Illness Management and Recovery for Veterans With Severe Mental Illness
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Purpose
The President's New Freedom Commission on Mental Health has called for a transformation of the mental health system to partner with consumers of those services in delivering effective interventions focused on recovery, and the Department of Veterans Affairs (VA) has developed a Mental Health Strategic Plan to address these recommendations. One promising approach is to implement Illness Management and Recovery (IMR), a structured curriculum to help mental health consumers manage their illnesses and pursue goals related to recovery from mental illness.
IMR was developed from a review of effective approaches for illness self-management training in persons with severe mental illness. The 9-month curriculum is taught using motivational, educational, and cognitive-behavioral techniques, and incorporates five evidence-based practices: education about mental illness, strategies for increasing medication adherence, skills training to enhance social support, relapse prevention planning, and coping skills training. The program was developed for widespread dissemination and includes a manual, worksheets, an introductory video, a clinical training video, a fidelity scale, and informational brochures for consumers, family members, clinicians, and administrators.
| Condition | Intervention |
|---|---|
|
Schizophrenia Schizo-affective Disorder |
Behavioral: Illness Management and Recovery Training |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Illness Management and Recovery for Veterans With Severe Mental Illness |
- Illness Management Ratings, Patient Activation, Functioning Level, Perceived Recovery [ Time Frame: 18 months ] [ Designated as safety issue: No ]
- Psychiatric symptoms, substance abuse, hope, employment, independent living [ Time Frame: 18 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 124 |
| Study Start Date: | January 2008 |
| Estimated Study Completion Date: | March 2013 |
| Primary Completion Date: | April 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Arm 1
Receives IMR groups once a week for 9 months in addition to care as usual.
|
Behavioral: Illness Management and Recovery Training
a structured curriculum to help mental health consumers manage their illnesses and pursue goals related to recovery from mental illness
Other Name: Experimental group is the IMR training program; the Control group is a weekly support group
|
|
Placebo Comparator: Arm 2
Receives support groups once a week for 9 months in addition to care as usual.
|
Behavioral: Illness Management and Recovery Training
a structured curriculum to help mental health consumers manage their illnesses and pursue goals related to recovery from mental illness
Other Name: Experimental group is the IMR training program; the Control group is a weekly support group
|
Detailed Description:
Background:
The President's New Freedom Commission on Mental Health has called for a transformation of the mental health system to partner with consumers of those services in delivering effective interventions focused on recovery, and the Department of Veterans Affairs (VA) has developed aMental Health Strategic Plan to address these recommendations. One promising approach is to implement Illness Management and Recovery (IMR), a structured curriculum to help mental health consumers manage their illnesses and pursue goals related to recovery from mental illness.
IMR was developed from a review of effective approaches for illness self-management training in persons with severe mental illness. The 9-month curriculum is taught using educational, motivational, and cognitive-behavioral techniques, and incorporates five evidence-based practices: education about mental illness, strategies for increasing medication adherence, skills training to enhance social support, relapse prevention planning, and coping skills training. The program was developed for widespread dissemination and includes a manual, worksheets, an introductory video, a clinical training video, a fidelity scale, and informational brochures for consumers, family members, clinicians, and administrators.
Objective:
Although IMR is based on practices shown to be effective in controlled research, effectiveness of the comprehensive package of IMR has not yet been demonstrated in a randomized, controlled trial. The primary aim of the proposed research is to test the effectiveness of IMR as an implementation package. Our primary focus is to examine the impact of IMR intervention on consumer outcomes related to illness self-management and recovery.
Methods:
This is a randomized, controlled trial comparing IMR to usual mental health treatment, with an attention-control group in 200 veterans with schizophrenia spectrum disorders. Assessment will include semi-structured interviews and standardized measures at baseline, 9 months, and 18 months to assess illness self-management (e.g., symptoms), objective indicators of recovery (e.g., role functioning), and subjective indicators of recovery (e.g., perceptions of well-being). Electronic medical records will be accessed to determine the impact of IMR on other service utilization and costs.
Impact:
The proposed study directly addresses a stated need in the VA's Mental Health Strategic Plan and is a critical first step to systematically evaluating the effectiveness of a comprehensive, manual-based approach to improving recovery outcomes for veterans with severe mental illness. As an implementation package, IMR offers mental health providers useful tools that could be widely disseminated across the VA system.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Currently receiving (or newly admitted to) mental health services from any mental health treatment programs at the Roudebush VAMC or Midtown Community Mental Health Center in Indianapolis, IN
- Age 18 or older
- SCID-confirmed diagnosis of schizophrenia or schizoaffective disorder
- Stated interest in learning more about their illness
- Willing and able to give informed consent
Exclusion Criteria:
- Severe medical condition that would limit participation in an 18-month study (e.g., end stage renal disease, metastatic cancer, life expectancy less than 18 months; if participant is unsure, with permission will contact primary physician)
- Evidence of dementia or severe cognitive dysfunction on cognitive screener
Contacts and Locations| United States, Indiana | |
| Richard Roudebush VA Medical Center | |
| Indianapolis, Indiana, United States, 46202-2884 | |
| Principal Investigator: | Michelle P Salyers, MS PhD | Richard Roudebush VA Medical Center, Indianapolis |
More Information
Additional Information:
Publications:
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00515671 History of Changes |
| Other Study ID Numbers: | IAC 05-254 |
| Study First Received: | August 10, 2007 |
| Last Updated: | September 17, 2012 |
| Health Authority: | United States: Federal Government |
Keywords provided by Department of Veterans Affairs:
|
self-management recovery severe mental illness |
Additional relevant MeSH terms:
|
Mental Disorders Psychotic Disorders Schizophrenia Mood Disorders Schizophrenia and Disorders with Psychotic Features |
ClinicalTrials.gov processed this record on October 17, 2012
