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Psychiatric hospital reform in low-income and middle-income countries Structured Individualised inTervention And Recovery (SITAR) : a two-arm pragmatic randomised controlled trial study protocol
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Raja, Tasneem, Tuomainen, Helena, Madan, Jason, Mistry, Dipesh, Jain, Sanjeev and Singh, Swaran P. (2020) Psychiatric hospital reform in low-income and middle-income countries Structured Individualised inTervention And Recovery (SITAR) : a two-arm pragmatic randomised controlled trial study protocol. BMJ Open, 10 (5). e035753. doi:10.1136/bmjopen-2019-035753
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WRAP-psychiatric-hospital-reform-low-middle-income-countries-structured-individualised-intervention-recovery-Singh-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (995Kb) | Preview |
Official URL: http://dx.doi.org/10.1136/bmjopen-2019-035753
Abstract
Introduction
Low-income and middle-income settings like India have large treatment gaps in mental healthcare. People with severe mental disorders face impediments to their clinical and functional recovery, and have large unmet needs. The infrastructure and standards of care are poor in colonial period psychiatric hospitals, with no clear pathways to discharge and successfully integrate recovered individuals into the community. Our aim is to study the impact of psychiatric hospital reform on individual patient outcomes in a psychiatric hospital in India.
Methods and analysis
Structured Individualised inTervention And Recovery (SITAR) is a two-arm pragmatic randomised controlled trial, focusing on patients aged 18–60 years with a hospital stay of 12–120 months and a primary diagnosis of psychosis. It tests the effectiveness of structural and process reform with and without an individually tailored recovery plan on patient outcomes of disability (primary outcome WHO Disability Assessment Scale), symptom severity, social and occupational functioning and quality of life. A computer-generated permuted block randomisation schedule will allocate recruited subjects to the two study arms. We aim to recruit 100 people into each trial arm. Baseline and outcome measures will be undertaken by trained researchers independent to the case managers providing the individual intervention. A health economic analysis will determine the costing of implementing the individually tailored recovery plan.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Mental health services , Mental health services -- India, Psychiatric hospital care -- India, Mentally ill -- Care -- India | ||||||
| Journal or Publication Title: | BMJ Open | ||||||
| Publisher: | BMJ | ||||||
| ISSN: | 2044-6055 | ||||||
| Official Date: | 5 May 2020 | ||||||
| Dates: |
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| Volume: | 10 | ||||||
| Number: | 5 | ||||||
| Article Number: | e035753 | ||||||
| DOI: | 10.1136/bmjopen-2019-035753 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| RIOXX Funder/Project Grant: |
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