Jennifer Humensky1,2, Luana Turner3, Lisa Dixon1,2, Keith Nuechterlein3; 1Columbia University, 2New York State Psychiatric Institute, 3University of California Los Angeles
Background: The Individual Placement and Support (IPS) model of supported education and employment is effective in improving vocational outcomes, and the use of IPS in early psychosis treatment is increasing. Little is known about the time use, and correspondingly cost, required to conduct effective IPS. Methods: We reviewed chart records of IPS services provided in a UCLA early psychosis intervention from 2000 to 2006. The total minutes spent per client and the frequency of individual services were recorded. We analyzed differences between supported education and employment services, using linear regression and population-averaged random effects models. N=44 used IPS services. Results: N= 26 used IPS for supported education, 16 for supported employment and 2 for both. On average, the IPS specialist spent 97 (SD 60) minutes per client per week: 88 (SD 58) for supported employment and 101 (SD 60) for supported education, p<0.05. Overall, 47% (46/97 minutes) were spent in direct contact, 14% (14/97) indirect contact, 15% (15/97) talking with treatment team, 14% (14/97) supervision and 33% (33/97) driving. Total time required per visit did not change significantly over the first year, but was significantly lower in the second year. Supported education required a greater variety of tasks than supported employment. Conclusions: IPS services required an average of 97 minutes per client per week, with about half in direct patient contact. Overall, supported education requires more time per visit and a greater variety of tasks than supported employment. Programs implementing IPS should effectively budget for the range of tasks required.
