Condition category
Mental and Behavioural Disorders
Date applied
Date assigned
Last edited
Prospectively registered
Overall trial status
Recruitment status
No longer recruiting

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Prof Graham Thornicroft


Contact details

Health Services Research
Institute of Psychiatry
De Crespigny Park
United Kingdom
+44 (0)20 7848 0735

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Randomised controlled trial of individual placement and support (IPS) to improve the occupational outcomes for people with severe mental illness in South London


SWAN - Supported Work And Needs

Study hypothesis

After receiving the supported employment intervention, a significantly greater percentage of individuals in the experimental group will be working at all compared to those in the control group.

Secondary hypotheses are that the individuals in the experimental group will be more likely to be:
1. Working competitively
2. Working more hours each week
3. Earning a higher net income
4. Making greater contributions to the national economy
5. Having a higher quality of life
6. Having more of their needs met

Ethics approval

The Joint South London and Maudsley and the Institute of Psychiatry NHS Research Ethics Committee gave approval on the 26th March 2004 (ref: 319/03)

Study design

Randomised controlled trial

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet

Can be found at:


Unemployed patients with severe mental illness


Experimental group:
The experimental condition will be Individual Placement and Support (IPS), a supported employment programme integrated within community mental health teams. The IPS model involves integrating an employment specialist into the community mental health team. This model focuses on rapid placement with continued follow-up support. The IPS model also seeks to find employment opportunities that are consistent with participants' preferences, skills, and abilities. Ongoing supervision and consultation will be provided by local experts in the use of supported employment models (status employment). The duration of the treatment is up to two years.

Control group:
The comparison condition consists of existing psychosocial rehabilitation and day care programmes available in the local area, which use a sheltered vocational rehabilitation approach. Unlike IPS, the comparison services are coordinated with, but not integrated into the community mental health teams. This is therefore a Treatment As Usual (TAU) control, which we have selected after considering options for a control matched for staff intensity of input, but we have ruled this out as current day care and voctional rehabilitation options are multiple and often intensive in the study areas (Croydon and Lambeth).

Further information (as of 23rd January 2007):
An adjunctive qualitative study is due to commence in November 2006. A semi-structured questionnaire will ask clients their views on any support they may have received to help them look for work, barriers to finding work, state benefits, positive and negative aspects of working and disclosure of mental health problems at work. It is planned to interview approximately 20 participants, with the project taking approximately one year to complete.

Intervention type



Not Applicable

Drug names

Primary outcome measure

1. Work status (all work, competitive work)
2. Total income, net income

Secondary outcome measures

1. Service use, service costs and societal costs
2. Quality of life
3. Unmet needs
4. Mental state

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Amended as of 30/01/2009: point one has been amended as follows:
1. Severe mental illness (duration of illness over two years, Global Assessment of Functioning score of 60 or less, and psychotic or chronic affective disorder)

Initial information at time of registration:
1. Severe mental illness (duration of illness over two years, Global Assessment of Functioning score of 50 or less, and psychotic or chronic affective disorder)
2. Receiving outpatient or community psychiatric care from local mental health services
3. Aged 18 to 65 years, either sex
4. Able to read and speak English
5. Giving informed written consent
6. Unemployed for at least three months before enrolment into the study

Participant type


Age group




Target number of participants


Participant exclusion criteria

1. Relapse in last three months
2. Cannot read or speak English
3. Employed in previous three months

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Health Services Research
United Kingdom

Sponsor information


King's College London (UK)

Sponsor details

Research and Development Office
Room W1.08
Institute of Psychiatry
De Crespigny Park
United Kingdom
+44 (0)20 7848 0251

Sponsor type




Funder type


Funder name

The Wellcome Trust (UK) (grant ref: 071272)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

1. 2009 recruitment difficulties results in
2. 2010 results in

Publication citations

  1. Recruitment difficulties results

    Howard L, de Salis I, Tomlin Z, Thornicroft G, Donovan J, Why is recruitment to trials difficult? An investigation into recruitment difficulties in an RCT of supported employment in patients with severe mental illness., Contemp Clin Trials, 2009, 30, 1, 40-46, doi: 10.1016/j.cct.2008.07.007.

  2. Results

    Howard LM, Heslin M, Leese M, McCrone P, Rice C, Jarrett M, Spokes T, Huxley P, Thornicroft G, Supported employment: randomised controlled trial., Br J Psychiatry, 2010, 196, 5, 404-411, doi: 10.1192/bjp.bp.108.061465.

Additional files

Editorial Notes