Patient Navigators for Community Mental Health Services

Overseen By Tara G Mehta, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Illinois at Chicago

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

Compensation: Varies

Number of Visits: 6

154 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new method to help African American and Latinx children in high-poverty urban areas access mental health care. It examines the use of patient navigators—community members trained to guide families through mental health services—to break down barriers and improve access. Participants will either work with these navigators or remain on a waitlist to assess the navigators' impact. Families recently referred for mental health services and involved in social services might be well-suited for this study. The goal is to reduce disparities in children's mental health care. As an unphased trial, this study provides a unique opportunity to contribute to innovative solutions for improving mental health care access in underserved communities.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this mental health navigation model is safe for children?

Research has shown that patient navigators can help families access the mental health care they need. These navigators guide individuals through their care plans, simplifying access to services. Studies have found that navigators remove obstacles without causing harm or discomfort. The focus is on improving access and support, not on medications, which can have side effects. As this trial does not test a new drug or therapy, it is considered very safe for participants. The goal is to make mental health care more accessible and effective, especially for often underserved communities. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the use of Patient Navigators in community mental health services because they offer a unique approach to overcoming barriers to care. Unlike traditional treatments that focus solely on direct therapy or medication, Patient Navigators work with caregivers to address logistical and attitudinal hurdles that often prevent individuals from accessing mental health services. This method is particularly promising because it aims to improve access and adherence to care, potentially leading to better mental health outcomes without directly altering the clinical treatment itself. By focusing on the systemic issues that impact care accessibility, Patient Navigators could complement existing therapies and enhance their effectiveness.

What evidence suggests that patient navigators are effective for reducing barriers to mental health care for children?

Research has shown that patient navigators can improve access to mental health care for children in high-poverty areas. In this trial, participants in the Paraprofessional Navigation Condition will receive help from navigators who focus on reducing logistical and attitudinal barriers to care. These navigators assist families by removing obstacles and guiding them through treatment plans. Studies have found that navigation services help families access care more quickly and facilitate transitions between different services. Although some research did not find a decrease in emergency visits, reviews highlight their positive role in linking primary care with community services. This approach shows promise, especially for reducing disparities in mental health services among African American and Latinx children. ^{1 4 6 7 8}

Who Is on the Research Team?

Tara Mehta, PhD

Principal Investigator

University of Illinois at Chicago

Are You a Good Fit for This Trial?

This trial is for African American and Latinx children aged 5-12 in high poverty urban areas, along with their caregivers. They must be new referrals on the waitlist for outpatient mental health services and screened as appropriate for services at participating community agencies.

Inclusion Criteria

Have been screened and deemed appropriate for services at one of two social service participating community mental health agencies

New referrals on the waitlist for outpatient mental health services

I am a caregiver of an African American or Latinx child aged 5-12.

Exclusion Criteria

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Paraprofessional Navigation

Paraprofessional Navigators implement a model of navigation with caregivers focused on reducing logistical and attitudinal barriers to care.

18 months

Periodic check-ins and training sessions

Active Waitlist

Participants are placed on an active waitlist with periodic check-ins by community agency intake staff.

18 months

Periodic check-ins

Follow-up

Participants are monitored for child and caregiver outcomes at baseline, 6, 12, and 18 months post intake.

18 months

Assessments at 6-month intervals

What Are the Treatments Tested in This Trial?

Interventions

• Patient Navigators

Trial Overview

The study tests a mental health navigation model to reduce parental barriers to care. It compares paraprofessional navigators familiar with the community against formally trained case manager navigators, plus a control group on a waitlist.

How Is the Trial Designed?

Group I: Paraprofessional Navigation Condition Experimental Treatment 1 Intervention

Paraprofessional Navigators will implement a model of navigation with caregivers focused on reducing logistical and attitudinal barriers to care.

Group II: Wait-List as Usual Active Control 1 Intervention

Participants will be assigned as wait-list as usual (active wait list) at each agency.

Who Is Running the Clinical Trial?

University of Illinois at Chicago

Lead Sponsor

Trials

653

Recruited

1,574,000+

Published Research Related to This Trial

A community-supported navigator model was implemented in a rural Canadian community to improve access to mental health and substance use services, effectively connecting clients with necessary care and resources.

The model demonstrated success in enhancing service access and coordination among various community services, ultimately leading to better support for individuals with mental health and addiction concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Navigating the mental health and addictions maze: a community-based pilot project of a new role in primary mental health care. Anderson, JE., Larke, SC.[2021]

Patient navigators can effectively connect individuals without a regular primary care source to healthcare providers, enhancing access to necessary medical services, as evidenced by a review of 20 studies.

Most studies emphasized patient-centred care principles, indicating that navigators not only facilitate connections but also promote a supportive healthcare environment that involves and informs patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient navigators facilitating access to primary care: a scoping review. Peart, A., Lewis, V., Brown, T., et al.[2019]

The Navigator model, developed by a community-based steering committee in rural BC, effectively improved access to mental health and addiction services by providing timely assessments and collaborative care planning for individuals seeking help.

This innovative approach enhanced communication and connections between primary care providers and the formal mental health service system, demonstrating the importance of community engagement in addressing mental health needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Sooke Navigator project: using community resources and research to improve local service for mental health and addictions. Anderson, JE., Larke, SC.[2021]

Many children with mental health issues are not receiving the help they need, and pediatric primary care clinics could be key places to identify and address these problems early.

Family navigators, who help families navigate the mental health system, show promise in improving engagement in mental health services for children, although more research is needed to fully understand their effectiveness in pediatric settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Mental Health Engagement From Primary Care: The Potential Role of Family Navigation. Godoy, L., Hodgkinson, S., Robertson, HA., et al.[2020]

A scoping review of 26 studies on mental health care navigation revealed that navigation significantly improves outcomes for individuals facing mental health and addiction (MHA) issues.

Key themes identified in MHA navigation include barrier reduction, client-centered support, and integrated care, highlighting the importance of these elements in enhancing access to appropriate mental health services.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Supporting Individuals with Mental Health and/or Addictions Issues Through Patient Navigation: A Scoping Review. Mullen, JN., Levitt, A., Markoulakis, R.[2023]

Patient navigators, originally designed for cancer care, have shown promise in improving treatment engagement and health outcomes for ethnic minority groups, which could be beneficial for people of color with serious mental illnesses.

Research is currently exploring how peer navigators can enhance integrated psychiatric care for patients of color, potentially leading to better health outcomes in this underserved population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer navigators and integrated care to address ethnic health disparities of people with serious mental illness. Corrigan, PW., Pickett, S., Batia, K., et al.[2022]

A patient navigation system was successfully implemented in a Head Start preschool setting, with 47 low-income mothers participating and no refusals, indicating high acceptability of the program.

The navigators maintained excellent fidelity to the model, and importantly, there were no adverse events reported, suggesting the intervention is safe for participants.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Harnessing the Capacity of Head Start to Engage Mothers with Depression in Treatment. Silverstein, M., Diaz-Linhart, Y., Grote, N., et al.[2022]

The PARTNER-MH intervention, designed to engage racially diverse veterans in mental health care, is being evaluated for its feasibility and acceptability over a 6-month period, focusing on improving patient activation and shared decision-making.

This pilot study involves 50 veterans, primarily Black and non-Hispanic, and aims to address mental health care disparities by enhancing patient-provider communication and empowering patients in their treatment decisions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Proactive, Recovery-Oriented Treatment Navigation to Engage Racially Diverse Veterans in Mental Healthcare (PARTNER-MH), a Peer-Led Patient Navigation Intervention for Racially and Ethnically Minoritized Veterans in Veterans Health Administration Mental Health Services: Protocol for a Mixed Methods Randomized Controlled Feasibility Study. Eliacin, J., Burgess, DJ., Rollins, AL., et al.[2023]

Patient navigation programs can significantly increase the rates of post-treatment surveillance mammography in women with breast cancer, suggesting a benefit in monitoring after treatment.

However, there is limited evidence that patient navigation improves treatment outcomes during breast cancer care, indicating a need for further research to fully understand its efficacy in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient Navigation in Breast Cancer Treatment and Survivorship: A Systematic Review. Baik, SH., Gallo, LC., Wells, KJ.[2019]

Women are at a higher risk for perinatal mood and anxiety disorders (PMADs) during the perinatal period, and many do not receive the necessary mental health care despite the availability of effective treatments.

The development of a patient navigation (PN) service in an intensive outpatient program has shown promise in improving treatment attendance and engagement for women with PMADs, suggesting that this model could be beneficial for other care facilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Stepped Care Model of Patient Navigation to Enhance Engagement with Perinatal Mental Health Care. DiSanza, CB., Geller, PA., Bonacquisti, A., et al.[2020]

Patient navigator programs can significantly improve access to clinical and social services for children and youth with developmental and mental health conditions, especially for those from disadvantaged backgrounds.

Implementing these programs with a strong evaluation framework is crucial for enhancing health outcomes and ensuring equitable resource distribution in healthcare, particularly as services become more complex.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient navigators: Mapping the route toward accessibility in health care. Rollins, M., Milone, F., Suleman, S., et al.[2020]

The study is a 90-day randomized trial involving parents of Medicaid-insured children under 13 with serious mental illness, comparing Family Navigator services to usual care, aiming to enhance family engagement in pediatric mental health.

Family Navigators provide peer support to parents, with outcomes measured including parent empowerment, satisfaction with services, and child functioning, highlighting the importance of family-centered care in mental health treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Family Value of Information, Community Support, and Experience Study: Rationale, Design, and Methods of a "Family-Centered" Research Study. Reeves, GM., Wehring, HJ., Connors, KM., et al.[2019]

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