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

Trial Summary

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 data supports the effectiveness of the treatment Patient Navigators for Community Mental Health Services?

Research shows that patient navigators can improve engagement and health outcomes in various settings, such as cancer care and mental health services, by helping people access necessary services and support. This suggests that using patient navigators in community mental health services could similarly enhance access and outcomes for patients. ^{1 2 3 4 5}

Is the use of patient navigators for mental health services safe?

Research on patient navigators in mental health services, including studies with diverse groups, shows no reported safety concerns or adverse events, suggesting they are generally safe for use. ^{2 6 7 8 9}

How is the Patient Navigator treatment different from other mental health treatments?

Patient Navigators are unique because they help connect individuals with mental health services by providing guidance, support, and facilitating access to care. Unlike traditional treatments that focus solely on medical interventions, navigators work to improve service access and communication between patients and various healthcare providers, making the mental health care process more integrated and patient-centered. ^{2 3 10 11 12}

What is the purpose of this trial?

The purpose is to study a model of mental health navigation for African American and Latinx children (0-14 years) in high poverty urban communities focused on reducing key parental attitudinal barriers to care. Reducing persistent racial and ethnic disparities in children's mental health is a national priority and patient navigation is a highly promising approach that is rarely used in children's mental health services. The study will examine the effectiveness of paraprofessional (PP) navigators who have strong community knowledge and waitlist as usual condition (active wailt list \[AWL\]. The study will examine specific mechanisms of navigator effectiveness in children's mental health and compare an AWL to provide a rigorous test of the proposed mechanisms. The knowledge gained from this application may be important to reducing disparities and employing the workforce best suited to navigation in the community mental health system. Two community boards, one focused on identifying factors important to supporting navigators at the agencies (Implementation and Sustainability Community Board) will meet quarterly, and the other focused on implications for state and federal policy (Public Policy Board), will meet annually.

Research Team

Tara Mehta, PhD

Principal Investigator

University of Illinois at Chicago

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Patient navigators: Mapping the route toward accessibility in health care. [2020]

2. United States pubmed.ncbi.nlm.nih.gov

Peer navigators and integrated care to address ethnic health disparities of people with serious mental illness. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Increasing Mental Health Engagement From Primary Care: The Potential Role of Family Navigation. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

Patient Navigation in Breast Cancer Treatment and Survivorship: A Systematic Review. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

A Stepped Care Model of Patient Navigation to Enhance Engagement with Perinatal Mental Health Care. [2020]

6. United States 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. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Supporting Individuals with Mental Health and/or Addictions Issues Through Patient Navigation: A Scoping Review. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Harnessing the Capacity of Head Start to Engage Mothers with Depression in Treatment. [2022]

9. Canada 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. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

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

11. United States 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. [2021]

12. England pubmed.ncbi.nlm.nih.gov

Patient navigators facilitating access to primary care: a scoping review. [2019]