The effect evaluation of Individual
Placement and Support (IPS)
in Norway
Silje Endresen Reme
Associate Professor, University of Oslo
Pain psychologist, Oslo University Hospital
Senior researcher, Uni Research Health
The study:
1. Effect evaluation: Is IPS effective?
–
–
Registry data
Questionnaire data
2. Process evaluation: Why & how?
–
–
–
Qualitative interview data
Questionnaire data
Document analysis
3. Cost-benefit-analysis: Is IPS profitable?
–
Registry data
Aim of the study
• Evaluate the effect of IPS on employment,
quality of life and mental health for people with
moderate to severe mental illness
• Primary outcome: Ordinary paid employment
– new registries in the State Register of Employers
and Employees
Design: RCT
IPS
IPS
6 months
12 months
NAV
6 months
12 months
Consent to participate
Population
Does not consent
Randomization
Excluded (no data)
High quality usual care
Anxiety
above clinical
cut-off
Depression above
clinical cut-off
Age:
35 years
Years with
mental illness
Higher
education
Women:
Reading- and
learning
difficulties
Age
50 and above
30-49 years
Below 30 years
0
10
20
30
40
50
60
Highest completed education
College/University
High school
Primary school
0
10
20
30
40
50
Psychiatric screening (n=300)
• Severe mental illness: 45%
– Psychotic disorders and bipolar disorder
• Moderate mental illness: 55%
– Major depressive episode and anxiety disorders
• Most frequent diagnoses:
– Major depressive episode: 57%
– Anxiety disorders: 55%
– Psychotic disorders: 27%
0 .05 .1 .15 .2 .25 .3 .35 .4 .45 .5
Gjennomsnittlig
sysselsettingsrate
Resultater:
sysselsetting
-60 -55 -50 -45 -40 -35 -30 -25 -20 -15 -10 -5 0 5
Antall mÂneder fra inklusjon
kontrollgruppe
10 15 20 25 30
behandlingsgruppe
Cost-benefit analysis
How much does every participant need to earn pr
year for a positive return of investment?
2 years
3 years
4 years 5 years
Critical value for gross income 395 000
254 000
184 000 142 000
Process evaluation
Challenges in the implementation:
– Focus on ordinary employment
– Employer relationship
– Integrated services
Patient experiences
Satisfaction with IPS
How helpful
was the job
support
Satisfaction with employment specialist
Misfornøyd(1%)
Svært misfornøyd
(3%)
Ikke så veldig
fornøyd (8%)
Ganske misfornøyd
(8%)
Litt fornøyd (18%)
Verken misfornøyd
eller fornøyd (9%)
Ganske fornøyd
(40%)
Ganske fornøyd
(35%)
Svært fornøyd
(33%)
Svært fornøyd
(44%)
Ikke nyttig i det
hele tatt (3%)
Ikke så veldig
nyttig (5%)
Litt nyttig (23%)
Ganske nyttig
(30%)
Svært nyttig (39%)
Discussion
• IPS is effective for people with severe mental
illness also in the Norwegian context
• No difference in effect between those with
moderate versus severe mental illness
• Significant effects on health, function and
quality of life
SEED: Supported Employment and
preventing Early Disability
•
•
•
•
•
Funded by the Norwegian Research Council
IPS vs sheltered employment
Young people, at risk of permanent disability
Regardless of diagnoses
RCT of N=96
Thank you!
Collaborators:
Tonje Fyhn
Gary Bond
Line R Solberg
Camilla Løvvik
Vigdis Sveinsdottir
Stein Atle Lie
Kari Ludvigsen
Hege R Eriksen
Torill H Tveito
Cécil Boot
Simon Øverland
[email protected]
@siljeendresen