Just Do You Program for Young Adults With Serious Mental IIlness
Condition: Depression; Bipolar Disorder; Psychosis; Anxiety Disorders
MeSH terms: Bipolar Disorder; Anxiety Disorders
Study type: Interventional

Summary: 
      Just Do You is a young-adult-centered and theoretically guided intervention that has shown
      promise for keeping young adults connected to their professional treatments, while also
      enhancing their hope for the future and their own recovery. Just Do You is a brief two-module
      engagement program that utilizes a hybrid provider team of a licensed clinician and peer to
      address mistrust, lack of hope for the future, stigma concerns, literacy and a sense of
      efficacy early on when young adults begin a new service experience in adult outpatient day
      programs (i.e., New York State Personalized Recovery Oriented Services). The aim of this
      study is to test Just Do You through a moderately-sized randomized trial in order to see if
      it improves initial and secondary engagement among young adults with serious mental health
      conditions. The program is designed as an orientation to services, coupled with a curriculum
      designed to enhance motivation and agency, and keep young adults connected to their care.

      This study utilizes a randomized controlled trial to test the preliminary impact of the
      intervention, compared to best available services (treatment as usual, TAU) at two outpatient
      programs for adults with serious mental illnesses (n = 195). The program was adapted to
      two-sessions from the piloted four-session version through conversations with leadership at
      partnering agencies. The intervention involves intensive staff training and 24 months of
      ongoing provision, monitoring and supervision of the program. Quantitative survey data will
      be collected at baseline (pre), 2 weeks (post), 1 month, and 3 months. In this
      intention-to-treat analysis, we will conduct basic omnibus analyses to examine whether Just
      Do You leads to improved outcomes relative to TAU utilizing t tests across treatment
      conditions for each outcome measure specified. The investigators will likewise examine
      whether changes in the proposed mediating variables differ across groups.
    

Detailed description: 
      Background

      Young adults have elevated rates of serious mental illnesses and they often do not receive
      consistent mental health care. This is a considerable challenge for public health, as most
      often mental health conditions persist into adulthood. Continuing to engage this population
      in their professional mental health treatment has been a pervasive challenge globally. Few
      mental health interventions have been designed specifically for young adults and none are
      conceptualized as meta-interventions or orientation programs. Just Do You is a
      young-adult-centered and theoretically guided intervention that has shown promise for keeping
      young adults connected to their professional treatments, while also enhancing their hope for
      the future and their own recovery. Just Do You is a brief two-module engagement program that
      utilizes a hybrid provider team of a licensed clinician and peer to address mistrust, lack of
      hope for the future, stigma concerns, literacy and a sense of efficacy early on when young
      adults begin a new service experience in adult outpatient day programs (i.e., New York State
      Personalized Recovery Oriented Services).

      Methods/design

      This study utilizes a randomized controlled trial to test the preliminary impact of the
      intervention, compared to best available services (treatment as usual, TAU) at two outpatient
      programs for adults with serious mental illnesses (n = 195). The program was adapted to
      two-sessions from the piloted four-session version through conversations with leadership at
      partnering agencies. The intervention involves intensive staff training and 24 months of
      ongoing provision, monitoring and supervision of the program. Quantitative survey data will
      be collected at baseline (pre), 2 weeks (post), 1 month, and 3 months. In this
      intention-to-treat analysis, the investigators will conduct basic omnibus analyses to examine
      whether Just Do You leads to improved outcomes relative to TAU utilizing t tests across
      treatment conditions for each outcome measure specified. The investigators will likewise
      examine whether changes in the proposed mediating variables differ across groups.

      Discussion

      The aim of this study is to test Just Do You through a moderately-sized randomized trial in
      order to see if it improves initial and secondary engagement among young adults with serious
      mental health conditions. The program is designed as an orientation to services, coupled with
      a curriculum designed to enhance motivation and agency, and keep young adults connected to
      their care. Continuity of care among this population is a serious challenge and Just Do You
      has the potential to address this challenge in the service system for poor, young adults
      living in low-resourced communities. If it is shown to be successful in this setting, it
      could likely be used to address the continuity of care issue more broadly in additional
      settings that serve young adults with serious mental illness. It may enhance the menu of care
      options for those who have been recently diagnosed with a serious mental health condition,
      providing them with an orientation for how professional mental health care can help them. The
      program is recovery-oriented, builds on the best evidence to date, and is in line with both
      local and national health care reform efforts.
    

Intervention name(s): Just Do You; Active Control
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Just Do You is an intervention designed to keep young adults connected to their professional behavioral health treatments. It is a brief two-module engagement program that utilizes a hybrid provider team of a licensed clinician and peer to increase young adult engagement in adult outpatient day programs (i.e., New York State Personalized Recovery Oriented Services). The first session consists of the following components: 1) Welcome; Group Guidelines, Purpose, 2) Discuss Recovery Principles; Narrative of Role Model; 3) Video of Celebrity Service User and Discussion, and 4) Recovery Goals (and role of services in that). The second session consists of: 1) What are services & how can they help? 2) Visual art exercise -- Cause of SMI and validation, 3) Maintaining my Medicaid Insurance, and 4) Discussion of Systemic Barriers.; The active control condition will receive the PROS program that is standard in the agencies, and a two-session curriculum on maintaining healthy relationships, which is an identified issue for the population.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other