Absence of conflict of interest.
Citation
Bond, G. R., Kim, S. J., Becker, D. R., Swanson, S. J., Drake, R. E., Krzos, I. M., . . . Frounfelker, R. L. (2015). A controlled trial of supported employment for people with severe mental illness and justice involvement. Psychiatric Services, 66(10), 1027-1034.
Highlights
- The study’s objective was to examine the impact of the Individual Placement and Support (IPS) intervention on employment and recidivism outcomes relative to a job club program called Work Choice.
- The authors used an experimental design to estimate the impact of IPS and analyzed data from people’s self-reports on forms and interviews and electronic medical and employment records.
- The authors found positive statistically significant impacts of IPS on employment compared with the job club program. The authors found no statistically significant impacts of IPS on recidivism.
- The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to the IPS intervention and not to other factors.
Intervention Examined
The Individual Placement and Support (IPS) intervention
Features of the Intervention
The goal of IPS is to help people with severe mental illness and a history of arrest or incarceration attain employment at prevailing wages through the competitive job market. People ages 18 and older with a severe mental illness and criminal justice history were eligible for IPS if they were enrolled in a mental health treatment team and served by an IPS team, were not employed in a competitive job in the last three months but were interested in obtaining a competitive job, and attended two informational groups.
Two of the six IPS teams in the Chicago area implemented IPS. Through IPS, employment specialists who were part of a community mental health team provided participants with employment services. Employment specialists were full-time staff who had a caseload of 20 clients. Employment specialists received a day-long training on criminal justice issues, received ongoing consultation, and two conference calls a month from a senior IPS trainer. Participants took a vocational assessment, engaged in a rapid job search, received individualized job search assistance to identify employment opportunities based on their preferences, and had an employment specialist accompany them to interviews if desired.
Features of the Study
The study has a randomized controlled trial design. The authors used a statistical model to compare the outcomes of 42 treatment and 43 comparison group members who enrolled in the study in 2011 and 2012 using data from individuals’ self-reports on forms and interviews and electronic medical and employment records. People assigned to the treatment group received IPS, and people assigned to the comparison group received Work Choice program services. Work Choice is a job club program that uses a self-directed job search approach with part-time recovery and peer support specialists providing job leads and referrals. The people in the study were 43 years old on average, 80 percent were male, 59 percent were African American, and 69 percent were never married. A third of the people in the study had less than a high school education, a third were high school graduates or earned a general education degree, and a third had some college experience.
Findings
Employment
- IPS had statistically significant, positive impacts on employment. People who participated in IPS were 24 percentage points more likely to be employed in competitively attained jobs than those who participated in the job club program.
Recidivism
- The authors did not find any statistically significant impacts of the IPS program on recidivism outcomes.
Considerations for Interpreting the Findings
The study was a well-conducted randomized controlled trial. Among the sample members, 95 percent completed 6-month follow-up interviews and 92 percent completed 12-month follow-up interviews.
Causal Evidence Rating
The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to the IPS intervention and not to other factors.