Mental Disorders
Conditions
Keywords
Mental Health, Primary health care, Case management
Brief summary
This study will determine the effectiveness of medical case management in improving the medical care of people with mental disorders or substance abuse problems.
Detailed description
Poor quality of care may contribute to impaired health status and increased mortality in individuals with serious mental disorders and substance abuse problems; interventions designed to improve medical care for this population need to be developed. This study will develop a population-based medical case management model for improving the primary medical care of patients at an inner city community mental health center. This study will last 2 years. Participants will be randomly assigned to receive medical case management or standard of care (typically drug and behavioral therapy) for 2 years. Participants in the case management group will receive help in overcoming barriers to receiving primary care. Participants will also undergo 5 interviews over the 2-year study duration, and have annual chart reviews. Results of the interviews will be used to assess quality of primary care, service use, health outcomes, psychiatric symptoms, and substance use.
Interventions
BEHAVIORALNurse case management
Nurse case management is a population-based medical case management program to improve the delivery of primary medical care to patients with serious mental illness in a Community Mental Health Center (CMHC) in Atlanta GA. The treatment draws on elements from the primary care, nursing case management, chronic disease, health behavior change literature, and from the study team's experience in integrating primary care services for patients with serious mental illnesses.
BEHAVIORALUsual care
Usual care includes standard mental health services.
Sponsors
National Institute of Mental Health (NIMH)
Emory University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of mental illness or substance abuse * Patient at Florida Hall (Grady Health Systems)
Exclusion criteria
* Current use of medical case management
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Quality of primary medical care | Measured over 2 years |
Secondary
| Measure | Time frame |
|---|---|
| Health status | Measured over 2 years |
| Psychiatric symptoms | 2004-2009 |
| Costs | 2004-2009 |
Countries
United States
Outcome results
None listed