The Integrated Care Model for Homeless Mothers

Study Overview
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Brief Summary
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The purpose of this study is to pilot test an adapted collaborative care model for homeless mothers with depression.

Detailed Description
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Homeless mothers are more vulnerable to Major Depressive Disorder (MDD) than comparable groups of impoverished mothers, with rates in recent community studies approaching 50%. Even though primary care offers an ideal venue to identify and manage depression among women who commonly fail to receive needed mental health services, rigorously tested primary care-based treatment strategies that address the needs of homeless mothers with depression are lacking. This study reports results on a pilot test and feasibility findings of a new intervention, the Integrated Care Model for Homeless Mothers (ICMHM), adapted from the collaborative care model for depression (CCM) to address unique aspects of care for homeless mothers who screened positive for depression during a shelter-based primary care visit.

Official Title
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The Integrated Care Model for Homeless Mothers

Conditions
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Depression

Intervention / Treatment
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* Behavioral: ICMHM


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mothers who are residing in emergency shelter 18 years of age or older Screen positive for depression Speak English or Spanish Exclusion Criteria: Not pregnant Not currently receiving depression treatment Not currently psychotic

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

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: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ICMHM<br>ICMHM mothers receive services of a primary care clinician (PCP) and a care manager both trained in depression care management in a shelter-based primary care clinic. | Behavioral: ICMHM<br>* ICMHM participants receive a collaborative care model adapted to include an engagement interview, attention to co-morbid conditions, and attention to basic needs.<br>|
| No Intervention: Treatment as Usual<br>Treatment as Usual mothers receive usual services of a PCP and case manager from a shelter-based primary care clinic. . | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in The Hopkins Depression Symptom Checklist -Depression Scale 20 (Williams et al, 2004) |  | The primary end point is 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of visits to the care manager and primary care physician | Visits documented between study entry and six months recorded from EMR | The primary end point is 6 months | 
| New antidepressant medication prescriptions | Documentation of new antidepressant medication prescriptions between study entry and six months recorded in EMR | The primary end point is 6 months | 
| Patient Reactions Assessment (Galassi et al, 1992) |  | The primary end point is 6 months | 
| Helping Alliance Questionnaire (Luborsky et al, 1985) |  | The primary end point is 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Homelessness, Primary care