Enhanced Case Management for Mental Health and Substance Use Disorders

(TeachMeToBuild Trial)

Overseen By Giulio DiDiodato, MD PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Royal Victoria Hospital, Canada

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to assist young adults who are not engaged in work, school, or training by addressing mental health and substance use issues that might hinder their completion of vocational programs. Participants will receive various types of support, including basic case management, self-reporting tools for distress, and rapid access to mental health services. The goal is to determine if these supports can reduce program dropouts and improve long-term job prospects. Ideal candidates are visible minorities or females living in Ontario who are fluent in English or French and have internet access. As an unphased trial, this study provides participants the opportunity to contribute to innovative solutions for overcoming barriers to employment and education.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that integrating mental health and addiction services benefits individuals with substance use problems. For instance, case management, which organizes care and support, helps individuals navigate complex healthcare systems, leading to improvements in work and family life.

Additionally, assessment tools can identify mental health issues early. These tools enhance patient care by providing a clear picture of a person's mental health, guiding further treatment and support.

Overall, combining case management with mental health tools and prompt healthcare access appears effective. No specific reports have indicated negative effects from these methods. They aim to provide comprehensive support, addressing both mental health and substance use issues effectively. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about these treatments for mental health and substance use disorders because they aim to enhance traditional case management with innovative tools and services. Unlike standard approaches, which often rely solely on regular check-ins and external support referrals, these experimental treatments incorporate a self-report distress tool and a rapid referral process. The distress tool allows individuals to report their stress levels daily, enabling more tailored and timely support. Additionally, the rapid referral process ensures quicker access to specialized mental health and addiction services, potentially reducing the risk of program dropouts. These enhancements could lead to more immediate and effective interventions, significantly improving outcomes for those struggling with mental health and substance use issues.

What evidence suggests that this trial's treatments could be effective for mental health and substance use disorders?

Research has shown that integrating mental health and addiction treatment with regular healthcare can improve outcomes for individuals with mental health and substance use issues. This trial evaluates various approaches to case management. One arm involves basic case management, including bi-weekly meetings and efforts to connect participants with external support services. Another arm supplements basic case management with a self-report distress tool, enabling individuals to report their mental state daily. This tool can help identify those at risk and provide timely support, reducing program dropout rates. Additional arms include rapid access healthcare services, either alone or combined with the distress tool, to further enhance support. Overall, these methods have shown promise in improving attendance and completion rates for those facing mental health and substance use challenges. ^{1 2 3 6 7}

Who Is on the Research Team?

Giulio Didiodato, MD

Principal Investigator

Royal Victoria Regional Health Centre

Are You a Good Fit for This Trial?

This trial is for young adults who are not in employment, education, or training (NEET), specifically visible minorities or females with mental health and substance use issues. Participants must have Wi-Fi access, a computing device, speak English or French, and possess an Ontario Health Insurance Plan number and Canadian Social Insurance Number.

Inclusion Criteria

Must have an active Ontario Health Insurance Plan number

I am a visible minority or female.

Must have a valid Canadian Social Insurance Number

Exclusion Criteria

Not applicable.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training Program

Participants undergo a 12-week vocational training program including in-classroom education and supervised hands-on experiential learning at construction sites

12 weeks

Daily in-person attendance required

Follow-up

Participants are monitored for program completion and employment outcomes

24 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Basic Case Management
• Basic Case Management plus Distress Tool
• Basic Case Management plus Distress Tool and rapid mental health & addictions healthcare access
• Basic Case Management plus rapid mental health & addictions healthcare access

Trial Overview The study tests if adding a daily self-reporting tool for distress and rapid access to mental health services improves the completion rates of vocational training programs for NEET youth at risk due to mental health/substance abuse.

How Is the Trial Designed?

Group I: Basic case management supplemented by self-reporting distress tool (DT) Experimental Treatment 1 Intervention

Basic case management plus access to the self-report daily distress tool. The trainees are provided web-based access to the daily distress tool and report their distress levels using a validated visual analog scale (Distress Thermometer), along with reporting their risk of missing work/class or dropping out of the program. The case manager responds to the distress tool by coordinating external support services as needed.

Group II: Basic case management supplemented by rapid access healthcare services Experimental Treatment 1 Intervention

Basic case management supplemented by a fit-for-purpose rapid referral process for trainees with active mental health and/or substance use disorders affecting their program participation.

Group III: Basic case management supplemented by DT and rapid access healthcare services Experimental Treatment 1 Intervention

Basic case management supplemented by both the self-report distress tool and rapid referral process for those trainees at-risk of program absence or drop-out from either mental health or addictions issues.

Group IV: Basic case management Active Control 1 Intervention

Basic case management with bi-weekly meetings between case manager and trainees that includes check-ins, frequent visits to construction sites and monitoring of feedback forms from mentors. Case managers attempt to connect trainees with external support services as needed.

Who Is Running the Clinical Trial?

Royal Victoria Hospital, Canada

Lead Sponsor

Trials

18

Recruited

10,400+

Citations

1. library.samhsa.gov library.samhsa.gov/sites/default/files/PEP20-02-02-013.pdf

COMPREHENSIVE CASE MANAGEMENT FOR ... Case management for patients with substance use disorders (SUDs) has been found to be effective because it helps them stay in treatment and recovery. Also, by ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC1994722/

The Development and Implementation of Case Management ... Although modeled after mental health examples, case management for persons with substance use disorders was developed separately, illustrating the originally ...

3. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK83253/

4 Screening and Assessment - Substance Abuse Treatment This chapter introduces and provides an overview of current screening and assessment processes that may best serve women across the continuum of care.

4. drugsandalcohol.ie drugsandalcohol.ie/17625/1/MentalHealthAssessmentTools.pdf

Mental Health Assessment Tools The use of validated assessment tools enhances assessment and can be incorporated into the management of patient/client care in a variety of ways.

5. library.samhsa.gov library.samhsa.gov/sites/default/files/sma15-4215.pdf

TIP 27: Comprehensive Case Management for Substance ... Comprehensive Case Management for Substance. Abuse Treatment. Treatment Improvement. Protocol (TIP) Series, No. 27. HHS Publication. No. (SMA) 15-4215.

6. samhsa.gov samhsa.gov/resource/dbhis/screening-assessment-tools-chart

Screening and Assessment Tools Chart This comprehensive chart shows screening and assessment tools for alcohol and drug misuse. Tools are categorized by substance type, audience for screening, and ...

7. facs.org facs.org/media/nrcj31ku/mental-health-guidelines.pdf

BEST PRACTICES GUIDELINES The intent is to improve overall outcomes for trauma patients by providing holistic, multidisciplinary disease-centered care. This publication is intended as a ...