Update on Individual Placement and Support for New Populations: A Meta-Analytic Review

Since individual placement and support (IPS) emerged as the premier evidence-based vocational rehabilitation for people with serious mental illness (SMI) in the early 2000s, several groups around the world have extended IPS to new disability groups. This review examines the rigorous evidence for five new populations: adults with early psychosis, common mental disorders, substance use disorders, posttraumatic stress disorders, and severe medical conditions.

This review updates the employment outcome findings from six recent systematic reviews of controlled trials of IPS for new populations using an electronic search. Using meta-analyses, the overall odds ratio (OR) and 95% confidence intervals (CI) for IPS-control differences in employment rate were calculated for RCTs of three new populations.

The search identified 19 controlled trials of IPS for new populations, including 9 published since 2019. Meta-analyses yielded ORs of 3.39 (95% CI: 2.11-5.46, p < .0001, N = 393) for 5 studies of adults with early psychosis, 1.42 (95% CI: 0.96-2.09, p = .08, N = 1728) for 5 studies of adults with common mental disorders and 1.88 (95% CI: 1.13-3.15, p = .02, N = 1830) for 5 studies of adults with substance use disorders. Two studies each of veterans with posttraumatic stress disorders and patients with serious medical conditions had a mix of small and large ORs.

IPS, the only vocational rehabilitation intervention with robust employment results, has been extended to several new populations with generally positive employment outcomes in controlled trials. However, poor implementation, small sample sizes, and other methodological problems limited the overall quality of this literature.