The British Journal of Psychiatry (2008) 193: 114-120. doi: 10.1192/bjp.bp.107.043109
© 2008 The Royal College of Psychiatrists
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Vocational intervention in first-episode psychosis: individual placement and support v. treatment as usual

Eóin Killackey, DPsych

Department of Psychology, School of Behavioural Science, The University of Melbourne, and ORYGEN Research Centre, Parkville

Henry J. Jackson, PhD

Department of Psychology, School of Behavioural Science, The University of Melbourne

Patrick D. McGorry, MD

ORYGEN Research Centre, Parkville, and Department of Psychiatry, The University of Melbourne, Australia

Correspondence: Dr Eóin Killackey, ORYGEN Research Centre, 35 Poplar Road, Parkville, Victoria 3052, Australia. E-mail: eoin{at}unimelb.edu.au

Declaration of interest

This research was supported by a National Health and Medical Research Council Program Grant (ID: 350241) and an unrestricted study grant from Bristol Myers Squibb. ORYGEN Research Centre is supported by the Colonial Foundation.

Background

Unemployment is a major problem for people with first-episode psychosis and schizophrenia. This has repercussions for the economy, social functioning and illness prognosis.

Aims

To examine whether a vocational intervention – individual placement and support (IPS) – which has been found to be beneficial in populations with chronic schizophrenia, was a useful intervention for those with first-episode psychosis.

Method

A total of 41 people with first-episode psychosis were randomised to receive either 6 months of IPS + treatment as usual (TAU) (n=20) or TAU alone (n=21).

Results

The IPS group had significantly better outcomes on level of employment (13 v. 2, P<0.001), hours worked per week (median 38 v. 22.5, P=0.006), jobs acquired (23 v. 3) and longevity of employment (median 5 weeks v. 0, P=0.021). The IPS group also significantly reduced their reliance on welfare benefits.

Conclusions

Individual placement and support has good potential to address the problem of vocational outcome in people with first-episode psychosis. This has economic, social and health implications.


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