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Study shows IPR does not decrease use of mental health services (USA)

January 26, 2012

A first of its kind, statewide study on the relationship between intensive psychiatric rehabilitation (IPR) and its impact on mental health service utilization, as well as on residential and employment outcomes, found unexpected results. Contrary to study hypothesis, mental health service use actually increased when people were engaged in psychiatric rehabilitation services.

Conducted in Iowa, the study was modeled on the “Choose, Get, Keep” service intervention, which contains the following components:

  1. Developing readiness for residential or vocational goals,
  2. Goal achievement
  3. Goal keeping

Five hundred and eleven study participants who use mental health services were divided into three groups:

  • Completers (of a 12 month program)
  • Late drop outs (participants who dropped out between 6 – 12 months), and
  • Early drop outs (leaving before 6 month period).

The participants were white, in their 30’s, and had a diagnosis of schizophrenia. Using a quantitative method, group outcomes based on residential status; employment status and earnings; and service use were examined. In addition, the “Completers” group outcomes were measured against a control group, to allow for measurement of the “dose response” relationship of IPR on clinical outcomes.

The authors hypothesized that use of IPR for job seekers would decrease mental health service use (such as outpatient services); however, the findings indicated that service use actually increased for IPR participants while it decreased significantly for the control group. The authors cautioned that while service utilization and some program outcomes could be analyzed, the study was not designed to examine the effectiveness of IPR or the participants’ characteristics that led to improved outcomes.

For those who completed the program, earnings were higher and their housing situation was improved, compared to those in the other two drop out groups. It was also supposed that those in the early drop out group had higher rates of substance use which indicated they were not ready for the intervention.

See, “Statewide Initiative of Intensive Psychiatric Rehabilitation: Outcomes and Relationship to Other Mental Health Service Use,” available at

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