Development of a model for shared care between general practice and mental healthcare: a protocol for a co-production study

Michael Marcussen, Lene Berring, Mogens Hørder, Jens Søndergaard, Birgitte Nørgaard, Michael Marcussen, Lene Berring, Mogens Hørder, Jens Søndergaard, Birgitte Nørgaard

Abstract

Introduction: Mental health illness represents one of the greatest health burdens in the world. It is well documented that treatment of these illnesses could be optimised through strengthened collaboration between general practice and specialised mental healthcare services (shared care). Furthermore, involvement of users in the design of new interventions to strengthen end-user value and sustainability is key. Therefore, the aim of this study is to develop a shared care intervention in co-production with users.

Methods and analysis: The study will take place at psychiatric outpatient clinics in Denmark.The project is described in four sequential steps, each informing and leading into the next: a systematic review (step 1) will be followed by an exploratory study investigating how stakeholders (general practitioners, mental healthcare staff and patients) perceive existing treatment and collaboration between general practice and mental health services. Steps 1 and 2 will inform and qualify the intervention that will be developed in step 3 as a co-creation study. Step 4 will assess the intervention in a feasibility study. Step 4 will be designed as a non-randomised intervention study with a control group with preassessments and postassessments. In total, 240 patients will be recruited. Questionnaires will be administered to the participants at their first visit to an outpatient clinic and again after 3 months. The primary outcome will be patients' self-reported mental health status (Short Form Health Survey, SF-36) and recovery (revised Recovery Assessment Scale, RAS-R). Recruitment will take place from June 2023 to May 2024.

Ethics and dissemination: The project is approved by the ethics committee (REG-016-2022). Informed consent based on written and verbal information about the aims, purpose and use of the study and the data collection will be obtained from all participants. The study findings will be published in peer-reviewed journals and presented at national and international conferences. The study is registered at ClinicalTrials.gov.

Trial registration number: NCT05172375.

Prospero registration number: 287989.

Keywords: depression & mood disorders; general medicine (see internal medicine); mental health.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Study design.

References

    1. Christensen TN, Wallstrøm IG, Bojesen AB, et al. . Predictors of work and education among people with severe mental illness who participated in the Danish individual placement and support study: findings from a randomized clinical trial. Soc Psychiatry Psychiatr Epidemiol 2021;56:1669–77. 10.1007/s00127-021-02107-8
    1. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics 2016;138:e20161878. 10.1542/peds.2016-1878
    1. World Health Organisation (WHO) . World mental health report: transforming mental health for all. Geneva, 2022.
    1. Kennedy N, Foy K, Sherazi R, et al. . Long-term social functioning after depression treated by psychiatrists: a review. Bipolar Disord 2007;9:25–37. 10.1111/j.1399-5618.2007.00326.x
    1. Iancu SC, Batelaan NM, Zweekhorst MBM, et al. . Trajectories of functioning after remission from anxiety disorders: 2-year course and outcome predictors. Psychol Med 2014;44:593–605. 10.1017/S0033291713001050
    1. Rugulies R, Aust B. Work and mental health: what do we know and how can we intervene? Scand J Work Environ Health 2019;45:529–32. 10.5271/sjweh.3856
    1. Søgaard HJ, Bech P. Psychiatric disorders in long-term sickness absence -- a population-based cross-sectional study. Scand J Public Health 2009;37:682–9. 10.1177/1403494809344357
    1. Manthey TJ, Goscha R, Rapp C. Barriers to supported education implementation: implications for administrators and policy makers. Adm Policy Ment Health 2015;42:245–51. 10.1007/s10488-014-0583-z
    1. Ringeisen H, Langer Ellison M, Ryder-Burge A, et al. . Supported education for individuals with psychiatric disabilities: state of the practice and policy implications. Psychiatr Rehabil J 2017;40:197–206. 10.1037/prj0000233
    1. Hunt J, Eisenberg D. Mental health problems and help-seeking behavior among college students. J Adolesc Health 2010;46:3–10. 10.1016/j.jadohealth.2009.08.008
    1. Weitkamp K, Klein E, Midgley N. The experience of depression: a qualitative study of adolescents with depression entering psychotherapy. Glob Qual Nurs Res 2016;3:2333393616649548. 10.1177/2333393616649548
    1. Bauer J, Okkels N, Munk-Jørgensen P. State of psychiatry in Denmark. Int Rev Psychiatry 2012;24:295–300. 10.3109/09540261.2012.692321
    1. Byng R, Norman I, Redfern S, et al. . Exposing the key functions of a complex intervention for shared care in mental health: case study of a process evaluation. BMC Health Serv Res 2008;8:274. 10.1186/1472-6963-8-274
    1. Møller MCR, Mygind A, Bro F. Who needs collaborative care treatment? A qualitative study exploring attitudes towards and experiences with mental healthcare among general practitioners and care managers. BMC Fam Pract 2018;19:78. 10.1186/s12875-018-0764-z
    1. Overbeck G, Kousgaard MB, Davidsen AS. The work and challenges of care managers in the implementation of collaborative care: a qualitative study. J Psychiatr Ment Health Nurs 2018;25:167–75. 10.1111/jpm.12449
    1. Curth NK, Brinck-Claussen Ursula Ødum, Hjorthøj C, et al. . Collaborative care for depression and anxiety disorders: results and lessons learned from the Danish cluster-randomized Collabri trials. BMC Fam Pract 2020;21:234. 10.1186/s12875-020-01299-3
    1. Magaard JL, Liebherz S, Melchior H, et al. . Collaborative mental health care program versus a general practitioner program and usual care for treatment of patients with mental or neurological disorders in Germany: protocol of a multiperspective evaluation study. BMC Psychiatry 2018;18:347. 10.1186/s12888-018-1914-5
    1. Bower P, Gilbody S. Managing common mental health disorders in primary care: conceptual models and evidence base. BMJ 2005;330:839–42. 10.1136/bmj.330.7495.839
    1. Lester H. Shared care for people with mental illness: a GP’s perspective. Advances in Psychiatric Treatment 2005;11:133–9. 10.1192/apt.11.2.133
    1. Hardwick R, Pearson M, Byng R, et al. . The effectiveness and cost-effectiveness of shared care: protocol for a realist review. Syst Rev 2013;2:12. 10.1186/2046-4053-2-12
    1. Overbeck G, Davidsen AS, Kousgaard MB. Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review. Implement Sci 2016;11:165. 10.1186/s13012-016-0519-y
    1. Ladefoged U, Højmark A, Universitet A. Integrerede indsatser for mennesker med psykiske lidelser - En forskningsoversigt. Mental Health Nursing 2017.
    1. Berring LL, Hummelvoll JK, Pedersen L, et al. . A co-operative inquiry into generating, describing, and transforming knowledge about De-escalation practices in mental health settings. Issues Ment Health Nurs 2016;37:451–63. 10.3109/01612840.2016.1154628
    1. Hostick T, McClelland F. 'Partnership': a co-operative inquiry between community mental health nurses and their clients. 2. The nurse-client relationship. J Psychiatr Ment Health Nurs 2002;9:111–7. 10.1046/j.1351-0126.2001.00457.x
    1. Skivington K, Matthews L, Simpson SA, et al. . A new framework for developing and evaluating complex interventions: update of medical Research Council guidance. BMJ 2021;374:n2061. 10.1136/bmj.n2061
    1. Page MJ, McKenzie JE, Bossuyt PM, et al. . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. 10.1136/bmj.n71
    1. CASP . Critical appraisal skills programme: making sense of evidence about clinical effectiveness: 11 questions to help you make sense of a trial, 2010: 1–3.
    1. Coffey A, Atkinson P. Concepts and coding. in: making sense of qualitative data, 1996.
    1. Hybholt L, Buus N, Erlangsen A, et al. . Psychosocial rehabilitation of elderly persons bereaved by suicide: a co-operative inquiry study protocol. Issues Ment Health Nurs 2019;40:382–90. 10.1080/01612840.2018.1543742
    1. Berring LL, Buus N, Hybholt L. Exploring the dynamics of a research partnership in a co-operative inquiry: a qualitative study. Issues Ment Health Nurs 2021;42:818–26. 10.1080/01612840.2021.1875275
    1. Hummelvoll JK, Severinsson E. Researchers' experience of co-operative inquiry in acute mental health care. J Adv Nurs 2005;52:180–8. 10.1111/j.1365-2648.2005.03570.x
    1. Bortoli S. Guidance on co-producing a research project, 2021.
    1. de Vocht F, Katikireddi SV, McQuire C, et al. . Conceptualising natural and Quasi experiments in public health. BMC Med Res Methodol []. 2021;21:32. 10.1186/s12874-021-01224-x
    1. Kates N, Ackerman S, Crustolo AM, et al. . Collaboration between mental health and primary care services, 2006.
    1. Richards DA, Hill JJ, Gask L, et al. . Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial. BMJ 2013;347:f4913. 10.1136/bmj.f4913
    1. Ware JE, Snow KK, Kosinski M. Sf-36 health survey manual and interpretation guide. The Health Institute, Boston New England Medical Centre, 1993.
    1. Guilfoyle MR, Seeley H, Laing RJ. The Short Form 36 health survey in spine disease--validation against condition-specific measures. Br J Neurosurg 2009;23:401–5. 10.1080/02688690902730731
    1. Bjorner JB, Thunedborg K, Kristensen TS, et al. . The Danish SF-36 health survey: translation and preliminary validity studies. J Clin Epidemiol 1998;51:991–9. 10.1016/s0895-4356(98)00091-2
    1. Biringer E, Tjoflåt M. Validation of the 24-item recovery assessment scale-revised (RAS-R) in the Norwegian language and context: a multi-centre study. Health Qual Life Outcomes 2018;16:23. 10.1186/s12955-018-0849-3
    1. Kessler RC, Andrews G, Colpe LJ, et al. . Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002;32:959–76. 10.1017/S0033291702006074
    1. Loh A, Simon D, Wills CE, et al. . The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial. Patient Educ Couns 2007;67:324–32. 10.1016/j.pec.2007.03.023
    1. De Wilde EF, Hendriks VM. The client satisfaction questionnaire: psychometric properties in a Dutch addict population. Eur Addict Res 2005;11:157–62. 10.1159/000086396
    1. Rettke H, Lehmann AI, Brauchli R, et al. . Capturing interprofessional collaboration between physicians and nurses in an acute care setting. A validation study of the revised German version of the Collaborative practice scales. J Interprof Care 2020;34:211–7. 10.1080/13561820.2019.1629399
    1. Kriston L, Scholl I, Hölzel L, et al. . The 9-item shared decision making questionnaire (SDM-Q-9). development and psychometric properties in a primary care sample. Patient Educ Couns 2010;80:94–9. 10.1016/j.pec.2009.09.034
    1. Murdoch J. Process evaluation for complex interventions in health services research: analysing context, text trajectories and disruptions. BMC Health Serv Res 2016;16:407. 10.1186/s12913-016-1651-8
    1. Anon . Declaration of Helsinki (1964). BMJ 1996;313:1448–9. 10.1136/bmj.313.7070.1448a
    1. The General Data Protection Regulations (GDPR) . The general data protection regulations (GDPR). Regulation (EU) 2016/679, 2016.

Source: PubMed

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