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Evaluation of intensive community care services for young people with psychiatric emergencies: study protocol for a
Thilipan Thaventhiran1, Ben Hoi-Ching Wong2, Izabela Pilecka3
1Queen Mary University of London, London, UK. thilipan.thaventhiran@kcl.ac.uk.
Insights
This study compares intensive community care services (ICCS) with treatment as usual (TAU) for young people experiencing psychiatric emergencies. It evaluates which approach is more effective and cost-effective for improving outcomes like education, employment, or training (EET).
Area of Science:
- Child and Adolescent Psychiatry
- Mental Health Services Research
- Health Economics
Background:
- Over 3000 young people under 18 are admitted to inpatient psychiatric care annually in the UK.
- The average inpatient stay for young people is 120 days, highlighting the need for efficient care models.
- Research is crucial to identify effective interventions for young people with psychiatric emergencies.
Purpose of the Study:
- To evaluate the clinical effectiveness of intensive community care service (ICCS) versus treatment as usual (TAU).
- To assess the cost-effectiveness of ICCS compared to TAU for young people with psychiatric emergencies.
- To determine the impact of these services on young people's return to education, employment, or training (EET).
Main Methods:
- A multicentre, two-arm randomized controlled trial (RCT) with an internal pilot phase.
- Young people aged 12 to <18 with psychiatric emergencies randomized 1:1 to ICCS or TAU.
- Primary outcome: time to return to or start education, employment, or training (EET) at 6 months; secondary outcomes include mental health, well-being, and patient satisfaction.
Main Results:
- This section is to be filled once the study is completed and results are available.
Conclusions:
- This trial is the first well-powered RCT in Great Britain to assess the clinical and cost-effectiveness of ICCS versus TAU for young people with psychiatric emergencies.
Background:
Over 3000 young people under the age of 18 are admitted to Tier 4 Child and Adolescent Mental Health Services (CAMHS) inpatient units across the UK each year. The average length of hospital stay for young people across all psychiatric units in the UK is 120 days. Research is needed to identify the most effective and efficient ways to care for young people (YP) with psychiatric emergencies. This study aims to evaluate the clinical effectiveness and cost-effectiveness of intensive community care service (ICCS) compared to treatment as usual (TAU) for young people with psychiatric emergencies.
Methods:
This is a multicentre two-arm randomized controlled trial (RCT) with an internal pilot phase. Young people aged 12 to < 18 considered for admission at participating NHS organizations across the UK will be randomized 1:1 to either TAU or ICCS. The primary outcome is the time to return to or start education, employment, or training (EET) at 6 months post-randomization. Secondary outcomes will include evaluations of mental health and overall well-being and patient satisfaction. Service use and costs and cost-effectiveness will also be explored. Intention-to-treat analysis will be adopted. The trial is expected to be completed within 42 months, with an internal pilot phase in the first 12 months to assess the recruitment feasibility. A process evaluation using visual semi-structured interviews will be conducted with 42 young people and 42 healthcare workers.
Discussion:
This trial is the first well-powered randomized controlled trial evaluating the clinical and cost-effectiveness of ICCS compared to TAU for young people with psychiatric emergencies in Great Britain.
Trial Registration:
ISRCTN ISRCTN42999542, Registration on April 29, 2020.
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