Clinical trial NCT00960024: Supported Employment in a Swedish Context
Official title: Supported Employment for People With Severe Mental Illness in a Swedish Context- A Randomised Controlled Trial
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE2
Conditions: Psychosis
Keywords: Vocational rehabilitation
Severe mental illness
Psychosis
Mental Health
Lead sponsor: Vardalinstitutet The Swedish Institute for Health Sciences
Sponsor class: OTHER
First posted: 2009-08-17
Enrollment: 120
Sex: ALL
Minimum age (years): 20
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: This project aims at generating evidence of a work-rehabilitation strategy that benefits the people with severe mental illness (SMI) who want to work, increase their sense of well-being and integration in society, decrease their financial dependence and experiences of stigma and discrimination. The project is likely to help form the basis of how to implement the evidence based supported employment (SE)-model, Individual Placement and Support model (IPS), in a Swedish work-rehabilitation context. In the long run, evidence of SE in a Swedish context could help to decrease the period of sick-leave and increase fulfilling and productive lifestyles among people with severe mental illness. In all, the effectiveness of SE can improve the quality of life for the target group, the quality in mental health care rehabilitation and decrease the costs of treatment and care.

Detailed description: Evidence-based mental health treatment and scientific support has gained increased attention in Sweden. The Swedish National Board of Health and Welfare emphasizes the importance of Supported Employment. Especially since there are no study in Sweden that has an RCT-design, and that fully take on the responsibility of implementing a SE- intervention in concordance with the evidence based version of SE in mental health care, the Individual Placement and Support model, IPS. Internationally, SE according to IPS is an evidence-based approach to help people with SMI find and keep employment. RCT and quasi-experimental studies showed that IPS (Place-Then-Train), is more effective than the traditional stepwise vocational rehabilitation model(Train-Then-Place. However, there is no research evidence if the SE/IPS will function in relation to a Swedish benefit and health system and work-rehabilitation context. This intervention project will therefore not only study the effects of vocational and health-related outcomes and experiences, but also study the implementation of SE/IPS, its feasibility and level of fidelity in a Swedish context.

Eligibility criteria: Inclusion Criteria:

* People with Severe mental illness, which mostly means having a diagnosis of psychosis
* Communicate in Swedish
* Express interest in working in the near future
* Have professional care or support from psychiatric clinic
* Attend to a SE-introductory meeting

Exclusion Criteria:

* Additional organic or physical disability to having psychosis

Primary outcomes:
measure: To determine the effectiveness of SE/IPS in terms of vocational outcomes, such as employment rate, monthly income, job-tenure and working hours compared to stepwise rehabilitation available, for people with SMI in a Swedish context
timeFrame: 6 months, 18 months, and 24 months (6 months after end of intervention)
Secondary outcomes:
measure: To determine the effectiveness of a SE in terms health-related and functional outcomes, such as symptoms, perceived discrimination, empowerment, work-readiness, self-image, level of social and community participation, and quality of life
timeFrame: 6 months, 18 months, and 24 months (6 months after end of intervention)
Other outcomes:
Locations:
city: Lund
country: Sweden
facility: The Vardal Institute, Medical Faculty, Lund University
Study officials:
affiliation: Vardalinstitutet The Swedish Institute for Health Sciences
name: Staffan Johansson, Assoc Prof
role: STUDY_DIRECTOR
References:
citation: Bejerholm U, Areberg C, Hofgren C, Sandlund M, Rinaldi M. Individual placement and support in Sweden - a randomized controlled trial. Nord J Psychiatry. 2015 Jan;69(1):57-66. doi: 10.3109/08039488.2014.929739. Epub 2014 Jul 1.
citation: Hasson H. Systematic evaluation of implementation fidelity of complex interventions in health and social care. Implement Sci. 2010 Sep 3;5:67. doi: 10.1186/1748-5908-5-67.