Implementation of a patient-focused psychosocial intervention guideline for people with severe mental illness: cluster-randomised controlled trial

  • Background Psychosocial interventions are vital in treating severe mental illness, yet their use remains limited, and patients often lack adequate information about them. Patient-focused versions of clinical guidelines are designed to enhance mental health literacy and inform patients about available treatments, but these resources are underutilized. This study evaluated the impact of implementing a patient-focused psychosocial intervention guideline on empowerment, knowledge, and use of psychosocial interventions among individuals with severe mental illness. Methods Multicentre, cluster-randomised trial. The study population comprised adult patients with a severe mental disorder. The intervention group received a multimodal, structured, and protocol-led patient-focused guideline implementation, whereas the control group received treatment as usual. Data were analysed using hierarchical linear models. The primary outcome was the change in patients’ empowerment. Results ThereBackground Psychosocial interventions are vital in treating severe mental illness, yet their use remains limited, and patients often lack adequate information about them. Patient-focused versions of clinical guidelines are designed to enhance mental health literacy and inform patients about available treatments, but these resources are underutilized. This study evaluated the impact of implementing a patient-focused psychosocial intervention guideline on empowerment, knowledge, and use of psychosocial interventions among individuals with severe mental illness. Methods Multicentre, cluster-randomised trial. The study population comprised adult patients with a severe mental disorder. The intervention group received a multimodal, structured, and protocol-led patient-focused guideline implementation, whereas the control group received treatment as usual. Data were analysed using hierarchical linear models. The primary outcome was the change in patients’ empowerment. Results There was no significant intervention effect on empowerment (effect size=0.13, p=0.605), which increased slightly in both groups. The number of psychosocial interventions familiar to patients increased significantly more in the intervention group. Exploratory analyses suggest that patient empowerment could have been influenced by COVID-19-related stress, patient age, the severity of functional impairment, and migration background. The improvement in the utilisation of psychosocial interventions did not differ significantly between the intervention group (M=1.1, SD=2.5) and the control group (M=1.3, SD=2.4). Conclusions The implementation of a patient-focused psychosocial intervention guideline failed to enhance empowerment among service users. However, our analyses indicate that the intervention led to an improvement in patient knowledge with respect to guideline content. The availability of psychosocial interventions may have been significantly constrained by the COVID-19 pandemic.show moreshow less

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Author:Markus Kösters, Andreas Allgöwer, Thomas Becker, Reinhold Kilian, Uta Gühne, Steffi Riedel-Heller, Alkomiet HasanORCiDGND, Peter Falkai, Klemens Ajayi, Peter Brieger, Karel Frasch, Theresa HalmsORCiDGND, Stephan Heres, Markus Jäger, Andreas Küthmann, Albert Putzhammer, Bertram Schneeweiß, Michael Schwarz, Johanna Breilmann
URN:urn:nbn:de:bvb:384-opus4-1260406
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/126040
ISSN:0924-9338OPAC
ISSN:1778-3585OPAC
Parent Title (English):European Psychiatry
Publisher:Cambridge University Press
Place of publication:Cambridge
Type:Article
Language:English
Year of first Publication:2026
Publishing Institution:Universität Augsburg
Release Date:2025/11/10
Volume:68
Issue:1
First Page:e163
DOI:https://doi.org/10.1192/j.eurpsy.2025.10126
Institutes:Medizinische Fakultät
Medizinische Fakultät / Lehrstuhl für Psychiatrie und Psychotherapie
Medizinische Fakultät / Bezirkskrankenhaus (BKH)
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung