PDF(Pubmed)
Abstract：
Over the past three decades, Individual Placement and Support (IPS) has emerged as a robust evidence-based approach to helping people with severe mental illnesses, such as schizophrenia, bipolar disorder, and major depression, to obtain and succeed in competitive employment. This review addresses the history, principles, research, and future directions of IPS. It covers current evidence on employment outcomes, cost-effectiveness, and nonvocational outcomes. It also describes current attempts to extend IPS to new populations. The authors provide an overview of numerous systematic reviews and meta-analyses of randomized controlled trials involving people with serious mental illness. For studies addressing nonvocational outcomes and new populations, the review uses best available evidence. Published reviews agree that IPS enables patients with serious mental illness in high-income countries to succeed in competitive employment at a higher rate than patients who receive other vocational interventions. Within IPS programs, quality of implementation, measured by standardized fidelity scales, correlates with better outcomes. Employment itself leads to enhanced income, psychosocial outcomes, clinical improvements, and decreased mental health service use. As IPS steadily spreads to new populations and new settings, research is active across high-income countries and spreading slowly to middle-income countries. IPS is an evidence-based practice for people with serious mental illness in high-income countries. It shows promise to help other disability groups also, and emerging research aims to clarify adaptations and outcomes.
摘要：
在过去的三十年里，个人安置和支持（IPS）已成为一种强大的循证方法，可以帮助患有严重精神疾病的人。比如精神分裂症，双相情感障碍,和严重的抑郁症，获得并在有竞争力的就业中取得成功。这篇评论涉及历史，原则,研究,以及IPS的未来发展方向。它涵盖了就业结果的当前证据，成本效益，和非职业成果。它还描述了当前将IPS扩展到新人群的尝试。作者提供了许多涉及严重精神疾病患者的随机对照试验的系统评价和荟萃分析的概述。对于解决非职业结果和新人群的研究，审查使用了现有的最佳证据。发表的评论认为，IPS使高收入国家的严重精神疾病患者能够以比接受其他职业干预措施的患者更高的比率在竞争性就业中取得成功。在IPS计划中，实施质量，用标准化的保真度量表测量，与更好的结果相关。就业本身导致收入增加，社会心理结果，临床改善，精神卫生服务使用减少。随着IPS稳步传播到新的人群和新的环境，研究在高收入国家活跃，并缓慢扩散到中等收入国家。IPS是高收入国家严重精神疾病患者的循证实践。它也显示了帮助其他残疾群体的希望，新兴研究旨在阐明适应和结果。
