Study protocol of a randomized controlled trial evaluating home treatment with peer support for acute mental health crises (HoPe)

Abstract

Background Home treatment (HT) is a treatment modality for patients with severe mental illness (SMI) in acute mental crises. It is frequently considered equivalent to psychiatric inpatient treatment in terms of treatment outcome. Peer Support (PS) means that people with lived experience of a mental illness are trained to support others on their way towards recovery. While PS is growing in international importance and despite a growing number of studies supporting its benefits, it is still not comprehensively implemented into routine care. The HoPe (Home Treatment with Peer Support) study investigates a combination of both – HT and PS – to provide further evidence for a recovery-oriented treatment of psychiatric patients. Methods In our randomized controlled trial (RCT), HT with PS is compared with HT without PS within a network of eight psychiatric clinical centers from the North, South and East of Germany. We investigate the effects of a combination of both approaches with respect to the prevention of relapse/recurrence defined as first hospitalization after randomization (primary outcome), disease severity, general functioning, self-efficacy, psychosocial health, stigma resistance, recovery support, and service satisfaction (secondary outcomes). A sample of 286 patients will be assessed at baseline after admission to HT care (data point t0) and randomized into the intervention (HT + PS) and control arm (HT). Follow-Up assessments will be conducted 2, 6 and 12 months after admission (resulting in three further data points, t1 to t3) and will be analyzed via intention-to-treat approach. Discussion This study may determine the positive effects of PS added to HT, prove additional evidence for the efficacy of PS and thereby facilitate its further implementation into psychiatric settings. The aim is to improve quality of mental health care and patients’ recovery as well as to reduce the risk of relapses and hospitalizations for patients with SMI. Trial registration The trial is registered with ClinicalTrials.gov: NCT04336527, April 7, 2020.

Perception of mental health services during the COVID-19 pandemic – a German service user survey

“…Professional networks, e.g. yers, websites and mailing lists and other mental health institutions associated with the participating hospitals of the HoPe study [14] 2. Social media, e.g.…”

“…Here is a short description of the pandemic situation in Germany during the time of the study to help readers understand the results of the study. The end of July 2021 marks the end of the summer plateau phase 2021 of the COVID-19 pandemic, during which case numbers were low and restrictions were partially lifted [14]. In the rst week of July 2021, there was an average of 604 new COVID-19 infections per day in Germany [15].…”

“…The survey was part of an RCT examining peer support in home treatment [14]. Peer support is an innovative approach to mental health care that has been gaining importance in recent years [15,16].…”

Patient satisfaction in inpatient psychiatric treatment compared with inpatient equivalent home treatment in Germany: an in-depth qualitative study

“…However, the results of this study are not published yet. A further interesting study protocol is the one of Reinke and colleagues (23). In their randomized controlled trial, IEHT with peer support (i.e., the people with lived experience of a mental illness are trained to support others on their way toward recovery) is compared with IEHT without peer support within a network of eight psychiatric clinical centers in Germany.…”

“…In their randomized controlled trial, IEHT with peer support (i.e., the people with lived experience of a mental illness are trained to support others on their way toward recovery) is compared with IEHT without peer support within a network of eight psychiatric clinical centers in Germany. The authors (23) give also an overview of studies on peer support in psychiatric care with promising results for patient-reported outcomes (PROs).…”