Coordinated Access to Care From Hospital Emergency Departments

Study Overview
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Brief Summary
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The study will assess the effectiveness and cost-effectiveness of providing brief, intensive case management for frequent users of hospital Emergency Departments who have mental health and/or addictions problems. The goals of the intervention are to support patients' transition to community-based health and social services and supports - including primary and urgent psychiatric care, peer support and other community services and supports - so as to improve patient wellbeing and reduce avoidable ED visits and hospitalizations.

Official Title
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Coordinated Access to Care From Hospital Emergency Departments - Assessing Effectiveness and Cost-Effectiveness

Conditions
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Mental Health

Intervention / Treatment
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* Other: Co-ordinated Access to Care from Hospital Emergency Departments
* Other: Coordinated Access to Care from Hospital Emergency Departments
* Behavioral: Counseling and Resource Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: legal adult status (age 18) able to give informed consent have made 5+ visits to participating hospital Emergency Department in the previous 12 months One of these visits will have been for a mental health and/or addiction problem. Exclusion Criteria: -
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>Participants will receive brief, intensive case management to connect them to health and social services and supports in the community | Other: Co-ordinated Access to Care from Hospital Emergency Departments<br>* brief, intensive case management for frequent users of hospital Emergency Departments who have mental health and/or addictions problems<br>Other: Coordinated Access to Care from Hospital Emergency Departments<br>* Participants will receive brief, intensive case management to connect them to health and social services and supports in the community<br>|
| Active Comparator: Counseling and Resource Education (CARE)<br>Participants will receive care as usual in the community. In addition, participants in this arm will receive an educational session and resource guide outlining available community-based services | Behavioral: Counseling and Resource Education<br>* Participants will receive usual care as well as an educational session and resource guide outlining community-based services<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of Emergency Department visits |  | Baseline, 6 and 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in symptom severity | A scales with good psychometric properties, the Colorado Symptom scale, will be used | Baseline, 6 and 12 months | 
| Days in hospital |  | baseline, 6 and 12 months | 
| Changes in substance use | The Addiction Severity index will be used | baseline 6 and 12 months | 
| Changes in health related quality of life | The SF-12 and EQ-5D will be used | baseline, 6 and 12 months |