Individual Placement and Support (IPS) for persons with severe mental illness -Outcomes of a randomised controlled trial in Sweden

Sammanfattning: In the light of the limited research on the subject of Individual Placement and Support (IPS) in a Swedish context, this thesis has contributed with knowledge of the effectiveness and experiences of IPS among persons with severe mental illness (SMI) living in Sweden. The thesis has also provided information about the work motivation among those persons with SMI who seek vocational support by IPS. The results revealed that IPS participation can provide a means for obtaining competitive employment, becoming integrated in the community and promoting personal recovery among the participants. The findings indicated that IPS was five times faster in supporting persons with SMI to obtain a competitive employment, as compared to traditional vocational rehabilitation (TVR). The IPS participants were also found to work significantly more hours and weeks, to have longer job tenure periods and better income in comparison to the TVR participants. In addition to obtaining competitive employment, the IPS group became more integrated in community mainstream settings by their gaining internship or studies. By the end of the trial the IPS group perceived higher quality of life and was more empowered than the TVR group. During IPS, the participants were shown to have maintained their work motivation. Furthermore, it was shown amongst the participants that a higher level of occupational engagement was found to be the most important factor for having a high work motivation. Having the motivation to work was also experienced, by the participants as a facilitator during IPS along with the particular skills and empowering approach of the employment specialist. Thus, participating in IPS and having support from an employment specialist brought feelings of hope and meaning to the participants who experienced their relationship with the employment specialist to be a partnership and something beyond the ordinary. To achieve their goals of obtaining competitive employment however, the participants also stated that they needed the parallel support of significant others in the IPS support network. The results in the present thesis support the earlier research findings of the advantage of IPS over TVR and further underpin the recommendation by the Swedish National Board of Health and Welfare to implement IPS in the country’s mental health care and municipality services.