A randomized controlled implementation trial of a multicomponent integrated care program to empower mental health service users and their relatives throughout the recovery process

Abstract

This study assessed the effectiveness of a psychosocial multicomponent program designed to empower individuals experiencing severe mental distress and their relatives throughout the recovery process. The program consisted of four consecutive interventions, including orientation, psychoeducation, empowerment, and mutual help. A randomized controlled implementation trial was conducted to investigate the program’s impact on the recovery of individuals experiencing mental distress, as well as on the caregiving burden and perceived social support experienced by their relatives. Two hundred twenty-two persons in recovery and one of their relatives from 12 different territories within Catalonia, Spain took part in the study. The intervention group exhibited higher recovery scores compared to the control group at 6 months, although this difference was not sustained at the 12-month follow-up. No statistically significant differences were found for burden and social support scores between experimental groups. However, time effects were found for recovery and burden scores regardless of experimental group membership. Dose–effect analyses showed that participation was related to recovery and burden scores, with no time interactions observed. Upon examining the interaction with sociodemographic variables, we discovered statistically significant group-by-time interactions, suggesting a more positive progression of recovery scores among the experimental group when either the person in recovery was younger, their relative was female, or lived outside of the Barcelona Metropolitan Area. These results allow us to conclude that the program has a positive effect on the recovery journey. However, the lack of effectiveness regarding burden and social support in relatives highlights the necessity of reconsidering implementation and evaluation strategies.