The Effectiveness of FMPO in Improving the Quality of Care for Persons With Severe Mental Illness.
Condition: Schizophrenia; Schizoaffective Disorder; Major Depression
MeSH terms: Schizophrenia; Psychotic Disorders; Mental Disorders
Study type: Interventional

Summary: 
      The purpose of this study is to learn how to help veterans play a stronger role in shaping
      their mental health care. Specifically we want to see if we can help veterans improve their
      mental health treatment by helping them decide if they want to involve family in their mental
      health treatment, and if so, how. The study will compare a "family member provider" program
      to an "enhanced treatment as usual approach" in achieving these goals.
    

Detailed description: 
      Previous research demonstrates that when families are active participants in the clinical
      care of persons with SMI, veterans experience improved outcomes, including treatment
      retention, vocational services participation, and empowerment. Numerous controlled trials
      show that when family involvement achieves the level of intensity and family psychoeducation
      (FPE), relapse rates are cut in half, and treatment adherence, clinical symptoms, and patient
      functioning are improved. However, despite these demonstrated benefits, rates of family
      involvement in the VA are unacceptably low. Even minimal family-clinician contact occurs for
      only one third of VA SMI patients, a lower rate than in non-VA systems of care. Therefore, it
      is not surprising that FPE, an intensive form of family-clinician contact, is almost never
      offered in the VA. In fact, a national VA survey conducted within the last three years
      indicated that 0% of VAs offer FPE programs conforming to EBP guidelines. Our previous
      experience further suggests that these deficits in care are due to combinations of provider,
      patient, and family factors, and that the VA presents specific challenges to implementing
      existing model programs, including FPE. We therefore believe it is necessary to approach the
      challenge of increasing family involvement in a step-wise fashion, first by engaging families
      in the processes of care, before trying to enlist them in more intensive programs such as
      FPE. Further, family engagement would likely be most effective if it builds on a foundation
      that empowers consumers to make informed choices regarding the involvement of relatives in
      care. Our group has developed and piloted a new, family-engagement approach that is gradual,
      patient-centered, recovery-based, and can address various barriers to improving care. It is
      manualized and thus replicable. The proposed study will implement and further evaluate this
      intervention, the brief Family Member Provider Outreach (FMPO).
    

Intervention name(s): Family Member Provider Outreach; Enhanced treatment as usual (e-TAU)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Family Member Provider Outreach is a brief recovery oriented model. THe FMPO meets with the consumer for 2-3 sessions and with the family for 2-3 sessions with the consumer's permission.; Enhanced treatment as usual. In this condition, the consumer is given a list of family services available including the family intervention team.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Mental Illness; Schizophrenia; Education; Family member treatment; Active psychoses