Engaging Homeless Youth in Vocational Training to Meet Their Mental Health Needs

NCT03118388 | Completed Phase 2 DMC

• 1 other identifier: 1R34MH082804-01A2
• Study Type: interventional
• Target: 72
• Locations: 0 countries
• Sites: N/A

Brief Summary

This randomized controlled trial (RCT) compared the efficacy between the Social Enterprise Intervention (SEI) and Individual Placement and Support (IPS) with homeless youth with mental illness. Methods: Non-probability quota sampling sampling was used to recruit 72 homeless youth from one agency, who were randomized to the SEI (n=36) or IPS (n=36) conditions.

Conditions

Mental Disorder; Mental Health; Employment; Housing Problems; Social Support

Outcome Measures

Primary Outcomes (4)

• Change in depression between baseline and follow-up (using the Adult Self-Report)

  Depression was assessed using the Adult Self-Report (ASR) DSM-Oriented Scale for Depressive Problems, consisting of 14 items that measure related emotions and behaviors (Achenbach, 1997). Scoring profiles used normed scales for adults ages 18-35. Higher scores reflected a higher presence of emotions and behaviors. For men, raw scores between 10 and 12 (11 and 13 for women) were within the borderline clinical range, whereas scores 13 and greater (14 and greater for women) were considered in the clinical range.

  20 months

• Change in social support between baseline and follow-up (using the Adult Self-Report)

  Social support was a composite-score variable of the sum of four items on the ASR Friends Subscale. The response categories for each item range from none to 5 or more for questions including: "About how many close friends do you have?" The range of scores is from 0 to 12, with higher scores indicating greater social support for the youth.

  20 months

• Change in housing stability status between baseline and follow-up (using a 3-item self-report measure of housing status)

  Youth were asked at 20 months about their housing status (i.e., whether they had lived on the streets, in a shelter or institution \[i.e., youth or adult shelter, or detention facility, jail, or prison\], or in a private residence with family \[i.e., biological or foster\], relatives, friends, a partner, roommate or alone). Each item was dichotomous and scored as 0 = no or 1 = yes.

  20 months

• Change in self-esteem between baseline and follow-up (using the Rosenberg Self-Esteem Scale)

  Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSE; Rosenberg, 1979), a 10-question assessment of feelings about self-worth. Each item is rated using a 4-point Likert-type scale ranging from strongly disagree to strongly agree. Five items are recoded so that higher scores indicate higher levels of self-esteem. The possible range of RSE raw scores is 0 to 30. Scores between 15 and 25 are within normal range, whereas scores below 15 suggest low self-esteem.

  20 months

Study Arms (2)

36 SEI youth

EXPERIMENTAL

36 homeless youth (ages 16-24) randomized to the SEI intervention

Behavioral: Social Enterprise Intervention

36 IPS youth

EXPERIMENTAL

36 homeless youth (ages 16-24) randomized to the IPS intervention

Behavioral: IPS

Interventions

Social Enterprise Intervention BEHAVIORAL

The SEI model was implemented in four stages: 1) Vocational skill acquisition (4 months); 2) Small business skill acquisition (4 months); 3) SEI formation and product distribution (12 months); and 4) Clinical/case-management services, (ongoing for 20 months).

Also known as: SEI, social enterprise

36 SEI youth

IPS BEHAVIORAL

To implement the IPS at the host agency, one employment specialist, two case managers, and two clinicians were assigned the 22 available IPS cases among them at baseline. Over the 20 months, all IPS participants met individually with the employment specialist, one case manager, and one clinician at least weekly. Regarding job development in the community, the IPS employment specialist also spent about 40% of each week out in the community building relationships with new and existing employers.

Also known as: Individual Placement and Support, supported employment

36 IPS youth

Eligibility Criteria

• Age: 16 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Age 16-24
• English speaking
• Primary clinical diagnosis in the past year (with at least one symptom in the past 4 weeks) using the DISC-Y interview for one of six mental illnesses (i.e., Major Depressive Episode, Mania/ Hypomania, Generalized Anxiety, Post-traumatic Stress Disorder, Conduct Disorder, and Alcohol/Substance Use Disorders
• Desire to work.

You may not qualify if:

• None

Sponsors & Collaborators

• Arizona State University: lead
• University of Southern California: collaborator

MeSH Terms

Conditions

Mental Disorders; Psychological Well-Being

Interventions

Palliative Care; Employment, Supported

Condition Hierarchy (Ancestors)

Personal Satisfaction; Behavior

Intervention Hierarchy (Ancestors)

Patient Care; Therapeutics; Health Services; Health Care Facilities Workforce and Services; Employment; Socioeconomic Factors; Population Characteristics; Rehabilitation, Vocational; Rehabilitation

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: The SEI model was implemented in four stages: 1) Vocational skill acquisition (4 months); 2) Small business skill acquisition (4 months); 3) SEI formation and product distribution (12 months); and 4) Clinical/case-management services, (ongoing for 20 months). The eight IPS principles were implemented over 20 months by an employment specialist, clinician, and case manager.

Study Record Dates

• First Submitted: April 6, 2017
• First Posted: April 18, 2017
• Study Start: September 18, 2009
• Primary Completion: August 31, 2011
• Study Completion: August 31, 2011
• Last Updated: April 18, 2017

Record last verified: 2017-04

Data Sharing

• IPD Sharing: Will not share