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Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial

Authors: Michelle R. Munson, Andrea Cole, Victoria Stanhope, Steven C. Marcus, Mary McKay, James Jaccard, Shelly Ben-David

Published in: Trials | Issue 1/2016

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Abstract

Background

Transition-age youth have elevated rates of mental disorders, and they often do not receive services. This is a serious public health concern, as mental health conditions persist into adulthood. Continuing to engage this population has been a pervasive challenge for the mental health care system worldwide. Few mental health interventions have been developed for transition-age youth, and even fewer have been found to be effective over the transition to adulthood. Cornerstone, a theoretically guided intervention has shown promise for addressing the mental health and psychosocial needs of this population as they emerge into adulthood. Cornerstone provides case management, trauma-focused cognitive behavioral therapy, mentoring/peer support, community-based in vivo practice, and groups to address stigma, mistrust, and practical skill development to improve the transition to independence among transition-age youth with serious mental health conditions.

Methods/design

This study utilizes a hybrid research design and focuses on examining feasibility, acceptability and preliminary impact, along with factors that influence implementation, to maximize new knowledge. The study combines qualitative methods and a randomized controlled trial, using data to inform and refine protocols and manuals, while testing the preliminary impact of the intervention, compared to best available services (treatment as usual, TAU) at a partnering outpatient mental health clinic (n = 60). Contributors to the intervention development research (n = 20) are national experts on mental health services, clinic administrators and staff and young adults with direct experience. The intervention involves intensive staff training and 18 months of ongoing service provision, monitoring and supervision. Quantitative survey data will be collected at baseline, 3 months, 6 months, and 9 months measuring mental health and practical life outcomes via self-report measures. Medical records will be used to triangulate self-report data (i.e., primary diagnosis, treatment planning and attendance). Qualitative data focuses on the intervention development process and implementation research and will use constant comparison coding techniques. In this intention-to-treat analysis, we will conduct basic omnibus analyses to examine whether Cornerstone leads to improved outcomes relative to TAU utilizing t tests across treatment conditions for each outcome measure specified. We will likewise examine whether changes in the proposed mediating variables differ across groups.

Discussion

The aim of this study is to refine Cornerstone through an intensive preliminary trial, learning through collaboration with clinic staff, project team members, and leaders in New York State and nationwide on how to best serve transition-age youth with serious mental health conditions. Cornerstone has the potential to fill a large gap in the service system for transition-age youth with serious mental health conditions, and may enhance the menu of care options for those who have been recently diagnosed with a serious mental health condition, and yet, have a long life to live. The program is recovery-oriented, builds on the best evidence to date, and is in line with both local and national health care reform efforts.

Trial registration

This trial was registered with ClinicalTrials.gov (Identifier: NCT02696109) on 22 April 16 as Protocol Record R34-MH102525-01A1MRM, as New York University, Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial.
Literature
1.
Munson MR, Smalling S, Spencer R, Scott Jr LD, Tracy EM. A steady presence in the midst of change: non-kin natural mentoring relationships among older youth exiting foster care. Child Youth Serv Rev. 2010;32(4):527–35.CrossRefPubMedPubMedCentral
2.
Institute of Medicine and National Research Council. Investing in the health and well-being of young adults. Washington: The National Academies Press; 2014.
3.
Kessler RC, Birnbaum H, Bromet E, Hwang I, Sampson N, Shahly V. Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R). Psychol Med. 2009;40(2):225–37.CrossRefPubMedPubMedCentral
4.
McMillen JC, Zima BT, Scott LD, Auslander WF, Munson MR. Prevalence of psychiatric disorders among older youths in the foster care system. J Am Acad Child Adolesc Psychiatry. 2005;44(1):88–95.CrossRefPubMed
5.
Teplin LA, Abram KR, McMlelland GM, Dulcan MK, Mericle AA. Psychiatric disorders in youth in juvenile detention. Arch Gen Psychiatry. 2002;59:1133–43.CrossRefPubMedPubMedCentral
6.
Gralinski-Baker JH, Hauser ST, Billings RL, Allen JP. Risks along the road to adulthood: challenges faced by youth with serious mental disorders. In: Osgood DW, Foster EM, Flanagan C, Ruth GR, editors. One your own without a net: the transition to adulthood for vulnerable populations. Chicago: University of Chicago Press; 2005.
7.
Munson MR, Jaccard J, Smalling SE, Kim H, Werner JJ, Scott Jr LD. Static, dynamic, integrated and contextualized: a framework for understanding mental health service use among young adults. Soc Sci Med. 2012;75(8):1441–9.CrossRefPubMed
8.
Munson MR, Narendorf S, Zajac K, Cole A. Treating common behavioral health concerns in young adulthood. In: Juntunen C, editor. Counseling across the lifespan. 2nd ed. Thousand Oaks: Sage; 2015.
9.
McMillen JC, Raghavan R. Pediatric to adult mental health service use of young people leaving the foster care system. J Adolesc Health. 2009;44(1):7–13.CrossRefPubMed
10.
Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26(1):17–31.CrossRefPubMed
11.
Melfi CA, Chawla AJ, Crogham TW, Hanna MP, Kennedy S, Sredl K. The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression. Arch Gen Psychiatry. 1998;55:1128–32.CrossRefPubMed
12.
Ringeisen H, Casanueva CE, Urato M, Stambaugh LF. Mental health service use during the transition to adulthood for adolescents reported to the child welfare system. Psychiatr Serv. 2009;60(8):1084–91.CrossRefPubMed
13.
Pottick KJ, Bilder S, Vander Stoep A, Warner LA, Alvarez MF. US patterns of mental health service utilization for transition-age youth and young adults. J Behav Health Serv Res. 2007;35(4):373–89.CrossRefPubMed
14.
McFarland BR, Klein DN. Mental health service use by patients with dysthymic disorder: Treatment use and dropout in a 7 1/2-year naturalistic follow up. Compr Psychiatry. 2005;46(4):246–53.CrossRefPubMed
15.
Kranke D, Guada J, Kranke B, Floersch J. What do African American youth with a mental illness think about help-seeking and psychiatric medication?: Origins of stigmatizing attitudes. Soc Work Ment Health. 2012;10:53–71.CrossRef
16.
Mendenhall AN, Fristad MA, Early TJ. Factors influencing service utilization and mood symptom severity in children with mood disorders: effects of multifamily psychoeducation groups. J Consult Clin Psychol. 2009;77(3):463–73.CrossRefPubMed
17.
Scott J, Colom F, Popova E, Benabarre A, Cruz N, Valenti M, Goikolea JM, Sanchez-Moreno J, Asenjo MA, Vieta E. Long-term mental health resource utilization and cost of care following group psychoeducation or unstructured group support for bipolar disorders: a cost-benefit analysis. J Clin Psychiatry. 2009;70(3):378–86.CrossRefPubMed
18.
Scott Jr LD, Munson MR, McMillen JC, Snowden LR. Predisposition to seek mental health care among Black males transitioning from foster care. Child Youth Serv Rev. 2007;29(7):870–82.CrossRefPubMedPubMedCentral
19.
Jivanjee P, Kruzich J. Supports for young people with mental health conditions and their families in the transition years: youth and family voices. Best Pract Ment Health. 2011;7(1):115–33.
20.
21.
Clark H, Davis M, editors. Transition to adulthood: a resource for assisting young people with emotional or behavioral difficulties. Baltimore: Paul H. Brookes, Co; 2000.
22.
Clark HB, Deschênes N, Sieler D, Green M, White G, Sondheimer D. Services for Youth in Transition to Adulthood in Systems of Care. In B.A. Stroul & G.M. Blau (Eds.), The System of Care Handbook: Transforming Mental Health Services for Children, Youth, and Families. Baltimore, MD: Paul H. Brookes. 2008. p. 517–543.
23.
Karpur A, Clark HB, Caproni P, Sterner H. Transition to adult roles for students with emotional/behavioral disturbances: a follow-up study of student exiters from Steps-to-Success. Career Dev Except Indiv. 2005;28:36–46.
24.
Weisz JR, Ugueto AM, Cheron DM, Herren J. Evidence-based youth psychotherapy in the mental health ecosystem. J Clin Child Psychol. 2013;42(2):274–86.CrossRef
25.
Haber MG, Karpur A, Deschenes N, Clark HB. Predicting improvement in transitioning young people in the Partnerships for Youth Transition Initiative: findings from a multisite demonstration. J Behav Health Serv Res. 2008;35(4):488–513.CrossRefPubMed
26.
New York State Office of Alcoholism & Substance Abuse Services Addiction Services for Prevention, Treatment, Recovery. New York State Cooperative Agreement for State Adolescent Treatment Enhancement and Dissemination: New York Serving Adolescents in Need of treatment (NYSAINT); 2012.
27.
Powers LE, Geenen S, Powers J, Pommier-Satya S, Turner A, Dalton LS, et al. My life: effects of a longitudinal, randomized study of self-determination enhancement on the transition outcomes of youth in foster care and special education. Child Youth Serv Rev. 2012;34(11):2179–87.CrossRef
28.
Davidson L, Chinman M, Sells D, Rowe M. Peer support among adults with serious mental illness: a report from the field. Schizophr Bull. 2006;32(3):443–50.CrossRefPubMedPubMedCentral
29.
Munson MR, Jaccard J. Mental health service use among young adults: a communication framework for program development. Adm Policy Ment Health Ment Health Serv Res. 2016. doi:10.​1007/​s10488-016-0765-y.
30.
Munson MR. Mentors value for recovery: healthy peer relationships heal. New York City Voices: Consum J Ment Health Advocacy. 2003;8(3).
31.
Rhodes JE. Stand by me: The risks and rewards of mentoring today’s youth. Cambridge: Harvard University Press; 2002.
32.
Munson MR, Floersch JE, Townsend L. Attitudes toward mental health services and illness perceptions among adolescents with mood disorders. Child Adolesc Soc Work J. 2009;26(5):447–66.CrossRef
33.
Munson MR, Cole A, Jaccard J, Kranke D, Farkas K, Frese III FJ. An engagement intervention for young adults with serious mental health conditions. J Behav Health Serv Res. 2016;43(4):542–63.CrossRefPubMed
34.
35.
Sparks E. Relational experiences of delinquent girls: a case study. In: Walker M, Rosen WB, editors. How connections heal: stories from relational-cultural therapy. New York: Guilford Press; 2004.
36.
Herman D, Mandiberg J. Critical Time Intervention: model description and implications for the significance of timing social work interventions. Res Soc Work Pract. 2010;20:502–8.
37.
38.
Draine J, Herman D. Critical time intervention for reentry from prison for persons with mental illness. Psychiatr Serv. 2007;58(12):1577–81.CrossRefPubMed
39.
Duffy FF, West JC, Wilk J, Narrow WE, Hales D, Thompson J, Manderscheid RW. Mental health practitioners and trainees. Mental health, United States, 2002. Rockville: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services; 2004. p. 327–68.
40.
41.
Garringer M, Kupersmidt J, Rhodes J, Stelter R, Tai T. Elements of effective practice for mentoring. Boston: MENTOR: The National Mentoring Partnership; 2015.
42.
43.
Gwadz M, Rotheram-Borus MJ. Tracking high-risk adolescents longitudinally. AIDS Educ Prev. 1992;Suppl:69–82.
44.
McMillen JC, Zima B, Scott L, Ollie M, Munson MR, Spitznagel E. The Mental health service use of older youth in foster care. Psychiatr Serv. 2004;55(7):811–7.CrossRefPubMed
45.
Fishbein M, Pequegnat W. Evaluating AIDS prevention interventions using behavioral and biological outcome measures. Sex Transm Dis. 2000;27(2):101–10.CrossRefPubMed
46.
Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage Publications; 1990.
47.
Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd ed. Thousand Oaks: Sage Publications; 1994.
48.
Padgett DK. Qualitative methods in social work research: challenges and rewards. Thousand Oaks: Sage Publications; 1998.
49.
Glaser B. The constant comparative method of qualitative analysis. Soc Probl. 1965;12(4):436–45.CrossRef
50.
Creswell JW. Qualitative inquiry and research design: choosing among five traditions. Thousand Oaks: Sage; 1998.
51.
Kraemer HC, Kupfer DJ. Size of treatment effects and their importance to clinical research and practice. Biol Psychiatry. 2006;59(11):990–6.CrossRefPubMed
52.
MacKenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaption and extension of the attitudes towards seeking professional psychological help scale. J Appl Soc Psychol. 2004;34(11):2410–35.CrossRef
53.
Martin JK, Howe TR. Attitudes toward mental health services among homeless and matched housed youth. Child and Youth Services. 2016;37(1):49–64.CrossRef
54.
Munson MR. Making the transition: supportive relationships, illness identity, and mental health service use. In Review for publication in Bi-Annual Report of funded research, Current Research in Mental Health. Ohio: Department of Mental Health; 2012.
55.
Thompson HS, Valdimarsdottir HB, Winkel G, Jandorf L, Redd W. The Group-Based Medical Mistrust Scale: psychometric properties and association with breast cancer screening. Prev Med. 2004;38(2):209–18.CrossRefPubMed
56.
Fishbein M, Ajzen I. Predicting and changing behavior: the reasoned action approach. New York: Psychology Press, Taylor & Francis Group; 2010.
57.
Munson MR, Floersch JE, Townsend L. Are health beliefs related to adherence among adolescents living with mood disorders? Adm Policy Ment Health. 2010;37(5):408–16.CrossRefPubMed
58.
Corrigan and Salzer et al. Recovery Assessment Short-Form. As cited in the Mental Health Disparities Initiative (MHDI) Baseline Protocol 1.8, University of Pennsylvania Center for Mental Health Policy and Services Research. 2004.
59.
Corrigan PW, Salzer M, Ralph RO, Sangster Y, Keck L. Examining the factor structure of the Recovery Assessment Scale. Schizophr Bull. 2004;30:1035–41.CrossRefPubMed
60.
Locke BA, Putman P. Center for Epidemiological Studies Depression Scale. Washington: National Institute of Mental Health, Public Health Service, Epidemiology and Psychopathology Research Branch; 1971.
61.
Radloff L. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRef
62.
Cohen S. Perceived stress scale. J Health Soc Behav. 1983;24(4):385–96.
63.
Munson MR, McMillen JC. Non-kin natural mentors in the lives of older youths in foster care. J Behav Health Serv Res. 2008;35(4):454–68.
64.
Munson MR, McMillen JC. Natural mentoring and psychosocial outcomes among older youth transitioning from foster care. Child Youth Serv Rev. 2009;31(1):104–11.
65.
Lehman A. Quality of life measures. 2004. As cited in the Mental Health Disparities Initiative (MHDI) Baseline Protocol 1.8, University of Pennsylvania Center for Mental Health Policy and Services Research.
66.
Kemp BJ, Ettelson D. Quality of life while living and aging with a spinal cord injury and other impairments. Topics Spinal Cord Inj Rehabil. 2001;6(3):116–27.
Metadata
Title
Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trial
Authors
Michelle R. Munson
Andrea Cole
Victoria Stanhope
Steven C. Marcus
Mary McKay
James Jaccard
Shelly Ben-David
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1654-0

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