability pensioners with mental illnesses were randomized into either IPS intervention group or treatment as usual group (TAU), were invited to face-to-face interviews, during which employment status, job tenure, workload, and salaries were assessed. One hundred and fourteen individuals agreed to participate in this follow-up study. Although during the first 2 years post-intervention, the IPS group had higher employment rates (40% (IPS) vs. 28% (TAU), < 0.05 at 24 months), these differences disappeared by the time of follow-up assessments (72 months). The results indicated no substantial differences in primary outcome measures between IPS and TAU groups: employment rate (36 vs. 33%), workload (10.57 vs. 10.07 h per week), job tenure (29 vs. 28 months), and salary (20.21CHF vs. 25.02 CHF). These findings provide important insights regarding the long-term effects of IPS among individuals with mental health illnesses. Further research is required to advance the current knowledge about IPS intervention and its years-long impact.
患有精神疾病的人在重新融入职场时常常会遇到困难，尽管众所周知就业有助于这些人康复。传统的“先培训，后安置”方法最近已被支持性就业（SE）方法所取代，后者采用“先安置，后培训”策略。个体安置与支持（IPS）是研究最多的SE方法之一，其核心原则是在快速求职过程中提供个性化帮助，随后安置到有薪工作岗位。大量高质量证据表明，在竞争激烈的就业市场中，IPS在提高就业率、延长工作任期以及提高薪资方面优于传统方法。尽管如此，我们对IPS介导的长期影响的了解仍然有限。这项对先前发表的名为ZhEPP的随机对照试验（RCT）进行的非干预性随访研究旨在了解自首次干预6年后IPS的长期影响。来自ZhEPP试验的参与者，其中250名患有精神疾病的残疾养老金领取者被随机分为IPS干预组或常规治疗组（TAU），被邀请参加面对面访谈，期间评估就业状况、工作任期、工作量和薪资。114人同意参加这项随访研究。尽管在干预后的前两年，IPS组的就业率较高（40%（IPS）对28%（TAU），24个月时P<0.05），但在随访评估（72个月）时这些差异消失了。结果表明，IPS组和TAU组在主要结局指标上没有实质性差异：就业率（36%对33%）、工作量（每周10.57小时对10.07小时）、工作任期（29个月对28个月）和薪资（20.21瑞士法郎对25.02瑞士法郎）。这些发现为IPS对患有精神疾病个体的长期影响提供了重要见解。需要进一步研究以推进目前关于IPS干预及其多年影响的知识。
