Thomas Nordahl Christensen1, Iben Gammelgaard Nielsen2, Merete Nordentoft1, Lene Falgaard Eplov1; 1Mental Health Center Copenhagen, University of Copenhagen, 2Research Unit of Psychiatry, Institute of Clinical Research, University of Southern Denmark
Individual Placement and Support (IPS) is an effective vocational intervention. However, the effects of IPS has not yet been demonstrated in a Danish welfare model and it has been suggested that the vocational effects can be further enhanced by supplementing IPS with cognitive remediation and work-related social skills training. The aim of the trial was to investigate the effects of 1) IPS; 2) IPS enhanced with cognitive remediation and work related social skills training (IPSe); and 3) service as usual (SAU). The trial was designed as an investigator-initiated, randomized, three-arm parallel, assessor-blinded, multi-center trial. A total of 720 patients with severe mental illness, recruited from early intervention teams (OPUS) or community mental health centers, were randomly assigned into the three groups at three sites in Denmark. Over the 18-month follow-up period 59.9% in the IPS group, 59.1% in the IPSe group and 46.5% in the SAU group worked competitively or were enrolled in education. IPS vs SAU (OR=1.79 (95% CI 1.14,2.81) P=0.014) and IPSe vs. SAU (OR=1.76 (95% CI 1.11,2.81), P=0.036). The IPSe group also worked or studied significantly more hours than SAU (OR= 1.76 (95% CI 1.15, 2.67), p= 0.005). The difference between IPS and SAU was (OR= 1.53 (95% CI 1.02,2.31), p =0.018). In conclusion, IPS and IPS supplemented with cognitive remediation and work-related skills training can be implemented in a Danish welfare model and demonstrate vocational effects in a Danish context.
