Effectiveness and Cost Effectiveness of Peer Mentors in Reducing Hospital Use (Project PEP)

The current study, through a randomized controlled design, will evaluate the effectiveness of peer support, as compared to usual care and to an equivalent amount of support offered by peer case managers and non-peer recovery mentors, in reducing hospital days and readmissions and in promoting recovery and community inclusion among adults with mental illnesses with histories of multiple hospitalizations. The current study evaluates the cost-effectiveness of adding peer support to the array of services available to persons with serious mental illnesses who have histories of multiple hospitalizations and will test a theoretical model of the active ingredients of peer support, focusing specifically on the roles of 1) instillation of hope through positive self-disclosure; 2) role modeling of self-care and exploring new ways of using experiential knowledge; and 3) a trusting relationship characterized by acceptance, understanding, and empathy with conditional regard.

Study Overview

• Status: Completed
• Conditions: Serious Mental Illness
• Intervention / Treatment: Behavioral: Community Connector; Behavioral: Peer Recovery Mentor; Behavioral: Peer Case Manager

• Study Type: Interventional
• Enrollment (Actual): 285
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Connecticut
    • New Haven, Connecticut, United States, 06519
      • Yale Psychiatric Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 2 or more psychiatric hospitalizations in the past year
• A diagnosis of serious mental illness

Exclusion Criteria:

• Dementia or other organic condition limiting ability to provide informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Treatment as usual
Experimental: Community Connector; The participant randomized into this arm of the study is invited to work with a person trained as a community connector, who is trained in Intentional Peer Support but does not have a lived experience of mental illness.	Behavioral: Community Connector; The participant randomized into this arm of the study is invited to work with a person trained as a community connector, someone who is trained in Intentional Peer Support but does not have a lived experience of mental illness.
Experimental: Peer Recovery Mentor; A participant randomized into this arm of the study is offered the chance to work with a Peer Recovery Mentor, who is trained in Intentional Peer Support.	Behavioral: Peer Recovery Mentor; A participant randomized into this arm of the study is offered the chance to work with a Peer Recovery Mentor, who is trained in Intentional Peer Support.
Experimental: Peer Case Manager; If a participant is randomized into this condition, they are offered the chance to work with a Case Manager, who is trained in strengths-based case management.	Behavioral: Peer Case Manager; A participant randomized into this arm of the study is offered the chance to work with a Peer Recovery Mentor, who is trained in Intentional Peer Support.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Service use	Via self-report from the participant	3 months
Service Use	Via self-report from the participant	9 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Psychiatric symptoms	Measured using the Symptom Distress scale and the Paranoia and Psychoticism subscales from the Symptom Check List-90 (SCL-90)	3 months
Quality of life	Measured using Lehman's Brief Quality of Life scale	3 month
Community inclusion	Measured using Mancini's Community Connections Inventory	3 months
Psychiatric symptoms	Measured using the Symptom Distress scale and the Paranoia and Psychoticism subscales from the Symptom Check List-90 (SCL-90)	9 months
Quality of Life	Measured using Lehman's Brief Quality of Life scale	9 months
Community Inclusion	Measured using Mancini's Community Connections Inventory	9 months

Collaborators and Investigators

• Sponsor: Yale University
• Collaborators: National Institute of Mental Health (NIMH)
• Investigators: Principal Investigator: Larry Davidson, PhD, Yale Program for Recovery and Community Health

Study record dates

Study Major Dates

• Study Start: August 1, 2011
• Primary Completion (Actual): November 1, 2013
• Study Completion (Actual): November 1, 2013

Study Registration Dates

• First Submitted: March 26, 2012
• First Submitted That Met QC Criteria: March 28, 2012
• First Posted (Estimate): March 29, 2012

Study Record Updates

• Last Update Posted (Estimate): January 26, 2015
• Last Update Submitted That Met QC Criteria: January 22, 2015
• Last Verified: January 1, 2015

More Information

Terms related to this study

• Keywords: Cost Effectiveness; Serious Mental Illness; Peer Support; Reducing Hospital use
• Additional Relevant MeSH Terms: Mental Disorders
• Other Study ID Numbers: 1010007542; 1R01MH091453 (U.S. NIH Grant/Contract)