Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, NL-1081 BT, Amsterdam, The Netherlands.
Research Centre for Insurance Medicine, collaboration between AMC, UMCG, UWV, VUmc, Amsterdam, The Netherlands.
BMC Psychiatry. 2022 Jul 15;22(1):473. doi: 10.1186/s12888-022-04121-9.
Individual Placement and Support (IPS) is an evidence-based, effective approach to help people with severe mental illness (SMI) obtain and maintain competitive employment. The aim of the present study was to examine employment outcomes and associations with an organizational and a financial factor in people with SMI who participated in Individual Placement and Support using a multifaceted implementation strategy (IPS + MIS). The goal of this strategy was to improve IPS implementation by enhancing collaboration among mental health care and vocational rehabilitation stakeholders, and realizing secured IPS funding.
An observational cohort study including 103 participants was conducted, with a 30-month follow-up. Descriptive analyses were used to examine employment outcomes. Multivariable logistic and linear regression analyses were performed to study associations with an organizational and a financial factor: the level of experience of mental health agencies with providing IPS + MIS and the type of IPS funding (i.e. municipality funding (reference group) and the Dutch Social Security Institute: the Institute for Employee Benefits Schemes (UWV) funding).
Forty-six percent of the participants were competitively employed at any time during the 30-month follow-up; the median number of days until competitive job obtainment and in competitive jobs was 201 and 265, respectively. The majority of all jobs obtained (81%) were categorized as 'elementary occupations', 'clerical support workers', and 'service and sales workers'. A higher level of experience of the mental health agencies with providing IPS + MIS was found to be positively associated with job obtainment (OR = 3.83, 95% CI 1.42-10.30, p = 0.01) and the number of days worked in competitive jobs (B = 1.21, 95% CI 0.36-2.07, p = 0.01). UWV funding was found to be negatively associated with job obtainment (OR = 0.30, 95% CI 0.11-0.77, p = 0.01). No association was found for the type of IPS funding and the number of days worked in competitive jobs (B = -0.73, 95% CI -1.48-0.02, p = 0.06).
This study shows that almost half of the people who participate in IPS + MIS obtain a competitive job within 30 months. The results further suggest that both the level of experience of mental health agencies with providing IPS + MIS, and funding may play a role in employment outcomes.
个体安置与支持（IPS）是一种循证的、有效的方法，可以帮助患有严重精神疾病（SMI）的人获得并维持竞争性就业。本研究的目的是检查在使用多方面实施策略（IPS+MIS）的患有 SMI 的人群中的就业结果，并与组织和财务因素相关联。该策略的目标是通过加强精神卫生保健和职业康复利益相关者之间的合作，以及实现 IPS 资金的保障，来提高 IPS 的实施水平。
对 103 名参与者进行了一项观察性队列研究，随访 30 个月。描述性分析用于检查就业结果。进行多变量逻辑回归和线性回归分析，以研究与组织和财务因素的关联：为提供 IPS+MIS 的心理健康机构的经验水平和 IPS 资金的类型（即市政资金（参考组）和荷兰社会保障协会：员工福利计划研究所（UWV）资金）。
46%的参与者在 30 个月的随访期间任何时候都有竞争性就业；获得竞争性工作的中位天数和从事竞争性工作的中位天数分别为 201 天和 265 天。获得的所有工作中（81%）大多数是“基础职业”、“文书支持人员”和“服务和销售人员”。发现提供 IPS+MIS 的心理健康机构的经验水平越高，与获得工作（OR=3.83，95%CI 1.42-10.30，p=0.01）和从事竞争性工作的天数（B=1.21，95%CI 0.36-2.07，p=0.01）呈正相关。UWV 资金与工作获得呈负相关（OR=0.30，95%CI 0.11-0.77，p=0.01）。IPS 资金类型与从事竞争性工作的天数之间没有关联（B=-0.73，95%CI-1.48-0.02，p=0.06）。
本研究表明，几乎一半参加 IPS+MIS 的人在 30 个月内获得了竞争性工作。结果进一步表明，提供 IPS+MIS 的心理健康机构的经验水平和资金都可能对就业结果产生影响。
