Integrating a mobile health device into a community youth mental health team to manage severe mental illness: A randomized controlled trial

Standard case management augmented by a integrated mobile Health device (unWIRED intervention): Participants will receive case management for their mental illness through a community mental health service, as well as wearing the Embrace2 mobile Health (mHealth) device. Case management involves an assessment followed by combinations of medication-based and/or psychosocial treatments. Participants are assigned a core case manager, however, their treatment is managed within a mental health team. Frequency of contact with the mental health service varies based on clinical necessity, typically weekly to monthly contact. Contact with the mental health service can be through phone calls, face to face meetings at the community health center or home visits if required. In addition to receiving standard case management, a mHealth device will continuously record the participant's physiological measurements including actigraphy (rest and activity) and electrodermal activity (EDA). The Embrace2 mHealth device will be worn on the wrist for up to 6 months during the trial. The participants will have access to activity-based information which will be transmitted to their mobile phone. These measurements will be relayed to health service computers and displayed on dashboards for the treating case manager to view. The dashboard will provide a visualization of the participant's EDA and activity over a 24-hour period. Based on this information, case managers and/or participants may choose to alter their management plan. For example, periods of high arousal and/or poor sleep may indicate a need for a medication change or a more assertive intervention. Physiological information relayed to both the case manager and participant will be regularly reviewed and discussed during clinical team meetings.