Wednesday, July 23, 2008

Concluded Project - end date

IPS Plus

Statement of Need

Individuals with psychiatric disabilities experience persistent and recurrent difficulties that can interfere with every aspect of their lives. The current mental health system of care in Oregon has trouble providing the services necessary to address the multiple needs of these individuals. Two problems that have been most difficult to resolve are providing employment opportunities and resolving substance abuse problems.

The Individual Placement and Support Plus (IPS+) Project recognizes the need to adopt a model of treatment that addresses the multiple needs of mental health consumers in an efficient and effective way. The goal of this project is to implement the IPS+ model where individuals with psychiatric disabilities have access to integrated, continuous treatment. IPS+ is expected to create better treatment outcomes at current or decreased costs of care.

What is IPS+?

IPS+ is a comprehensive system of care that combines the Individual Placement and Support (IPS) model with the Intensive Case Management services (ICM).


Features of IPS

  • Competitive employment is both the goal and the treatment;
  • Rapid job search and placement;
  • Integration of employment services and mental health treatment;
  • Attention to consumer preferences;
  • Continuous and comprehensive employment assessment;
  • Unlimited support;
  • Non-coercive;
  • Manageable caseloads for employment specialist.

Plus in IPS+

  • Addition of Substance Abuse Specialist on treatment team;
  • Addition of Consumer Case Manager on treatment team;
  • Recovery/strengths based approach.

Features of ACT

  • Treatment team approach (team of clinicians know and work with all clients);
  • Daily check-ins to plan and review services for each client;
  • Treatment team includes: licensed medical practitioners, substance abuse specialist, vocational specialist, case managers;
  • Treatment team carries full responsibility for all treatment needs, including: crisis management, hospital & discharge planning, employment support, substance abuse treatment;
  • Services are provided for as long as consumer wants and needs treatment;
  • Services are intensive, with frequent contact as needed;
  • Small caseloads and low intake rate.

Why IPS+ ?

  • ICM models using this approach are the best researched and most effective mental health treatment for persons with serious mental illness (Mueser, Bond, Drake & Resnick, 1998);
  • Over 50% of persons with serious mental illness experience both disorders of mental illness and substance abuse (Mueser, Bellack & Blanchard, 1992);
  • Integrating substance abuse and mental health treatment by placing a substance abuse specialist on ICM teams has proven to be effective (Drake et al., 1998);
  • IPS teams have demonstrated improved outcomes when paired with an ICM treatment team (Mueser, Bond, Drake & Resnick, 1998);
  • Consumers can be effective mental health providers and provide valuable role models (Paulson et al., 1998).

What can IPS+ Do?

  • Reduce hospitalization (50%), increase consumer satisfaction and residential stability (Mueser, et al., 1998);
  • Increase employment of mental health consumers, thereby reducing their dependence on the mental health system (Becker & Drake, 1998);
  • Increase cost effectiveness compared to other community & in-patient alternatives (Becker & Drake, 1998).

Effective September 2000, the IPS+ Project was successful in implementing this best practice model at two sites in the Portland Metropolitan Area. Unity, Inc. and Network Behavioral Health Care jointly implemented a program serving 150 individuals. Tualatin Valley Centers in Washington County is the other IPS+ implementation site, also serving 150 individuals. During this first year of implementation, both projects will receive training and evaluation support funded by a SAMHSA Community Action Grant awarded to Portland State University's Regional Research Institute.

Desired outcomes for the IPS+ programs

  • Achieve competitive integrated employment for at least 50% of those enrolled in IPS+ Programs;
  • Sustain IPS+ Programs beyond the committed funding year;
  • Use QA and evaluation results to secure adoption of model state-wide.