Posttraumatic Stress Disorder, Supported Employment, and Outcomes in People with Severe Mental Illness

AbstractObjective: To evaluate whether posttraumatic stress disorder (PTSD) is related to outcomes in persons with severe mental illness (SMI) participating in a study of vocatinal rehabilitation programsBackground: PTSD is a common comorbid disorder in people with SMI, but it is unknown whether PTSD interferes with the ability to benefit from rehabilitation programs such as supported employment.Methods: The relationships between PTSD and symptoms, health, quality of life, and work outcomes was examined in 176 clients with SMI participating in a 2-year randomized controlled trial of three vocational rehabilitation programs: supported employment based on the Individual Placement and Support model, a psychosocial rehabilitation program based on transitional employment, and standard services.Results: The overall rate of current PTSD in the sample was 16%. Compared with clients without PTSD, clients with PTSD had more severe psychiatric symptoms, worse reported health, lower self-esteem, and lower subjective quality of life. Clients with PTSD who participated in the Individual Placement and Support model (the most effective vocational model of the three studied) also had worse employment outcomes over the 2-year study period than clients without PTSD, with lower rates of compeitive work, fewer hours worked, and fewer wages earned. Employment outcomes did not differ between clients with PTSD versus without PTSD in the other two vocational rehabilitation approaches.Conclusion: The findings suggest that PTSD may contribute to worse work outcomes in clients participating in supported employment programs. Effective treatment of these clients with PTSD may improve their ability to benefit from supported employment.

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Generalisability of the individual placement and support model of supported employment: results of a Canadian randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.105.012641 ◽

2006 ◽

Vol 189 (1) ◽

pp. 65-73 ◽

Cited By ~ 91

Author(s):

Eric A. Latimer ◽

Tania Lecomte ◽

Deborah R. Becker ◽

Robert E. Drake ◽

Isabelle Duclos ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Supported Employment ◽

Control Group ◽

Competitive Employment ◽

Individual Placement And Support ◽

Vocational Services ◽

The Usa ◽

The Individual ◽

Individual Placement

BackgroundStudies conducted in the USA have found the individual placement and support model of supported employment to be more effective than traditional vocational rehabilitation at helping people with severe mental illness to find and maintain competitive employment.AimsTo determine the effectiveness of the individual placement and support (supported employment) model in a Canadian setting.MethodA total of 150 adults with severe mental illness, who were not currently employed and who desired competitive employment, were randomly assigned to receive either supported employment (n=75) or traditional vocational services (n=75).ResultsOver the 12 months of follow-up, 47% of clients in the supported employment group obtained at least some competitive employment, v. 18% of the control group (P<0.001). They averaged 126 h of competitive work, v. 72 inthe control group (P<0.001).ConclusionsSupported employment proved more effective than traditional vocational services in a setting significantly different from settings in the USA, and may therefore be generalised to settings in other countries.

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An effective intervention delivered at sub-therapeutic dose becomes an ineffective intervention

The British Journal of Psychiatry ◽

10.1192/bjp.bp.109.073338 ◽

2010 ◽

Vol 196 (5) ◽

pp. 341-342 ◽

Cited By ~ 17

Author(s):

Eric Latimer

Keyword(s):

Mental Illness ◽

Therapeutic Dose ◽

Supported Employment ◽

Effective Intervention ◽

Individual Placement And Support ◽

People With Mental Illness ◽

The Individual ◽

Individual Placement ◽

Support Model

SummaryEvidence to date indicates that the individual placement and support model of supported employment helps people with mental illness to obtain competitive jobs. The study by Howard et al (this issue) is the first unsuccessful trial of this model. Vocational workers had far fewer contacts with clients and employers than normal.

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Experiences of the individual placement and support approach in persons with severe mental illness

Scandinavian Journal of Caring Sciences ◽

10.1111/j.1471-6712.2012.01056.x ◽

2012 ◽

Vol 27 (3) ◽

pp. 589-596 ◽

Cited By ~ 27

Author(s):

Cecilia Areberg ◽

Tommy Björkman ◽

Ulrika Bejerholm

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Individual Placement And Support ◽

The Individual ◽

Individual Placement

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Relationship Between Self-Assessed Fidelity and Self-Reported Employment in the Individual Placement and Support Model of Supported Employment

Psychiatric Services ◽

10.1176/appi.ps.201700472 ◽

2018 ◽

Vol 69 (5) ◽

pp. 609-612 ◽

Cited By ~ 4

Author(s):

Paul J. Margolies ◽

Jennifer L. Humensky ◽

I-Chin Chiang ◽

Nancy H. Covell ◽

Thomas C. Jewell ◽

...

Keyword(s):

Supported Employment ◽

Individual Placement And Support ◽

The Individual ◽

Individual Placement ◽

Support Model

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Implementing evidence-based supported employment

Psychiatric Bulletin ◽

10.1192/pb.bp.106.010199 ◽

2007 ◽

Vol 31 (7) ◽

pp. 244-249 ◽

Cited By ~ 26

Author(s):

Miles Rinaldi ◽

Rachel Perkins

Keyword(s):

Supported Employment ◽

Educational Activity ◽

Client Outcomes ◽

Individual Placement And Support ◽

Individual Client ◽

The Individual ◽

Work Education ◽

The Impact ◽

Individual Placement ◽

Employment Specialists

Aims and MethodWe evaluated the impact of implementing the individual placement and support (IPS) approach within eight community mental health teams (CMHTs) in two London boroughs. Demographic, clinical and vocational data were collected enabling a comparison of the number of people supported in work/education and individual client outcomes at 6 and 12 months.ResultsFollowing the integration of employment specialists there were significant increases in the number and proportion of clients engaged in mainstream work or educational activity at 6 months and 12 months. The employment specialists supported 38% in open employment at 6 months and 39% at 12 months.Clinical ImplicationsThe results support the use of IPS in clinical practice in CMHTs.

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Mental health in the workplace

European Psychiatry ◽

10.1016/s0924-9338(11)72400-2 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 694-694 ◽

Cited By ~ 1

Author(s):

H.Ø. Sørensen ◽

P. Munk-Joergensen

Keyword(s):

Quality Of Life ◽

Mental Illness ◽

Psychiatric Symptoms ◽

Correct Diagnosis ◽

Mental Illnesses ◽

The Public ◽

Need For Treatment ◽

Increased Risk ◽

The Individual

IntroductionDepression and simple phobia are the most prevalent mental illnesses among employees leading to an increased number of sick days, decreased social and professional function, job satisfaction, quality of life and increased risk of loss of work.Around 25% of the working population is affected by psychiatric symptoms in a way that is painful to the individual, but not of such severity that is qualifies as a genuine disease.Untreated and not early identified these cases could lead to actual mental illness.Moreover, less than half of those currently suffering from depression are provided with the correct diagnosis in general practice, and less the half, diagnosed correctly, receive the proper medical treatment.ObjectivesTo identify, treat and thereby interrupt pre-existing cases of mental illness in the workplace. To prevent worsening of minor cases of psychiatric illness and symptomatic cases not considered a genuine disease.AimsTo develop models for early tracing and treatment of mental illness in the workplace with consequent improved health status and quality of life for the individual and improved economy for the workplace and the public.MethodsThis intervention study includes larger companies with more than 100 employees in the Region of North Denmark.The study design is a before-after study using self-reporting questionnaires as a basis for identification of cases of mental illness and follow-up of treatment. The study uses clinical interview and examination for determining the need for treatment.ResultsResults not yet available.

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Is Supported Employment Replacing Traditional Vocational Rehabilitation Services?

European Psychiatry ◽

10.1016/s0924-9338(09)70474-2 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

C. Lauber

Keyword(s):

Mental Illness ◽

Vocational Rehabilitation ◽

Supported Employment ◽

Bipolar Disorders ◽

Daily Practice ◽

Rehabilitation Services ◽

Individual Placement And Support ◽

Vocational Rehabilitation Services ◽

Further Development ◽

Individual Placement

The only study in Europe that compared traditional vocational rehabilitation with Individual Placement and Support (IPS) in people with psychotic and bipolar disorders clearly showed that IPS is more effective. Based on these data, this paper will review the current situation of vocational rehabilitation in Europe and analyse whether these or other research do influence the daily practice in vocational rehabilitation. Moreover, it will summarise potential for further development of Supported Employment in people with severe mental illness.

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