The effects of a pretreatment educational group programme on mental health treatment outcomes: a randomized controlled trial

John Morten Koksvik, Olav Morten Linaker, Rolf Wilhelm Gråwe, Johan Håkon Bjørngaard, Mariela Loreto Lara-Cabrera, John Morten Koksvik, Olav Morten Linaker, Rolf Wilhelm Gråwe, Johan Håkon Bjørngaard, Mariela Loreto Lara-Cabrera

Abstract

Background: Patients dropping out of mental health treatment is considered a widespread and significant obstacle to providing effective treatment, thus reducing the probability of patients achieving the desired improvement. Here, relative to ordinary treatment, we investigate the effects of providing an educational group programme before mental health treatment on mental health symptomatology and the risk of patients dropping out or prematurely discontinuing treatment.

Methods: A randomized controlled trial in which adults referred to a community mental health center were randomized to either a Control Group (n = 46) or a pretreatment educational programme followed by treatment as usual (Intervention Group, n = 45). The primary outcome was self-reported mental health symptomatology assessed with BASIS-32. Data were analyzed by multilevel linear regression and Cox's regression.

Results: We recruited 93 patients during a 26-month period. Assessments were performed before (0 month, baseline) and after the intervention (1 month, before treatment initiation), and after 4 and 12 months. The net difference in BASIS-32 score between 0 and 1-month was - 0.27 (95% confidence interval CI] -0.45 to - 0.09) in favor of the intervention group. Although both groups had a significant and continuous decline in psychopathology during the treatment (from 1 month and throughout the 4- and 12-month follow-up assessments), the group difference detected before treatment (between 0 and 1 month) persisted throughout the study. Premature treatment discontinuation was partially prevented. The dropout risk was 74% lower in the Intervention Group than in the Control Group (hazard ratio 0.26, 95% CI = 0.07-0.93).

Conclusions: A brief educational intervention provided before mental health treatment seems to have an immediate and long-lasting effect on psychopathology, supplementary to traditional treatment. Such an intervention might also have a promising effect on reducing treatment dropout.

Trial registration: NCT00967265 , clinicaltrials.gov . Registered August 27, 2009, retrospectively registered.

Keywords: Community mental health centers; Mental health; Patient dropout; Patient education; Peer group; Randomised controlled trial; Self-management.

Conflict of interest statement

Ethics approval and consent to participate

The Regional Committee for Medical and Health Research Ethics in Central Norway approved the trial (No. 4.2009.77). The study was carried out in accordance with the Helsinki Declaration. All participants were given a minimum of 1-h oral information about the project, along with written information about the study.

Participants signed informed consent. Patients did not receive any compensation for participating.

Consent for publication

Not applicable.

Competing interests

The authors declare that there are no conflicts of interest to this article.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Recruitment and attrition according to CONSORT guidelines
Fig. 2
Fig. 2
The estimated level of BASIS-32 at baseline (0), 1 month, 4 months, and 12 months follow-up. 95% confidence intervals (vertical lines)
Fig. 3
Fig. 3
Kaplan-Meier survival curve showing the dropout rates for the IG and the CG

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