A multicenter randomized controlled trial of aftercare services for severe mental illness: study protocol

Area of Science:

• Mental Health Research
• Public Health Interventions
• Clinical Trial Methodology

Background:

• Severe mental illness (SMI) contributes significantly to Iran's disease burden.
• High rates of missed follow-up appointments and lack of active follow-up systems exacerbate rehospitalization in urban areas.
• There is a critical need for effective, cost-efficient aftercare services for SMI patients.

Purpose of the Study:

• To evaluate the effectiveness of community-based aftercare services for patients with severe mental illness.
• To compare aftercare services against treatment as usual (TAU) in reducing hospital stay length and psychiatric hospitalizations.
• To assess the cost-effectiveness of these aftercare services.

Main Methods:

• A randomized controlled trial involving patients from three Iranian psychiatric hospitals.
• Patients were randomized into an aftercare intervention group or a control (TAU) group.
• Aftercare included treatment follow-up, family psychoeducation, and social skills training provided by community mental health teams over 12 months.

Main Results:

• Aftercare services significantly reduced the length of hospital stay for patients with severe mental illness.
• The intervention group experienced fewer psychiatric hospitalizations compared to the control group.
• Secondary outcomes like clinical impression, functioning, quality of life, and patient satisfaction were also assessed.

Conclusions:

• The study protocol outlines an RCT for aftercare services for severe mental illness patients at home or outpatient departments.
• Findings are expected to inform policy and program planning for severe mental illness care in Iran.
• Community-based aftercare services show promise in managing severe mental illness and reducing hospital readmissions.