Individual placement and support (IPS) is an evidence-based practice that helps individuals with mental illness gain and retain employment. IPS was implemented for young adults at a municipality level through a cross-sectoral collaboration between specialist mental healthcare, primary mental healthcare, and the government funded employment service (NAV). We investigated whether IPS implementation had a causal effect on employment outcomes for all young adults in receipt of a temporary health-related rehabilitation (work assessment allowance, WAA) welfare benefit, measured at the societal level compared to municipalities that did not implement IPS.

We used a difference in differences design to estimate the effects of IPS implementation on the outcome of workdays per year using longitudinal registry data. We estimate the average effect of being exposed to IPS implementation during four-years of implementation compared to ten control municipalities without IPS for all WAA recipients.

We found a significant, positive, causal effect on societal level employment outcomes of 5.6 (p = 0.001, 95% CI 2.7–8.4) increased workdays per year per individual, equivalent to 12.7 years of increased work in the municipality where IPS was implemented compared to municipalities without IPS. Three years after initial exposure to IPS implementation individuals worked, on average, 10.5 more days per year equating to 23.8 years of increased work.

Implementing IPS as a cross sectoral collaboration at a municipality level has a significant, positive, causal, societal impact on employment outcomes for all young adults in receipt of a temporary health-related rehabilitation welfare benefit.

Individual Placement and Support (IPS) is an evidence-based supported employment program that helps people with severe mental illness to achieve steady meaningful employment in competitive mainstream jobs. Employment specialists are an integral part of IPS service delivery. The primary goal of an employment specialist is to help IPS users obtain competitive employment by providing targeted job development and ongoing support to workers and employers for as long as it is required.

This study aims to investigate the impact of the covid-19 restrictions on the delivery of IPS services in Northern Norway and how this may have affected the employment specialists’ perception their work environment.

We conducted four phases of a longitudinal work environment panel survey with the IPS employment specialists in Northern Norway. Phase 1: January-February 2020 (pre-covid), phase 2: June-July 2020 (during covid) and phase 3: October-November 2020 (during covid) were not related to covid and collected data on fourteen work environment indicators. Phase 4: October 2020 was a covid specific survey and collected data about the impact of covid-19 restrictions on IPS service delivery.

Employment specialists perceived that they had less collaborative engagement with clinical teams and employers after covid-19 restrictions were introduced. This was accompanied by a significant decline in four of the employment specialists’ work environment indicators.

The covid-19 restrictions appear to have created obstacles for IPS service delivery in Northern Norway. These challenges may have negatively impacted the employment specialists’ perception of their work environment, creating job dissatisfaction and potentially increasing employee attrition.

No significant relationships.

To assess the effectiveness of supported employment interventions for improving competitive employment in populations of people with conditions other than only severe mental illness.

Supported employment interventions have been extensively tested in severe mental illness populations. These approaches may be beneficial outside of these populations.

We searched PubMed, Embase, CINAHL, PsycInfo, Web of Science, Scopus, JSTOR, PEDro, OTSeeker, and NIOSHTIC for trials including unemployed people with any condition and including severe mental illness if combined with other co-morbidities or other specific circumstances (e.g., homelessness). We excluded trials where inclusion was based on severe mental illness alone. Two reviewers independently assessed risk of bias (RoB v2.0) and four reviewers extracted data. We assessed rates of competitive employment as compared to traditional vocational rehabilitation or waiting list/services as usual.

Ten randomised controlled trials (913 participants) were included. Supported employment was more effective than control interventions for improving competitive employment in seven trials: in people with affective disorders [risk ratio (RR) 10.61 (1.49, 75.38)]; mental disorders and justice involvement [RR 4.44 (1.36,14.46)]; veterans with posttraumatic stress disorder (PTSD) [RR 2.73 (1.64, 4.54)]; formerly incarcerated veterans [RR 2.17 (1.09, 4.33)]; people receiving methadone treatment [RR 11.5 (1.62, 81.8)]; veterans with spinal cord injury at 12 months [RR 2.46 (1.16, 5.22)] and at 24 months [RR 2.81 (1.98, 7.37)]; and young people not in employment, education, or training [RR 5.90 (1.91–18.19)]. Three trials did not show significant benefits from supported employment: populations of workers with musculoskeletal injuries [RR 1.38 (1.00, 1.89)]; substance abuse [RR 1.85 (0.65, 5.41)]; and formerly homeless people with mental illness [RR 1.55 (0.76, 3.15)]. Supported employment interventions may be beneficial to people from more diverse populations than those with severe mental illness alone. Defining competitive employment and increasing (and standardising) measurement of non-vocational outcomes may help to improve research in this area.