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Predictors of work and education among people with severe mental illness who participated in the Danish individual placement and support study: findings from a randomized clinical trial

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

People with severe mental illness experience disproportionately high rates of unemployment. Nonetheless, a substantial amount of research has demonstrated vocational benefits of the Individual Placement and Support (IPS) model and IPS supplemented with cognitive remediation (IPSE). The present study sought to examine demographic and clinical predictors of employment or education among people with severe mental illness and to investigate if IPS or IPSE can compensate for risk factors for unemployment.

Methods

Seven hundred twenty participants were randomly assigned to IPS, IPSE or Service as Usual. During the 18-month follow-up period participants in the two experimental groups obtained significantly more work or education. A series of univariate and multiple logistic regression analyses were conducted to assess the predictive power of demographic and clinical factors for the total population and for the three groups individually.

Results

The strongest predictor for vocational recovery, besides treatment allocation, was previous work history (OR = 1.78; 95% CI = 1.28–2.47). Men had a lower probability for vocational recovery compared to women (OR = 0.71; 95% CI = 0.50–0.99) and higher age was also negatively associated with work or education (OR = 0.79; 95% CI = 0.67–0.93). Moreover, vocational recovery was predicted by higher readiness for change, measured on the readiness for change scale (OR = 1.42; 95% CI = 1.19–1.70). Participation in IPS or IPSE could not compensate for negative risk factors such as low cognitive function or negative symptoms.

Conclusions

In a multiple logistic regression analysis age, previous work history and motivation for change were statistically significant predictors of obtaining work or education among people with severe mental illness who participated in the Danish IPS trial.

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Availability of data and material

Data supporting the findings of this study are not publicly available due to legal restrictions from the Danish data protection agency and the European data protection regulation.

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Funding

The study was funded by the Danish Agency for Labour Market and Recruitment; the Danish foundation TrygFonden; and the Obel Family Foundation. The funders of the study had no role in the study design, data collection, data analysis, data interpretation or writing of the report.

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Authors and Affiliations

  1. Copenhagen Research Center for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen, Denmark

    Thomas Nordahl Christensen, Anders Bo Bojesen, Merete Nordentoft & Lene Falgaard Eplov

  2. Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark

    Iben Gammelgård Wallstrøm

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  1. Thomas Nordahl Christensen
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Correspondence to Thomas Nordahl Christensen.

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Christensen, T.N., Wallstrøm, I.G., Bojesen, A.B. et al. Predictors of work and education among people with severe mental illness who participated in the Danish individual placement and support study: findings from a randomized clinical trial. Soc Psychiatry Psychiatr Epidemiol 56, 1669–1677 (2021). https://doi.org/10.1007/s00127-021-02107-8

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