Until recently, three major approaches have been used in the USA and Canada to favor employment integration of people with severe mental disorders : training for competitive employment, non-competitive jobs as a substitute to competitive employment and incentives aiming at alleviating hesitation of potential employers to hire people with mental disorders. Supported employment represents a new approach that is increasingly spreading in the USA as well as in Canada. The principles of IPS, based on results of evaluative research, aim at placing individuals as rapidly as possible in regular jobs according to the interests and skills of the client. It implies close integration of both employment support and clinical activities. Studies reviewed show that this approach is more effective than others assessed regarding obtaining regular employment. Studies conducted in Québec are necessary to evaluate its effectiveness here. Its implementation in Québec raises several questions relative to organization of services and employment and income support policies. Current policies do not favor integration in the regular job market.