Abstract
Objectives Individual placement and support (IPS) is an effective approach for helping people with severe mental illness gain employment. This study aimed to investigate if IPS can be effectively repurposed to support young adults at risk of early work disability due to various social and health related problems. Methods A randomized controlled trial including 96 young adults (18‒29 years; 68% men) was conducted in Norway. Participants were not in employment, education, or training, received temporary benefits due to social or health-related problems, and were eligible for traditional vocational rehabilitation (TVR). Participants were randomized to IPS (N=50) or TVR (N=46). Self-reported data were collected at baseline and at 6- and 12-months follow-up. The primary outcome was obtaining any paid employment in the competitive labor market during follow-up. Secondary outcomes were physical and mental health, well-being, coping, alcohol consumption, and drug use. Results Significantly more IPS participants obtained competitive employment compared to TVR participants during 12-months follow-up (48% versus 8%; odds ratio 10.39, 95% confidence interval 2.79‒38.68). The IPS group reported significantly better outcomes than the TVR group in subjective health complaints, helplessness, and hopelessness. In post hoc analyses adjusted for baseline and missing data, the IPS group reported significantly better outcomes on these measures in addition to level of disability, optimism about future well-being, and drug use. Conclusions IPS is effective for young adults at risk of early work disability. IPS was superior to TVR in increasing competitive employment and promoted improvements in some non-vocational outcomes. IPS services should be offered to improve employment rates in this vulnerable group.
Highlights
The results of paper I were the development of the design, methodology and procedures for the SEED-trial, the first randomized controlled trial (RCT) to investigate the effectiveness of Individual Placement and Support (IPS) for young adults at risk of early work disability due to various social or health-related problems
Individual Placement and Support (IPS) can be successfully repurposed to young adults who are at risk of early work disability due to various social and health-related problems in Norway
This group is characterized by high levels of psychological distress, alcohol use, and psychosocial problems related to bullying and violence
Summary
During the same period, an increased rate of labor immigration (mainly young males) has inflated the Musculoskeletal and common mental disorders account for about 2/3 of sickness benefits and disability pensions issued in Norway [5, 6], but within the subgroup of disability pensioners aged 18–29, 59 % are receiving disability pensions due to mental illness and behavior disorders alone [7] This type of early withdrawal or exclusion from the labor market leads to vast personal and societal costs, especially when seen in context with the aging of the Norwegian population causing a disparity between the supply of available workforce and the need of work capacity [8]. We will use three sources of information for competitive employment: Survey data for hours worked and success in employment; register data from the NAV for receipt of social security benefits and income; and register data from Statistics Norway (SSB) for financial assistance and educational activity
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