Testing Self-Directed Care in Florida

University of Illinois

Status: Completed

Conditions: Mental Disorder

Treatments: Behavioral: Self-Directed Care; Behavioral: Services as usual

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT05649449

STUDY2008-0970

Details and patient eligibility

About

This study tests a psychosocial intervention called mental health self-directed care by assessing its impact on recovery, mental health status, rehabilitation outcomes, and service costs in the state of Florida.

Full description

With additional funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), a new cohort of 40 study subjects will be recruited in the state of Florida to test mental health self-directed care (SDC). SDC is a self-directed model of service delivery in which participants manage a personal budget from which they purchase goods and services, including specific types of mental health care, social supports, and items that allow them to recover their health and emotional wellness and live independently. Investigators are studying the impact of SDC on recovery, mental health status, rehabilitation outcomes, and service costs. Working with Lutheran Services Florida, a public managing entity coordinating mental health care management in northeastern and central Florida, adults with mental health conditions will be recruited into the study and randomly assigned to receive SDC for one year or continue receiving services as usual. Assessments will occur at baseline, 6- and 12-month followup.

Enrollment: 42 patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 and older
• Serious mental illness
• Receiving services coordinated by behavioral health managing entity

Exclusion criteria

• Cognitive impairment preventing informed consent
• Enrollment in Medicaid/Medicare
• Representative payeeship
• Court-mandated treatment
• Recent substance disorder crisis
• In residential treatment
• History of violent behavior in the past 10 years

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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42 participants in 2 patient groups

Experimental

Experimental group

Description:

Participants meet with self-directed care program staff called brokers to receive a program orientation, share perceptions of their current life situation and mental health status, and review past year behavioral health service use as well as participants' views of service helpfulness. This culminates in participants' choice of recovery goals and development of an individual budget to pay for for services and material goods directly related to recovery goals. After budget approval by the program supervisor, brokers make purchases. At quarterly meetings, brokers and participants discuss the latter's progress toward recovery goals and create the next quarter's budget. After receiving 12 months of SDC services, participants are helped to transition back to usual community mental health services.

Treatment:

Behavioral: Self-Directed Care

Control

Active Comparator group

Description:

Subjects receive routine mental health care from community agencies consisting of outpatient services coordinated at community behavioral health programs.

Treatment:

Behavioral: Services as usual