Integrating behavioral healthcare for individuals with serious mental illness: A randomized controlled trial of a peer health navigator intervention

Objective: Individuals with serious mental illness also have high rates of comorbid physical health issues. To address those issues, this population needs interventions that improve self-management of health and healthcare.Methods: In order to improve the health and healthcare of individuals with serious mental illnesses, 151 consumers with serious mental illness were randomized to receive either usual mental healthcare plus the Bridge intervention (n = 76) or usual mental healthcare while on a 6 month waitlist (n = 75). The waitlist group received the intervention after the waitlist period.Results: Change score comparisons (difference of differences) of the treatment vs the waitlist groups revealed that the treated group showed significantly greater improvement in access and use of primary care health services, higher quality of the consumer-physician relationship, decreased preference for emergency, urgent care, or avoiding health services and increased preference for primary care clinics, improved detection of chronic health conditions, reductions in pain, and increased confidence in consumer self-management of healthcare.Conclusions: Peer providers using a manualized intervention can be an important part of the efforts to address the general medical care of individuals with serious mental illnesses. (C) 2016 Elsevier B.V. All rights reserved.

目的：患有严重精神疾病的个体同时患有身体健康问题的比率也很高。为了解决这些问题，这一人群需要能够改善健康自我管理和医疗保健的干预措施。 方法：为了改善患有严重精神疾病个体的健康和医疗保健状况，151名患有严重精神疾病的患者被随机分组，一组接受常规精神医疗护理以及“桥梁”干预措施（n = 76），另一组在6个月的等待名单期间接受常规精神医疗护理（n = 75）。等待名单组在等待期结束后接受干预措施。 结果：治疗组与等待名单组的变化分数比较（差异中的差异）显示，治疗组在获得和使用初级保健医疗服务方面有显著更大的改善，医患关系质量更高，对急诊、紧急护理的偏好降低或避免医疗服务的情况减少，对初级保健诊所的偏好增加，慢性健康状况的检测得到改善，疼痛减轻，患者对自身医疗保健管理的信心增强。 结论：使用规范化干预措施的同伴服务提供者可以成为解决患有严重精神疾病个体的普通医疗护理问题的重要部分。（C）2016爱思唯尔B.V. 保留所有权利。