Article Details

Research Database: Article Details

Citation:  Bond, G. & Kukla, M. (2011). Is job tenure brief in individual placement and support(ips)employment programs?. Psychiatric Services, 62 (8), 950–953.
Title:  Is job tenure brief in individual placement and support(ips)employment programs?
Authors:  Bond, G. & Kukla, M.
Year:  2011
Journal/Publication:  Psychiatric Services
Publisher:  American Psychiatric Association
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Yes
Research design:  Quasi-experimental

Structured abstract:

Background:  Individual placement and support (IPS) is a well-defined model of supported employment for clients with severe mental illness. Competitive employment rates for IPS programs are more than twice those for other vocational approaches. However, despite strong and consistent findings for job acquisition, observers have noted that job retention rates for IPS clients are fairly brief. One widely cited review of eight studies concluded that job tenure for clients enrolled in supported employment was typically less than four months and ranged from 70 to 151 days. However, the studies reviewed were conducted between 1994 and 2004 and are now dated.
Purpose:  The purpose of the study was to analyze the job tenure issue for high-fidelity IPS programs and to use standardized measures of job tenure and an adequate sample and follow-up period. To avoid some of the limitations mentioned earlier, this study estimated job tenure by defining the sample and follow-up period for IPS clients after they obtained competitive employment, thereby differentiating the question of job acquisition from job tenure.
Setting:  Study participants were enrolled from November 2005 until June 2007. Two-year follow-up data collection ended in June 2009. This study was reviewed by the Indiana University-Purdue University Indianapolis Institutional Review Board and was deemed an exempt study. Four urban sites located in the Midwest region of the United States participated in the study. Three sites were community mental health centers, and each operated a single IPS program. The fourth site was a large psychiatric rehabilitation center with three IPS teams. In addition to offering IPS, all four sites provided comprehensive mental health and substance abuse services.
Study sample:  Participants were clients with severe mental illness aged 18 and older and enrolled in IPS at one of the participating sites. To be eligible, a client was required to be identified by an employment specialist as meeting the study criteria: currently working at least ten hours per week in competitive employment and having begun a competitive employment position within the preceding six months. Most IPS clients who work competitively do so at least ten hours a week. In one large database of four IPS trials, 74% of IPS clients worked at least ten hours a week. The study enrolled all eligible clients during the study period.
Intervention:  Individual Placement and Support (IPS) is a systematic approach to helping people with severe mental illness achieve competitive employment. It is based on eight principles: eligibility based on client choice, focus on competitive employment, integration of mental health and employment services, attention to client preferences, work incentives planning, rapid job search, systematic job development, and individualized job supports. Systematic reviews have concluded that IPS is an evidence-based practice. The intervention was IPS services with high fidelity to the program model and practices.
Control or comparison condition:  The comparison condition was a retrospective sample of IPS clients who were served prior to the initiation of high-fidelity services.
Data collection and analysis:  Monthly data about job tenure were collected for 82 clients upon beginning competitive employment (prospective sample) and from 60 clients who had begun competitive employment in the preceding six months (retrospective sample). At study entry, information on demographic characteristics, employment history, diagnosis, Social Security entitlements, and current employment was collected. The monthly employment update included information on employment status (employed or unemployed), job losses, job starts, job type, days worked during the past month, changes in hours worked per week, and changes in wage rate.
Findings:  The 142 clients worked a mean of 12.86 months overall and 9.96 months at their first job; compared with the prospective sample, the retrospective sample worked for more months (13.69 versus 11.02; p<.05) and worked more months at the first job (12.63 versus 8.01; p<.01). A total of 100 (70%) clients remained enrolled in IPS during the 24-month follow-up period, and 42 (30%) did not. Of the 42 non-completers, four (3%) terminated during the first six months, 15 (10%) during months 7–12, 13 (9%) during months 13–18, and ten (7%) during months 19–24. Twenty-one (50%) non-completers were employed at the point of termination. Across 24 months of follow-up, the total sample worked an average of 15.6±10.2 hours per week and 10.7±6.8 days per month. Limiting the statistics to periods in which clients were employed, clients worked an average of 23.5±8.3 hours per week and 16.4±4.2 days per month. Mean wage rate for working clients was $7.90±$3.00 per hour
Conclusions:  Job tenure among employed clients of high-fidelity IPS was twice as long as previously reported, and about 40% became steady workers over two years. The proportion of IPS clients who begin a long-term attachment to the labor market is higher than has sometimes been asserted in the literature. Long-term follow-up studies of IPS are needed. As this study suggests, short-term studies may not correctly forecast long-term outcomes

Disabilities served:  Bi-polar
Populations served:  Gender: Female and Male
Race: American Indian or Alaska Native
Race: Asian
Race: Black / African American
Race: White / Caucasian
Ethnicity: Hispanic or Latino
Interventions:  Individual Placement and Support (IPS) model of supported employment
Outcomes:  Increase in tenure