HoPe: Home Treatment and Peer Support for Acute Mental Health Crisis
- Conditions
- Severe Mental Health Condition With Indication of Hospital Admission
- Interventions
- Behavioral: Home Treatment with Peer SupportBehavioral: Home Treatment without Peer Support
- Registration Number
- NCT04336527
- Lead Sponsor
- Universitätsklinikum Hamburg-Eppendorf
- Brief Summary
Home treatment (HT) is an effective treatment modality for patients with severe mental illness (SMI) in acute crisis that can often be considered equivalent to inpatient treatment in terms of treatment outcome. In Peer Support (PS) patients are supported by people with personal experiences in psychiatric crises. The current study investigates a combination of both approaches - a HT plus PS intervention - versus sole HT at different study sites throughout Germany. It is hypothesized that a peer-supported home-delivered treatment (HT plus PS) is more effective than a professional-led home-delivered treatment (HT alone) with respect to the time until hospital readmission, self-efficacy, psychosocial health, recovery orientation, internalized stigma and service satisfaction. Furthermore, it is hypothesized, that a peer-supported home delivered treatment (HT plus PS) is as effective as a professional-led home-delivered treatment (HT alone) with respect to disease severity and general functioning (secondary outcomes).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 201
- severe mental illness with indication of hospital admission (F2, F3, F6, F41, F42)
- primary diagnosis of F0 or F1 (Mental disorders due to known physiological conditions; Mental and behavioral disorders due to psychoactive substance use)
- acute suicidality
- verbal or cognitive impairment severe enough to be unable to give informed consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Home Treatment with Peer Support Home Treatment with Peer Support Patients receive a peer supported home treatment, i.e. treatment by a home treatment/crisis resolution team with a peer support worker. Home Treatment without Peer Support Home Treatment without Peer Support Patients receive conventional home treatment by a home treatment/crisis resolution team without contacts to a peer support worker.
- Primary Outcome Measures
Name Time Method Time to first readmission to inpatient hospital treatment 1 year after last patient in
- Secondary Outcome Measures
Name Time Method means in recovery support scores as assessed by Brief INSPIRE at six months six months after allocation Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
means in recovery support scores as assessed by Brief INSPIRE at twelve months twelve months after allocation Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
change from baseline in stigma resistance scores as assessed by ISMI at two months two months after allocation ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
change from baseline in psychosocial health scores as assessed by Health-49 at two months two months after allocation Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
change from baseline in psychosocial health scores as assessed by Health-49 at twelve months twelve months after allocation Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
change from baseline in stigma resistance scores as assessed by ISMI at twelve months twelve months after allocation ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
change from baseline in self-efficacy expectation scores as assessed by SWE at two months two months after allocation SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
change from baseline in self-efficacy expectation scores as assessed by SWE at twelve months twelve months after allocation SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
means in service satisfaction scores as assessed by ZUF-8 at twelve months twelve months after allocation ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
change from baseline in disease severity scores ay assessed by CGI at two months two months after allocation CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
change from baseline in general functioning scores as assessed by GAF at two months two months after allocation GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
change from baseline in self-efficacy expectation scores as assessed by SWE at six months six months after allocation SWE = Skala zur Allgemeinen Selbstwirksamkeitserwartung by Schwarzer \& Jerusalem (1999); minimum value = 10; maximum value = 40; higher scores mean a better outcome
change from baseline in psychosocial health scores as assessed by Health-49 at six months six months after allocation Health-49 = Hamburger Module zur Erfassung allgemeiner Aspekte psychosozialer Gesundheit für die therapeutische Praxis by Rabung et al. (2009); subscales: somatoform complaints (SOM; min-max values=0-28; higher scores mean aworse outcome); depressiveness (DEP; min-max=0-24, higher values mean a worse outcome); phobic anxiety (PHO; min-max=0-20; higher values mean a worse outcome); psychological and somatoform complaints (PSB; min-max=0-72; higher values mean a worse outcome); psychological wellbeing (WOHL; min-max=0-20; higher values mean a better outcome); interactional problems (INT; min-max=0-28; higher values mean a worse outcome); self-efficacy (SELB; min-max=0-20; higher values mean a better outcome); activity and participation (A\&P; min-max=0-24; higher values mean a better outcome); social support (SOZU; min-max = 0-16; higher values mean a better outcome); social stress (SOZB, min-max=0-16; higher values mean a worse outcome)
means in recovery support scores as assessed by Brief INSPIRE at two months two months after allocation Brief INSPIRE is a short version of INSPIRE by Williams et al. (2015); minimum value = 0; maximum value = 100; higher scores mean a better outcome
means in service satisfaction scores as assessed by ZUF-8 at six months six months after allocation ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
change from baseline in disease severity scores ay assessed by CGI at six months six months after allocation CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
change from baseline in disease severity scores ay assessed by CGI at twelve months twelve months after allocation CGI = clinical global impressions, see Forkmann et al., 2011; minimun value = 1; maximum value = 7; higher scores mean a worse outcome
change from baseline in general functioning scores as assessed by GAF at six months six months after allocation GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
change from baseline in stigma resistance scores as assessed by ISMI at six months six months after allocation ISMI = Internalized Stigma of Mental Illness Inventory by Sibitz et al. (2013); subscale stigma resistance; minimum value: 5; maximum value = 20; higher scores mean a better outcome
means in service satisfaction scores as assessed by ZUF-8 at two months two months after allocation ZUF-8 = Fragebogen zur Messung der Patientenzufriedenheit by Schmidt et al. (1989); minimum value = 8; maximum value = 32; higher scores mean a better outcome
change from baseline in general functioning scores as assessed by GAF at twelve months twelve months after allocation GAF = Global Assessment of Functioning by Jones et al. (1995), minimum value = 0; maximum value = 100; higher scores mean a better outcome
Trial Locations
- Locations (8)
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum Neukölln
🇩🇪Berlin, Germany
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Vivantes Klinikum am Urban
🇩🇪Berlin, Germany
Abteilung für Psychiatrie und Psychotherapie, Asklepios Westklinikum Hamburg
🇩🇪Hamburg, Germany
Klinik für Psychiatrie und Psychotherapie II, Günzburg, Universitätsklinikum Ulm
🇩🇪Günzburg, Germany
Zentrum für Psychosoziale Medizin, Gesundheit Nord, Klinikverbund Bremen
🇩🇪Bremen, Germany
Psychiatrische Klinik Lüneburg
🇩🇪Lüneburg, Germany
Bezirkskrankenhaus Donauwörth, Fachklinik für Psychiatrie, Psychotherapie und Psychosomatik an der Donau-Ries Klinik
🇩🇪Donauwörth, Germany
Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Hochschule Brandenburg, Immanuel Klinik Rüdersdorf
🇩🇪Rüdersdorf, Germany