A Trial of "Opening Doors to Recovery" for Persons With Serious Mental Illnesses (ODR)
Mental Disorders, Severe, Schizophrenia and Related Disorders, Bipolar Disorder
About this trial
This is an interventional health services research trial for Mental Disorders, Severe focused on measuring serious mental illness, community navigation
Eligibility Criteria
Inclusion Criteria:
- Able to speak/read English
- Clinical diagnosis of one of the following: psychotic disorder, bipolar disorder, or major depressive disorder
- Capacity to give informed consent
- Being discharged to one of seven counties served by Gateway Behavioral Health Services
- Being hospitalized on an adult, non-forensics unit at Georgia Regional Hospital at Savannah, the Gateway-Brunswick CSU, or the Savannah CSU (located at Coastal Harbor) for ≥2 nights
- At least one additional prior hospitalization or CSU stay of ≥2 nights within the past 12 months (our definition of "institutional recidivism")
Inability to complete activities of daily living in at least two of the following areas despite support from caregiver or behavioral health staff (this is a criterion previously established for receiving ICM services):
- navigate and self-manage necessary services,
- maintain personal hygiene, meet nutritional needs,
- care for personal business affairs, obtain or maintain medical, legal, and housing services,
- recognize and avoid common dangers or hazards to self and possessions,
- perform daily living tasks,
- obtain or maintain employment at a self-sustaining level or consistently perform homemaker roles (meal preparation, washing clothes, budgeting, or childcare tasks and responsibilities),
- maintain safe living situation (evicted from housing/recent loss of housing/imminent risk of loss of housing)
- Requires assistance with one or more of the following as an indicator of demonstrated ownership and engagement with his/her own illness self-management (this also is a criterion previously established for receiving ICM services): a. Taking prescribed medications b. Following a crisis plan c. Maintaining community integration d. Keeping appointments with needed services which have resulted in the exhibition of specific behaviors that have led to two or more of the following within the past 18 months (hospitalization, incarcerations, homelessness, or use of other crisis services)
Exclusion Criteria:
- Known or suspected intellectual disability, mental retardation, or dementia
- Known or suspected autism-spectrum disorder, organic mental disorder, and/or traumatic brain injury
- Significant medical condition compromising ability to participate (e.g., short of breath, in pain)
- Having taken part in the initial ODR study or being enrolled in any other study.
- Being referred to ACT
- Not having the ability to provide informed consent for the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Opening Doors to Recovery
Intensive Case Management or Case Management
Participants will receive services from the team of three ODR navigators: one professional social worker, one navigator who is a family member of someone with SMI, and one peer navigator with lived experience.
Participants randomized to the control group will either receive standard services of Intensive Case Management or Case Management, depending on the services that are available in their county.