Table 1 Routine care, timelines and corresponding study activities
Stage in MHSU care | MHSU care activity | Corresponding research activity | |
|---|---|---|---|
Routine care | Treatment as usual = routine care PLUS | Intervention = treatment as usual PLUS | |
In pre-discharge ward | The MHSU receives standard pre-discharge care. This includes Clinical review Finalizing of treatment plan Psychosocial rehabilitation programmes Individual and group psychoeducation Discharge planning by the clinical team, encompassing identification of which CHC the MHSU will be discharged to and when, as well as arrangement of post-discharge psychosocial support for the MHSU | 1. We obtained informed consent from eligible patients 2. We conducted recruitment activities including diagnostic and baseline measures as described in the text 3. We randomized recruited participants to receive either treatment as usual or the intervention 4. We informed participants which group they had been randomized to | 5. Participants who had been randomized to receive the intervention selected a treatment partner as described in the text 6. These selected treatment partners were contacted telephonically, consented and a date was set for the psychoeducation and contracting session 7. The psychoeducation and contracting session was conducted at Valkenberg Hospital for the participant and treatment partner pair |
On day of discharge | The MHSU discharged from inpatient care with referral letter detailing course of admission, diagnosis, treatment plan, review CHC and date | 8. Participants were enrolled onto the text message platform | 9. The first text message was sent to the participant/ treatment partner pair containing details of first clinic appointment as per discharge treatment plan 10. Fieldworker handsets received updated participant review schedules |
1Â week before first clinic appointment | No activity | No activity | 11. A text message reminder was sent to the participant/treatment partner pair containing same details as first message |
At first clinic appointment | The MHSU is reviewed by the mental health nurse or psychiatry registrar at the psychiatry clinic of CHC Medication is renewed or modified A follow up appointment is issued The MHSU’s CHC clinical record clinical record updated to indicate Attendance for review Clinical status Medication review and prescription Next scheduled appointment date The MHSU collects his or her medication and leaves the CHC | No additional activity | 12. On arrival, mental health nurse checks the participant as present 13. The mental health nurse asks the participant how many days of medication have been missed since discharge from hospital and enters this information on the fieldworker handset 14. The mental health nurse enters the next scheduled clinic review appointment date onto the text message platform via the fieldworker handset 15. The participant/treatment partner pair immediately received a text message notification indicating the next appointment date with the name of the CHC as in the initial text message |
After the first clinic appointment | The MHSU is reviewed on the scheduled review date and the process described above at first clinic appointment is repeated for subsequent visits | No additional activity | 16. The participant/treatment partner pair receives a text message reminder of the next appointment date one week before that appointment 17. The process described at steps 12-16 above is repeated for three visits in total |
3Â months after discharge | Routine clinical care is continued | 18. All participants, accompanied by their caregivers for the TAU group or treatment partners for the intervention group, returned at 3 months after discharge for clinical and review and qualitative interviews as described in the text | |
9Â months after discharge | 19. Any readmissions were noted for all participants were noted via Clinicom | ||