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Remote psychosocial interventions to prevent avoidable psychiatric hospital admissions in people with serious mental health problems: a multi-arm multi-stage trial

Remote Approaches to Psychosocial Intervention Delivery

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
ISRCTN
Registry ID
ISRCTN33079589
Enrollment
991
Registered
2022-06-20
Start date
2022-07-01
Completion date
Unknown
Last updated
2026-08-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Serious mental health problems Mental and Behavioural Disorders

Interventions

Current interventions as of 19/09/2024: Following the results of the planned interim analysis, RAPID will move to a two-arm trial in Stage 2 with one brief and remotely delivered intervention in compa
ii) utilising internal coping strategies
iii) engaging social contacts & social settings to distract from suicidal thoughts
iv) contacting social supports for assistance in resolving the suicidal crisis
v) contacting mental health professionals
vi) minimising access to lethal means.). The suitability and likelihood of employing these strategies during a suicidal crisis are explored, as well as examples of such strategies being provided. Foll
2) review of the participant’s safety plan, with revisions made if required
3) supporting treatment engagement through exploration of barriers to engagement, motivational enhancement, problem-solving and support. The core element of SAFETEL is the collaborative development o

Sponsors

University of Manchester
Lead Sponsor

Eligibility

Sex/Gender
All
Age
16 Years to 100 Years

Inclusion criteria

Inclusion criteria: Current inclusion criteria as of 05/06/2023: 1. Currently receiving care from a Home-Based Treatment Team/Crisis team or have done so within the last 14 days, since referrals to HBTT/Crisis Team are associated with increased risk of a psychiatric hospital admission in the near future 2. Aged 16 years or above 3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder, EUPD, PTSD or cPTSD) since these diagnoses account for the majority of PHAs for mental health difficulties 4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale. 5. Able to provide informed consent 6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT. _____ Previous inclusion criteria from 09/01/2023 to 05/06/2023: 1. Currently receiving care from a Home-Based Treatment Team/Crisis team or have done so within the last 14 days, since referrals to HBTT/Crisis Team are associated with increased risk of a psychiatric hospital admission in the near future 2. Aged 16 years or above 3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder or EUPD) since these diagnoses account for the majority of PHAs for mental health difficulties 4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale. 5. Able to provide informed consent 6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT. _____ Previous inclusion criteria: 1. Receiving care from a HBTT (referrals to HBTT are associated with increased risk of a PHA in the near future) 2. Aged 16 years or above 3. Meet criteria for a diagnosis of SMHP (schizophrenia spectrum, bipolar, major depressive disorder or EUPD) since these diagnoses account for the majority of PHAs for mental health difficulties 4. Experienced suicidal ideation or attempt within the last month / current crisis episode, as operationalised by answering ‘yes’ to items 1 or 2 of the Columbia-Suicide Severity Rating Scale. 5. Able to provide informed consent 6. Receiving care from a Community Mental Health Team or Early Intervention Service, to ensure ongoing specialist mental health support following discharge from HBTT.

Exclusion criteria

Exclusion criteria: Current inclusion criteria as of 05/06/2023: 1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP 2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds. 3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP 4. Moderate to severe learning disability as confirmed by the participant's responsible clinician in their care team. 5. Immediate risk to others, for ethical and safety reasons 6. Currently receiving psychiatric inpatient care (since people in recent contact with crisis teams may have already been admitted to hospital) _____ Previous inclusion criteria from 09/01/2023 to 05/06/2023: 1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP 2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds. 3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP 4. Moderate to severe learning disability as confirmed by the participants responsible clinician in their care team, since the BrighterSide app has not been developed or tested with people with moderate to severe learning disability. 5. Visual impairment, severe enough to prevent engagement with the BrighterSide app as provision would be impossible on both financial and logistical grounds. 6. Immediate risk to others, for ethical and safety reasons 7. Currently receiving psychiatric inpatient care (since people in recent contact with crisis teams may have already been admitted to hospital) _____ Previous inclusion criteria: 1. Organic impairment, as this could be the cause of mental health symptoms rather than a SMHP 2. Non-English speaking, since two of the interventions are remotely delivered talking therapies and one of the interventions is a smartphone app which has only been developed in English. Provision for non-English speakers would be impossible on both financial and logistical grounds. 3. Primary diagnosis of a drug or alcohol dependence, as this could be the cause of mental health symptoms rather than a SMHP 4. Moderate to severe learning disability as confirmed by the participants responsible clinician in their care team, since the BrighterSide app has not been developed or tested with people with moderate to severe learning disability. 5. Visual impairment, severe enough to prevent engagement with the BrighterSide app as provision would be impossible on both financial and logistical grounds. 6. Immediate risk to others, for ethical and safety reasons

Design outcomes

Primary

MeasureTime frame
Psychiatric hospital admission (yes/no) over a 6-month period measured using patient records

Secondary

MeasureTime frame
Measured at baseline, 3 and 6 months 1. Suicidal thoughts and behaviours using the Columbia–Suicide Severity Rating Scale 2. Recovery assessed using the Process of Recovery Questionnaire 3. Health status using the EQ-5D-5L 4. The Recovering Quality of Life (ReQoL-10) 5. Wider NHS and social care use assessed by the Economic Patient Questionnaire 6. Anxiety measured using the GAD-7 7. Depression measured using the PHQ-9 8. Hope using the Adult HOPE Scale 9. Entrapment measured using the 4-item self-report Entrapment Scale Short-Form 10. Adverse effects measures on exit from the study at 6-month assessment

Countries

England, United Kingdom

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Aug 9, 2026