Youth psychotherapy change trajectories and outcomes in usual care: Community mental health versus managed care settings.

2010 ◽  
Vol 78 (2) ◽  
pp. 144-155 ◽  
Author(s):  
Jared S. Warren ◽  
Philip L. Nelson ◽  
Sasha A. Mondragon ◽  
Scott A. Baldwin ◽  
Gary M. Burlingame
Keyword(s):  
Mental Health ◽  
Managed Care ◽  
Community Mental Health ◽  
Usual Care ◽  
Change Trajectories ◽  
Care Community ◽  
Youth Psychotherapy

scholarly journals Effectiveness of embedding a specialist preventive care clinician in a community mental health service in increasing preventive care provision: A randomised controlled trial

2020 ◽  
Vol 54 (6) ◽  
pp. 620-632
Author(s):  
Caitlin MC Fehily ◽  
Kate M Bartlem ◽  
John H Wiggers ◽  
Paula M Wye ◽  
Richard V Clancy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Community Mental Health ◽  
Health Service ◽  
Confidence Interval ◽  
Usual Care ◽  
Preventive Care ◽  
Risk Ratio ◽  
Community Mental Health Service ◽  
Risk Behaviours

Objective: Clinical practice guidelines recommend that community mental health services provide preventive care for clients’ chronic disease risk behaviours; however, such care is often not routinely provided. This study aimed to assess the effectiveness of offering clients an additional consultation with a specialist clinician embedded within a community mental health service, in increasing client-reported receipt of, and satisfaction with, preventive care. Method: A randomised controlled trial was undertaken in one Australian community mental health service. Participants ( N = 811) were randomised to receive usual care (preventive care in routine consultations; n = 405) or usual care plus the offer of an additional consultation with a specialist preventive care clinician ( n = 406). Blinded interviewers assessed at baseline and 1-month follow-up the client-reported receipt of preventive care (assessment, advice and referral) for four key risk behaviours individually (smoking, poor nutrition, alcohol overconsumption and physical inactivity) and all applicable risks combined, acceptance of referrals and satisfaction with preventive care received. Results: Analyses indicated significantly greater increases in 12 of the 18 preventive care delivery outcomes in the intervention compared to the usual care condition from baseline to follow-up, including assessment for all risks combined (risk ratio = 4.00; 95% confidence interval = [1.57, 10.22]), advice for all applicable risks combined (risk ratio = 2.40; 95% confidence interval = [1.89, 6.47]) and offer of referral to applicable telephone services combined (risk ratio = 20.13; 95% confidence interval = [2.56, 158.04]). For each component of care, there was a significant intervention effect for at least one of the individual risk behaviours. Participants reported high levels of satisfaction with preventive care received, ranging from 77% (assessment) to 87% (referral), with no significant differences between conditions. Conclusion: The intervention had a significant effect on the provision of the majority of recommended elements of preventive care. Further research is needed to maximise its impact, including identifying strategies to increase client uptake.

Youth Psychotherapy Change Trajectories and Early Warning System Accuracy in a Managed Care Setting

2013 ◽  
Vol 69 (9) ◽  
pp. 880-895 ◽  
Author(s):  
Philip L. Nelson ◽  
Jared S. Warren ◽  
Robert L. Gleave ◽  
Gary M. Burlingame
Keyword(s):  
Managed Care ◽  
Early Warning ◽  
Early Warning System ◽  
Care Setting ◽  
Warning System ◽  
Change Trajectories ◽  
Youth Psychotherapy

scholarly journals Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT

2019 ◽  
Vol 23 (65) ◽  
pp. 1-136 ◽  
Author(s):  
Elizabeth Hughes ◽  
Natasha Mitchell ◽  
Samantha Gascoyne ◽  
Thirimon Moe-Byrne ◽  
Amanda Edmondson ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Illness ◽  
Community Mental Health ◽  
Sexual Health ◽  
Usual Care ◽  
Serious Mental Illness ◽  
Sexual Behaviour ◽  
Health Technology ◽  
Randomised Controlled

Background People with serious mental illness have sexual health needs, but there is limited evidence regarding effective interventions to promote their sexual health. Objectives To develop a sexual health promotion intervention for people with serious mental illness, and to conduct a feasibility trial in order to establish the acceptability and parameters for a fully powered trial. Design A two-armed randomised controlled, open feasibility study comparing usual care alone with usual care plus the adjunctive intervention. Setting Five community mental health providers in Leeds, Barnsley, Brighton and London. Participants Adults aged ≥ 18 years with serious mental illness and receiving care from community mental health teams. Interventions A remote, web-based computer randomisation system allocated participants to usual care plus the RESPECT (Randomised Evaluation of Sexual health Promotion Effectiveness informing Care and Treatment) intervention (three sessions of 1 hour) (intervention arm) or usual care only (control arm). The intervention was an interactive manualised package of exercises, quizzes and discussion topics focusing on knowledge, motivation and behavioural intentions to adopt safer sexual behaviours. Main outcome measures Feasibility parameters including establishing the percentage of people who were eligible, consented and were retained in each arm of the trial, retention for the intervention, as well as the completeness of the data collection. Data were collected on knowledge, motivation to adopt safer sexual behaviour, sexual behaviour, sexual stigma, sexual health service use and quality of life. Data were collected at baseline and then at 3 months and 6 months post randomisation. Results Of a target of 100 participants, 72 people participated in the trial over 12 months. Of the 36 participants randomised to the intervention arm, 27 received some of the intervention (75.0%). At 3 months, 59 of the 72 participants completed follow-up questionnaires (81.9%) (30 participants from the intervention arm and 29 participants from the control arm). Only the first 38 participants were followed up at 6 months. However, data were collected on 29 out of 38 participants (76.3% retention): 13 in the intervention arm and 16 in the control arm. No adverse events were reported. Participant feedback confirmed that both the design and the intervention were acceptable. The economic analysis indicated high completion rates and completeness of data among participants who continued the trial. Conclusions Despite the limitations, the findings suggest that it is both acceptable and feasible to undertake a sexual health promotion study for people with serious mental illness. Future work A fully powered randomised controlled trial would be required to establish the clinical effectiveness of the intervention. Trial registration Current Controlled Trials ISRCTN15747739. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 65. See the NIHR Journals Library website for further project information.

Community Mental Health Centers under Managed Care

1999 ◽  
Vol 59 (4) ◽  
pp. 367
Author(s):  
Keon S. Chi ◽  
Pamela Diamond ◽  
David Warner ◽  
Patrick Wong
Keyword(s):  
Mental Health ◽  
Managed Care ◽  
Community Mental Health ◽  
Health Centers ◽  
Community Mental Health Centers ◽  
Mental Health Centers
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