Do Consumer Providers Enhance Recovery?

NCT00781079 | Completed Results DMC

• 1 other identifier: IIR 06-227
• Study Type: interventional
• Target: 285
• Locations: 1 country
• Sites: 7

Brief Summary

Serious mental illness (SMI) is the second most costly disorder treated in the VHA, yet clinical outcomes for these patients in public sector settings are often poor due to a combination of low quality care and severe cognitive and functional impairments evidenced by this group. While these problems are multifaceted, studies outside the VHA have shown that using "consumer providers" (CPs) can improve and augment public care. Similar to recovering addiction counselors, CPs are individuals with SMI who use their lived experiences to provide services to others with SMI. CPs can reach out to patients that are difficult to engage, assist patients with tasks of daily living, offer a variety of rehabilitation (vocational, social, residential) services, be role models and offer hope for recovery, and facilitate support groups. Randomized controlled and quasi-experimental trials, all done outside the VHA, have shown that CPs can provide services that yield at least equivalent patient outcomes with particular benefits noted on intensive case management teams. Based on these successes both the President's New Freedom Commission and the Veteran Administration's Mental Health Strategic Plan call for broader dissemination of CPs as way to make mental health services more recovery-oriented, a recent national priority. Because of these recent calls, employing mentally ill veterans has just begun, although no effort has been made to evaluate their impact inside the VA mental health system. Yet its success outside the VHA and the recent emphasis on recovery-oriented care suggests the need to test this model in the VHA.

Conditions

Mental Disorder

Keywords

Organization Innovation; Opinion Leaders; Schizophrenia

Outcome Measures

Primary Outcomes (1)

• BASIS-R

  The BASIS-R is a 24 item, comprehensive instrument assessing a range of psychiatric symptoms and problems. It is valid and reliable in both inpatient and outpatient settings in populations with SMI. All items have five response options ranging from 0 to 4, with higher scores indicating more problems (range in possible scores is 0 to 96).

  immediately before the intervention (BL), and 12 months post intervention (Post).

Secondary Outcomes (5)

• Mental Health Recovery Measure (MHRM)

  immediately before the intervention (BL), and 12 months post intervention (Post).

• Patient Activation Measure

  immediately before the intervention (BL), and 12 months post intervention (Post).

• Recovery Self-Assessment: Person in Recovery Version

  immediately before the intervention (BL), and 12 months post intervention (Post)

• Illness Management and Recovery Scale: Client Self-Rating

  12 months prior to the intervention (BL1), immediately before the intervention (BL2), and 12 months post intervention (Post).

• Quality of Life Interview, Brief Version

  immediately before the intervention (BL), and 12 months post intervention (Post).

Study Arms (2)

Consumer Provider

EXPERIMENTAL

Adding a Consumer Provider to Intensive Case Management Teams (called MHICM in the VA)

Behavioral: Consumer Provider

Care as Usual

NO INTERVENTION

Care as usual

Interventions

Consumer Provider BEHAVIORAL

Adding a Consumer Provider to Intensive Case Management Teams (called MHICM in the VA)

Consumer Provider

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patient must have a Serious Mental Illness;
• Patient must be working with a VA Intensive Case Management team

You may not qualify if:

• Prior exposure to intervention; Reduced capacity;
• Patient is no longer working with a VA Intensive Case Management

Sponsors & Collaborators

• VA Office of Research and Development: lead

Study Sites (7)

VA Loma Linda Healthcare System, Loma Linda, CA

Loma Linda, California, 92357, United States

Location

VA Long Beach Healthcare System, Long Beach, CA

Long Beach, California, 90822, United States

Location

VA San Diego Healthcare System, San Diego, CA

San Diego, California, 92161, United States

Location

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

West Los Angeles, California, 90073, United States

Location

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Indianapolis, Indiana, 46202-2884, United States

Location

VA Southern Nevada Healthcare System, North Las Vegas, NV

Las Vegas, Nevada, 89106, United States

Location

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, 15240, United States

Location

Related Publications (6)

• Chinman M, Shoai R, Cohen A. Using organizational change strategies to guide peer support technician implementation in the Veterans Administration. Psychiatr Rehabil J. 2010 Spring;33(4):269-77. doi: 10.2975/33.4.2010.269.277.

  PMID: 20374985 RESULT

• Chinman M, Salzer M, O'Brien-Mazza D. National survey on implementation of peer specialists in the VA: implications for training and facilitation. Psychiatr Rehabil J. 2012 Dec;35(6):470-3. doi: 10.1037/h0094582.

  PMID: 23276242 RESULT

• Chinman M, Oberman RS, Hanusa BH, Cohen AN, Salyers MP, Twamley EW, Young AS. A cluster randomized trial of adding peer specialists to intensive case management teams in the Veterans Health Administration. J Behav Health Serv Res. 2015 Jan;42(1):109-21. doi: 10.1007/s11414-013-9343-1.

  PMID: 23657754 RESULT

• Hamilton AB, Chinman M, Cohen AN, Oberman RS, Young AS. Implementation of consumer providers into mental health intensive case management teams. J Behav Health Serv Res. 2015 Jan;42(1):100-8. doi: 10.1007/s11414-013-9365-8.

  PMID: 24091610 RESULT

• Chinman M, George P, Dougherty RH, Daniels AS, Ghose SS, Swift A, Delphin-Rittmon ME. Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatr Serv. 2014 Apr 1;65(4):429-41. doi: 10.1176/appi.ps.201300244.

  PMID: 24549400 RESULT

• Chinman M, Oberman RS, Hanusa BH, Cohen AN, Salyers MP, Twamley EW, Young AS. Erratum to: A Cluster Randomized Trial of Adding Peer Specialists to Intensive Case Management Teams in the Veterans Health Administration. J Behav Health Serv Res. 2015 Jan;42(1):122. doi: 10.1007/s11414-013-9377-4. No abstract available.

  PMID: 24217992 RESULT

Related Links

• Paper linked to the study

MeSH Terms

Conditions

Mental Disorders; Schizophrenia

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders

Limitations and Caveats

1\. cluster randomized trial - teams may have exerted influence on the findings. 2. analyses were intent-to-treat, but about half the veterans in the PS group did not receive any PS services. 3. the study involved a small number of peers (n=6)

Results Point of Contact

• Title: Matthew Chinman
• Organization: Pittsburgh VA

matthew.chinman@va.gov

412 360-2438

Study Officials

• Matthew J. Chinman, PhD

  VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

  PRINCIPAL INVESTIGATOR

• Amy N. Cohen, PhD

  VA Greater Los Angeles Healthcare System, West Los Angeles, CA

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 27, 2008
• First Posted: October 28, 2008
• Study Start: April 1, 2008
• Primary Completion: April 1, 2011
• Study Completion: January 1, 2012
• Last Updated: October 11, 2018
• Results First Posted: October 6, 2014

Record last verified: 2018-09

Locations

US (7)