Original Title: Eficacia y efectividad de las estrategias de empleo competitivo como intervención terapéutica en personas con discapacidad por trastorno mental grave y persistente

Authors' objectives: To analyze the effectiveness of IPS to people with severe mental disorder in vocational and no vocational outcomes, opposite the usual care of vocational rehabilitation

Authors' results and conclusions: RESULTS: A total of 1709 references in the electronic databases were found. Once the duplicates were discarded, 1056 references were reviewed. Next, were retrieved 50, of which 19 were included: 5 systematic reviews, 7 RCTs reported in 9 articles, 1 RCT that also offers data from a comparison group, and 5 comparative studies. As for the methodological quality of RCTs included was an average score of 2.14 points (s.d = 0.9). In the comparative studies the average score for the overall quality of the studies was 19.2 points (s.d = 2.28). In the Oxman scale the Systematic Reviews reached the highest ratings in all categories. The results indicate that the IPS groups was significantly better than the control groups in the percentage of people who obtained competitive employment, as well as the total hours worked, earned income, and weeks competitive in such work. Differences in income and working hours are not so consistent across studies when is considered any kind of paid job (for example, protected). As far as no vocational outcomes, there are not significant differences among programs in their effects on psychiatric symptoms, hospitalizations, self-esteem, social adjustment or quality of life. CONCLUSIONS: There is strong evidence that the IPS model of supported employment is more effective than traditional services to promote the achievement of competitive employment for people with severe mental illness, and to get more hours and more weeks working on them, gaining more incomes. Once established this evidence, future research should analyze aspects more related to the quality of the work and the factors that influence their maintenance or termination, as well as the correlates and predictors (demographic, contextual, clinical, biographical) of the vocational results. There is no enough evidence that the vocational intervention, through the IPS model, produces significant differences compared to traditional services in non-vocational outcomes (symptoms, hospitalizations, self-esteem, quality of life). This will not be seen necessarily as a lack of the model, but alternatively can be interpreted as absence of adverse effects that a demanding work environment could produce in people with severe mental illness. In any case, it is also necessary to analyze the relationships that may exist between these variables and the maintenance and performance in the job, besides their acquisition, as well as longer-term effects of interventions.

Project Status: Completed

Year Published: 2010

URL for published report: https://sescs.es/eficacia-y-efectividad-de-las-estrategias-de-empleo-competitivo-como-intervencion-terapeutica/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es