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Working with mental health problems: clients’ experiences of IPS, vocational rehabilitation and employment

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Although the effectiveness of individual placement and support (IPS) has been well established, little is known about clients’ perceptions of the model compared to usual vocational rehabilitation, nor about their experiences of searching for and returning to work with this kind of support. This qualitative study aimed to explore clients’ views of the difficulties of obtaining and maintaining employment, their experiences of the support received from their IPS or Vocational Service workers and the perceived impact of work on clients’ lives.

Method

Semi-structured interviews were conducted with 48 people with psychotic disorders participating in a six-centre international randomised controlled trial of IPS compared to usual vocational rehabilitation. To assess their experiences of the services and the perceived effects of working, two IPS and two Vocational Service clients at each centre who had found work during the study period were interviewed, along with two IPS and two Vocational Service clients at each centre who had not.

Results

IPS clients reported having received more help seeking and maintaining employment, whereas Vocational Service clients reported having received more help in finding sheltered employment or placements. Clients who had worked associated this with financial stability, improved social lives, increased self-esteem, integration into society and amelioration of their symptoms, as well as reduced feelings of boredom and isolation, but also reported increased levels of stress. IPS clients as well as Vocational Service ones reported not receiving enough follow-up support, despite this being proposed as a key feature of the model.

Conclusion

Findings from the in-depth interviews reflect differences in service models that have also been tested quantitatively but further work in disaggregating the IPS model and assessing the impact of each component would be valuable.

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Acknowledgments

This study was funded by a grant from the European Union, Quality of Life and Management of Living Resources Programme (QLRT 2001-00683). Thanks are due to Greg McHugo for methodological advice, to Deborah R. Becker and Miles Rinaldi for training the IPS Workers, and to the IPS Workers themselves: Alison Lewis (London), Wulf Dorn and Eva Marischka (Ulm), Donato Piegari (Rimini), Bettina Bartsch and Patric Meyer (Zurich), Anne Mieke Epema, Laureen Jansen and Bea Hummel (Groningen) and Petar Karaginev (Sofia).

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Mental Health, St. George’s, University of London, London, UK

    Marsha Koletsi & Jocelyn Catty

  2. University Medical Centre, University of Groningen, Groningen, The Netherlands

    Astrid Niersman, Jooske T. van Busschbach & Durk Wiersma

  3. Department of Psychiatry II, University of Ulm, BKH Gunzburg, Gunzburg, Germany

    Thomas Becker & Rana Kalkan

  4. University Department of Psychiatry, Warneford Hospital, Oxford, UK

    Tom Burns

  5. Programma Salute Mentale, Azienda USL Rimini, Rimini, Italy

    Angelo Fioritti

  6. Psychiatric University Hospital, University of Liverpool, Zurich, Switzerland

    Christoph Lauber & Wulf Rössler

  7. Bulgarian Institute of Human Relations, Sofia, Bulgaria

    Toma Tomov

Authors
  1. Marsha Koletsi
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  2. Astrid Niersman
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  3. Jooske T. van Busschbach
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  4. Jocelyn Catty
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  5. Thomas Becker
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  6. Tom Burns
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  7. Angelo Fioritti
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  8. Rana Kalkan
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  9. Christoph Lauber
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  10. Wulf Rössler
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  11. Toma Tomov
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  12. Durk Wiersma
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Consortia

for the EQOLISE Group

Corresponding author

Correspondence to Jooske T. van Busschbach.

Additional information

The EQOLISE Group: Tom Burns, Jocelyn Catty, Connie Geyer, Marsha Koletsi, Pascale Lissouba, Miles Rinaldi, Sarah White (London), Thomas Becker, Ulrike Ehiosun, Rana Kalkan, Reinhold Kilian (Ulm), Angelo Fioritti, Denise Manchisi (Rimini), Astrid Niersman, Jooske T. van Busschbach, Durk Wiersma (Groningen), Christoph Lauber, Wulf Rössler, Ingeborg Warnke (Zurich), Dimitar Germanov, Toma Tomov (Sofia), Adelina Comas, Claire Curran, Martin Knapp, Anita Patel (LSE).

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Koletsi, M., Niersman, A., van Busschbach, J.T. et al. Working with mental health problems: clients’ experiences of IPS, vocational rehabilitation and employment. Soc Psychiat Epidemiol 44, 961–970 (2009). https://doi.org/10.1007/s00127-009-0017-5

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  • DOI: https://doi.org/10.1007/s00127-009-0017-5

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