Severe Mental Disorders
Conditions
Keywords
Individual Placement and Support, Health-economic evaluation
Brief summary
The Individual Placement and Support (IPS) model was developed in the United States in the 1990s to help people with severe mental health issues get back into regular jobs. This model is based on the idea that a quick job search that takes into account what patients want, followed by ongoing and intensive support in the community, is especially good for this group. To date, although the effectiveness of the IPS model has been widely demonstrated (for a review, see Metcalfe et al., 2018), only a few studies have evaluated its efficiency in foreign contexts (Knapp et al., 2013; Christensen et al., 2020). Although the IPS model has been in place in France for around ten years, no studies have yet been conducted to validate its efficiency in the French healthcare system. The main objective of this prospective, real-life, multicenter study is to evaluate the efficiency of the IPS practice model compared to the conventional method of follow-up by social workers for patients with severe mental illness in terms of cost per additional day worked, from a collective perspective.
Interventions
The Individual Placement and Support (IPS) model is an employment support program specifically designed for people with severe mental illness (Bond, Drake, & Becker, 2012). The core philosophy of IPS is that anyone can obtain competitive employment in the open labor market, provided it is the right job combined with appropriate support. IPS support is delivered by a job coach, specifically trained in this model, who devotes their entire working time to assisting patients in their vocational integration.
OTHERStandard Method
In psychiatric wards, patients who wish to do so are usually offered support to initiate the process of returning to competitive employment in the open labor market. This assistance is provided by the social workers (such as social workers or educators) within the care unit.
Sponsors
University Hospital, Tours
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Aged ≥ 18 years * Participant with a chronic psychiatric disorder causing significant functional impairment * Unemployed * Wishing to return to competitive employment in the open labor market * Informed about the study and consenting to participate * Able to read french
Exclusion criteria
* Individuals not eligible for legal employment due to irregular residency status in France * Individuals not affiliated with a social security system * Individuals wishing to work in a sheltered/protected setting * Individuals currently enrolled in a training program * Individuals refusing to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficiency of the IPS practice model compared to the conventional method of follow-up by social workers for patients with severe mental illness | 18 months | Incremental cost-effectiveness ratio (ICER) expressed as cost per additional day worked at 18 months, from a collective perspective, of the IPS practice model in patients with severe mental disorders. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cost-benefit ratio of the IPS practice model compared to the conventional method of follow-up by social workers for patients with severe mental illness, | 18 months | Benefit-cost ratio of the IPS model compared to the conventional method of follow-up by social workers at 18 months, from a societal perspective, among patients with severe mental illness |
| Budgetary impact on the French national health insurance system (AM) of changes in clinical practices with regard to the two types of support for returning to work. | 5 years | Budgetary impact for the Health Insurance system per year and over 5 years of the evolution of practices with regard to the two types of support for return to work |
| Compare work productivity and activity disorders between the two groups. | 0, 6, 12 and 18 months | Comparison of scores on the questionnaire on work productivity and activity impairment (French version of the Work Productivity and Activity Impairment, WPAI) |
| Efficiency of the IPS model compared to the conventional method of monitoring by social workers among patients with severe mental illness | 18 months | Incremental cost-utility ratio (ICUR) expressed as cost/QALY gained at 18 months, from a collective perspective, of the IPS model in patients with severe mental disorders. |
| Impact of a return to work on patients' level of recovery and overall health. | 18 months | Comparison of scores on a clinical scale of recovery and overall health (French version of the Recovery Assessment Scale, RAS) between the two groups |
| Impact of a return to work on patients' level of social cognition. | 18 months | Comparison of scores on the ACSo clinical social cognition scale between the two groups |
| Impact of a return to work on patients' cognitive functioning | 18 months | Comparison of scores on the clinical cognitive functioning scale (French version of the Subjective Scale to Investigate Cognition in Schizophrenia, SSTICS) between the two groups |
| Compare the rate of hospital care use between the two groups. | 18 months | Comparison of the number of hospitalizations, number of visits to psychiatric emergency rooms, and number of day hospital visits between the two groups |
Countries
France
Contacts
Primary ContactJérôme GRAUX
Backup ContactHelen CLERY
Outcome results
None listed