IPS Supported Employment for People with Mental Illness Bob Drake Dartmouth Psychiatric Research...

IPS Supported EmploymentIPS Supported Employmentfor People with Mental Illnessfor People with Mental Illness

Bob DrakeBob Drake

Dartmouth Psychiatric Research CenterDartmouth Psychiatric Research Center

20142014

Individual Placement Individual Placement and Support (IPS)and Support (IPS) IPS Supported EmploymentIPS Supported Employment25 years of refinement25 years of refinementSerious mental illnessesSerious mental illnessesHighly individualizedHighly individualizedClient choice at every stepClient choice at every step

Current Status of IPSCurrent Status of IPS

IPS model is simple and directIPS model is simple and direct IPS is effectiveIPS is effective Other benefits accrue with consistent workOther benefits accrue with consistent work Work outcomes improve over timeWork outcomes improve over time IPS is relatively easy to implementIPS is relatively easy to implement

IPS Supported EmploymentIPS Supported Employment Competitive employmentCompetitive employment Team approachTeam approach Integrated mental health and vocational servicesIntegrated mental health and vocational services Job developmentJob development Client choice regarding timingClient choice regarding timing Benefits counselingBenefits counseling Rapid job searchRapid job search Job matching based on client preferencesJob matching based on client preferences On-going supportsOn-going supports

• Becker (IPS Fidelity Scale, 2010)Becker (IPS Fidelity Scale, 2010)

22 Randomized Controlled Trials of Individual Placement and Support (IPS)

Best evidence available on effectiveness

RCTs are gold standard in medical research

Bond, Drake, & Becker (2012)

Competitive Employment Rates in 20 Randomized Controlled Trials of IPS

Employment OutcomesEmployment Outcomes

IPS superior for obtaining employment, time employed, hours of work, and wages earned

Unrelated to any client characteristics, including homelessness, except previous employment

All subgroups, including people who are homeless, benefit more from IPS than comparators

Non-Employment OutcomesNon-Employment Outcomes

Self-esteemSelf-esteemQuality of lifeQuality of lifeSymptom ControlSymptom Control*No changes with sustained *No changes with sustained

sheltered employmentsheltered employment

(Bond et al., 2001)(Bond et al., 2001)

Long-Term OutcomesLong-Term Outcomes

4 studies with 10-year follow-ups4 studies with 10-year follow-ups(Test, 1989; Salyers, 2004; Becker, 2006; Bush, 2009)(Test, 1989; Salyers, 2004; Becker, 2006; Bush, 2009)

Work outcomes improve over timeWork outcomes improve over time Costs decrease dramatically for consistent Costs decrease dramatically for consistent

workers workers (Bush et al., 2009; Hoffman et al., 2014)(Bush et al., 2009; Hoffman et al., 2014)

Johnson & Johnson-Johnson & Johnson-Dartmouth ProjectDartmouth Project Mental health-vocational rehabilitation collaboration Mental health-vocational rehabilitation collaboration Implement evidence-based supported employment - IPSImplement evidence-based supported employment - IPS Local programs selected by statesLocal programs selected by states Dartmouth provides training, consultation, evaluationDartmouth provides training, consultation, evaluation National Learning CollaborativeNational Learning Collaborative States: Alameda Co. (CA), CO, CT, DC, IL, KS, KY, States: Alameda Co. (CA), CO, CT, DC, IL, KS, KY,

MD, MN, MO, NC, OH, OR, SC, VT, WIMD, MN, MO, NC, OH, OR, SC, VT, WI International: Italy, Netherlands, SpainInternational: Italy, Netherlands, Spain

• (Becker et al., 2011)(Becker et al., 2011)

J&J-Dartmouth Program: Real World J&J-Dartmouth Program: Real World AgenciesAgencies

IPS InternationalIPS International Many countries adopting IPS: Australia, Many countries adopting IPS: Australia,

Canada, Germany, Holland, Hong Kong, Canada, Germany, Holland, Hong Kong, Italy, Japan, New Zealand, Norway, Spain, Italy, Japan, New Zealand, Norway, Spain, Sweden, Switzerland, United KingdomSweden, Switzerland, United Kingdom

Italy, Netherlands, and Spain: first Italy, Netherlands, and Spain: first international J&J-Dartmouth collaboratorsinternational J&J-Dartmouth collaborators

New IPS PopulationsNew IPS Populations

Posttraumatic Stress DisorderPosttraumatic Stress DisorderSubstance Use DisorderSubstance Use DisorderTraumatic Brain InjuryTraumatic Brain InjurySpinal Cord InjurySpinal Cord Injury

Financial SupportFinancial Support

Grants from NIDA, NIDRR, NIMH, RWJF, Grants from NIDA, NIDRR, NIMH, RWJF, SAMHSA, SSASAMHSA, SSA

Contracts from Guilford Press, Hazelden Press, Contracts from Guilford Press, Hazelden Press, U.S. Department of Health and Human Services, U.S. Department of Health and Human Services, MacArthur Foundation, Oxford Press, New York MacArthur Foundation, Oxford Press, New York Office of Mental Health, Research Foundation for Office of Mental Health, Research Foundation for Mental HealthMental Health

Gifts from Johnson & Johnson Corporate Gifts from Johnson & Johnson Corporate Contributions, Segal Foundation, Thomson Contributions, Segal Foundation, Thomson Foundation, Vail Foundation, West FoundationFoundation, Vail Foundation, West Foundation

Many ThanksMany Thanks Deborah Becker Gary Bond Greg McHugo Haiyi Xie Jon Skinner Phil Bush Will Torrey Kim Mueser Rob Whitley Susan McGurk Eric Latimer Elizabeth Carpenter-Song

Matt Merrens Paul Gorman Sarah Swanson Sarah Lord Howard Goldman Sandy Reese Kikuko Campbell Will Haslett Saira Nawaz Crystal Glover

Information: books, Information: books, videos, research articlesvideos, research articles

Susan MorrisSusan.morris@Dartmouth.edu603-448-0263http://www.dartmouthips.org