Testing a Community-Based Support Program to Help Adults With Severe Mental Illness After Hospital Discharge in South Africa

What this Trial Is About

Researchers are evaluating a health system strengthening intervention designed to support people living with severe mental illness SMI in South Africa. This study aims to determine the feasibility, appropriateness, and limited efficacy of a co-developed program to reduce hospital readmissions following acute psychiatric hospitalization. The research focuses on addressing the cycle of readmission by improving community-based care in a low-resource setting, building on partnerships and government collaboration in the uMgungundlovu District. The intervention includes multiple components improved referral pathways across healthcare levels psychosocial rehabilitation programs delivered by multidisciplinary teams and registered counselors refresher training for primary healthcare clinicians a community mental health education and detection toolkit for outreach teams and a Household Champion program to empower caregivers. Participants are randomly assigned to receive either this full intervention package or standard care with improved hospital-level referral and discharge processes. Participants will be monitored for 4 months after hospital discharge. Assessments include hospital readmission rates, recovery scores, internalized stigma, and treatment adherence, measured through questionnaires and medical records. Researchers will also collect qualitative data on the interventions acceptability, demand, implementation, practicality, adaptation, integration, and potential for expansion. This combination of data will provide insight into the programs feasibility and limited efficacy in reducing psychiatric relapse in the community.

Feasibility and Acceptability of an Intervention to Support People With Severe Mental Illness in South Africa