Schizophrenia Clinical Trial
Official title:
A Randomized Controlled Trial Examining the Effectiveness of Digital Picture Frame Use on the Long Term Inpatient Experience
This study will be a randomized controlled trial that investigates the effectiveness of digital picture frames (DPF) installed in inpatient rooms on long stay inpatient wards servicing schizophrenia clients at CAMH. The effects on client experience will consider the domains of self-concept, interactions with healthcare staff, perception of space, and implications for the recovery process. The comparison of inpatient client experience with DPFs versus a control group (Treatment as Usual - TAU), offers the opportunity to examine the effectiveness of this type of environmental adaptation. This trial builds upon earlier work that demonstrated the feasibility of DPFs in this context.
Long term stays in mental health facilities have been shown to have unique challenges and
implications. To a considerable extent these challenges grow out of the stigmatized nature of
severe mental illnesses (SMI) such as schizophrenia. The social and self-stigma surrounding
SMI can have major effects on those affected including decreased self-esteem,
self-deprecation, and the development of a self-concept defined by the illness. When
stigmatized interpretations of mental illness are internalized, those affected can find it
very challenging to sustain non-illness identities and can ultimately result in the loss of
non-illness related aspects of self-concept. Inpatient contexts are particularly challenging
in this regard, with non-illness oriented identities very difficult to sustain given
considerations of power differentials with providers, the reduction of autonomy and choice,
and the removal of the individual from environments that are demonstrative of non-illness
aspects of self.
Accordingly, a randomized controlled trial design will be used to consider the question: Does
having a DPF in psychiatric inpatient unit rooms lead to improvements in interactions with
the clinical team, perceptions of enhanced quality of physical space, and an improvement in
the sustaining of non-illness aspects of self-concept? While the promising feasibility study
findings might suggest hypotheses of improvement in these domains, we will consider this
study exploratory given the complex environments inpatient units represent in the study of
care quality and outcomes and the modest scope of this intervention. Finally, we will
continue to collect feasibility data qualitatively, to inform further refinement of metrics
and otherwise consider enhancements in intervention and research design.
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