Remote psychosocial interventions to prevent avoidable psychiatric hospital admissions in people with serious mental health problems: a multi-arm multi-stage trial
- Conditions
- Serious mental health problemsMental and Behavioural Disorders
- Registration Number
- ISRCTN33079589
- Lead Sponsor
- niversity of Manchester
- Brief Summary
2024 Protocol article in https://pubmed.ncbi.nlm.nih.gov/38971788/ (added 08/07/2024)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Ongoing
- Sex
- All
- Target Recruitment
- 991
Current inclusion criteria as of 05/06/2023:
1. Currently receiving care from a Home-Based Treatment Team/Crisis team or have done so within the last 14 days, since referrals to HBTT/Crisis Team are associated with increased risk of a psychiatric hospital admission in the near future
2. Aged 16 years or above
3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder, EUPD, PTSD or cPTSD) since these diagnoses account for the majority of PHAs for mental health difficulties
4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale.
5. Able to provide informed consent
6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT.
_____
Previous inclusion criteria from 09/01/2023 to 05/06/2023:
1. Currently receiving care from a Home-Based Treatment Team/Crisis team or have done so within the last 14 days, since referrals to HBTT/Crisis Team are associated with increased risk of a psychiatric hospital admission in the near future
2. Aged 16 years or above
3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder or EUPD) since these diagnoses account for the majority of PHAs for mental health difficulties
4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale.
5. Able to provide informed consent
6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT.
_____
Previous inclusion criteria:
1. Receiving care from a HBTT (referrals to HBTT are associated with increased risk of a PHA in the near future)
2. Aged 16 years or above
3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder or EUPD) since these diagnoses account for the majority of PHAs for mental health difficulties
4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale.
5. Able to provide informed consent
6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT.
Current inclusion criteria as of 05/06/2023:
1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP
2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds.
3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP
4. Moderate to severe learning disability as confirmed by the participant's responsible clinician in their care team.
5. Immediate risk to others, for ethical and safety reasons
6. Currently receiving psychiatric inpatient care (since people in recent contact with crisis teams may have already been admitted to hospital)
_____
Previous inclusion criteria from 09/01/2023 to 05/06/2023:
1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP
2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds.
3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP
4. Moderate to severe learning disability as confirmed by the participants responsible clinician in their care team, since the BrighterSide app has not been developed or tested with people with moderate to severe learning disability.
5. Visual impairment, severe enough to prevent engagement with the BrighterSide app as provision would be impossible on both financial and logistical grounds.
6. Immediate risk to others, for ethical and safety reasons
7. Currently receiving psychiatric inpatient care (since people in recent contact with crisis teams may have already been admitted to hospital)
_____
Previous inclusion criteria:
1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP
2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds.
3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP
4. Moderate to severe learning disability as confirmed by the participants responsible clinician in their care team, since the BrighterSide app has not been developed or tested with people with moderate to severe learning disability.
5. Visual impairment, severe enough to prevent engagement with the BrighterSide app as provision would be impossible on both financial and logistical grounds.
6. Immediate risk to others, for ethical and safety reasons
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Psychiatric hospital admission (yes/no) over a 6 month period measured using patient records
- Secondary Outcome Measures
Name Time Method Measured at baseline, 3 and 6 months<br>1. Suicidal thoughts and behaviours using The Columbia–Suicide Severity Rating Scale<br>2. Recovery assessed using The Process of Recovery Questionnaire<br>3. Health status using the EQ-5D-5L<br>4. The Recovering Quality of Life (ReQoL-10)<br>5. Wider NHS and social care use assessed by the Economic Patient Questionnaire<br>6. Anxiety measured using the GAD-7<br>7. Depression measured using the PHQ-9<br>8. Hope using the Adult HOPE Scale<br>9. Entrapment measured using the 4-item self-report Entrapment Scale Short-Form<br>10. Adverse effects measures on exit from the study at 6-month assessment