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.

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.

[Exercise contacts in the treatment of substance dependence and mental disorders]. / Treningskontaktar ved rusproblem og psykiske lidingar.

BACKGROUND: Physical exercise is useful for individuals with mental disorders with additional substance dependency or abuse. Many exercise actively while in institution, but a major challenge is to continue after discharge. Many patients are isolated and lonely and find it hard to motivate themselves to exercise on their own. MATERIAL AND METHODS: In Sogn og Fjordane county, Norway, the problem was dealt with through a training program of exercise contacts. These are social support persons who were thus assigned a new function. By way of a 40-hour course that covered physical activity, psychological problems, and substance abuse and dependency, lay people were trained to help people in their home environment. RESULTS AND DISCUSSION: By the end of 2005, almost 300 exercise contacts, living in 25 of the 26 municipalities in the county, had passed the course exam. Their expertise is highly demanded and more courses have been requested. The course evaluations have been quite positive. In particular, the practical instructions about how to exercise, in combination with updated theory on substance abuse/dependence and mental disorders, were highly appreciated. Clients were helped to continue with regular physical activity and they have appreciated the improved physical and mental health that was associated with regular exercise. Moreover, the exercise contacts help clients break social isolation and have given them access to the common social arenas.