Improving mental health care for people with psychosis in Uganda

Strengthening Care in Collaboration With People With Lived Experience of Psychosis in Uganda

This study is testing whether having people who have experienced psychosis help train health workers and deliver mental health services at home can improve care for others with similar challenges in Uganda.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 132 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: George Washington University (Academic / other)
• Locations: 1 site (Kampala)
• Trial ID: NCT05863572 on ClinicalTrials.gov

What this trial studies

This pilot study aims to evaluate the feasibility and acceptability of involving individuals with lived experience of psychosis in training primary care and community health workers, as well as co-delivering mental health services in home settings. Conducted in urban and peri-urban areas around Kampala, Uganda, the study will compare standard training methods with an experimental approach that includes these individuals. The trial will assess the impact on service users' symptoms, quality of life, and health system outcomes, while also gathering data to inform a larger future trial.

Who should consider this trial

Good fit: Ideal candidates include adults diagnosed with a primary psychotic disorder who are engaged in the YouBelongHOME program and have supportive family members.

Not a fit: Patients who do not have a confirmed diagnosis of a primary psychotic disorder or those who are not fluent in the local language may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could enhance the quality of mental health services for individuals with psychosis, leading to better health outcomes and reduced hospitalizations.

How similar studies have performed: While the involvement of individuals with lived experience in mental health services is gaining attention, this specific approach in the context of psychosis is relatively novel and has not been extensively tested.

Eligibility criteria

Inclusion Criteria:

1. Facilitators of the implementation strategy:

   1. At least 18 years of age
   2. Confirmed diagnosis of a primary psychotic disorder (e.g., schizophrenia) by a psychiatrist or psychiatric clinical officer
   3. Completion of the YouBelongHOME (YBH) program
   4. Provision of informed consent,
   5. Fluency in the local language (Luganda)
   6. Good functioning with respect to performance of daily chores,engagement with family members, comprehension and community participation as assessed by the YBH team
   7. A supportive family member.
2. Primary care providers:

   1. Provides primary care in health facility of Kampala/Wakiso District
   2. Selected by facility in-charge
3. Community health workers

   1. Provides community based health service in health facility where primary care providers are trained (from Kampala/Wakiso district)
   2. Selected by facility in-charge
4. Patients (Primary beneficiaries)

   1. Persons diagnosed with psychosis at a primary health care facility in Kampala/Wakiso District; For this study, a diagnosis of psychosis will include the following diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):schizophrenia spectrum and other psychotic disorders \[brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, schizophrenia, and organic psychosis (i.e., psychosis secondary to a medical condition such as HIV or an alcohol- or substance-use disorder)\];bipolar affective disorder and related disorders;
   2. Ability of the patient or responsible surrogate to consent to study enrolment and procedures;
   3. Persons eligible for outpatient management of psychosis
5. Family members a. Family member or caregiver of the patients above.

Exclusion Criteria:

1. Facilitators of the implementation strategy:

   a. Inability to provide informed consent.
2. Primary care providers:

   None
3. Community health workers:

   None
4. Patients

   1. Persons diagnosed with psychosis requiring inpatient management/services; and
   2. Persons for whom consent for participation in the study cannot be obtained.
   3. Patients found to be severely ill beyond the capacity of the health facility to treat.
5. Family members a. Family members who doesn't provide consent for participation

Where this trial is running

Kampala

• YouBelong Uganda — Kampala, Uganda (Recruiting)

Study contacts

• Principal investigator: Brandon Kohrt, MD, PhD — George Washington University
• Study coordinator: Brandon A Kohrt, MD, PhD

Conditions Psychosis