Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Team Approach to Improve the Quality of Diabetes Care for Patients With Schizophrenia
Brief Summary: This proposal aims to demonstrate the feasibility and acceptability of adapting TEAMcare for patients with schizophrenia. The aim of this innovative mental health center-based team intervention is to improve diabetes, cardiovascular and psychiatric outcomes among patients with poorly controlled type 2 diabetes. The study will be conducted in two phases over the 2-year grant period.

Phase 1. Development of the adapted TEAMcare intervention and training of team members.

Phase 2. During year 2, we will implement the intervention on the caseload of 40 outpatients at Harborview Mental Health Services with schizophrenia and poorly controlled type 2 diabetes. The intervention involves the management of subjects' diabetes, hypertension, and hyperlipidemia by a CMHC diabetes team for 6 months (advanced nurse specialist on-site at supervised in weekly meetings by a psychiatrist and a UW Diabetes Center endocrinologist).

The primary aim of this pilot research grant is to evaluate the feasibility of implementing this complex intervention, in order to guide the design of a larger scale efficacy study (R01). Both process and outcome measures will be evaluated at baseline, and at 3- and 6-month follow-up visits for the 40 subjects enrolled in this feasibility trial.


Options:
A: Inclusion Criteria:

* Persons with schizophrenia spectrum disorders

Exclusion Criteria:

* IQ \<70
* neurological disease diagnosis
* Active suicidality
* Severe drug abuse
B: Inclusion Criteria:

* Reside in Cameron, Hidalgo, or Willacy County
* Have a severe, persistent mental illness as diagnosed by a licensed behavioral health care provider
* Be eligible to receive behavioral health services from TTBH
* Must not be receiving any primary care outside of TTBH (as ascertained via patient self-report)
* Have a diagnosis of one or more chronic conditions:
* Hypertension (blood pressure of 140/90 mmHg or higher)
* Obesity (body mass index of 30.0 or higher)
* Poorly controlled diabetes (HbA1c over 8.5%)
* Hypercholesterolemia (Total cholesterol level above 200)

Exclusion Criteria:

* Not actively suicidal at time of enrollment
C: Inclusion Criteria:

* Diagnosis of bipolar disorder (I, II, not otherwise specified, or schizoaffective-bipolar subtype)
* Have a diagnosis or be at risk for arteriosclerotic cardiovascular disease (ASCVD).

We define this as a patient having a current diagnosis of or receiving treatment for at least one of the following medical conditions:

* hyperlipidemia or dyslipidemia (documented diagnosis or low-density lipoprotein \>=160, or receiving statin or other treatment)
* hypertension (documented diagnosis or blood pressure of \>=140/90 on 2 occasions)
* diabetes mellitus (documented diagnosis or HbA1C \>=7%, or receiving treatment)
* obesity (documented diagnosis or BMI \>30), based on medical record review of current problems
* current ASCVD diagnosis

Exclusion Criteria:

* Have unresolved substance intoxication or withdrawal, such as appearing to be intoxicated (e.g., incoherent, slurred speech), or experiencing withdrawal symptoms from substance abuse at the time of enrollment.
* Are already enrolled in a mental health program with a mobile outreach component in which clinical caregivers deliver services to the patient in the community (e.g., assertive community treatment or intensive case management). These patients may be receiving similar services to those offered in the intervention.
* Are unwilling or unable to provide informed consent or comply with study requirements at the time of enrollment (e.g., unable to complete forms or attend scheduled sessions due to serious illness or substantial functional limitations).
D: Inclusion Criteria:

* adult (18-70 years);
* enrolled to receive mental health treatment at Harborview Mental Health Services or Downtown Emergency Services Mental Health center
* a diagnosis of type 2 diabetes mellitus or cardiovascular disease
* Hemoglobin A1c \>8 or BP \> 140/90

Exclusion Criteria:

* cognitive, hearing, or language impairment that would preclude a subject from providing informed consent;
* current suicidality, homicidality, or grave disability that requires psychiatric hospitalization;
* current substance abuse or dependence, as defined by SCID.

Answer: D