Cited by 613Disability Education and EmploymentEmployment and Welfare StudiesSchizophrenia research and treatment

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The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial

Burns, Tom, Catty, Jocelyn, Becker, Thomas, Drake, Robert E, Fioritti, Angelo, Knapp, Martin, Lauber, Christoph, Rössler, Wulf, Tomov, Toma, van Busschbach, Jooske, White, Sarah, Wiersma, Durk·2007·The Lancet

DOI 10.1016/s0140-6736(07)61516-5

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Abstract

Background The value of the individual placement and support (IPS) programme in helping people with severe mental illness gain open employment is unknown in Europe. Our aim was to assess the effectiveness of IPS, and to examine whether its effect is modified by local labour markets and welfare systems.Methods 312 patients with severe mental illness were randomly assigned in six European centres to receive IPS (n=156) or vocational services (n=156). Patients were followed up for 18 months. The primary outcome was the difference between the proportions of people entering competitive employment in the two groups. The heterogeneity of IPS effectiveness was explored with prospective meta-analyses to establish the effect of local welfare systems and labour markets. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, with the number NCT00461318.Findings IPS was more effective than vocational services for every vocational outcome, with 85 (55%) patients assigned to IPS working for at least 1 day compared with 43 (28%) patients assigned to vocational services (difference 26.9%, 95% CI 16.4-37.4). Patients assigned to vocational services were significantly more likely to drop out of the service and to be readmitted to hospital than were those assigned to IPS (drop-out 70 [45%] vs 20 [13%]; difference -32.1% [95% CI -41.5 to -22.7]; readmission 42 [31%] vs 28 [20%]; difference -11.2% [-21.5 to -0.90]). Local unemployment rates accounted for a substantial amount of the heterogeneity in IPS effectiveness.Interpretation Our demonstration of the effectiveness of IPS in widely differing labour market and welfare contexts confirms this service to be an effective approach for vocational rehabilitation in mental health that deserves investment and further investigation.

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Gjerdalen, O. S., Aas, E. M., Lystad, J. U., Ueland, T., Arnevik, E. A., Falkum, E., Evensen, S., Bull, H. C., Rème, S. E., Ringen, P. A., et al. (2026) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2026.2625696
Les ESAT de transition, une voie de rétablissement "par et vers" l’emploi pour les personnes vivant avec des troubles psychiques
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Le travail protégé à l’ère de l’inclusion : analyse comparée (France – Suède) de l’action publique pour l’emploi et le travail des personnes handicapées
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Rehabilitation in Adults with Complex Psychosis: A Clinician-Oriented Narrative Review of Multidimensional Approaches to Functional Recovery
Pinzi, M., Fagiolini, A. M., Gualtieri, G., Rescalli, M. B., Pierini, C., Santangelo, A., Patrizio, B., & Cuomo, A. (2026) · Medicina · doi:10.3390/medicina62050841

Authors: Burns, T., Catty, J., Becker, T., Drake, R. E., Fioritti, A., Knapp, M., Lauber, C., Rössler, W., Tomov, T., van Busschbach, J., White, S., & Wiersma, D.
Affiliations: Warneford Hospital (GB)
St George's, University of London (GB)
Universität Ulm (DE)
Dartmouth Psychiatric Research Center (US)
London School of Economics and Political Science (GB)
Psychiatrische Universitätsklinik Zürich (CH)
University Medical Center Groningen (NL)
Corresponding author: Burns, Tom
ORCID: Catty, Jocelyn
Becker, Thomas
Drake, Robert E
Fioritti, Angelo
Knapp, Martin
Tomov, Toma
White, Sarah
Venue: The Lancet
Publisher: Elsevier BV
Published: 2007-09
Volume: 370
Issue: 9593
Pages: 1146-1152
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(07)61516-5
OpenAlex: W2128678354
Cited by: 613
References: 30
Citations by year: 2026: 15 · 2025: 11 · 2024: 15 · 2023: 11 · 2022: 17 · 2021: 25 · 2020: 32 · 2019: 36 · 2018: 29 · 2017: 26 · 2016: 42 · 2015: 37 · 2014: 54 · 2013: 56 · 2012: 44
FWCI: 111.72
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
Research Portal (King's College London) (submittedVersion)
University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics: Social Sciences › Education › Disability Education and Employment
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords: supported employment, Individual Placement and Support, severe mental illness, vocational rehabilitation, competitive employment, vocational services, local labor markets, welfare system, unemployment, service dropout, hospital readmission, treatment effect heterogeneity
MeSH terms: Adult, Mental Disorders, Europe, Female, Hospitalization, Humans, Male, Rehabilitation, Vocational, Program Evaluation, Logistic Models, Employment, Supported

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The effectiveness of supported employment for people with severe mental illness: a randomised controlled trial

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