Supported Employment Approach Helps People Diagnosed with Serious Mental Illness Find Meaningful Jobs

April 30, 2018

New York, NY (April 30, 2018)—Work is important to many people diagnosed with serious mental illness, yet too few find employment. A new study suggests that when a specific approach to supported employment (Individual Placement and Support, or IPS) is implemented well, as self-assessed by mental health program sites, it is associated with higher employment rates, which were sustained over time. 

The findings were published online in Psychiatric Services on April 16, 2018.

“People diagnosed with serious mental illness are interested in employment, yet most studies find that less than 15% are working at any point in time. The IPS approach to supported employment is very different than traditional vocational rehabilitation approaches and over many years has been found to help individuals find and keep jobs in the community”, said Paul Margolies, PhD, assistant professor of clinical psychology (in psychiatry) at the Columbia University Vagelos College of Physicians and Surgeons, an Associate Director of the Center for Practice Innovations (CPI), New York State Psychiatric Institute, and lead author of the study.

Lisa Dixon, M.D., M.P.H, Director of CPI and Edna L. Edison Professor of Psychiatry notes that “People who use behavioral health services have benefited from the development of a number of evidence-based practices to assist with their recoveries. Fidelity scales help agencies to implement these practices as intended. One important issue is whether high fidelity implementation is associated with desired outcomes – do consumers benefit when these practices are provided as designed? In this study, we found that this was indeed the case.”

This study examined the work of 78 community sites in New York State (34 state facility outpatient mental health clinics and 44 Personalized Recovery Oriented Services programs) who implemented the IPS approach in 2016. These sites submitted data on a monthly basis including employment outcomes of individuals receiving IPS services. They also used the IPS fidelity scale to self-assess the quality of IPS implementation.

This study demonstrated a significant positive relationship between IPS self-reported fidelity and employment, consistent with several prior studies. This relationship was sustained through time (up to one year). An important finding was that this relationship was observed in agency self-reported fidelity, rather than assessments by external reviewers.

Employment is a normalizing activity for individuals with serious mental illness and can be an important component of their recovery, providing both an income and a quantifiable way to participate in the community. Programs that offer high-fidelity IPS services can help their clients achieve their goals.

The study is titled, “Relationship Between Self-Assessed Fidelity and Self-Reported Employment in the Individual Placement and Support Model of Supported Employment.”

The contributors to this paper are Paul J. Margolies, Jennifer L. Humensky, Ph.D., I-Chin Chiang, M.S., Nancy H. Covell, Ph.D., Thomas C. Jewell, Ph.D., Karen Broadway-Wilson, B.S., Raymond Gregory, B.S., Gary Scannevin, Jr., M.P.S., C.P.R.P. and Lisa B. Dixon, M.D., M.P.H. Dr. Margolies, Dr. Humensky, Dr. Covell, and Dr. Dixon are affiliated with the Department of Psychiatry at Columbia University Irving Medical Center. They are also affiliated with the New York State Psychiatric Institute, where all of the other authors are affiliated.

Dr. Humensky receives salary support from the National Institute of Mental Health (grant K01MH103445). The authors report no financial relationships with commercial interests.


Columbia University Department of Psychiatry

Columbia Psychiatry is among the top ranked psychiatry departments in the nation and has contributed greatly to the understanding and treatment of brain disorders. Co-located at the New York State Psychiatric Institute on the NewYork-Presbyterian Hospital/Columbia University Irving Medical Center campus in Washington Heights, the department enjoys a rich and productive collaborative relationship with physicians in various disciplines at the Columbia University Vagelos College of Physicians and Surgeons. Columbia Psychiatry is home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders, eating disorders, substance use disorders, and childhood psychiatric disorders.

Columbia University Irving Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the Vagelos College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Irving Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit or