Recovery Bridge Intervention for Mental Health Disorders

Recruiting in Palo Alto (17 mi)

Overseen by Richard W Goldberg, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: VA Office of Research and Development

No Placebo Group

Trial Summary

What is the purpose of this trial?

The time following discharge from psychiatric hospitalization is a high-risk period and has been associated with a range of negative outcomes including high rates of hospital readmission and suicide. The purpose of this proposal is to: 1) create a Peer Specialist facilitated intervention, called Recovery Bridge, designed to facilitate the transition from inpatient psychiatric hospitalization to community living; 2) examine feasibility, fidelity, and acceptability; and preliminarily explore the impact of the intervention on: a) readmission rates and connection to outpatient care compared to a control group identified from administrative data; and b) change in recovery and quality of life measures over time in the intervention participants. Results from the proposed open pilot trial will set the stage for next steps including a larger effectiveness trial followed by a possible hybrid-I effectiveness/implementation trial to inform future dissemination and implementation of the intervention more broadly across the VA.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Recovery Bridge Intervention for Mental Health Disorders is an effective treatment?

The available research shows that peer-led education programs like the Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) can help people with mental health disorders. In a study with 160 participants, the BRIDGES program, which is similar to Recovery Bridge Intervention, showed positive changes in participants. This suggests that having peers who have experienced similar challenges can provide valuable support and education. While the evidence is still growing, these peer-led interventions seem to offer a promising alternative to traditional treatments by focusing on recovery and self-management. ^{1 2 3 4 5}

What safety data exists for the Recovery Bridge Intervention?

The provided research does not directly address safety data for the Recovery Bridge Intervention or its variants. The studies focus on peer-led education and support programs like BRIDGES, which are similar in nature, but they do not specifically mention safety outcomes or data. Further research specifically targeting safety aspects of the Recovery Bridge Intervention is needed. ^{1 2 3 4 6}

Is the Recovery Bridge treatment a promising treatment for mental health disorders?

Yes, the Recovery Bridge treatment is promising because it uses peer support to help people manage their mental health after a crisis. This approach can provide the knowledge, skills, and support needed for a successful recovery, as shown in similar programs like BRIDGES. ^{1 2 3 4 7}

Research Team

Richard W Goldberg, PhD

Principal Investigator

Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD

Eligibility Criteria

This trial is for adults over 18 who are transitioning from psychiatric hospitalization to community living. Participants must be planning to discharge into the community and enrolled in an inpatient program. They need access to a computer or phone post-discharge and must be able to give consent.

Inclusion Criteria

I am 18 years old or older.

Enrolled in the inpatient program

Planned discharge to the community

Exclusion Criteria

No access to either a computer or a telephone after discharge (as at least one of these will be needed should the Veteran and PS interventionist decide to continue to meet remotely)

I am unable to give consent by myself.

Treatment Details

Interventions

• Recovery Bridge (Behavioral Intervention)

Trial Overview The 'Recovery Bridge' intervention, facilitated by Peer Specialists, aims to support individuals moving from psychiatric hospitals back into the community. The study will assess how well it works, its acceptability, and its effect on reducing readmissions and improving recovery and quality of life.

Participant Groups

Group I: Recovery Bridge Experimental Treatment 1 Intervention

Open trial single arm pilot study

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Dr. Grant Huang

VA Office of Research and Development

Acting Chief Research and Development Officer

PhD in Medical Psychology and Master of Public Health from the Uniformed Services University of Health Sciences

Dr. Erica M. Scavella

VA Office of Research and Development

Chief Medical Officer since 2022

MD from University of Massachusetts School of Medicine

Findings from Research

The BRIDGES peer-led education program, involving 160 participants over 8 weeks, significantly reduced psychiatric symptoms and improved feelings of hopefulness, self-advocacy, and empowerment after the intervention.

Participants also reported a decrease in maladaptive coping behaviors, indicating that peer-led education can enhance recovery and provide valuable support for individuals with mental health challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Early outcomes and lessons learned from a study of the Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) program in Tennessee. Pickett, SA., Diehl, S., Steigman, PJ., et al.[2019]

A peer-provided self-management intervention for mental health service users after discharge from crisis resolution teams was developed through a comprehensive five-stage process involving 41 service users and various consultations, indicating a strong need for structured support to reduce relapse.

Feedback from participants during feasibility testing was positive, highlighting the acceptability of peer support workers as facilitators, although the self-management materials required adjustments to enhance their use in future trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a peer-supported, self-management intervention for people following mental health crisis. Milton, A., Lloyd-Evans, B., Fullarton, K., et al.[2022]

Peer support services, particularly those where peers are added to traditional services or deliver structured curricula, show moderate evidence of effectiveness in improving recovery outcomes for individuals with serious mental illnesses or co-occurring disorders, based on a review of 20 studies.

Peers were found to be more effective than professional staff in reducing inpatient use and enhancing recovery outcomes, although the effectiveness of peers in existing clinical roles was less consistent, indicating a need for more rigorous studies to clarify these roles.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer support services for individuals with serious mental illnesses: assessing the evidence. Chinman, M., George, P., Dougherty, RH., et al.[2014]

The BRIDGES peer-led mental illness education program significantly improved self-perceived recovery and hopefulness in 428 individuals with serious mental illness, as measured by the Recovery Assessment Scale and State Hope Scale, compared to a control group.

Participants attended an average of five out of eight sessions, and the positive effects of the intervention were observed regardless of the severity of depressive symptoms, indicating its broad efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled trial of peer-led recovery education using Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES). Cook, JA., Steigman, P., Pickett, S., et al.[2016]

This study is the first of its kind in Germany to implement peer support interventions for individuals with severe mental illness on a large scale in a metropolitan area, aiming to improve recovery outcomes.

The research focuses on refining mental health interventions to reduce hospital re-admissions and enhance quality of life for patients and their families, aligning with the global trend towards recovery-oriented care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Peer Support for Individuals with Mental Health Problems and their Relatives - Background, Concept and Baseline Data]. Mahlke, C., Heumann, K., Ruppelt, F., et al.[2015]

A community psychoeducation program on recovery and peer support services led to significant improvements in participants' knowledge, awareness, and interest in peer services, as shown by quantitative survey results before and after the sessions.

Participants reported feeling a sense of hope, motivation, and support from the program, highlighting the importance of role modeling and shared experiences from trained mental health peers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recovery 101: A Community Psychoeducation Program on Mental Health Recovery and Peer Support Services Created by an Academic Psychiatrist and Delivered by Peers. Guillory, J., North, CS.[2022]

In a study of 195 participants, supportive peer services were favored over confrontational styles for both serious mental illness (SMI) and substance use disorder, highlighting the importance of a supportive approach in recovery.

Positive associations were found between supportive peer styles and recovery outcomes, indicating that supportive interactions may enhance recovery processes for individuals with SMI and substance use disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Public Perceptions of Recovery Prospects and Peer Style (Support and Confrontation) in Services for Serious Mental Illness Versus Substance Use Disorder. Corrigan, PW., Qin, S., Davidson, L., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

Early outcomes and lessons learned from a study of the Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES) program in Tennessee. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Development of a peer-supported, self-management intervention for people following mental health crisis. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Peer support services for individuals with serious mental illnesses: assessing the evidence. [2014]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Randomized controlled trial of peer-led recovery education using Building Recovery of Individual Dreams and Goals through Education and Support (BRIDGES). [2016]

5. Germany pubmed.ncbi.nlm.nih.gov

[Peer Support for Individuals with Mental Health Problems and their Relatives - Background, Concept and Baseline Data]. [2015]

6. United States pubmed.ncbi.nlm.nih.gov

Recovery 101: A Community Psychoeducation Program on Mental Health Recovery and Peer Support Services Created by an Academic Psychiatrist and Delivered by Peers. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Public Perceptions of Recovery Prospects and Peer Style (Support and Confrontation) in Services for Serious Mental Illness Versus Substance Use Disorder. [2020]