The pandemic has left millions of Americans out of work and dealt a stunning blow to their mental health. In fact, Americans reporting anxiety, depression, substance use, and suicidal ideation jumped from 26% before COVID-19 to 43% in September 2020, according to national surveys. To help the unemployed regain satisfying work, Robert Drake, Lloyd Sederer, Deborah Becker, and Gary Bond offer a powerful solution, described in a recently published article, COVID-19, Unemployment, and Behavioral Health Conditions: The Need for Supported Employment.
We reached out to Dr. Bond to learn more. He is a Westat Senior Research Associate for Social Policy and Economics Research, former Professor of Psychiatry at Geisel School of Medicine at Dartmouth College, and an expert in evidence-based psychiatric rehabilitation services and the Individual Placement and Support (IPS) model of supported employment. The following is a short interview with Dr. Bond about how the IPS model may help the country move forward.
Q: How has COVID-19 impacted the behavioral health of Americans?
A: Millions of Americans have lost their jobs and financial security. Fear, uncertainty, stress, and grief are affecting their lives. Americans with pre-existing behavioral health disorders, such as bipolar disorder, schizophrenia, and severe depression, have had these issues compounded by the pandemic and its effect on their lives and livelihoods. For others, the pandemic has precipitated new mental health disorders.
Q: What solutions do you see that might help these individuals recover?
A: Our Westat research team recommends offering IPS supported employment services to people with behavioral health conditions who have lost their jobs because of the pandemic. Twenty-eight randomized controlled trials —including studies we have conducted—have demonstrated that IPS programs for people with serious mental illness enable about 2/3 of participants to gain employment, and about half become steady workers in long-term follow-up studies of a decade or more. IPS is increasingly being offered to people with other conditions, with encouraging results. Thus, we believe IPS is well-suited to helping this new population of Americans recover from this extraordinary challenge in their lives.
Q: What is the IPS model and why is it successful?
A: IPS programs consist of teams of employment specialists providing individualized aid to help people achieve their employment goals. These teams coordinate employment services with mental health treatment teams. IPS is a rapid job search approach to help people find satisfying, competitive jobs—leading to their independence, financial security, social connectedness, and positive self-esteem.
The IPS model was developed 30 years ago by my Westat colleagues, Robert Drake, Ph.D., M.D., Vice President for Social Policy and Economics Research and Deborah Becker, M.Ed., Director of the IPS Learning Community. Today, there are 1,000 IPS programs in the U.S., serving 50,000 people with serious mental health conditions every year.
Q: What studies has Westat conducted that demonstrate that the IPS program is beneficial?
A: We conducted the Mental Health Treatment Study (MHTS) for the Social Security Administration (SSA), finding that IPS services helped disability beneficiaries with mental health impairments return to work, improve their health, and lower their hospital utilization. We are now leading SSA’s Supported Employment Demonstration to learn the effects of offering the same MHTS services to people with mental impairments recently denied disability benefits.
Q: How would Westat launch an IPS study for this new population?
A: We could launch it at any U.S. location with an IPS program, where people are jobless due to the pandemic. Over the last year, IPS teams have of necessity offered most services remotely—via videoconference and phone. This approach has been generally successful in helping people find and keep jobs. IPS teams would continue to offer services remotely to the new population.
Q: What are the challenges of this study?
A: Right now, we are looking for funding to conduct a pilot study as the first step to a full-scale multisite study. That, in part, is why my colleagues and I wrote the article—to bring attention to the urgent need to help these displaced Americans. Our solution will not only help them recover but also will help our country recover as well.
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