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Registry of Systematic Reviews - Search Results

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1. Citation: Metcalfe, J. D., Drake, R. E., & Bond, G. R. (2018). Economic, labor, and regulatory moderators of the effect of individual placement and support among people with severe mental illness: A systematic review and meta-analysis. Schizophrenia Bulletin, 44(1), 22-31.
Keywords: Competitive employment, economics, employment legislation, international rehabilitation, literature reviews, outcomes, psychiatric disabilities, regulations, supported employment, vocational rehabilitation, workers with disabilities
Abstract: Study examined the influences of economic, labor, and regulatory moderators of individual placement and support (IPS) employment outcomes for people with serious mental illness. As IPS has become the international standard for vocational rehabilitation of adults with serious mental illness, researchers must consider the relationship between IPS and local environments. The authors identified 21 studies for inclusion in this meta-analysis, which used mixed-effects meta-regressions to assess the impact of site-level moderators on the likelihood that IPS recipients, compared with recipients of alternative vocational services, achieved competitive employment. Potential moderators included change in gross domestic product, local unemployment and unionization rates, and indices describing employment protection regulations, level of disability benefits compensation, and efforts to integrate people with disabilities into the workforce. Regulatory moderators represent facilitators and barriers to employment that may reinforce or detract from the effectiveness of IPS. Across 30 sites drawn from 21 randomized controlled trials in 12 countries (33 percent in the United States), IPS recipients were 2.31 times more likely to find competitive employment than recipients of alternative vocational rehabilitation services. The significant competitive-employment rate advantage of IPS over control services increased in the presence of weaker employment protection legislation and integration efforts, and less generous disability benefits. Policy makers should recognize and account for the fact that labor and disability regulations can create an arrangement of incentives that reduces the relative efficacy of supported employment.
Plain Language Summary:

Plain Language Title

The impact of individual person, you, man, woman, one placement and support on employment outcomes for people with severe strong, serious, harmful, dangerous, very bad mental illness under different economic, labor, and regulatory conditions: A systematic planned out, orderly, regular review go over, check and meta-analysis

Review go over, check Question

Individual person, you, man, woman, one placement and support (IPS) is an approach to supporting employment for people with serious mental illness. How do employment outcomes for IPS participants change under different economic, labor, and regulatory conditions?

Background

IPS has become the international standard for vocational rehabilitation for adults with serious mental illness. Many rigorous hard studies have evaluated the effectiveness of IPS interventions, but there is less research about how economic, labor, or regulatory conditions may impact the success of an IPS intervention. care For example, IPS may work differently during an economic recession, in a unionized workplace, or in a place where there are fewer laws to protect workers.

Search Date

The review go over, check includes studies published between 1996 and May 2017.

Study Characteristics

The review go over, check includes only randomized controlled trials (RCTs), studies in which researchers use random selection to choose IPS participants and a comparison group. RCTs are the highest standard of evidence. The study population included adults (aged 18 or older) with a serious mental illness, such as schizophrenia, affective disorder, or post-traumatic stress physical strain, mental strain, pressure, worry disorder. condition, illness, medical problem

To be included, studies had to measure the ?competitive employment rate,? which is the share of participants who worked in a competitive job after the intervention. care A competitive job is a job that anyone can apply use, put on, rub onto, sign up for for and that pays the same wage to workers with or without a disability.

Twenty-one studies met the inclusion requirements. needs, regulations Studies took place in 30 locations across 12 countries (33% in the United States).

NIDILRR Affiliation

90RT5029 (formerly H133B140028): Rehabilitation Research and Training Center on Improving Employment Outcomes for Individuals With Psychiatric Disabilities

Key Results

Overall, IPS recipients were more than twice as likely to find competitive employment than recipients of other vocational rehabilitation services. There is no evidence that the effect result, cause of IPS changes under different economic or labor conditions, such as high unemployment or unionization rates. But the effect result, cause of IPS does appear to change under different regulatory conditions.

IPS was particularly effective works well, good, strong in the presence of weaker employment protections, less generous disability benefits, and less aggressive pushy, dangerous, gets worse fast, fast growing state say, tell, condition efforts to integrate combine with, make part of, mix individuals with disabilities into the workforce. However, in the presence of more aggressive pushy, dangerous, gets worse fast, fast growing regulations (such as stronger employment protections), IPS programs experienced reduced employment rates, while other vocational rehabilitation services had stable okay, no change, constant, even, unchanging employment rates. This observation close look, remark, watching, sighting suggests that certain regulations can make IPS less effective works well, good, strong at finding employment for individuals with serious mental illness, even if these regulations are intended to protect workers with disabilities.

Use of Statistics

The effect result, cause of IPS is measured using a ?risk ratio,? which compares the competitive employment rate of individuals receiving IPS to individuals in the comparison group. The authors calculated a separate risk chance ratio for each location place, spot in the included studies. They used government data sources to find data on each location?s economic, labor, and regulatory conditions. The authors used standard statistical tests to determine figure out, decide, find out, test whether the effect result, cause of IPS varies based on local conditions.

Quality of Evidence

This study has several many limitations. The relationships between local conditions and employment outcomes are correlations, so the authors cannot claim that local conditions cause different employment outcomes. Studies also included a wide range of populations and services, so it is hard to compare effects across studies. The authors state say, tell, condition that there may have been sampling bias in the selection of studies.

Full-Text Availability Options:https://www.ncbi.nlm.nih.gov/pubmed/29036727
https://academic.oup.com/schizophreniabulletin/article-abstract/44/1/22/4259764?redirectedFrom=fulltext
NIDILRR Affiliation:

Rehabilitation Research and Training Center on Improving Employment Outcomes for Individuals with Psychiatric Disabilities

Record Updated:2022-01-05
 

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