Department of Psychiatry, University of Rochester Medical Center, Rochester, New York (Thompson, Serody); Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, New Jersey (Thompson, Holloway, Karyczak, Gill); Department of Psychiatry, University of Massachusetts Medical School, Worcester (Lane, Ellison, Davis, Mullen).
Psychiatr Serv. 2022 Jul;73(7):787-800. doi: 10.1176/appi.ps.202000033. Epub 2021 Dec 8.
The authors conducted a systematic review of studies evaluating vocational interventions for young people with psychiatric conditions to determine the extent to which services were adapted for young people and whether services promoted gains in postsecondary education and employment.
Five databases (PubMed, PsycINFO, Web of Science, Academic Search Premier, and ERIC) were searched. Sources eligible for inclusion were controlled studies published between 2000 and mid-2020 that evaluated a vocational intervention and examined postsecondary educational or employment outcomes for youths or young adults (ages 14-35 years) with psychiatric conditions.
Ten studies met the inclusion criteria. Several of the studies evaluated services that were adapted for young people, including through the incorporation of educational supports. The most consistent finding was that services based on the individual placement and support (IPS) model improved employment outcomes more effectively than did comparison approaches and treatment as usual. Fewer studies assessed educational outcomes, and they yielded mixed results; however, recent findings from a controlled trial indicate that an enhanced IPS intervention that included well-specified supported education and skills training led to significantly superior outcomes in both education and employment.
These results provide support for the efficacy of IPS-based services to improve employment outcomes among young people with psychiatric conditions and suggest that adapting IPS to include comprehensive educational supports and skills training may be important for efforts to improve postsecondary educational outcomes. Additional well-controlled intervention studies that examine educational and longer-term outcomes should further inform the development and delivery of vocational services for this population.
作者对评估精神疾病青年职业干预的研究进行了系统回顾，以确定服务在多大程度上针对年轻人进行了调整，以及服务是否促进了他们接受中等后教育和就业。
对五个数据库（PubMed、PsycINFO、Web of Science、Academic Search Premier 和 ERIC）进行了检索。符合纳入标准的来源是 2000 年至 2020 年年中期间发表的对照研究，评估了针对精神疾病青年的职业干预，并检查了他们的中等后教育或就业结果。
符合纳入标准的研究有 10 项。其中一些研究评估了针对年轻人进行了调整的服务，包括通过纳入教育支持。最一致的发现是，基于个体安置和支持（IPS）模式的服务比对照方法和常规治疗更有效地改善了就业结果。评估教育结果的研究较少，结果也不一致；然而，最近一项对照试验的结果表明，包括明确规定的支持性教育和技能培训的强化 IPS 干预在教育和就业方面都取得了显著的优越结果。
这些结果为基于 IPS 的服务对改善精神疾病青年就业结果的有效性提供了支持，并表明为了努力改善中等后教育结果，将 IPS 调整为包括全面教育支持和技能培训可能很重要。进一步的干预研究，检验教育和长期结果，应能为该人群的职业服务的发展和提供提供更多信息。
