Evaluation of intensive community care services for young people with psychiatric emergencies

Comparison of effectiveness and cost-effectiveness of intensive community care services versus treatment as usual including inpatient care for young people with psychiatric emergencies (IVY): An internal pilot followed by a randomised controlled trial comprising all intensive community service care teams in Great Britain

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN42999542

Enrollment

252

Registered

2020-04-29

Start date

2022-02-15

Completion date

Unknown

Last updated

2026-03-02

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

Conditions

Psychiatric emergencies Mental and Behavioural Disorders

Interventions

Current intervention as of 11/02/2022: Randomisation will be at the level of the individual. Young people will be randomised to either the Intensive Community Care Service (ICCS) or the treatment as u

clinicians know and work with all clients. 3. ICCS TEAM MEETING: ICCS Team meets frequently to plan and review services for each service user. 4. PRACTICING TEAM LEADER: Supervisor of front-line clini

Eligibility

Sex/Gender

All

Age

12 Years to 18 Years

Inclusion criteria

Inclusion criteria: Current participant inclusion criteria as of 11/08/2022: 1. Young people aged 12 years 0 months to 17 years 11 months 2. Young people who can consent* and who are being considered for inpatient psychiatric admission or ICCS in the participating NHS Trusts *Eligible participants under 16 years of age will require the consent of at least one person with parental responsibility. _____ Previous participant inclusion criteria from 11/02/2022 to 11/08/2022: 1. Young people aged 12 years 0 months to 17years 11 months 2. Young people who can consent* and who are being considered for inpatient psychiatric admission in the participating NHS Trusts *Eligible participants under 16-year of age will require the consent of at least one person with parental responsibility. _______ Previous participant inclusion criteria: 1. Young people aged 12-18 who can consent/assent and who are being considered for inpatient admission in the catchment areas of one of 97 existing ICCSs or other ICCSs as they are developed will be eligible for recruitment 2. All under 16-year olds will require the consent of at least one person with parental responsibility

Exclusion criteria

Exclusion criteria: Current participant exclusion criteria as of 11/08/2022: 1. Local ICCS teams or TAU unable to accept new referrals due to their full capacity being reached 2. Young people unable to consent due to their mental state 3. The risk profile of the young person is not compatible with ensuring their safety and/or the safety of others in the community*. *We will use the Children Clinical Global Scale (CGAS) to standardise our approach to risk. The CGAS is used to rate the general functioning of young people under the age of 18. It has good validity and reliability. Scores range from 1 to 100, with high scores indicating better functioning. A score of <20, indicating that the young person needs considerable supervision to prevent hurting others or self will be used as a guide to risk, indicating that the young person must be admitted for inpatient care and is therefore ineligible for randomisation _____ Previous participant exclusion criteria from 11/02/2022 to 11/08/2022: 1. Local ICCS teams unable to accept new referrals due to their full capacity being reached 2. Young people unable to consent due to their mental state 3. The risk profile of the young person is not compatible with ensuring their safety and/or the safety of others in the community*. *We will use the Children Clinical Global Scale (CGAS) to standardise our approach to risk. The CGAS is used to rate the general functioning of young people under the age of 18. It has good validity and reliability. Scores range from 1 to 100, with high scores indicating better functioning. A score of <20, indicating that the young person needs considerable supervision to prevent hurting others or self will be used as a guide to risk, indicating that the young person must be admitted for inpatient care and is therefore ineligible for randomisation _______ Previous participant exclusion criteria: 1. Local ICCS teams unable to accept new referrals due to their full capacity being reached 2. Young people unable to consent/assent due to their mental state 3. The risk profile of the young person is not compatible with ensuring their safety and/or the safety of others in the community. We will use the Children Clinical Global Scale (CGAS) to standardise our approach to risk. The CGAS is used to rate the general functioning of young people under the age of 18. It has good validity and reliability. Scores range from 1 to 100, with high scores indicating better functioning. A score of <20, indicating that the young person needs considerable supervision to prevent hurting others or self will be used as a guide to risk, indicating that the young person must be admitted for inpatient care and is therefore ineligible for randomisation

Design outcomes

Primary

Measure	Time frame
Time to returning to/time to gaining education/employment/training, collected by contacting the relevant clinical team or the relevant educational, employment or training establishments, measured from the day of randomisation to the first day of attending either an educational institution, employment or training at 6 months post randomisation	—

Secondary

Measure	Time frame
Current secondary outcome measures as of 11/02/2022: 1. Emotional and behavioural problems measured using the Strengths and Difficulties Questionnaire at baseline and 6 months post randomisation 2. Functioning measured using the Children’s Global Assessment Scale at baseline (pre-randomisation) 3. Clinician’s view of the patient’s global functioning assessed using the Clinical Global Impressions Scale pre-randomisation and at 6 months post randomisation and Clinical Global Improvement Scale at 6 months post randomisation 4. Patients’ satisfaction with services measured using Service Satisfaction Survey (ChASE self-report questionnaire) at 6 months post randomisation 5. General health and social functioning measured using the Health of the Nation Outcome Scales for Children and Adolescents at pre-randomisation and 6 months post randomisation 6. Health-related quality of life measured using EuroQol-5 dimensions, 3 levels (EQ-5D-3L) at baseline and 6 months post randomisation. The primary economic analysis will be a cost-utility analysis using Quality Adjusted Life Years (QALYs) derived from the EQ-5D-3L at 6-month follow-up 7. Self-harm thoughts and behaviours measured using Self-Harm Questionnaire at baseline and 6 months post randomisation 8. Time spent in hospital (in days) measured using electronic patient records at 6 months post randomisation 9. Participants’ use of health and social care services (resource-use data) measured using Child and Adolescent Service Use Schedule (CA-SUS) covering participants’ use of these services for the last 3 months (at baseline) and since they last completed the questionnaire (6 months prior) at 6 months post randomisation 10. Number of days attending education, training or employment, collected by contacting the relevant clinical team or the relevant educational, employment or training establishments, in the 6 months following the day of randomisation 11. Service users’ subjective experiences of receiving ICCS vs TAU, determined	—

Measure

Time frame

Current secondary outcome measures as of 11/02/2022: 1. Emotional and behavioural problems measured using the Strengths and Difficulties Questionnaire at baseline and 6 months post randomisation 2. Functioning measured using the Children’s Global Assessment Scale at baseline (pre-randomisation) 3. Clinician’s view of the patient’s global functioning assessed using the Clinical Global Impressions Scale pre-randomisation and at 6 months post randomisation and Clinical Global Improvement Scale at 6 months post randomisation 4. Patients’ satisfaction with services measured using Service Satisfaction Survey (ChASE self-report questionnaire) at 6 months post randomisation 5. General health and social functioning measured using the Health of the Nation Outcome Scales for Children and Adolescents at pre-randomisation and 6 months post randomisation 6. Health-related quality of life measured using EuroQol-5 dimensions, 3 levels (EQ-5D-3L) at baseline and 6 months post randomisation. The primary economic analysis will be a cost-utility analysis using Quality Adjusted Life Years (QALYs) derived from the EQ-5D-3L at 6-month follow-up 7. Self-harm thoughts and behaviours measured using Self-Harm Questionnaire at baseline and 6 months post randomisation 8. Time spent in hospital (in days) measured using electronic patient records at 6 months post randomisation 9. Participants’ use of health and social care services (resource-use data) measured using Child and Adolescent Service Use Schedule (CA-SUS) covering participants’ use of these services for the last 3 months (at baseline) and since they last completed the questionnaire (6 months prior) at 6 months post randomisation 10. Number of days attending education, training or employment, collected by contacting the relevant clinical team or the relevant educational, employment or training establishments, in the 6 months following the day of randomisation 11. Service users’ subjective experiences of receiving ICCS vs TAU, determined

—

Countries

England, Scotland, United Kingdom, Wales

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Mar 14, 2026