A Randomized Controlled Trial Evaluating the Effectiveness of Supported Employment Integrated in Primary Care.
A Randomized Controlled Trial Evaluating the Effectiveness of Supported Employment Integrated in Primary Care.
复制标题
评估初级保健中支持性就业的有效性的随机对照试验。
DOI：
10.1176/appi.ps.202000926
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bartolucci,Al
中科院分区：
文献类型：
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作者：
Davis,LoriL;Mumba,MercyN;Toscano,Richard;Pilkinton,Patricia;Blansett,CatherineM;McCall,Kimberly;MacVicar,David;Bartolucci,Al
ObjectivesMental health issues can cause serious problems in occupational functioning, including higher rates of unemployment. Individual placement and support (IPS) is an evidence-based supported employment intervention that is typically integrated within a mental health setting; however, many primary care patients view referral to a mental health clinic as stigmatizing. Thus, this study examined whether delivery of IPS in a primary care setting provides an effective treatment option and avoids unnecessary delays in obtaining competitive employment.MethodsU.S. military veterans (N=119) who had a diagnosis in a broad range of nonpsychotic psychiatric disorders and who were receiving care from Veterans Health Administration (VHA) patient-aligned care teams were prospectively randomly assigned to IPS (N=58) or standard VHA non-IPS vocational rehabilitation (VR) (N=61). The primary outcome was achievement of steady worker status, defined as holding a competitive job for ≥6 months of the 12-month follow-up.ResultsAs hypothesized, a significantly greater proportion of IPS participants achieved steady worker status (45%), compared with VR participants (25%) (p=0.02; odds ratio=2.49, 95% confidence interval=1.14–5.43). On average, the IPS participants worked significantly more weeks (p=0.003) and earned significantly more income (p=0.033) from competitive jobs, compared with VR participants.ConclusionsThe results provide supporting evidence for offering IPS within primary care with the aim of restoring meaningful and sustained competitive employment for veterans living with a mental disorder. Such modifications could improve veterans’ vocational outcomes, moving a significantly greater number of disabled veterans back to full and productive lives in the community.
