Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial

Abstract

Background: Young adults have elevated rates of mental health disorders, yet they often do not receive consistent care. The challenge of continuing to engage young adults has been pervasive worldwide. Few engagement interventions have been designed for young adults with serious mental illness. Just Do You is a theoretically guided engagement intervention. It uses innovative modalities (i.e., technology, expressive arts activities, narrative expression, mentoring) to engage participants in conversations about services and how they work, while simultaneously orienting them to treatment. Methods/design: This pilot and feasibility study utilizes a hybrid research design, examining feasibility, acceptability, and preliminary impact, alongside implementation. The study combines qualitative methods, a small pilot randomized trial, and a small cost-benefit analysis. Respondents are clinic staff and young adults who have made initial contact with the Personalized Recovery Oriented Services (PROS) program. Quantitative survey data are collected at baseline, 2 weeks (post-intervention), 1 month, and 3 months. The assessments focus on measuring feasibility, acceptability, engagement, and mental health outcomes. Medical record extraction will be used to triangulate self-report data. We will conduct single degree of freedom contrasts to examine whether Just Do You leads to improved outcomes relative to Treatment-As-Usual using robust regression for each outcome measure. We will examine whether changes in the proposed mediating variables occur across groups using a similar contrast strategy. In addition, we will use structural equation modeling to examine the contribution of mediators to ultimate outcomes. Finally, we will use constant comparison coding techniques for qualitative analyses. Discussion: The aim of this study is to examine the feasibility of a young adult engagement meta-intervention through an intensive preliminary pilot trial, learning through collaboration with stakeholders. Just Do You has the potential to fill a gap in the service system for young adults with serious mental illnesses, improving the seemingly intractable problem of disengagement. The program uses culturally responsive strategies, is recovery-oriented, and builds upon the best evidence to date. Our efforts align with local and national health care reform efforts embedding people with lived experience.

Research‐ and health‐related youth advisory groups in Canada: An environmental scan with stakeholder interviews

“…This is not surprising as the literature in the last decade has called for an increase in youth engagement in mental health research 29 and service planning 27,30 . People with lived experience of mental health issues are crucial to shaping mental health research and services because they have ‘been there’ and can offer insights and suggestions that may not otherwise come to light 29,31,32 . Unsurprisingly, many of the mental health groups included in this ES recruited youth with lived experience.…”

“…27 , 30 People with lived experience of mental health issues are crucial to shaping mental health research and services because they have ‘been there’ and can offer insights and suggestions that may not otherwise come to light. 29 , 31 , 32 Unsurprisingly, many of the mental health groups included in this ES recruited youth with lived experience.…”

Outcomes of a Metaintervention to Improve Treatment Engagement Among Young Adults With Serious Mental Illnesses: Application of a Pilot Randomized Explanatory Design

“…Just Do You (JDY) evolved from extensive qualitative research [11] from decision science and from traditional mental health service uses frameworks (see Figure 1). The program targets selected mediators from Figure 1 [12]. It integrates expressive art activities (music and visual arts), technology-based narratives (e.g., celebrity testimonials), psychoeducation, and motivational interviewing principles [12].…”

“…The program targets selected mediators from Figure 1 [12]. It integrates expressive art activities (music and visual arts), technology-based narratives (e.g., celebrity testimonials), psychoeducation, and motivational interviewing principles [12]. Delivery of JDY can take either a group or individual format depending on the number of individuals experiencing intake at a given point in time at a clinic.…”

“…Provider teams include the clinic intake staff, clinicians, and what we call recovery role models (RRMs). RRMs possess lived experiences with the mental health system [12,13] having undergone treatment within it. Clinicians and RRMs cofacilitate two 90-minute modules offered during treatment initiation.…”