Serious Mental Illness
Conditions
Keywords
SMI, Latino, Peer, Recovery, Engagement
Brief summary
The goal of this clinical trial is to learn if a culturally responsive peer-delivered motivational interviewing intervention can enhance mental health treatment engagement in Latinos with serious mental illness. The main questions it aims to answer are: * How feasible is it to recruit 30 Latinos with serious mental illness into a 6 week treatment engagement intervention? * How acceptable is the intervention to Latinos with serious mental illness? Participants will: * Receive six sixty-minute sessions * Complete weekly measures, along with pre-, post-, 30-day, and 60-day post-intervention assessments
Detailed description
Despite the availability of effective mental health treatment, approximately 47% of Latino adults with trauma and serious mental illness (SMI) are not engaged in treatment. The main goal of this current study is to conduct a pilot study to establish the feasibility and acceptability of implementing a culturally responsive motivational interviewing engagement intervention and to ascertain preliminary evidence of the engagement of hypothesized target mechanisms that may mediate enhanced engagement in mental health treatment. The adapted intervention will be implemented by Latino peers with a single cohort (N=30) of Latinos with SMI and not in treatment. Each peer will carry a caseload of 5-6 participants. All participants who meet the inclusion criteria and are interested in participating will complete pre-intervention (baseline), end-of-six-week-intervention, 30-day, and 60-day follow-ups to determine whether there is an increase in treatment engagement, significant changes in measures, and engagement of target mechanisms. Mental health treatment engagement will be measured in multiple ways: 1) as the binary distinction between those who self-report initiation /re-initiation of formal mental health treatment (i.e., outpatient mental health treatment, psychotherapy, medication) within 60 days of the final adapted session 2) and additional indicators of engagement as determined by (e.g., completion of homework, implementation of skills, number of sessions attended). The intervention will approximate the following schedule: session 1 (psychoeducation on SMI and research participation in the current study), session 2 (exploration of strengths and values), session 3 (identification of areas of growth, session 4 (demystifying mental health myths), session 5 (planning for success), and session 6 (planning for growth). The focus is on the change processes-basic motivational interviewing components: awareness of ambivalence about mental health and about change; pros and cons of changing and staying the same; exploration of values and strengths; exploration of possible future; importance and confidence in engaging in treatment; and desire to plan for change.
Interventions
BEHAVIORALCulturally responsive motivational interviewing
Six sixty-minute sessions of culturally responsive motivational interviewing, once a week.
Sponsors
Yale University
National Institute of Mental Health (NIMH)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Intervention model description
The six sessions are: session 1 (psychoeducation on SMI and research participation in the current study), session 2 (exploration of strengths and values), session 3 (identification of areas of growth, session 4 (demystifying mental health myths), session 5 (planning for success), and session 6 (planning for growth). The sessions will be delivered by a Latino peer with lived experience.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Meet criteria for serious mental illness * Not in treatment * 18 years of age or older * Reside in CT * Self-identify as Latino * Speak English and/or Spanish * History of trauma * Have not received any treatment in the past 30 days * Willing and able to be contacted for follow-up
Exclusion criteria
* Individuals in formal mental health treatment in the past 30 days * Have a life-threatening or unstable medical, surgical, or psychiatric condition * Inability to provide \> 1 form of contact information * Anticipate being unable to return for a follow-up assessment * Reported active risk of suicide or homicide * Fail capacity to consent * Cognitively impaired * Currently in jail or other overnight facilities as required by courts or law
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of participants recruited | From April 2026 to April 2027 (approximately 1 year) | The average number of participants recruited to participate in the study |
| Number of participants that complete the study | From enrollment to the end of follow-up at 60 days post-session 6 | The average number of participants who complete the study |
| Number of sessions completed | From enrollment to the end of treatment at 6 weeks | The average number of sessions completed by the participant |
| The Client Satisfaction Questionnaire | From enrollment to the end of treatment at 6 weeks | The Client Satisfaction Questionnaire (CSQ-8) uses a 4-point Likert scale (1-4) for each item, typically ranging from "Quite dissatisfied" to "Very satisfied" or similar, for a total of 8 to 32 points. High scores indicate greater satisfaction across nine dimensions of service quality. |
| Number of assessments completed | From enrollment to the end of treatment at 6 weeks | The average number of assessments completed by participants |
| Qualitative acceptability questions | End of treatment at 6 weeks | Participants will participate in qualitative interviews regarding their satisfaction with the intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Religious Practices and beliefs (RPB 2I) | At enrollment | The Religious Practices and Beliefs (RPB 2I) is a 13-item instrument scored by recoding responses to establish a zero floor, with higher scores indicating greater religiosity. It measures religious beliefs (0-4) and behavioral frequencies (past year/lifetime) using Likert scales (e.g., 0-7 or 1-3) to assess four dimensions: believing, bonding, behaving, and belonging. To ensure a score floor of zero, responses must be recoded before summing. Generally, this means subtracting 1 from the response value (e.g., if using a 1-8 scale, it becomes 0-7). |
| Marin Short Acculturation Scale for Hispanics (SASH) | At enrollment | The Marin Short Acculturation Scale for Hispanics (SASH) is a 12-item tool scored by averaging responses, where 1 represents "Only Spanish" and 5 represents "Only English." Higher average scores (closer to 5) indicate higher U.S. acculturation, while lower scores (closer to 1) reflect lower acculturation, and middle scores indicate biculturalism |
| The Multigroup Ethnic Identity Measure-Revised | At enrollment | The Multigroup Ethnic Identity Measure-Revised (MEIM-R) is a 6-item instrument that uses a 4-point or 5-point Likert scale (e.g., 1=Strongly Disagree to 4/5=Strongly Agree) to measure ethnic identity commitment and exploration. Scoring involves calculating the mean of all items, with higher scores indicating a stronger, more developed ethnic identity |
| Familism Scale | At enrollment | The Familism Scale is a 14, 5-point Likert scale (1=Very Much in Disagreement, 5=Very Much in Agreement) measuring familism via three subscales: familial obligations, perceived support, and family as referents. Higher scores indicate stronger familism. |
| Life Events Checklist for DSM-5 (LEC-5) | At enrollment | The Life Events Checklist for DSM-5 (LEC-5) is a 17-item self-report tool measuring lifetime trauma exposure (Criterion A). It screens for events "happened to me," "witnessed it," "learned about it," "part of job," or "not sure," with no official total severity score, but often used to confirm Criterion A for PTSD |
| PCL-5 | From enrollment to the end of follow-up at 60 days post-session 6 | The PCL-5 is a 20-item self-report questionnaire assessing DSM-5 PTSD symptoms, scored from 0 ("Not at all") to 4 ("Extremely"), with a total severity score of 0-80. A total score of 31-33 or higher indicates probable PTSD, while a 5-point change represents a response, and 10-20 points indicate clinically meaningful improvement. |
| Perceived Stress | From enrollment to the end of follow-up at 60 days post-session 6 | The Perceived Stress Scale (PSS) is a measure of the degree to which situations in one's life are appraised as stressful. PSS items were designed to tap the degree to which respondents found their lives unpredictable, uncontrollable, and overloading. The PSS comprises 14 items, rated from 0 (never) to 4 (very often). Scores range from 0-56, with higher scores indicating greater perceived stress. |
| Brief Symptom Inventory | From enrollment to the end of follow-up at 60 days post-session 6 | The Brief Symptom Inventory (BSI) is a 53-item self-report tool that measures the intensity of psychological distress (0=not at all, 4=extremely) over seven days. Scores are converted to normalized T-scores (Mean=50, SD=10). A T-score 63 on the Global Severity Index (GSI) or two subscales indicates clinically significant distress; 50-62: moderate-to-high-moderate distress; and \< 50: below average or nominal distress. |
| Barriers to Access to Care Evaluation (BACE-3) | From enrollment to the end of follow-up at 60 days post-session 6 | The Barriers to Access to Care Evaluation (BACE-3) is a 30-item self-report tool used to assess attitudinal and structural barriers to seeking mental health services, featuring a 12-item stigma subscale. It utilizes a 4-point Likert scale to measure the extent to what extent items stop, delay, or discourage care, with higher total scores indicating greater barriers to access. Summing all 30 items (ranging from 0 to 90) yields a total barrier burden score. |
| Internalized Stigma of Mental Illness Inventory (ISMI) | From enrollment to the end of follow-up at 60 days post-session 6 | The Internalized Stigma of Mental Illness Inventory (ISMI) is a 29-item self-report questionnaire scoring 1-4 per item, used to measure subjective self-stigma. A mean total score (sum of items divided by number of items) ranging from 1 to 4 is calculated. A higher mean score indicates greater internalized stigma, typically categorized into minimal (1.0-2.0), mild (2.01-2.5), moderate (2.51-3.0), or severe (\>3.0). |
| University of Rhode Island Change Assessment Scale (URICA) | From enrollment to the end of follow-up at 60 days post-session 6 | The University of Rhode Island Change Assessment Scale (URICA) is a 32-item self-report tool evaluating motivation to change using a 5-point Likert scale (1=Strongly Disagree to 5=Strongly Agree). It calculates scores for four stages-Precontemplation, Contemplation, Action, and Maintenance-which can be used independently or combined into a continuous "Readiness to Change" formula. Higher scores indicate greater readiness to change. Respondents can score high on more than one stage, reflecting that the stages of change are not always discrete |
| Empowerment | From enrollment to the end of follow-up at 60 days post-session 6 | The Rogers Empowerment Scale is a 28-item self-report tool designed to measure mental health service user empowerment across five factors. It uses a 4-point Likert scale (1=Strongly Agree, 4=Strongly Disagree), with total scores ranging from 28 to 112, where higher scores indicate greater empowerment. |
| WHO Quality of Life Brief | From enrollment to the end of follow-up at 60 days post-session 6 | The WHOQOL-BREF is scored by calculating the mean score for each of the four domains (Physical, Psychological, Social, Environment), and multiplying by 4 to create a 4-20 scale. Finally, these scores are often transformed to a 0-100 scale, where higher scores indicate a higher quality of life. Scores are typically presented as a profile of the four domains rather than a single total score. |
| Working Alliance Inventory Client - Short Revised (WAI-SR-C) | From enrollment to the end of treatment at 6 weeks | The Working Alliance Inventory - Short Revised Client version (WAI-SR-C) is a 12-item self-report questionnaire assessing the therapy bond, goals, and tasks. Clients rate items on a 5-point Likert scale (1 = Seldom to 5 = Always), with higher total scores (12-60) indicating a stronger therapeutic alliance. |
| Working Alliance Inventory Therapist - Short Revised (WAI-SR-T) | From enrollment to the end of treatment at 6 weeks | The Working Alliance Inventory - Short Revised - Therapist (WAI-SR-T) is a 12-item self-report questionnaire that measures a therapist's perspective on the alliance with their client. It uses a 5-point Likert scale (1 = Seldom to 5 = Always) to score three subscales (Bond, Goals, Tasks). The total score ranges from 12 to 60, with higher scores reflecting a stronger alliance. |
| Treatment engagement | From enrollment to the end of follow-up at 60 days post-session 6 | Binary (yes or no) engaged in treatment |
Countries
United States
Contacts
CONTACTOscar F Rojas Perez, PhD
PRINCIPAL_INVESTIGATOROscar F Rojas Perez, PhD
Yale University
Outcome results
None listed