Vocational intervention in first-episode psychosis: individual placement and support v. treatment as usual

Br J Psychiatry. 2008 Aug;193(2):114-20. doi: 10.1192/bjp.bp.107.043109.

Abstract

Background: Unemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.

Aims: To examine whether a vocational intervention - individual placement and support (IPS) - which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.

Method: A total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).

Results: The IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.

Conclusions: Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Career Choice
  • Community Mental Health Services / methods
  • Employment, Supported / methods*
  • Employment, Supported / psychology
  • Female
  • Humans
  • Male
  • Patient Care
  • Psychotic Disorders / rehabilitation
  • Psychotic Disorders / therapy*
  • Regression Analysis
  • Rehabilitation, Vocational / methods*
  • Rehabilitation, Vocational / psychology
  • Victoria