A cluster randomised controlled trial and process evaluation of a training programme for mental health professionals to enhance user involvement in care planning in service users with severe mental health issues (EQUIP): study protocol for a randomised controlled trial.

Peter Bower,Anita Rolfe,Oonagh Meade,Karina Lovell,Lindsey Cree,Penny Bee,Patrick Cahoon,Chris Roberts,Susan Beatty,Neil O’Leary,Patrick Callaghan,Linda Davies,Caroline Sanders,Kathryn Berzins,Helen Brooks,Andrew Grundy,Richard Drake,Nicola Olleveant,Chris Gibbons,Anne Rogers,Lauren Walker,Claire Fraser

doi:10.1186/s13063-015-0896-6

Abstract

BackgroundInvolving service users in planning their care is at the centre of policy initiatives to improve mental health care quality in England. Whilst users value care planning and want to be more involved in their own care, there is substantial empirical evidence that the majority of users are not fully involved in the care planning process. Our aim is to evaluate the effectiveness and cost-effectiveness of training for mental health professionals in improving user involvement with the care planning processes.Methods/DesignThis is a cluster randomised controlled trial of community mental health teams in NHS Trusts in England allocated either to a training intervention to improve user and carer involvement in care planning or control (no training and care planning as usual).We will evaluate the effectiveness of the training intervention using a mixed design, including a ‘cluster cohort’ sample, a ‘cluster cross-sectional’ sample and process evaluation. Service users will be recruited from the caseloads of care co-ordinators.The primary outcome will be change in self-reported involvement in care planning as measured by the validated Health Care Climate Questionnaire. Secondary outcomes include involvement in care planning, satisfaction with services, medication side-effects, recovery and hope, mental health symptoms, alliance/engagement, well-being and quality of life. Cost- effectiveness will also be measured. A process evaluation informed by implementation theory will be undertaken to assess the extent to which the training was implemented and to gauge sustainability beyond the time-frame of the trial.DiscussionIt is hoped that the trial will generate data to inform mental health care policy and practice on care planning.Trial Registration NumberISRCTN16488358 (14 May 2014)

Highlights

IntroductionPsychiatrists and allied health and social care workers provide the majority of care for service users regardless of setting
Involving service users in planning their care is at the centre of policy initiatives to improve mental health care quality in England
It is hoped that the trial will generate data to inform mental health care policy and practice on care planning

Summary

Introduction

Psychiatrists and allied health and social care workers provide the majority of care for service users regardless of setting They have a pivotal role in the development of care planning, as care coordinators under the Care Programme Approach (CPA) [5, 6]. Despite the consensus among policy-makers, professionals, service users and carers about the importance of involvement there is substantial empirical evidence that the majority of users and carers are marginalised in the care planning process. This lack of involvement occurs in both in-patient and community settings [7, 8] and there is evidence that current models of involving users and carers in their care are less effective than first envisaged

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