Effect of Early Assessment Team for Clarification and Follow-up of Patients Referred to Outpatient Mental Health Care: A Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Early assessment team
- Conditions
- Mental Disorder
- Sponsor
- St. Olavs Hospital
- Enrollment
- 588
- Locations
- 1
- Primary Endpoint
- Work and Social Adjustment Scale (WSAS)
- Status
- Active, not recruiting
- Last Updated
- 2 months ago
Overview
Brief Summary
Loss of function and incapacity for work as a result of mental disorders are increasing, especially among young people (under 30 years of age), even though the prevalence of mental illness is fairly stable. Many of the patients referred to outpatient mental health care have complex difficulties with both mental and somatic ailments, in addition to difficulties with social conditions related to, for example, education, work, finances and social support. Functional difficulties can come as a result of mental illness. However, it can also be the opposite way; not functioning at work, study or daily life in general can cause mental symptoms and ailments. Many of these people are referred to mental health care even if the basic problem cannot be solved by psychotherapy or medication. Some of the referred patients do not have a psychiatric illness, but a reaction to a stressful and demanding situation and strains over time. Compound health challenges require individualized assessments and clarifications in order to offer the right measures. Traditionally in mental health care, the patient is placed on a waiting list to receive assessment and therapy for a specific condition.
With this background, the investigators believe it is important to early identify the referred patients who will benefit from measures other than traditional assessment and treatment in mental health care. Knowledge of other aid agencies is important to find the right measures at the right time. This is important for the individual patients, who are often young people going to "get started in life". It is also important for the health services because the capacity to provide a good health service is a limited resource. From a societal perspective it is important that the health care offered contributes to reducing social security dependence.
The purpose of this randomized, controlled trial is to compare the effect of traditional management of newly referred patients in outpatient clinics with assessment through an Early Assessment Team. The investigators believe that early assessment may have a positive effect on mental health, quality of life and function. The outcome goals can be summarized as less use of resources in outpatient clinics and society and better function and life for patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •all patients referred to a general psychiatric outpatient clinic
- •necessary capacity to consent
- •master Norwegian language to such an extent that the patient can understand the written consent
Exclusion Criteria
- •patients that an admission team at the outpatient clinic consider obviously must have a TAU for some time
- •patients too healthy to receive specialized mental health care
- •patients in need of acute psychiatric assessment
- •relevant participants who do not respond digitally or who do not confirm consent in writing within given deadlines
Arms & Interventions
Early assessment group
Intervention: Early assessment team
Usual admission procedure group
Intervention: Admission to General psychiatric outpatient clinic
Outcomes
Primary Outcomes
Work and Social Adjustment Scale (WSAS)
Time Frame: 1 year
WSAS is a self-report questionnaire with five items covering the following dimensions; influence on work, home management, social leisure activity, private leisure activities and relationships with others. The items are scored from 0 to 8, with a total score from minimum 0 to maximum 40, with lower scores indicating better adjustment.
Secondary Outcomes
- Clinical Outcome in Routine Evaluation Outcome Measure (CORE-10)(2, 4, 8 months after enrollment)
- The Questionaire about the Process of Recovery (QPR-15)(2, 4, 8, 12, 24 months after enrollment)
- EuroQoL EQ-5D-5L(2, 4, 8, 12, 24 months after enrollment)
- World Health Organization Well Being Index (WHO-5)(2, 4, 8, 12, 24 months after enrollment)
- Client Satisfaction Questionnaire (CSQ-8)(Through study completion, an average of 1 year)
- Clinical Outcome in Routine Evaluation Outcome Measure (CORE-OM)(12, 24 months after enrollment)
- Occupational status - data extracted from The Norwegian Labour and Welfare Administration (NAV)(12 and 24 months)
- Work and Social Adjustment Scale (WSAS)(2, 4, 8, 24 months after enrollment)