Contents and Intensity of Services in Low- and High-Fidelity Programs for Supported Employment: Results of a Longitudinal Survey

Sosei Yamaguchi · Sayaka Sato · Asami Matsunaga · Natsuki Sasaki · Michiyo Shimodaira · Chiyo Fujii

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Disability Education and Employment Schizophrenia research and treatment Psychiatric care and mental health services

Abstract

OBJECTIVE: Little is known about the association between service intensity and fidelity scale score in supported employment programs. This study compares service contents and intensity in low- and high-fidelity programs and examines the validity of the Japanese version of the individualized Supported Employment Fidelity Scale. METHODS: The vocational outcomes and service provision data for 51 individuals with schizophrenia in 13 supported employment programs were collected over a 12-month study period. Outcomes, service contents, and service intensity were compared between the low-fidelity group (seven programs; N=29) and the high-fidelity group (six programs; N=22). RESULTS: In both groups, 70% of the total services (hours) were provided in the first 6 months. The high-fidelity group, which was associated with better vocational outcomes than the low-fidelity group (employment rate, 68% versus 38%, respectively), made the greatest effort in job development outside of the agency, whereas the low-fidelity group spent more time on group services. In addition, before the client obtained a job, high-fidelity programs provided outreach services (B=7.2, p=0.043) and agency-based individual services (B=5.7, p<0.001) at greater intensity than did low-fidelity programs. However, no significant between-group difference was found in service intensity once clients were employed. CONCLUSIONS: Supported employment programs with a high fidelity score focus more intensely on providing individual services in and outside of the agency, particularly before clients obtain a job. However, clarification of the relationships among service quality at the structure level, amount of follow-up services, and individual needs in supported employment programs is a future issue.

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References

2003A Working Life for People with Severe Mental Illness 2003Cognitive and Symptom Predictors of Work Outcomes for Clients With Schizophrenia in Supported Employment 2012Validation of the Revised Individual Placement and Support Fidelity Scale (IPS-25)2005Integration of Psychiatric and Vocational Services: A Multisite Randomized, Controlled Trial of Supported Employment 2010Supported employment: randomised controlled trial 2010Three Year Follow-Up Study of an Integrated Supported Employment for Individuals with Severe Mental Illness 2017Economic, Labor, and Regulatory Moderators of the Effect of Individual Placement and Support Among People With Severe Mental Illness: A Systematic Review and Meta-analysis 2016Cost-effectiveness of cognitive remediation and supported employment for people with mental illness: a randomized controlled trial

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2021Participation in Individual Placement and Support in the Supported Employment Demonstration

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