Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Trials
Published in: Trials 1/2024

Open Access 01-12-2024 | Study protocol

Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial

Authors: Camilla Angelsen Kvestad, Ingvild Rønneberg Holte, Solveig Klæbo Reitan, Charlotte S. Chiappa, Gunn Karin Helle, Anne E. Skjervold, Anne Marit A. Rosenlund, Øyvind Watne, Heidi Brattland, Jon Helle, Turid Follestad, Karen Walseth Hara, Katrine Høyer Holgersen

Published in: Trials | Issue 1/2024

Login to get access

Abstract

Background

Referrals to specialised mental health care (such as community mental health centres; CMHC) have increased over the last two decades. Patients often have multifaceted problems, which cannot only be solved by such care. Resources are limited, and triaging is challenging. A novel method which approaches patients early and individually upon referral to a CMHC—possibly with a brief intervention—is an Early assessment Team (EaT). In an EaT, two therapists meet the patient early in the process and seek to solve the present problem, often involving community services, primary health care, etc.; attention is paid to symptoms and functional strife, rather than diagnoses. This is in contrast to treatment as usual (TAU), where the patient (after being on a waiting list) meets one therapist, who focuses on history and situation to assign a diagnosis and eventually start a longitudinal treatment. The aim of this study is to describe and compare EaT and TAU regarding such outcomes as work and social adjustment, mental health, quality of life, use of health services, and patient satisfaction. The primary outcome is a change in perceived function from baseline to 12-month follow-up, measured by the Work and Social Adjustment Scale.

Method

Patients (18 years and above; n = 588) referred to outpatient health care at a CMHC are randomised to EaT or TAU. Measures (patient self-reports and clinician reports, patients’ records, and register data) are collected at baseline, after the first and last meeting, and at 2, 4, 8, 12, and 24 months after inclusion. Some participants will be invited to participate in qualitative interviews.

Trial design

The study is a single-centre, non-blinded, RCT with two conditions involving a longitudinal and mixed design (quantitative and qualitative data).

Discussion

This study will examine an intervention designed to determine early on which patients will benefit from parallel or other measures than assessment and treatment in CMHC and whether these will facilitate their recovery. Findings may potentially contribute to the development of the organisation of mental health services.

Trial registration

ClinicalTrials.gov NCT05087446. Registered on 21 October 2021.
Appendix
Available only for authorised users
Literature
1.
2.
3.
Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta-analysis. Aust N Z J Public Health. 2018;42(2):186–94.PubMedCrossRef
4.
Schiøtz ML, Stockmarr A, Høst D, Glümer C, Frølich A. Social disparities in the prevalence of multimorbidity - a register-based population study. BMC Public Health. 2017;17(1):422.PubMedPubMedCentralCrossRef
5.
Holgersen KH, Holte IR, Gluppe E, Watne W, Meisingset WK, Rostad M, et al. Tidlig avklaring: ny tilnærming for vurdering og planlegging av behandling i poliklinisk psykisk helsevern [Early assessment: A new approach for assessment and treatment in community mental health service]. Tidsskrift for norsk psykologforening. 2021;58:1012–20.
6.
Martin CM. What matters in “multimorbidity”? Arguably resilience and personal health experience are central to quality of life and optimizing survival. J Eval Clin Pract. 2018;24(6):1282–4.PubMedCrossRef
7.
Read JR, Sharpe L, Modini M, Dear BF. Multimorbidity and depression: a systematic review and meta-analysis. J Affect Disord. 2017;221:36–46.PubMedCrossRef
8.
Suls J, Green PA, Boyd CM. Multimorbidity: Implications and directions for health psychology and behavioral medicine. Health Psychol. 2019;38(9):772–82.PubMedPubMedCentralCrossRef
9.
Xu X, Mishra GD, Jones M. Evidence on multimorbidity from definition to intervention: an overview of systematic reviews. Ageing Res Rev. 2017;37:53–68.PubMedCrossRef
10.
Heggestad T, Greve G, Skilbrei B, Elgen I. Complex care pathways for children with multiple referrals demonstrated in a retrospective population-based study. Acta Paediatr. 2020;109(12):2641–7.PubMedCrossRef
11.
Simmons LA, Drake CD, Gaudet TW, Snyderman R. Personalized health planning in primary care settings. Fed Pract. 2016;33(1):27.PubMedPubMedCentral
12.
Wang L, Si L, Cocker F, Palmer AJ, Sanderson K. A systematic review of cost-of-illness studies of multimorbidity. Appl Health Econ Health Policy. 2018;16(1):15–29.PubMedCrossRef
13.
14.
15.
16.
17.
Holman PA, Ruud T, Grepperud S. Horizontal equity and mental health care: a study of priority ratings by clinicians and teams at outpatient clinics. BMC Health Serv Res. 2012;12(1):162.PubMedPubMedCentralCrossRef
18.
Nymoen M, Biringer E, Helgeland J, Hellesen HB, Alsaker Sande L, Hartveit M. Defining when specialised mental health care is needed: a focus group study. BJGP Open. 2020;4(1):bjgpopen20X101004.PubMedPubMedCentralCrossRef
19.
20.
Meneton P, Kesse-Guyot E, Méjean C, Fezeu L, Galan P, Hercberg S, et al. Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals. Int Arch Occup Environ Health. 2015;88(6):707–16.PubMedCrossRef
21.
Clemens T, Popham F, Boyle P. What is the effect of unemployment on all-cause mortality? A cohort study using propensity score matching. Eur J Public Health. 2015;25(1):115–21.PubMedCrossRef
22.
23.
Reme SE. Common mental disorders and work: barriers and opportunities. In: Bültmann U, Siegrist J, editors. Handbook of disability, work and health. Springer International Publishing; 2020. p. 467–81.
24.
van der Noordt M, Ijzelenberg H, Droomers M, Proper KI. Health effects of employment: a systematic review of prospective studies. Occup Environ Med. 2014;71(10):730–6.PubMedCrossRef
25.
Paul KI, Moser K. Unemployment impairs mental health: meta-analyses. J Vocat Behav. 2009;74(3):264–82.CrossRef
26.
Probst T, Lambert MJ, Loew TH, Dahlbender RW, Tritt K. Extreme deviations from expected recovery curves and their associations with therapeutic alliance, social support, motivation, and life events in psychosomatic in-patient therapy. Psychother Res. 2015;25(6):10.CrossRef
27.
28.
Victor M, Lau B, Ruud T. Predictors of return to work among patients in treatment for common mental disorders: a pre-post study. BMC Public Health. 2018;18(1):1–11.CrossRef
29.
Victor M, Lau B, Ruud T. Patient characteristics in a return to work programme for common mental disorders: a cross-sectional study. BMC Public Health. 2016;16(1):1–12.CrossRef
30.
Reme SE, Grasdal AL, Løvvik C, Lie SA, Øverland S. Work-focused cognitive–behavioural therapy and individual job support to increase work participation in common mental disorders: a randomised controlled multicentre trial. Occup Environ Med. 2015;72(10):745–52.PubMedCrossRef
31.
Reme SE, Monstad K, Fyhn T, Sveinsdottir V, Løvvik C, Lie SA, et al. A randomized controlled multicenter trial of individual placement and support for patients with moderate-to-severe mental illness. Scand J Work Environ Health. 2019;45:33.PubMedCrossRef
32.
Baxter AJ, Scott KM, Vos T, Whiteford HA. Global prevalence of anxiety disorders: a systematic review and meta-regression. Psychol Med. 2013;43(5):897–910.PubMedCrossRef
33.
Harvey SB, Deady M, Wang MJ, Mykletun A, Butterworth P, Christensen H, et al. Is the prevalence of mental illness increasing in Australia? Evidence from national health surveys and administrative data, 2001–2014. Med J Aust. 2017;206(11):490–3.PubMedCrossRef
34.
de Graaf R, ten Have M, van Gool C, van Dorsselaer S. Prevalence of mental disorders and trends from 1996 to 2009. Results from the Netherlands mental health survey and incidence study-2. Soc Psychiatry Psychiatr Epidemiol. 2012;47(2):203–13.PubMedCrossRef
35.
Ten Have M, Tuithof M, van Dorsselaer S, Schouten F, Luik AI, de Graaf R. Prevalence and trends of common mental disorders from 2007–2009 to 2019–2022: results from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS), including comparison of prevalence rates before vs. during the COVID-19 pandemic. World Psychiatry. 2023;22(2):275–85.PubMedPubMedCentralCrossRef
36.
37.
Cetrano G, Salvador-Carulla L, Tedeschi F, Rabbi L, Gutiérrez-Colosía MR, Gonzalez-Caballero JL, et al. The balance of adult mental health care: provision of core health versus other types of care in eight European countries. Epidemiol Psychiatr Sci. 2018;29:e6.PubMedPubMedCentralCrossRef
38.
39.
Alonso J, Codony M, Kovess V, Angermeyer MC, Katz SJ, Haro JM, et al. Population level of unmet need for mental healthcare in Europe. Br J Psychiatry. 2007;190(4):299–306.PubMedCrossRef
40.
Horwitz AV. Transforming normality into pathology: the DSM and the outcomes of stressful social arrangements. J Health Soc Behav. 2007;48(3):211–22.PubMedCrossRef
41.
Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13:e010.PubMedPubMedCentralCrossRef
42.
43.
Nymoen M, Biringer E, Hetlevik Ø, Thorsen O, Assmus J, Hartveit M. The impact of referral letter quality on timely access to specialised mental health care: a quantitative study of the reliability of patient triage. BMC Health Serv Res. 2022;22(1):735.PubMedPubMedCentralCrossRef
44.
Ryan T, Hatfield B, Sharma I. Outcomes of referrals over a six-month period to a mental health gateway team. J Psychiatr Ment Health Nurs. 2007;14(6):527–34.PubMedCrossRef
45.
Parkin A, Frake C, Davison I. A triage clinic in a child and adolescent mental health service. Child Adolesc Mental Health. 2003;8(4):177–83.CrossRef
46.
Rockland-Miller HS, Eells GT. The implementation of mental health clinical triage systems in university health services. J Coll Stud Psychother. 2006;20(4):39–51.CrossRef
47.
IS -1388. Distriktspsykiatriske sentre-med blikket vendt mot kommunene og spesialiserte sykehusfunksjoner i ryggen. [Community Mental Health centres- focus on the municipalities with support from the specialized hospital functions.] Norwegian Directorate og Health; 2006 [Available from: http://​hdl.​handle.​net/​11250/​2444716.
48.
49.
50.
Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.PubMedPubMedCentralCrossRef
51.
52.
Mundt JC, Marks IM, Shear MK, Greist JH. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002;180:461–4.PubMedCrossRef
53.
Mataix-Cols D, Cowley AJ, Hankins M, Schneider A, Bachofen M, Kenwright M, et al. Reliability and validity of the work and social adjustment scale in phobic disorders. Compr Psychiatry. 2005;46(3):223–8.PubMedCrossRef
54.
Evans JMC, Margison F, Barkham M, Audin K, Connell J, McGrath Graeme C. CORE: clinical outcomes in routine evaluation. J Mental Health. 2000;9(3):247–55.CrossRef
55.
Barkham M, Bewick B, Mullin T, Gilbody S, Connell J, Cahill J, et al. The CORE-10: a short measure of psychological distress for routine use in the psychological therapies. Couns Psychother Res. 2013;13(1):3–13.CrossRef
56.
Evans C, Connell J, Barkham M, Margison F, McGRATH G, Mellor-Clark J, et al. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE–OM. Br J Psychiatry. 2002;180(1):51–60.PubMedCrossRef
57.
Beck P. The clinical consequence of IRT analyses: health-related quality of life. Clin Psychometr. 2012;1:74.CrossRef
58.
Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167–76.PubMedCrossRef
59.
Neil ST, Kilbride M, Pitt L, Nothard S, Welford M, Sellwood W, et al. The questionnaire about the process of recovery (QPR): a measurement tool developed in collaboration with service users. Psychosis. 2009;1(2):145–55.CrossRef
60.
Law H, Neil ST, Dunn G, Morrison AP. Psychometric properties of the questionnaire about the process of recovery (QPR). Schizophr Res. 2014;156(2–3):184–9.PubMedCrossRef
61.
Skar-Fröding R, Clausen HK, Šaltytė Benth J, Ruud T, Slade M, Sverdvik HK. Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study. BMC Health Serv Res. 2021;21(1):439.PubMedPubMedCentralCrossRef
62.
Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption–II. Addiction. 1993;88(6):791–804.PubMedCrossRef
63.
Berman AH, Bergman H, Palmstierna T, Schlyter F. Evaluation of the Drug Use Disorders Identification Test (DUDIT) in criminal justice and detoxification settings and in a Swedish population sample. Eur Addict Res. 2005;11(1):22–31.PubMedCrossRef
64.
Reinert DF, Allen JP. The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcohol Clin Exp Res. 2002;26(2):272–9.PubMedCrossRef
65.
Hildebrand M. The psychometric properties of the Drug Use Disorders Identification Test (DUDIT): a review of recent research. J Subst Abuse Treat. 2015;53:52–9.PubMedCrossRef
66.
67.
Feng YS, Kohlmann T, Janssen MF, Buchholz I. Psychometric properties of the EQ-5D-5L: a systematic review of the literature. Qual Life Res. 2020;30:647–73.
68.
Attkisson CC, Zwick R. The client satisfaction questionnaire: Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982;5(3):233–7.PubMedCrossRef
69.
Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD. Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979;2(3):197–207.PubMedCrossRef
70.
Pedersen H, Havnen A, Brattmyr M, Attkisson CC, Lara-Cabrera ML. A digital Norwegian version of the client satisfaction questionnaire 8: factor validity and internal reliability in outpatient mental health care. BMC Psychiatry. 2022;22(1):671.PubMedPubMedCentralCrossRef
71.
72.
Munder T, Wilmers F, Leonhart R, Linster HW, Barth J. Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clin Psychol Psychother. 2010;17(3):231–9.PubMedCrossRef
73.
Cirasola A, Midgley N, Fonagy P, Martin P. The factor structure of the working alliance inventory short-form in youth psychotherapy: an empirical investigation. Psychother Res. 2021;31(4):535–47.PubMedCrossRef
74.
Duncan BL, Miller SD, Sparks JA, Claud DA, Reynolds LR, Brown J, et al. The session rating scale: preliminary psychometric properties of a “working” alliance measure. J Brief Ther. 2003;3(1):3–12.
75.
Ali S, Galloway S. Developing a screening tool for offenders with intellectual disabilities – the RAPID. J Intellect Disabil Offend Behav. 2016;7(3):161–70.CrossRef
76.
77.
Wing J, Beevor A, Curtis R, Park S, Hadden J, Burns A. Health of the nation outcome scales (HoNOS). Br J Psychiatry. 1998;172(1):11–8.PubMedCrossRef
78.
Dittner AJ, Hodsoll J, Rimes KA, Russell AJ, Chalder T. Cognitive-behavioural therapy for adult attention-deficit hyperactivity disorder: a proof of concept randomised controlled trial. Acta Psychiatr Scand. 2018;137(2):125–37.PubMedCrossRef
79.
Proudfoot J, Goldberg D, Mann A, Everitt B, Marks I, Gray JA. Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Psychol Med. 2003;33(2):217–27.PubMedCrossRef
80.
Proudfoot J, Ryden C, Everitt B, Shapiro DA, Goldberg D, Mann A, et al. Clinical efficacy of computerised cognitive-behavioural therapy for anxiety and depression in primary care: randomised controlled trial. Br J Psychiatry. 2004;185:46–54.PubMedCrossRef
81.
Giorgi A. The descriptive phenomenological method in psychology: a modified Husserlian approach. Pittsburg, Pennsylvania: Duquesne University Press; 2009.
82.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
83.
Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport, Exerc Health. 2019;11(4):589–97.CrossRef
Metadata
Title
Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial
Authors
Camilla Angelsen Kvestad
Ingvild Rønneberg Holte
Solveig Klæbo Reitan
Charlotte S. Chiappa
Gunn Karin Helle
Anne E. Skjervold
Anne Marit A. Rosenlund
Øyvind Watne
Heidi Brattland
Jon Helle
Turid Follestad
Karen Walseth Hara
Katrine Høyer Holgersen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Trials / Issue 1/2024
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-024-08028-6

Other articles of this Issue 1/2024

Trials 1/2024 Go to the issue

Study protocol

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

Study protocol

Health economic evaluation of a nurse-assisted online eye screening in home healthcare to reduce avoidable vision impairment (iScreen): study protocol for a cluster randomized controlled trial

Study protocol

Heart rate and breathing effects on attention and memory (HeartBEAM): study protocol for a randomized controlled trial in older adults

Study protocol

Does the use of higher versus lower oxygen concentration improve neurodevelopmental outcomes at 18–24 months in very low birthweight infants?

Study protocol

mini-MED: study protocol for a randomized, multi-intervention, semi-controlled feeding trial of a Mediterranean-amplified vs. habitual Western dietary pattern for the evaluation of food-specific compounds and cardiometabolic health

Study protocol

Effectiveness of telerehabilitation intervention to improve pain and physical function in people with patellofemoral pain syndrome: study protocol for a randomized controlled trial