Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT03962348 |
| Other study ID # |
NYSPI 7771 - 251051 |
| Secondary ID |
R34MH117766 |
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
January 8, 2020 |
| Est. completion date |
March 2, 2023 |
Study information
| Verified date |
June 2023 |
| Source |
Columbia University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
The investigators are studying a jail-based intervention to reduce the duration of untreated
psychosis (DUP) among young adults with previously undetected first-episode psychosis who are
detained in jail. Longer DUP (or treatment delay) is linked to poorer outcomes in
first-episode psychosis and there is evidence that justice-involved young adults with
first-episode psychosis have an alarmingly long DUP. Thus, despite the expansion of
Coordinated Specialty Care (CSC) programs that improve outcomes through early,
multi-component care, there is a need to establish early detection services in the criminal
justice system and create pathways from justice involvement to CSC. This intervention offers
a novel and potentially high impact approach for reducing DUP in jail settings: a jail-based
Specialized Early Engagement Support Service that receives referrals, engages detainees, and
serves as a bridge to community-based CSC. The study team will design and implement the
intervention, thoroughly study its feasibility and acceptability, and prepare an intervention
manual for broader use in diverse jails and future formal research.
Description:
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: a Specialized Early Engagement Support Service (SEESS) 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 DUP-1 (psychosis onset to antipsychotic initiation). Then, the
jail-based SEESS (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 SEESS 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.
