14 December 2018

Individualised support leads to better employment outcomes in young people

Individualised support leads to better employment outcomes in young people

An approach to helping older people with chronic psychotic illnesses such as schizophrenia find employment may also be effective in assisting young people with first episode psychosis return to the workforce, a study by researchers from Orygen, the National Centre of Excellence in Youth Mental Health, has found.

The approach, called individual placement and support (IPS), has been tested by Professor Eóin Killackey from Orygen through a randomised control trial.

Professor Killackey said although previous studies had shown that the IPS model was effective for people with long-standing illness, there had been only been two small trials to test the IPS model with young people experiencing first episode psychosis. “We wanted to test the model with these young people on a larger scale,” he said.

Under the IPS model, people with mental ill-health work with a vocational specialist who is employed as part of their clinical team. The vocational specialist provides individualised support and connects the person to employers. Once employment is secured, the vocational specialist provides support to ensure employment is maintained.

Professor Killackey said approximately 90% of people with psychosis experience long-term unemployment, as people often experience first episode psychosis in early adulthood; a time when they are finishing secondary education and making a transition into further training or entering the workforce. The onset of their illness disrupts this process.

In the trial, 146 young people attending Orygen Youth Health’s Early Psychosis Prevention and Intervention Centre (EPPIC) for first episode psychosis were randomly assigned to receive either their usual treatment plus IPS, or treatment as usual without IPS. Each group was followed up at six-month intervals for a period of 12 months following the trial.   

The results have been published in the British Journal of Psychiatry.

Professor Killackey said the results showed that at the trial’s conclusion, the people who had received IPS had a significantly higher rate of being employed (71.2%) than those who did not receive IPS (48%). Additionally, people who received IPS were also slightly more likely to be studying than those who did not receive IPS. Professor Killackey said this suggested IPS may be most useful for young people who require additional assistance in making a vocational recovery.   

“Without the trial, these young people would have been referred to government employment agencies. However, the primary aim of these agencies is to get the young person employed, regardless of their career goals or ambitions. Whereas IPS allowed these young people to gain employment in fields they wanted to work in or fields which are similar; it gave them a career rather than a job,” he said.

“Recovery from mental ill-health needs to be more than an improvement in symptoms. It has to be about reconnecting people with the things they want to do with their lives.”

The trial was supported by the Australian Research Council, Australian Rotary Health, the National Health and Medical Research Council, the University of Melbourne and the BB & A Miller Foundation.