Skip to main content
OpenTrials
Completed

NCT Number: NCT05649449

Testing Self-Directed Care in Florida

This study tests a psychosocial intervention called mental health self-directed care by assessing its impact on recovery, mental health status, rehabilitation outcomes, and service costs in the state of Florida.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Mental Disorder Mental Disorders

Age range

18 year–100 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Illinois at Chicago, Department of Psychiatry

Chicago, Illinois, 60612, United States

About this study

With additional funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), a new cohort of 40 study subjects will be recruited in the state of Florida to test mental health self-directed care (SDC). SDC is a self-directed model of service delivery in which participants manage a personal budget from which they purchase goods and services, including specific types of mental health care, social supports, and items that allow them to recover their health and emotional wellness and live independently. Investigators are studying the impact of SDC on recovery, mental health status, rehabilitation outcomes, and service costs. Working with Lutheran Services Florida, a public managing entity coordinating mental health care management in northeastern and central Florida, adults with mental health conditions will be recruited into the study and randomly assigned to receive SDC for one year or continue receiving services as usual. Assessments will occur at baseline, 6- and 12-month followup.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age 18 and older
  • Serious mental illness
  • Receiving services coordinated by behavioral health managing entity

Exclusion criteria

  • Cognitive impairment preventing informed consent
  • Enrollment in Medicaid/Medicare
  • Representative payeeship
  • Court-mandated treatment
  • Recent substance disorder crisis
  • In residential treatment
  • History of violent behavior in the past 10 years

Treatment and study plan

Self-directed care

Behavioral

Participants meet with self-directed care program staff called brokers to receive a program orientation, share perceptions of their current life situation and mental health status, and review past year behavioral health service use as well as participants' views of service helpfulness. This culminates in participants' choice of recovery goals and development of an individual budget to pay for for services and material goods directly related to recovery goals. After budget approval by the program supervisor, brokers make purchases. At quarterly meetings, brokers and participants discuss the latter's progress toward recovery goals and create the next quarter's budget. After receiving 12 months of SDC services, participants are helped to transition back to usual community mental health services.

Services as usual

Behavioral

Participants receive usual outpatient psychiatric care delivered at community programs from which the person can choose from an array of services negotiated with the state mental health authority.

Primary outcomes

  1. Change in perceived competence for mental health self-management

    Time frame: study entry (pre-intervention), 6-months (intervention mid-point), 12-months (immediate post-intervention)

    Perceived competence is measured with the Perceived Competence Scale that includes 4 items that assess subjects' self-rated ability to manage their mental health and recovery, with scores ranging from 4 to 28, with higher scores indicating greater perceived competence for mental health self-management.

Secondary outcomes

  1. Change in met and unmet needs related to multiple life domains

    Time frame: study entry (pre-intervention), 6-months (intervention mid-point), 12 months (immediate post-intervention)

    Change in met and unmet needs is measured with the Camberwell Assessment of Need Short Appraisal Schedule with 22 items that assess needs across multiple life domains such as psychological distress, general health, and finances, which results in 2 scores, each ranging from 0-22, with higher scores indicating more met needs or more unmet needs.

  2. Change in perception of service providers as supportive of client autonomy

    Time frame: study entry (pre-intervention), 6-months (intervention mid-point), 12-months (immediate post-intervention)

    Change in provider support for client autonomy is measured by the Health Care Climate Questionnaire with 6 items that assess the degree to which subjects rate their services providers as encouraging autonomy by providing information, encouraging choice, and acknowledging subjects' emotions, with scores ranging from 6 to 42, with higher scores indicating more perceived autonomy support.

  3. Change in self-rated recovery from mental illness

    Time frame: study entry (pre-intervention), 6-months (intervention mid-point), 12-months (immediate post-intervention)

    Change in self-rated recovery is measured by the Recovery Assessment Scale with 41 items that assess perceived level of recovery from mental illness, with higher scores indicating greater recovery.

  4. Change in employment status

    Time frame: study entry (pre-intervention), 6-months (intervention mid-point), 12-months (immediate post-intervention)

    Assessment of employment status using the U.S. Bureau of Labor Statistics definition of paid employment which ranges from 0 (no) to 1 (employed) where a higher score indicates employment.

  5. Change in service costs

    Time frame: 12-month period of study participation

    Service cost is measured by the dollar amount of reimbursement paid by the behavioral health managing entity to a service provider or program for a paid claim for a discrete service with scores ranging from 0 dollars to no upper limit of dollars where higher scores indicate greater cost.

Sponsors and collaborators

Lead sponsor

University of Illinois at Chicago

Other

Collaborators

  • National Institute on Disability, Independent Living, and Rehabilitation Research

Registry information

Official study title

Money Follows the Person Through Self-Directed Care in Florida

Important dates

Study start
2017
Primary completion
2020
Study completion
2020
First posted
Dec 14, 2022
Registry last updated
May 9, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.