Reducing DUP Through Early Detection in a Large Jail System
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|ClinicalTrials.gov Identifier: NCT03962348|
Recruitment Status : Suspended (This study is temporarily suspended due to COVID-19 pandemic.)
First Posted : May 24, 2019
Last Update Posted : April 21, 2020
|Condition or disease||Intervention/treatment||Phase|
|First-Episode Psychosis||Behavioral: Targeted Educational Campaign Behavioral: Specialized Early Engagement Team||Not Applicable|
Persons with serious mental illnesses are overrepresented in jails. Criminal justice (CJ) involvement, including jail detention, is common among those with first-episode psychosis (FEP) and frequently precedes psychiatric treatment engagement. Yet, no documented interventions currently exist specifically to identify/engage such individuals while in jail and connect them to Coordinated Specialty Care (CSC) in the community upon release. Expansion of CSC programs across the U.S. provides an opportunity for partnership with the CJ system—one that has the potential to reduce the duration of untreated psychosis (DUP) and thus improve outcomes.
To detect FEP and reduce DUP among detainees in a large, urban jail, the investigators propose to implement: (1) a "Targeted Educational Campaign" (TEC), and (2) a Specialized Early Engagement Team (SEET) in 3 jails on Rikers Island in New York City (NYC): Anna M. Kross Center (AMKC), Rose M. Singer Center (RMSC) and Robert N. Davoren Complex (RNDC).
The investigators expect the multimedia TEC to generate referrals to the Correctional Health Services (CHS), and to reduce our DUP-1 (psychosis onset to antipsychotic initiation). Then, the jail-based SEET (a Social Worker and Peer Specialist) will link those identified to community-based CSC (primarily OnTrackNY sites in NYC), thus reducing DUP-2 (psychosis onset to CSC enrollment).
The investigators will examine a set of hypothesized targets/mediators (the "how's"). These are key ingredients that underpin the intervention's ability to reduce DUP.
The multi-media TEC will generate referrals to the CHS, by improving the behavioral capabilities, expectations, and self-efficacy (constructs from Social Cognitive Theory) of the Correction Officers trained. The SEET will then link detainees with FEP, using tenets of person-centered treatment and shared decision-making, and the Critical Time Intervention model, to community-based CSC. This will occur through engagement of detainees while in jail, and telephonically (when possible) after release. The investigators will assess feasibility and acceptability to lay the groundwork for a multi-site, definitive effectiveness trial.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||20 participants|
|Intervention Model:||Sequential Assignment|
|Intervention Model Description:||Feasibility and Acceptability Study|
|Masking:||None (Open Label)|
|Primary Purpose:||Health Services Research|
|Official Title:||Reducing Duration of Untreated Psychosis Through Early Detection in a Large Jail System|
|Actual Study Start Date :||January 6, 2020|
|Estimated Primary Completion Date :||July 2021|
|Estimated Study Completion Date :||August 2021|
Experimental: Targeted Educational Campaign (TEC) for Correction Officers
The investigators will implement a Targeted Educational Campaign (TEC) within 3 jails at New York City's Rikers Island. The TEC is designed to lead to referrals of detainees (previously not detected as having potential mental health concerns) to Correctional Health Services (CHS) by Correction Officers.
Behavioral: Targeted Educational Campaign
Correction Officers will be exposed to the Targeted Educational Campaign (TEC) with the aim to increase their knowledge about the early symptoms of psychosis, and how to make a referral to the CHS staff, their self-efficacy to detect symptoms of psychosis and make referrals, and their expectations about their ability to be successful in making that referral (and for referrals to result in beneficial outcomes).
Correction Officers will be approached and recruited during roll call and in the staff canteen where they take their meal breaks, or at a time/location agreed upon by the Department of Correction, to complete brief surveys at three different times: pre-exposure, after 6 months, and after 12 months from the beginning of the TEC.
Experimental: Specialized Early Engagement Team
The investigators will implement a Specialized Early Engagement Team (SEET) in the same three jails. The SEET will increase the likelihood that referred individuals found to have first-episode psychosis enroll in Coordinated Specialty Care upon release.
Behavioral: Specialized Early Engagement Team
The Specialized Early Engagement Team (SEET - a Social Worker and Peer Specialist) will link detainees with first-episode psychosis (FEP), using tenets of person-centered treatment and shared decision-making, and the Critical Time Intervention model, to community-based Coordinated Specialty Care (CSC).
- Number of referrals to Correctional Health Services (CHS) due to the Targeted Educational Campaign (TEC) [ Time Frame: 2 Years ]Numbers of referrals of detainees (previously not detected as having potential mental health concerns) to CHS by Correction Officers.
- Number of referrals to Coordinated Specialty Care (CSC) [ Time Frame: 1 year ]Number individuals found to have first-episode psychosis enrolled in CSC upon release from jail.
- Acceptability of the jail-based TEC and SEET [ Time Frame: 2 Years ]Stakeholder qualitative interviews and focus groups with all relevant end-users of the new intervention (TEC+SEET).
- Feasibility of the jail-based TEC and SEET [ Time Frame: 2 Years ](1) the number of detainees referred to the SEET, (2) the number of those referred who have FEP, (3) the DUP for this sample, and (4) the proportion who later engage in CSC.
- Changes in Correction Officers' behavioral capability, expectations, and selfefficacy across the duration of the TEC [ Time Frame: 1 Year ]Changes in survey-based scores on behavioral capability (knowledge/skills), expectations, and self-efficacy (among Correction Officers) at baseline, 6-months, and 12-months.
- Survey-based engagement and working alliance between SEET and referred individuals [ Time Frame: 1 Year ]Positive correlation between scores of engagement and working alliance, and enrollment in CSC upon release.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03962348
|United States, New York|
|Rikers Island Jails (Anna M. Kross Center, Rose M. Singer Center, and Robert N. Davoren Complex)|
|E. Elmhurst, New York, United States, 11370|
|Principal Investigator:||Michael T Compton, M.D., P.H.D.||Columbia University|