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Recovery Is Working: Piloting Individual Placement and Support With Assertive Community Treatment Teams
Jacqueline A Pogue1, Noah Lipton1, I-Chin Chiang1
1Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Lebanon, New Hampshire (Pogue); New York State Psychiatric Institute, New York City (Lipton, Chiang, Scannevin, Margolies); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York City (Margolies, Thorning); School of Global Public Health, New York University, New York City (Hameed).
Objective:
Employment rates are low among individuals receiving assertive community treatment (ACT) services in New York State (9% of approximately 6,400 individuals in 2023). This project aimed to increase employment rates by implementing the individual placement and support (IPS) model of supported employment within ACT services.
Methods:
To assess the effectiveness of IPS for ACT participants and what adaptations might be needed, IPS was piloted with six ACT teams from October 2021 to October 2022. The teams received live IPS training and monthly consultation. They took part in pre-post fidelity assessments, provided monthly performance data, and engaged in semistructured interviews at the conclusion of the pilot.
Results:
During the pilot, 109 ACT participants received IPS services. The monthly employment rate ranged from 25% to 46% and fluctuated over time. ACT participants receiving IPS started 71 jobs during the pilot. ACT teams demonstrated a culture shift that embraced employment and IPS principles such as zero exclusion. They dedicated a mean of 0.5 full-time equivalent (FTE) hours to providing IPS services, divided among one to six team members. The total IPS fidelity score increased (i.e., improved) by an adjusted mean of approximately 14 points from the start (77.5 points) to the end (91.8 points) of the pilot.
Conclusions:
Future efforts to implement IPS within ACT teams may need to incorporate extended or additional supports and ways to dedicate vocational specialist time to IPS service provision in order to achieve better employment outcomes.
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