An individual placement and support programme is more effective than skills training and temporary employment for people with severe mental illness.

Intervention: Individual placement and support (IPS): employment specialists worked with case managers, psychiatrists and the client to integrate employment services with treatment. Services included vocational assessment and identifying job interests, job finding, and support, and were provided away from the mental health centre. Psychosocial rehabilitation programme (PSR): skills training was given followed by transitional employment and support for obtaining competitive work. PSR also gave social support and housing services, which were provided to all participants in the study. Standard services: access to local vocational services and a programme supplying subminimum wage employment in supervised janitorial positions.