Mindfulness-based crisis interventions (MBCI) for psychosis within acute inpatient psychiatric settings; a feasibility randomised controlled trial

• Published in: BMC psychiatry Vol. 20; no. 1; pp. 193 - 12
• Main Authors: Jacobsen, Pamela, Peters, Emmanuelle, Robinson, Emily J., Chadwick, Paul
• Format: Journal Article
• Language: English
• Published: London BioMed Central 29.04.2020; BioMed Central Ltd; BMC
• Subjects: Adolescent; Adult; Aftercare; Aged; Behavior modification; Care and treatment; Clinical trials; Crisis Intervention; Crisis intervention (Psychology); Feasibility Studies; Female; Health care costs; Hospital patients; Humans; Inpatients - psychology; Intervention; Male; Medical research; Medicine; Medicine & Public Health; Mental health; Mental health services; Middle Aged; Mindfulness; Mindfulness meditation; Patient Discharge; Psychiatric hospital readmission; Psychiatric hospitals; Psychiatric units; Psychiatry; Psychosis; Psychotherapy; Psychotic disorders; Psychotic Disorders - therapy; Questionnaires; Research Article; Short term; State Medicine; Therapists; Therapy; Young Adult; United Kingdom; United Kingdom > UK; United States > US; Psychosis; Psychotherapy; Crisis intervention; Psychiatric hospital readmission; Psychiatric units; Mindfulness
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-020-02608-x

Background Inpatient psychiatric care is a scarce and expensive resource in the National Health Service (NHS), with chronic bed shortages being partly driven by high re-admission rates. Brief inpatient talking therapies for psychosis could help reduce re-admission rates. The primary aim was to assess feasibility and acceptability of a novel, brief, mindfulness-based intervention for inpatients with psychosis. The secondary aim was to collect pilot outcome data on readmission rate, at 6 and 12 months (m) post discharge, and self-report symptom measures at 6 m. Methods The amBITION study (BrIef Talking therapIes ON wards) was a parallel group, feasibility randomised controlled trial (RCT). In addition to treatment as usual (TAU), eligible inpatients with psychotic symptoms were randomly allocated to receive either (Mindfulness-Based Crisis Intervention; MBCI) or a control intervention (Social Activity Therapy; SAT), for 1–5 sessions. Results Fifty participants were recruited (26 MBCI; 24 SAT); all received at least 1 therapy session (mean = 3). Follow-up rates were 98% at 6 m and 96% at 12 m for service use data extracted from clinical notes, and 86% for self-report measures. At 6 m follow-up, re-admission rates were similar across groups (MBCI = 6, SAT = 5; odds ratio = 1.20, 95% CI: 0.312–4.61). At 12 m follow-up, re-admissions were lower in the MBCI group (MBCI = 7, SAT = 11; odds ratio = 0.46, 95% CI: 0.14–1.51). Three participants experienced adverse events; none was related to trial participation. Conclusions Delivering a brief mindfulness-based inpatient intervention for psychosis is feasible and acceptable, and may reduce risk of short-term readmission. These promising findings warrant progression to a larger clinical effectiveness trial. Trial registration ISRCTN37625384 .