Doelgroep Ernstige Psychiatrische Aandoeningen (EPA), dat wil zeggen een ernstige DSM IV diagnosis, met een langere ziekteduur (> 2 jaar in zorg bij de GGZ) en beperkingen in het functioneren op meerdere levensterreinen Severe Mental Illness (SMI)
Conditions
Interventions
generic mental health nurse care, social work and generic vocational
rehabilitation programmes.
BPR uses a methodology that helps patients to explore, choose and realize their
rehabilitation goals in the areas of working, learning, social contacts and
living environment. The approach has three
b) planning: describing necessary interventions (skills
training,support) to achieve these goals and c) carry out these interventions.
MHC workers receive training and gather practical experience wi
Sponsors
Altrecht GGZ, Divisie Willem Arntsz
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: The inclusion criteria are: (a) Having Severe Mental Illness (SMI); a diagnosis according to DSM IV, duration of service contact more than two years; GAF S-D score indicating substantial handicaps in global psychosocial functioning (GAF S-D: Global Assessment of Functioning - Symptoms and Dissabilities; score 60 or lower) b) Expressing a wish for change in societal participation (work, education, daily activities outside the home). c) Between 18-64 years of age. d) Willing to participate in a rehabilitation process and in the research
Exclusion criteria
Exclusion criteria: Excluded are patients that: a) are legally incompetent b) are younger than 18 years c) are older than 64 years. We decided for the maximum age of 64 years because patients with older age usually have different goals in social participation, notably other than obtaining regular employment d) received Boston Psychiatric Rehabilitation in the four months preceding the start of the trial e) for all except for patients from Rintveld: are admitted as inpatient to a MHC centre, f) for patients from Rintveld: inpatient to a MHC centre and NOT in the last phase of inpatient treatment and date of end of admission period is set.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome for the effect study will be increase in societal participation (getting paid work, voluntary work, and schooling (yes/no; after 6 and 12 months), measured with the Birchwood Social Functioning Scale (Birchwood et al, 1990). The primary outcome measures for the cost-effectiveness study are change in social participation expressed in terms of incremental cost per proportion increase in societal participation, and a cost-utility analysis in terms of Quality Adjusted Life Years (QUALY). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Change in the number of hours of societal participation and in the position of patients on the national societal participation ladder (Divosa, www.participatieladder.nl). 2. Patients* experience of success (yes/no) in achieving societal participation goals in the areas addressed, such as work and schooling. For this purpose we developed an instrument in previous RCT*s (Swildens et al, 2011). 3. Change in quality of life measured by the Manchester Quality of life Schedule/MANSA (Priebe S, 1999). 4. Change in functioning is measured from different perspectives. First, psychosocial functioning is measured by the Birchwood Social Functioning Scale (Birchwood et al, 1990). Further change in psychosocial functioning is measured from the MHC team*s perspective with the Activity and Participation scale (Van Wel et al, 2002). Further change in symptomatic functioning and psychiatric remission is measured with the (remission items) of the Brief Psychiatric Rating Scale (Ventura et al, 1993). 5. Increase of self-esteem with the Recovery Assement Scale (Corrigan et al, 2004). All aforementioned instruments are designed to measure change in patients with SMI and are sensitive to measure change. | — |
Countries
Netherlands
Outcome results
None listed