Peer Supported Collaborative Care Mental Health and Substance Use Disorder Care

N/AActive Not RecruitingNCT04601064

Johns Hopkins University405 enrolled

Overview

This is a research study to assess the effectiveness of a peer-led collaborative care model for integrating treatment for substance use and or mental health disorders into HIV care settings. Depending on whether or not participants enroll in this study, participants will be assigned randomly (by chance, like drawing a number from a hat) to one of two groups. In group 1, participants would receive usual clinical care. In group 2, participants would work with a peer-case manager who would help support participants to engage in substance use or mental health disorder care. Regardless of the group participants are in, participants will fill out a survey when first enrolled in the study, and then again 12 months later.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

405

Conditions

HIV Infections Substance Use Disorders Mental Health Disorder Addiction

Interventions

Collaborative Care ModelBEHAVIORAL

Collaborative care (CC) is an evidence-based model of integrated mental health and substance use disorder care endorsed by the American Psychiatric Association for the integration of mental health and substance use disorder care into primary care settings. CC includes the following components: 1) A collaborative care team of multidisciplinary health care providers consisting of the primary physician, a care manager and a consulting psychiatrist, providing care in a coordinated fashion; 2) A population focus with the team working together to provide care and continuously measure and track health outcomes of a defined population of patients; 3) A measurement-guided approach with systematic use of disease specific patient reported outcome measures, such as symptom rating scales like the PHQ-9 to drive clinical decision making; and 4) Evidence-based practices with the team adapting scientifically proven treatments within an individual clinical context to achieve improved health outcomes.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Individuals 18-99 years old * accessing HIV care at the Bartlett HIV clinic * Screened positive for a Mental health disorder or substance use disorder based on a computerized self-administered screen with Patient Health Questionnaire (PHQ-9)(score\>10), General Anxiety Disorder (GAD-7) (score\>10), National Institute on Drug Abuse Drug Use Screening Tool: 3 Question Quick Screen (Response of "Yes" to one or more heavy drinking days or "Yes" to use of illegal drugs or prescription drugs for non-medical reasons. * Does not currently have a Mental Health or Substance Use Disorder treatment provider and or not receiving any current treatment (psychotherapy or pharmacotherapy) for Mental Health or Substance Use Disorder. * English speaking Exclusion Criteria: • Individuals lacking the capacity to consent

Outcomes

Primary Outcomes

The Number of Participants with HIV Virologic Suppression

This is defined as a viral load \< 200 copies/ml

Time frame: Within a 3 month window of the 12 month follow-up (i.e. 3 months before or after the 12 month follow up)

Secondary Outcomes

Number of Participants with Retention in HIV Care

At least 2 medical visit dates, specifically for HIV care, that are at least 90 days apart

Time frame: Within 12 months of patient entrance into the study

Number of Participants Who Obtain Treatment for Mental Health and Substance Use Disorder

Receipt of evidence-based treatment for Mental Health and Substance Use Disorder, including medication and brief psychotherapy

Time frame: Within 12 month of patient entrance into the study

Number of Participants with Change in Severity of Mental Health and Substance Use Disorder

The following changes in Mental Health and Substance Use Disorder outcomes from baseline to 12 month follow up: Depression- 50% reduction in PHQ 9, Anxiety- 50% reduction in GAD 7, Bipolar Disorder- 50% reduction in Altman Mania Scores, PTSD- 50% reduction in PTSD Checklist 5, and Substance Use Disorder- 50% reduction in severity of dependence scale score

Time frame: Changes from baseline to 12 month follow up