Kvestad Camilla Angelsen, Holte Ingvild Rønneberg, Reitan Solveig Klæbo, Chiappa Charlotte S, Helle Gunn Karin, Skjervold Anne E, Rosenlund Anne Marit A, Watne Øyvind, Brattland Heidi, Helle Jon, Follestad Turid, Hara Karen Walseth, Holgersen Katrine Høyer
Nidelv Community Mental Health Center, Clinic of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.
Trials. 2024 Mar 11;25(1):179. doi: 10.1186/s13063-024-08028-6.
Referrals to specialised mental health care (such as community mental health centres; CMHC) have increased over the last two decades. Patients often have multifaceted problems, which cannot only be solved by such care. Resources are limited, and triaging is challenging. A novel method which approaches patients early and individually upon referral to a CMHC-possibly with a brief intervention-is an Early assessment Team (EaT). In an EaT, two therapists meet the patient early in the process and seek to solve the present problem, often involving community services, primary health care, etc.; attention is paid to symptoms and functional strife, rather than diagnoses. This is in contrast to treatment as usual (TAU), where the patient (after being on a waiting list) meets one therapist, who focuses on history and situation to assign a diagnosis and eventually start a longitudinal treatment. The aim of this study is to describe and compare EaT and TAU regarding such outcomes as work and social adjustment, mental health, quality of life, use of health services, and patient satisfaction. The primary outcome is a change in perceived function from baseline to 12-month follow-up, measured by the Work and Social Adjustment Scale.
Patients (18 years and above; n = 588) referred to outpatient health care at a CMHC are randomised to EaT or TAU. Measures (patient self-reports and clinician reports, patients' records, and register data) are collected at baseline, after the first and last meeting, and at 2, 4, 8, 12, and 24 months after inclusion. Some participants will be invited to participate in qualitative interviews.
The study is a single-centre, non-blinded, RCT with two conditions involving a longitudinal and mixed design (quantitative and qualitative data).
This study will examine an intervention designed to determine early on which patients will benefit from parallel or other measures than assessment and treatment in CMHC and whether these will facilitate their recovery. Findings may potentially contribute to the development of the organisation of mental health services.
ClinicalTrials.gov NCT05087446. Registered on 21 October 2021.
在过去二十年中，转介至专门心理健康护理机构（如社区心理健康中心；CMHC）的情况有所增加。患者通常存在多方面问题，仅靠此类护理无法解决。资源有限，进行分诊具有挑战性。一种在患者转介至CMHC时尽早且单独接触患者的新方法——可能辅以简短干预——是早期评估团队（EaT）。在EaT中，两名治疗师在过程早期与患者会面，试图解决当前问题，通常涉及社区服务、初级卫生保健等；关注的是症状和功能冲突，而非诊断。这与常规治疗（TAU）不同，在常规治疗中，患者（在等候名单上之后）与一名治疗师会面，该治疗师专注于病史和情况以进行诊断并最终开始长期治疗。本研究的目的是描述和比较EaT和TAU在工作和社会适应、心理健康、生活质量、卫生服务利用及患者满意度等方面的结果。主要结局是通过工作和社会适应量表测量的从基线到12个月随访时感知功能的变化。
转介至CMHC接受门诊医疗护理的患者（18岁及以上；n = 588）被随机分配至EaT或TAU。在基线、首次和末次会面后以及纳入后的2、4、8、12和24个月收集测量数据（患者自我报告和临床医生报告、患者记录及登记数据）。部分参与者将被邀请参加定性访谈。
该研究是一项单中心、非盲、随机对照试验，有两种情况，涉及纵向和混合设计（定量和定性数据）。
本研究将考察一种干预措施，旨在早期确定哪些患者将从CMHC的并行或除评估和治疗之外的其他措施中获益，以及这些措施是否会促进他们的康复。研究结果可能有助于心理健康服务组织的发展。
ClinicalTrials.gov NCT05087446。于2021年10月21日注册。
