A digital intake approach in specialized mental health care: study protocol of a cluster randomised controlled trial

Metz, Margot J.; Elfeddali, Iman; Krol, David G. H.; Veerbeek, Marjolein A.; Beurs, Edwin de; Beekman, Aartjan T.F.; Feltz-Cornelis, Christina M. van der

doi:10.1186/s12888-017-1247-9

Cited by 5 publications

(9 citation statements)

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“…In this study, the application of SDM-Digital Intake (SDM-DI) was compared with the Intake As Usual (IAU). The design of this study has been described in more detail elsewhere [ 16 ]. The trial is registered in the Dutch trial register with number: NTR5677, registration date: 17 January 2016 ( http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5677 ).…”

Section: Methodsmentioning

confidence: 99%

“…The intervention is briefly described below. A comprehensive description can be found elsewhere [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…We used the following validated self-report questionnaires to measure the secondary outcomes: Patient Participation Questionnaire (PPQ) [ 16 ], the patients’ and clinicians’ versions of the Shared Decision Making-Questionnaire-9 (SDM-Q-9) [ 23 ], Patient-Doctor Relationship Questionnaire-9 (working alliance) [ 24 ] and Symptom Questionnaire-48 (SQ-48) [ 25 , 26 ]. The Cronbach’s alphas of the total scores of these secondary outcome questionnaires in this study population were good (PPQ α = .90; SDM-Q-9 patient α = .95; SDM-Q-9 clinician α = .86; PDRQ-9 α = .97; SQ-48 α = .93).…”

Section: Methodsmentioning

confidence: 99%

“…The Cronbach’s alphas of the total scores of these secondary outcome questionnaires in this study population were good (PPQ α = .90; SDM-Q-9 patient α = .95; SDM-Q-9 clinician α = .86; PDRQ-9 α = .97; SQ-48 α = .93). At the end of the study, patients received an additional question about the extent to which they achieved their personal treatment goals [ 16 ]. Finally, treatment adherence was assessed by the number of missed appointments (no-shows) and patients who did not want to proceed with treatment (treatment drop out) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

“…To stimulate the shift towards SDM from the start of treatment, GGz Breburg, a specialist mental health organisation in the southern part of the Netherlands, invested in the development and implementation of a novel multi-facetted digital SDM intervention in the intake process [ 16 ]. This intervention, called SDM-Digital Intake (SDM-DI), consisted of a blended eHealth intervention integrated with the initial Routine Outcome Measurement (ROM), peer workers support and clinicians’ training.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a multi-facetted blended eHealth intervention during intake supporting patients and clinicians in Shared Decision Making: A cluster randomised controlled trial in a specialist mental health outpatient setting

et al. 2018

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ObjectiveTo investigate the effectiveness of a multi-facetted blended eHealth intervention, called SDM-Digital Intake (SDM-DI), in which patients and clinicians are supported in Shared Decision Making during the intake process.MethodsThe study is a two-arm matched-paired cluster Randomised Controlled Trial in a specialist mental health outpatient setting with two conditions: SDM-DI and Intake As Usual (IAU). Four intake teams were allocated to each arm. All patients who followed an intake, were asked to participate if they were capable to complete questionnaires. Decisional Conflict (DC), referring to patients’ engagement and satisfaction with clinical decisions, was the primary outcome. Secondary outcomes were patient participation, applying Shared Decision Making (SDM), working alliance, treatment adherence and symptom severity. Effects were measured at two weeks (T1) and two months (T2) after intake. Multilevel regression and intention-to-treat analyses were used. Additionally, the influence of subgroups and intervention adherence on DC were explored.ResultsAt T1, 200 patients participated (47% intervention, 53% control), and at T2 175 patients (47% intervention, 53% control). At T1 and T2, no differences were found between conditions on DC. Subgroup analyses showed that effects of SDM-DI on DC were not modified by primary diagnoses mood, anxiety and personality disorders. Compared to IAU, at T2, patients reported positive effects of SDM-DI on SDM (β 7.553, p = 0.038, 95%CI:0.403–14.703, d = 0.32) and reduction of symptoms (β -7.276, p = 0.0497, 95%CI:-14.544–-0.008, d = -0.43). No effects were found on patient participation, working alliance and treatment adherence. Exploratory analyses demonstrated that if SDM was applied well, patients reported less DC (β = -0.457, p = 0.000, 95%CI:-0.518–-0.396, d = -1.31), which was associated with better treatment outcomes.ConclusionAlthough, this trial fails to demonstrate that SDM-DI by itself is sufficient to reduce DC, the results are encouraging for further efforts in improving and implementing the SDM intervention.

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Section: Methodsmentioning

confidence: 99%

“…The intervention is briefly described below. A comprehensive description can be found elsewhere [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effectiveness of a multi-facetted blended eHealth intervention during intake supporting patients and clinicians in Shared Decision Making: A cluster randomised controlled trial in a specialist mental health outpatient setting

et al. 2018

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Connected Mental Health: Systematic Mapping Study

Drissi¹,

Ouhbi²,

Idrissi³

et al. 2020

J Med Internet Res

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Background Although mental health issues constitute an increasing global burden affecting a large number of people, the mental health care industry is still facing several care delivery barriers such as stigma, education, and cost. Connected mental health (CMH), which refers to the use of information and communication technologies in mental health care, can assist in overcoming these barriers. Objective The aim of this systematic mapping study is to provide an overview and a structured understanding of CMH literature available in the Scopus database. Methods A total of 289 selected publications were analyzed based on 8 classification criteria: publication year, publication source, research type, contribution type, empirical type, mental health issues, targeted cohort groups, and countries where the empirically evaluated studies were conducted. Results The results showed that there was an increasing interest in CMH publications; journals were the main publication channels of the selected papers; exploratory research was the dominant research type; advantages and challenges of the use of technology for mental health care were the most investigated subjects; most of the selected studies had not been evaluated empirically; depression and anxiety were the most addressed mental disorders; young people were the most targeted cohort groups in the selected publications; and Australia, followed by the United States, was the country where most empirically evaluated studies were conducted. Conclusions CMH is a promising research field to present novel approaches to assist in the management, treatment, and diagnosis of mental health issues that can help overcome existing mental health care delivery barriers. Future research should be shifted toward providing evidence-based studies to examine the effectiveness of CMH solutions and identify related issues.

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Digital Interventions to Enhance Readiness for Psychological Therapy: Scoping Review

Jardine¹,

Bowman²,

Doherty³

2022

J Med Internet Res

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Background Psychological therapy is an effective treatment method for mental illness; however, many people with mental illness do not seek treatment or drop out of treatment early. Increasing client uptake and engagement in therapy is key to addressing the escalating global problem of mental illness. Attitudinal barriers, such as a lack of motivation, are a leading cause of low engagement in therapy. Digital interventions to increase motivation and readiness for change hold promise as accessible and scalable solutions; however, little is known about the range of interventions being used and their feasibility as a means to increase engagement with therapy. Objective This review aimed to define the emerging field of digital interventions to enhance readiness for psychological therapy and detect gaps in the literature. Methods A literature search was conducted in PubMed, PsycINFO, PsycARTICLES, Scopus, Embase, ACM Guide to Computing Literature, and IEEE Xplore Digital Library from January 1, 2006, to November 30, 2021. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) methodology was applied. Publications were included when they concerned a digitally delivered intervention, a specific target of which was enhancing engagement with further psychological treatment, and when this intervention occurred before the target psychological treatment. Results A total of 45 publications met the inclusion criteria. The conditions included depression, unspecified general mental health, comorbid anxiety and depression, smoking, eating disorders, suicide, social anxiety, substance use, gambling, and psychosis. Almost half of the interventions (22/48, 46%) were web-based programs; the other formats included screening tools, videos, apps, and websites. The components of the interventions included psychoeducation, symptom assessment and feedback, information on treatment options and referrals, client testimonials, expectation management, and pro-con lists. Regarding feasibility, of the 16 controlled studies, 7 (44%) measuring actual behavior or action showed evidence of intervention effectiveness compared with controls, 7 (44%) found no differences, and 2 (12%) indicated worse behavioral outcomes. In general, the outcomes were mixed and inconclusive owing to variations in trial designs, control types, and outcome measures. Conclusions Digital interventions to enhance readiness for psychological therapy are broad and varied. Although these easily accessible digital approaches show potential as a means of preparing people for therapy, they are not without risks. The complex nature of stigma, motivation, and individual emotional responses toward engaging in treatment for mental health difficulties suggests that a careful approach is needed when developing and evaluating digital readiness interventions. Further qualitative, naturalistic, and longitudinal research is needed to deepen our knowledge in this area.

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A digital intake approach in specialized mental health care: study protocol of a cluster randomised controlled trial

Cited by 5 publications

References 62 publications

Effectiveness of a multi-facetted blended eHealth intervention during intake supporting patients and clinicians in Shared Decision Making: A cluster randomised controlled trial in a specialist mental health outpatient setting

Effectiveness of a multi-facetted blended eHealth intervention during intake supporting patients and clinicians in Shared Decision Making: A cluster randomised controlled trial in a specialist mental health outpatient setting

Connected Mental Health: Systematic Mapping Study

Digital Interventions to Enhance Readiness for Psychological Therapy: Scoping Review

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