Implementation of a Social and Mental Health Support to Promote Recovery in Five Mental Health Facilities in Paris Area

Versailles Hospital300 enrolled

Overview

Prospective longitudinal uncontrolled multicenter study, with cohort follow-up, focusing on patients, professionals, relatives and structures evolution during the implementation of recovery based intervention.

This is a hybrid efficacy-implementation Type I recovery based interventional study based on a multicenter follow-up of a cohort of 300 patients with severe and persistent mental disorders (60 patients per center). The evolution of concepts and means of evaluation now allow a precise description of the mechanisms of recovery in all the diversity of its expression among patients, their entourages and the psychiatric facilities. In the present study, the investigators aim to characterize simultaneously the patients' trajectories and the evolution of the care facilities and their professionals with respect to the principles of recovery. This double exploration should allow to build theoretical and practical references for the extension of this approach to other centers in France. The study considers a dual timeline for data collection: * The timeline associated with patients defined by the inclusion of each patient and extending to 24 months after, punctuated by an assessment at 12 months; * The timeline of the inclusion centers and professionals involved in the rehabilitation projects defined by the beginning of the study and extending beyond the end of inclusion of the last patient, punctuated by annual intermediate evaluations of the means allocated by the structure and the positioning of the personnel in terms of recovery. The intervention consists in a follow-up of the patients and their relatives by a psychiatric nurse and a social worker during 12 months. Both professionals, trained to rehabilitation and recovery principles, will focus on the patient's needs and goals in order to improve the outcome, quality-of-life and clinical status.

Study Type

INTERVENTIONAL

Allocation

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

300

Conditions

Severe Mental Disorder

Interventions

Patient group/PassversBEHAVIORAL

Passvers intervention aims at : * helping patients followed in the centers, presenting a Severe and Persistent Mental Disorder (schizophrenia, mood disorder, autism spectrum disorder, etc.), at risk or in a situation of psychological disability, to enroll in a rehabilitation program towards recovery. * supporting the emergence and construction of projects by the people themselves, and to accompany them to realize them. * Encouraging the use of resources in their environment and common law mechanisms (city hall, department, associations, etc.) for better social integration. * encouraging involvement in care understood as useful tools for the realization of the personal project. Passvers also aims at : * promoting a change in professional practices within the team, in favor of recovery-oriented practices based on the concept of engagement or empowerment. * allowing cooperation between health and social structures aiming at destigmatizing mental illness.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Presence of a severe and persistent mental disorder among the following ICD10 compliant diagnostic categories: * Schizophrenia spectrum disorder (F2x) * Recurrent or persistent mood disorders (F30.x, F31.x, F33.x, F34.x, F38.x) * Psychological developmental disorders including autism spectrum disorders (F8x) and childhood and adolescent onset disorders (F9x) * Presence of an indication for inclusion in the rehabilitation project identified by the treating psychiatrist and endorsed in the inclusion session by the PASSVers staff. * Written consent from the patient or his/her legal representative to participate in the study. Exclusion Criteria: * Presence of an not stabilized or progressive organic neurological pathology, neurodegenerative disease * Psychological or behavioral disorders mainly related to addictions with substances * Psychiatric disorders secondary to an organic pathology that is not stabilized or that is evolving * The following psychiatric situations are reasons for non-inclusion in the absence of an argued and collegial reassessment (the reason being that, although PASSVers2 must be considered as a first intention proposal in many situations meeting the inclusion criteria, it cannot intervene or be thought of as a "solution" to certain complex situations): * Psychiatric disorders caused by pregnancy or immediate postpartum * Severe borderline personality disorder * Current suicidal crisis * Extreme fragility of the patient with respect to changes that may be induced by the project, associated with a high risk of self or hetero-aggression. * Patient under justice constraint * Foreseeable departure from the geographic area, not allowing for certainty of further evaluation * Refusal of the patient to be followed by a social-health team (i.e. refusal of care or refusal of a dialogue on social aspects and projects).

Locations (5)

Centre Hospitalier d'Argenteuil, secteurs 95G05, 95G06, 95G13,

Argenteuil, France

Hôpital Sainte Anne - GHU Paris Psychiatrie & Neurosciences, secteur G75015

Paris, France

Centre Hospitalier de Plaisir, secteur 78G16, CMP de Rambouillet

Rambouillet, France

Etablissement de Santé Mentale de Rueil-Malmaison, Groupe MGEN, secteur 92G13, CMP de Rueil-Malmaison

Rueil-Malmaison, France

Outcomes

Primary Outcomes

Patient self rating of recovery support by caregivers T0

5-item short version of INSPIRE measure (Brief INSPIRE), range from 5 to 25, 25 corresponds to maximal support

Time frame: baseline

Patient self rating of recovery support by caregivers T12

5-item short version of INSPIRE measure (Brief INSPIRE), range from 5 to 25, 25 corresponds to maximal support

Time frame: 1 year

Patient self rating of recovery support by caregivers and structure T0

Recovery Self-Assessment (RSA-R), range from 32 to 160, higher values correspond to more perceived help

Time frame: baseline

Patient self rating of recovery support by caregivers and structure T12

Recovery Self-Assessment (RSA-R), range from 32 to 160, higher values correspond to more perceived help

Time frame: 1 year

Patient functioning T0

Personal and Social Performance scale (PSP), range 0-100, 100 corresponds to better functioning

Time frame: baseline

Patient functioning T12

Personal and Social Performance scale (PSP), range 0-100, 100 corresponds to better functioning

Time frame: 1 year

Patient functioning T24

Personal and Social Performance scale (PSP), range 0-100, 100 corresponds to better functioning

Time frame: 2 years

Patient self rating of quality of life T0

Shortened quality of life questionnaire (SQoL-18), range 18-90, higher values correspond to better quality of life

Central Contacts

Virginie Bulot, MD

CONTACT

33 1 39 63 90 11 vbulot@ch-versailles.fr

Eric Brunet-Gouet, MD PhD

CONTACT

ebrunet@ch-versailles.fr

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.

Secondary Outcomes

Professional's Recovery knowledge on patients T0

Recovery knowledge inventory (RKI), range 20-100, higher values correspond to better knowledge on recovery processes

Time frame: baseline

Professional's Recovery knowledge on patients T12

Recovery knowledge inventory (RKI), range 20-100, higher values correspond to better knowledge on recovery processes

Time frame: 1 year

Professional's Recovery opinions on patients T0

Practitioners' Beliefs, Goals and Practices in Psychiatric Rehabilitation (PBGP), range 26-104, higher values correspond to better views on patients recovery

Time frame: baseline

Professional's Recovery opinions on patients T12

Practitioners' Beliefs, Goals and Practices in Psychiatric Rehabilitation (PBGP), range 26-104, higher values correspond to better views on patients recovery

Time frame: 1 year

Stigmatization T0

Internalized stigma of mental illness: self-stigma (ISMI), range 29-116, higher values correspond to worse stigmatization perception

Time frame: baseline

Stigmatization T12

Internalized stigma of mental illness: self-stigma (ISMI), range 29-116, higher values correspond to worse stigmatization perception

Time frame: 1 year

Perceived needs T0

Perceived needs scale (ELADEB), Composite measure of perceived difficulty in meeting needs and needs of help

Time frame: baseline

Perceived needs T12

Perceived needs scale (ELADEB), Composite measure of perceived difficulty in meeting needs and needs of help

Time frame: 1 year

Goal achievement T12

Goal achievement scale (GAS), range -2 to +2, higher values correspond to better achievement of one specific goal

Time frame: 1 year

Metacognitive strategies T0

Versailles Metacognitive Strategies Evaluation Questionnaire (V-MSEQ), range 25-175, higher values correspond to better metacognitive strategies

Time frame: baseline

Sleep T0

Patient self rating of sleep (1 item Pittsburgh sleep quality index PSQI), range 1-4, lower values correspond to better sleep quality

Time frame: baseline

Sleep T12

Patient self rating of sleep (1 item Pittsburgh sleep quality index PSQI), range 1-4, lower values correspond to better sleep quality

Time frame: 1 year

Medication adherence T0

Medication Adherence Rating Scale (MARS), range 5-25, lower values correspond to better adherence to treatment

Time frame: baseline

Medication adherence T12

Medication Adherence Rating Scale (MARS), range 5-25, lower values correspond to better adherence to treatment

Time frame: 1 year

Illness severity T0

Clinical Global Impressions Scale (CGI-S), range 1-7, higher values correspond to more severe illness

Time frame: baseline

Illness severity T12

Clinical Global Impressions Scale (CGI-S), range 1-7, higher values correspond to more severe illness

Time frame: 1 year

Cognitive disability T0

Cognitive processes involved in disability in schizophrenia scale (CPSD), range 0-78, higher values correspond to better cognitive functioning

Time frame: baseline

Cognitive disability T12

Cognitive processes involved in disability in schizophrenia scale (CPSD), range 0-78, higher values correspond to better cognitive functioning

Time frame: 1 year

Entourage assessment of structure recovery orientation T0

Recovery Self-Assessment Significant other version (RSA-R entourage), range 40-200, higher values correspond to better recovery orientation

Time frame: baseline

Entourage assessment of structure recovery orientation T12

Recovery Self-Assessment Significant other version (RSA-R entourage), range 40-200, higher values correspond to better recovery orientation

Time frame: 1 year