People with serious mental illness may benefit from resource groups

Resource groups improved psychiatric outcomes, including empowerment, among people with serious mental illness who received community-based mental health services, according to results of a randomized clinical trial.

“The origins of the [resource group] method lie in the optimal treatment model, which integrates biomedical, psychological and social strategies in the management of [serious mental illness],” Cathelijn Tjaden, MSc, of the department of reintegration and community care at Trimbos Institute in the Netherlands, and colleagues wrote in JAMA Psychiatry. “In Sweden, the optimal treatment model was further developed to [Resource Group] Assertive Community Treatment (RACT). A meta-analysis showed outcomes in favor of RACT for patients with psychosis in social functioning, well-being and symptoms.”

However, the researchers noted RACT differed from care as usual, with the use of resource groups being only one such difference. In the current study, they aimed to assess the potential of resource groups in flexible assertive community treatment (FACT) to favorably affect empowerment and recovery-related outcomes among individuals with serious mental illness.

They conducted the trial between Sept. 1, 2017, and Sept. 30, 2020, with follow-up at 9 months and 18 months. They randomly assigned 158 participants aged 18 to 65 years (median age, 38 years) who met the criteria for serious mental illness to FACT plus resource group (n = 80) compared with FACT as usual (n = 78) in a 1:1 ratio in 20 FACT teams throughout the Netherlands.

Patients in the FACT plus resource group condition selected members from their informal and formal networks to assemble a resource group that met quarterly to discuss self-formulated recovery goals. The resource group underwent integration into the multidisciplinary support offered by the FACT team. The FACT as-usual group incorporated empowerment, defined as overcoming powerlessness and gaining control over one’s life, and involvement of significant others as part of the provided care, minus the structure of the resource group. Self-reported empowerment, measured via the Netherlands Empowerment List, served as the primary outcome.

Results of intention-to-treat analyses revealed that random assignment to the resource group condition correlated with a clinically significant increase in empowerment and improved outcomes with small to medium effect sizes related to quality of life, personal recovery, quality of social contact, disability, general functioning and social functioning. The researchers observed no differences between conditions related to psychopathological symptoms, attachment, frequency of social contact and employment. Participants who stayed with the assigned treatment in the resource group vs. FACT as usual reported higher satisfaction with treatment at 9 and 18 months.

“Replication of the results in various local and international contexts and health economic data are recommended,” Tjaden and colleagues wrote.