Evaluation of a Collaborative Mental Health Care System (MED@PSY)

In the absence of easy access to second-line ambulatory care, the number of 'inappropriate' psychiatric emergency visits is increasing, with emergency departments becoming the gateway to mental health care.

This is the context in which the 'med@psy' system was set up in the Toulon-Provence-Mediterranean metropolitan area by a private psychiatrist. It facilitates access to psychiatric second referral for General Practitioners (GPs) by pooling the 48-hour supply of psychiatric consultations in real time. It is assumed that this system will facilitate access to outpatient psychiatric care and help to optimize the organisation of patient care and follow-up. The aim of this study is to evaluate the med@psy system in the care pathway for patients with psychiatric disorders.

This study main objective is to compare the proportion of patients with a psychiatric disorder who will receive outpatient follow-up 1 month after a visit to a psychiatric emergency department without hospitalization (Group 1) versus 1 month after a consultation with a psychiatrist within 48 hours via the med@psy system (Group 2).

Study Overview

• Status: Recruiting
• Conditions: Psychiatric Adults Patients
• Intervention / Treatment: Other: Clinical assessment by emergency psychiatrist; Other: Psychiatric consultation booked through Med@Psy platform

Detailed Description

General practitioners (GPs) are the gateway to the healthcare system and therefore the first point of contact for mental health. A significant proportion of psychiatric disorders can be treated in primary care if GPs have easy access to psychiatric support. However, they are faced with difficulties in accessing secondary care. Around 9/10 consider that it is more difficult to obtain specialist advice than for other disciplines, and say they have difficulty referring a patient for mental health care.

In the absence of easy access to second-line ambulatory care, the number of 'inappropriate' psychiatric emergency visits is increasing, with emergency departments becoming the gateway to mental health care. It is recognized that the deployment of earlier and more graduated care reduces the intensity of disorders, prescriptions for time off work and psychotropic drugs, and hospitalizations.

A new, more preventive, efficient and cost-effective approach to mental health is emerging, with psychiatrists working closely with GPs. This is the context in which the 'med@psy' system was set up in the Toulon-Provence-Mediterranean metropolitan area by a private psychiatrist. It facilitates access to psychiatric second referral for GPs by pooling the 48-hour supply of psychiatric consultations in real time. We assume that this system will facilitate access to outpatient psychiatric care and help to optimize the organisation of patient care and follow-up. The aim of this study is to evaluate the med@psy system in the care pathway for patients with psychiatric disorders.

This study main objective is to compare the proportion of patients with a psychiatric disorder who will received outpatient follow-up 1 month after a visit to a psychiatric emergency department without hospitalization (Group 1) versus 1 month after a consultation with a psychiatrist within 48 hours via the med@psy system (Group 2).

• Study Type: Interventional
• Enrollment (Estimated): 418
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Asmaa Jobic; Phone Number: +33 +33 4 83 77 20 61; Email: asmaa.jobic@ch-toulon.fr
• Study Contact Backup: Name: Fabien Korrichi, MD; Email: docteurkorrichifabien@gmail.com

Study Locations

• France
  • Var
    • Toulon, Var, France, 83000
      • Recruiting
      • Cabinet médical Korrichi (Med@psy program linked to this office)
      • Contact: Fabien Korrichi, MD; Phone Number: +33 +33 4 94 38 37 53; Email: docteurkorrichifabien@gmail.com
    • Toulon, Var, France, 83100
      • Recruiting
      • Centre Hospitalier Intercommunal Toulon La Seyne sur Mer emergency reception service
      • Contact: Manuel Dias Alves, MD; Phone Number: +33 +33 4 94 14 53 86; Email: manuel.diasalves@ch-toulon.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patient ≥ 18 years ;
• Patient presenting to the Centre hospitalier de Toulon La Seyne sur Mer emergency department, with or without referral, and receiving psychiatric advice with discharge without hospitalization after clinical assessment (Group 1) or patients referred for psychiatric consultation via the Med@psy system (Group 2).
• Patient with indication for outpatient follow-up
• Patient with open social security rights

Exclusion Criteria:

• Patient's refusal to take part in research ;
• Patient currently being followed by a psychiatrist. Psychiatric follow-up is defined as at least one consultation with a psychiatrist in the last 3 months, outside an unscheduled care consultation or in an emergency department;
• Patients referred for a suicide attempt, violent or non-violent, serious or non-serious;
• Patients without a declared general practioner;
• Patients already included in the study;
• Patients who do not speak French;
• Patients under judicial protection (guardianship, curatorship, etc.) or safeguard of justice;
• Patient under compulsory care, under a care order or deprived of liberty.
• Any other reason which, in the investigator's opinion, could interfere

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Sham Comparator: Emergency; Adult patients presenting to the emergency department of the Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer, whether or not referred by their general practitioner.	Other: Clinical assessment by emergency psychiatrist; After a clinical assessment by the emergency department psychiatrist which does not lead to hospitalization, the patient will be given a psychiatric interview and sent home.
Experimental: Med@Psy Platform; Adult patients referred by their general practioner for a psychiatric consultation via the med@psy system.	Other: Psychiatric consultation booked through Med@Psy platform; The patient will be seen within 48 hours after the consultation with his or her general practitioner by a psychiatrist taking part in the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of patients with a consultation with a psychiatrist, a psychologist or a general practioner one month after the consultation via the med@psy system or the visit to emergency department	Setting up outpatient follow-up from a binary point of view (outpatient follow-up absent or present). This will be defined by whether or not each group has had at least one consultation with a psychiatrist (apart from emergency psychiatric consultations or psychiatric consultations set up at 48 hours with the system), a psychologist or a general practitioner. It will be evaluated by means of a telephone survey carried out among patients 1 month after consultation with a psychiatrist via the med@psy system or a visit to the emergency department.	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Outpatient follow-up at three months	Outpatient follow-up will be evaluated by the proportion of patients who have had at least one consultation with a psychiatrist, psychologist or general practitioner, in each group, by means of a telephone survey carried out with patients 3 months after the consultation or visit to the emergency department.	3 months
Medical partners commitment (part 1)	Medical partners commitment will be assessed by the number of GPs and psychiatrists registered in the Med@psy program.	1 year
Medical partners commitment (part 2)	Medical partners commitment will be assessed by the number of patients treated via the program.	1 year
Medical partners commitment (part 3)	Medical partners commitment will be assessed by the frequency of use of Med@psy program.	1 year
Medical partners commitment (part 4)	Medical partners commitment will be assessed by the average time between referral by the GPs and the psychiatric consultations offered through the Med@psy program, 12 months after its start of use.	1 year
Med@psy platform patients characteristics	Description of the patient population who get a psychiatric consultation within 48 hours through the Med@psy platform but who don't come to the consultation. The elements which will be evaluated are : age, sex, place of residence, pathology and reason for referral by a GP.	1 month
Functioning Global Assessment	Overall psychological, social and professional functioning will be assessed using the Global Assessment of Functioning (GAF), which will be carried out by a psychologist during a teleconsultation with the patient at 1 and 3 months. Each time, GAF score will be assessed by a second psychologist on the basis of teleconsultation report and the two scores calculated will be compared. In case of different conclusions, the average of the two scores will be taken into account. GAF is a scale used to rate how serious a mental illness may be. It measures how much a person's symptoms affect their day-to-day life on a scale of 0 to 100. 100 corresponds to a better ability to handle daily activities.	3 months

Collaborators and Investigators

• Sponsor: Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer
• Investigators: Study Director: Fabien Korrichi, MD

Publications and helpful links

General Publications

• Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry. 1995 May;166(5):654-9. doi: 10.1192/bjp.166.5.654.
• Kates N, Arroll B, Currie E, Hanlon C, Gask L, Klasen H, Meadows G, Rukundo G, Sunderji N, Ruud T, Williams M. Improving collaboration between primary care and mental health services. World J Biol Psychiatry. 2019 Dec;20(10):748-765. doi: 10.1080/15622975.2018.1471218. Epub 2018 Jun 20.
• Truelove S, Ng V, Kates N, Alloo J, Sunderji N, Patriquin MJ. Les soins de sante mentale en collaboration: Mobiliser les systemes de sante pour soutenir une approche d'equipe. Can Fam Physician. 2023 Feb;69(2):86-88. doi: 10.46747/cfp.690286. No abstract available. French.
• Dias Alves M, Jobic A, Rosso N, Abello M, Autret A, Vion-Dury J, Belzeaux R, Korrichi F. Evaluation of a collaborative care system in primary care in the implementation of ambulatory follow-up in mental health: A study protocol. PLoS One. 2026 Feb 25;21(2):e0343295. doi: 10.1371/journal.pone.0343295. eCollection 2026.

Study record dates

Study Major Dates

• Study Start (Actual): March 3, 2025
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): June 1, 2027

Study Registration Dates

• First Submitted: August 30, 2024
• First Submitted That Met QC Criteria: August 30, 2024
• First Posted (Actual): September 3, 2024

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 10, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: emergency; psychiatry; ehealth; collaborative care; outpatient follow-up
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Pathological Conditions, Signs and Symptoms; Emergencies
• Other Study ID Numbers: 2024-CHITS-005; 2024-A01115-42 (Other Identifier: ID-RCB)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No