Innovation details
The COPSI study was a parallel group RCT (ISRCTN 56877013) testing a combination of facility-based care and CCBC against facility-based care alone at three sites in India.1
Community-based collaborative care (CBCC):
The CCBC intervention was specifically designed to promote collaboration between the person with schizophrenia, their caregiver(s), and the treatment team (the psychiatrist and the community health worker) to deliver a flexible, individualized and needs-based intervention. All community health workers were systematically trained over 6 weeks and assessed for adequate competence using a specially-developed intervention manual.
The individual components of the COPSI CCBC intervention were:
Clinical support
- Structured needs assessments at enrollment and, every three months thereafter, to develop matched individualized treatment plans
- Structured clinical reviews by treating team and supervision for community health workers
- Adherence management strategies
- Health promotion strategies to address physical health problems in participants
- Individualized rehabilitation strategies to improve the personal, social and work functioning of participants
Psychosocial support
- Psychoeducational information for both participants and caregivers
- Specific efforts with participants and caregivers to deal with experiences of stigma and discrimination
- Linkage to self-help groups and other methods of user-led support
- Networks with community agencies to address social problems, to facilitate social inclusion, access to legal benefits and employment opportunities
Facility-based care
Facility-based care reflects the usual care provided by specialist mental health practitioners (psychiatrists) for persons with schizophrenia and their families in India. This care was available to participants in both study arms:
Clinical support
- 10-15 minute consultation
- Prescription for antipsychotic medication
- Some adherence encouragement
Psychosocial support
- Some psycho-educational information
- Some additional discussion of participants’ and/or caregivers’ concerns
Comments
Congratulations COPSI. The