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RECRUITING

NCT07339462

Feasibility and Acceptability of an Intervention to Support People With Severe Mental Illness in South Africa

Sponsor: University of KwaZulu

View on ClinicalTrials.gov

Summary

Despite commendable progress in developing mental health systems in low-and-middle income countries, critical gaps remain, particularly the development of community-based systems of support for people living with severe mental illness (SMIs). This application will pilot a co-developed health system strengthening intervention programme in a South African district in order to determine its feasibility, appropriateness and limited efficacy in reducing readmission following discharge from acute psychiatric hospitalization. By generating preliminary data on the real-world implementation of a co-developed programme in low-resource contexts in South Africa, this application seeks to build on an existing foundation of research partnerships and local government collaboration to develop a transitional support intervention that could yield significant and tangible impacts on people living with SMIs in low-resource communities.

Official title: Feasibility and Acceptability of Critical Time Intervention to Support People With Severe Mental Illness Following Post-acute Hospital Discharge in South Africa

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

Start Date

2025-08-01

Completion Date

2026-08-31

Last Updated

2026-01-14

Healthy Volunteers

Conditions

Mental Disorders, Severe

Interventions

BEHAVIORAL

Multilevel psychosocial support for people living with severe mental illness and their caregivers

The intervention is the product of a human-centred design process, involving a range of health system actors. The intervention entails 1) A revised, integrated referral pathway across tertiary, secondary and primary levels of care; 2) A psychosocial rehabilitation programme, introduced to multidisciplinary teams and nursing staff in specialist, regional and district hospitals; 3) A psychosocial rehabilitation programme, introduced to registered counsellors in PHC facilities; 4) Refresher training on management of severe mental health conditions for physicians and nurses in PHC facilities; 5) A community mental health education and detection toolkit and associated training package for community health worker outreach teams; 6) The Household Champion programme, a psychoeducation, empowerment and support programme to improve caregiver capacity for care.

Service user inclusion criteria: * Adults (aged 18 years and above); * Being admitted to the psychiatric ward of a hospital for observation and treatment due to an acute psychiatric event, based on ICD diagnosis on patient charts according to the following criteria: * F20-29 including schizophrenia, delusional disorders, schizotypal disorders, acute polymorph psychotic disorders, schizoaffective disorders * F30-39 Mood \[affective\] disorders with psychoses * F30.2 Mania with psychotic symptoms * F31.2 Bipolar affective disorder, current episode manic with psychotic symptoms * F31.5 Bipolar affective disorder, current episode severe depression with psychotic symptoms * F32.3 Severe depressive episode with psychotic symptoms * F33.3 Recurrent depressive disorder, current episode severe with psychotic symptoms * Determined by the attending psychiatrist to be discharged into community settings following appropriate recovery from the psychiatric event; * Willing and able to participate in the intervention programme * Resides with a caregiver (which could be a family member or member of the household). * Resides within the geographic boundaries of uMgungundlovu Service user exclusion criteria: * Under 18 years of age * Are indicated by their chart history to have the following conditions: * Active suicidal ideation * Substance abuse or dependence as primary diagnosed psychiatric condition * Personality disorders * Serious cognitive or other sensorial impairment likely to preclude informed consent and reliable assessment * Does not reside with a caregiver * Does not reside within the geographic boundaries of uMgungundlovu Caregiver inclusion criteria * Adults (aged 18 years and above) * Willing and able to participate in the intervention programme * Resides with a caregiver (which could be a family member or member of the household). * Resides within the geographic boundaries of uMgungundlovu Caregiver exclusion criteria * Adults (aged 18 years and above) * Willing and able to participate in the intervention programme * Resides with a caregiver (which could be a family member or member of the household). * Resides within the geographic boundaries of uMgungundlovu

Locations (1)

Msunduzi Local Municipality

Pietermaritzburg, KwaZulu-Natal, South Africa