Illness Management and Recovery (IMR) in Danish Community Mental Health Centres

Illness Management and Recovery (IMR) in Danish Community Mental Health Centres: Protocol of a Randomized, Assessor-blinded Multi-centre Clinical Trial of a Recovery-oriented Program for People With Schizophrenia or Bipolar Disorder

The aim of this trial is to evaluate the effectiveness of the Illness Management and Recovery program for people diagnosed with schizophrenia or bipolar disorder in according to their level of functioning.

Background: Illness Management and Recovery (IMR) is a curriculum-based psychosocial intervention designed as structured program with a recovery-oriented approach. The aim of IMR is to rehabilitate people with severe mental illnesses by helping them acquire knowledge and skills in managing their illness and achieve personal recovery goals. Previous randomised clinical trials indicate that IMR can be implemented with a good effect and a high fidelity though further trials are crucial to demonstrate the potential effectiveness of IMR.

Methods/Design: The trial design is a randomised, assessor-blinded, multi-centre, clinical trial of the IMR program compared with treatment as usual for 200 participants diagnosed with schizophrenia or bipolar disorder under the care of two community mental health centres in the Capital Region of Denmark. The primary outcome is level of functioning at the end of treatment and at follow-up 21 months after baseline. The secondary outcomes are disease symptoms; use of alcohol/drugs; individual meaning of recovery; hope; hospital admissions and out-patient psychiatric treatment at the end of treatment and at follow-up 21 months after baseline.

Inclusion Criteria:

• adults (age 18+)
• both sexes
• associated with one of the two participating community mental health centres
• diagnosed following the ICD-10 criteria of schizophrenia or bipolar disorder
• able to speak and understand Danish
• giving informed consent verbally and in writing

Exclusion Criteria:

• have a guardian or a forensic psychiatric arrangement
• comorbidity with the ICD-10 criteria of the diagnoses of dementia or mental retardation
• a large-scale substance abuse - if later on the abuse is under control inclusion in the trial will be possible
• a current home of supported housing - since the treatment as usual given to this group of patients is significant different from patients living independently
• a current involvement in a psycho-educational course - patients are eligible for participation in the trial after the psycho-educational course has ended if they meet the inclusion criteria at this point
• not given informed consent.