Clinical trial NCT05087446: Effect of Early Assessment Team for Patients Referred to Outpatient Mental Health Care
Official title: Effect of Early Assessment Team for Clarification and Follow-up of Patients Referred to Outpatient Mental Health Care: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Mental Disorder
Lead sponsor: St. Olavs Hospital
Sponsor class: OTHER
Collaborators: name: Norwegian University of Science and Technology
First posted: 2021-10-21
Enrollment: 588
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Loss of function and incapacity for work as a result of mental disorders are increasing, especially among young people (under 30 years of age), even though the prevalence of mental illness is fairly stable. Many of the patients referred to outpatient mental health care have complex difficulties with both mental and somatic ailments, in addition to difficulties with social conditions related to, for example, education, work, finances and social support. Functional difficulties can come as a result of mental illness. However, it can also be the opposite way; not functioning at work, study or daily life in general can cause mental symptoms and ailments. Many of these people are referred to mental health care even if the basic problem cannot be solved by psychotherapy or medication. Some of the referred patients do not have a psychiatric illness, but a reaction to a stressful and demanding situation and strains over time. Compound health challenges require individualized assessments and clarifications in order to offer the right measures. Traditionally in mental health care, the patient is placed on a waiting list to receive assessment and therapy for a specific condition.

With this background, the investigators believe it is important to early identify the referred patients who will benefit from measures other than traditional assessment and treatment in mental health care. Knowledge of other aid agencies is important to find the right measures at the right time. This is important for the individual patients, who are often young people going to "get started in life". It is also important for the health services because the capacity to provide a good health service is a limited resource. From a societal perspective it is important that the health care offered contributes to reducing social security dependence.

The purpose of this randomized, controlled trial is to compare the effect of traditional management of newly referred patients in outpatient clinics with assessment through an Early Assessment Team. The investigators believe that early assessment may have a positive effect on mental health, quality of life and function. The outcome goals can be summarized as less use of resources in outpatient clinics and society and better function and life for patients.


Eligibility criteria: Inclusion Criteria:

* all patients referred to a general psychiatric outpatient clinic
* necessary capacity to consent
* master Norwegian language to such an extent that the patient can understand the written consent

Exclusion Criteria:

* patients that an admission team at the outpatient clinic consider obviously must have a TAU for some time
* patients too healthy to receive specialized mental health care
* patients in need of acute psychiatric assessment
* relevant participants who do not respond digitally or who do not confirm consent in writing within given deadlines

Primary outcomes:
measure: Work and Social Adjustment Scale (WSAS)
timeFrame: 1 year
Secondary outcomes:
measure: World Health Organization Well Being Index (WHO-5)
timeFrame: 2, 4, 8, 12, 24 months after enrollment
measure: EuroQoL EQ-5D-5L
timeFrame: 2, 4, 8, 12, 24 months after enrollment
measure: Client Satisfaction Questionnaire (CSQ-8)
timeFrame: Through study completion, an average of 1 year
measure: Clinical Outcome in Routine Evaluation Outcome Measure (CORE-OM)
timeFrame: 12, 24 months after enrollment
measure: Clinical Outcome in Routine Evaluation Outcome Measure (CORE-10)
timeFrame: 2, 4, 8 months after enrollment
measure: The Questionaire about the Process of Recovery (QPR-15)
timeFrame: 2, 4, 8, 12, 24 months after enrollment
measure: Occupational status - data extracted from The Norwegian Labour and Welfare Administration (NAV)
timeFrame: 12 and 24 months
measure: Work and Social Adjustment Scale (WSAS)
timeFrame: 2, 4, 8, 24 months after enrollment
Other outcomes:
Locations:
city: Trondheim
country: Norway
facility: Nidelv DPS, Tiller
Study officials:
affiliation: Nidelv DPS, Tiller, St.Olavs hospital
name: Jon Helle, MD
role: STUDY_CHAIR
References: