Implementing individual and placement support for patients with severe mental illness: findings from the real world

Maria Lorena Ficarelli 1, Elisa Troisi 2, Elisabetta Vignali 1, Simona Artoni 1, Maria Cristina Franzini 1, Serenella Montanaro 1, Maria Vittoria Andreoli 1, Sara Marangoni 3, Elizabeth Ciampà 3, Diana Erlicher 3, Simona Pupo 4,5, Lorenzo Pelizza 1,6

1 Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Italy; 2 School of Psychiatric Rehabilitation Techniques, Università di Modena e Reggio Emilia, Italy; 3 E.N.A.I.P. Foundation, Reggio Emilia, Italy; 4 Intensive Care Unit, Guastalla Civil Hospital, Azienda USL-IRCCS di Reggio Emilia, Italy; 5 Anesthesia and Resuscitation Service, Azienda Ospedaliero-Universitaria di Parma, Italy; 6 Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Italy

Objective

Individual Placement and Support (IPS) is a psychosocial intervention with a considerable body of evidence for its effectiveness in helping people with Severe Mental Illness (SMI) to obtain and maintain competitive job. However, little is known about IPS model in Italy, a country with a different socioeconomic climate than the USA and the UK. Aim of this study was to investigate the effect of IPS in Italian patients with SMI, assessing the main competitive employment outcomes and drop-out rates during a 3-year follow-up period.

Methods

Participants (n = 46) were recruited from the 7 adult Community Mental Health Centers (CMHCs) of the Reggio Emilia Department of Mental Health. Together with drop-out rates, we examined job acquisition (employment in the labor market for at least 1 day during the follow-up), job duration (total number of days worked), job tenure (weeks worked on the longest-held competitive job), and total hours per week worked.

Results

A crude competitive employment rate of 50% and a crude drop-out rate of 34.8 over the 3-year follow-up period were found. Using a Kaplan-Meyer survival analysis, the cumulative employment rate reached a 73% percentage at 36 months.

Conclusions

This study shows the feasibility and the utility of an implementation strategy for applying the IPS approach in the public mental health care system in Italy. 

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