Abstract
BackgroundThe community-based mental health care programme GBV is based on the British Community Mental Health Teams and the Dutch Flexible Assertive Community Treatment model. In addition, the programme offers crisis-intervention services. A special feature of this integrated care programme is the initial standardised assessment process regarding empowerment, unmet care needs, and psychosocial functioning, used to verify the need for such a comprehensive form of care. The project evaluates the assessment process and analyses the effectiveness and cost-effectiveness of GBV compared to treatment as usual.MethodsThis randomised, controlled study includes five assessments over 2 years. In twelve regions in Germany, 1000 patients with severely impaired psychosocial functioning and unmet care needs will be recruited. Study eligibility relies on an indication for GBV based on the results of the initial assessment. The primary outcome is improved self-reported empowerment. Further outcomes include improved treatment satisfaction and subjective quality of life, reductions in patients’ unmet needs and illness-related clinical and social impairment, and an improved cost-effectiveness ratio of the resources used (from the perspectives of both statutory health insurance and the national economy). In addition, the GBV’s effects on the burden and quality of life of informal caregivers of patients will be investigated.DiscussionThe study’s results are expected to provide information on whether the community-based mental health care programme GBV contributes to improving mental health care provision in Germany. In addition, the study will show whether the GBV successfully overcomes the weaknesses that former research has identified regarding a German integrated care programme. Such improvement is particularly expected with respect to the semi-structured assessment within GBV.Trial registrationGerman Clinical Trial Register, DRKS00019086. Registered on 3 January 2020.
Highlights
Background and rationale {6a} Beyond controlling psychiatric symptoms and ensuring the satisfaction of elementary needs, contemporary psychiatric services are expected to support individual recovery and comprehensive social inclusion among their main targets [1]
The study’s results are expected to provide information on whether the community-based mental health care programme grant number 01NVF18028 (GBV) contributes to improving mental health care provision in Germany
Such improvement is expected with respect to the semi-structured assessment within GBV
Summary
Background and rationale {6a} Beyond controlling psychiatric symptoms and ensuring the satisfaction of elementary needs, contemporary psychiatric services are expected to support individual recovery and comprehensive social inclusion among their main targets [1] For this purpose, the World Health Organization considers the provision of comprehensive, integrated, and responsive mental health and social care services in community-based settings as the universal state of the art of mental health care systems [2]. Beyond historical developments in the German health and social care system, the current disparities in the provision of community mental health care mainly exist because, in contrast to medical care, the responsibility for providing and financing community care is at the level of the federal states and the communities [4, 5]. The project evaluates the assessment process and analyses the effectiveness and cost-effectiveness of GBV compared to treatment as usual
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