Project management:
Priv. Doz. Dr Markus Kösters, Department of Psychiatry and Psychotherapy II, University of Ulm

Consortium partners:
Forum für Gesundheitswirtschaft gGmbH (Dr Peter Brückner-Bozetti)
Heidelberg University Hospital, Heidelberg (Prof. Dr Hans-Christoph Friederich, PD Dr Ulrike Dinger-Ehrenthal, Prof. Beate Wild)
Deutsches Krankenhausinstitut e. V. (Dr Karl Blum)

Co-operation partners:
DGPPN
DGPM
DGKJP

Collaborators University of Ulm:
Priv. Doz. Dr Markus Kösters
Dr Johanna Breilmann
Kathrin Mayer
Thomas Klein

Funding: Innovation Committee of the Federal Joint Committee (G-BA)

Funding amount: € 2,026,730

Duration: 04/2021 - 03/2024

Summary:
With the aim of improving the determination of personnel requirements, a working group of scientific societies and professional associations (Platform for Personnel Assessment) has developed a structural model (so-called "platform model") that is intended to enable the estimation of treatment costs, taking into account demand and treatment clusters as well as guideline-compliant treatment.

The EPPIK project aims to contribute to the evaluation and validation of the platform model. To this end, two sub-projects will create a basis for a final target estimate of staffing levels for all professional groups based on the platform model, both for psychiatry and for psychosomatic medicine and psychotherapy (PSM-PT). In the psychiatry sub-project, the reliability of the allocation of patients to treatment clusters will first be examined for adult and paediatric psychiatry. In addition, prototypical guideline-compliant components of treatments are defined for case vignettes of the needs clusters in order to enable an assessment of the treatment needs derived from the treatment guidelines across the professional groups. In the PSM-PT sub-project, a modification of the personnel assessment is necessary due to a different work and care structure and a different focus of the disorders. For PSM-PT, the validity of the treatment clusters developed by experts as part of the platform model will therefore be examined. Secondly, the actual staffing levels and the prototype treatment plans for the treatment clusters developed in the project will be used to estimate the target staffing requirements.

If successful, the project will develop guideline-orientated prototypes for the demand and treatment clusters, which will allow a structured, evidence- and expert-based assessment of the profession-specific staffing requirements.

Project management: Prof. Dr phil. Bernd Puschner

Project partners:
University of Nottingham, United Kingdom
University Medical Center Hamburg-Eppendorf, Germany
Butabika National Referral Hospital, Uganda
London School of Hygiene and Tropical Medicine, United Kingdom
Ifakara Health Institute, Tanzania
Ben-Gurion University of the Negev, Israel
Centre for Mental Health Law and Policy, India

Ulm University staff:
Prof. Dr phil. Bernd Puschner
Dr biol. hum. Annabel Sandra Müller-Stierlin
Prof. Dr rer. soc. Reinhold Kilian
Priv. Doz. Dr phil. Silvia Krumm
Eva Paul
Ramona Hiltensperger, M. Sc.

Funding: EU (HORIZON2020), Global Alliance Chronic Diseases (GACD)

Funding amount: € 3,100,000

Duration: 01/2018 - 12/2022

Summary:

A large number of people with severe mental illnesses do not receive treatment. This treatment gap is very pronounced in low- and middle-income countries (LMIC) and has detrimental effects on individuals (social role, quality of life, stigmatisation) and societies (equity, costs). Peer support is an established treatment method in which a person who has experienced mental illness supports other people with mental illness. Recovery counsellors are an untapped resource in the global care of people with mental illness.

UPSIDES aims to establish the recovery counsellor model of care for people with severe mental illness in high, middle and low income countries. An international practice-based community of recovery support workers, researchers and other key stakeholders will be established in Europe, Africa and Asia (8 study centres in 6 countries). There, peer support will be implemented and adapted to local conditions. Peer support is evaluated comprehensively at various levels using a mixed-method approach: Affected people and recovery companions (psychosocial and clinical endpoints), care performance (cost-effectiveness, return on investment) and implementation (uptake, sustainability and organisational change). Science-based guidelines will be provided to local, national and international stakeholders to ensure the sustainability and dissemination of the care model.

UPSIDES will improve the lives of many people in Europe and LMIC by transforming mental health care systems through the inclusion of people with psychiatric experience. The involvement of recovery counsellors is particularly important for developing countries in view of the shortage of professionals in these countries. The efficiency of psychiatric care systems is maximised by actively involving and empowering those affected. This leads to system changes in the direction of patient-centredness, recovery orientation and community participation. UPSIDES aims to change the care system so that mental health is realised as a human right.

Head of the overall project: Dr Maurice Cabanis, Klinikum der Landeshauptstadt Stuttgart gKAöR

Head of the evaluation: Dr biol. hum. Annabel Sandra Müller-Stierlin, Clinic for Psychiatry and Psychotherapy II at the University of Ulm

Project partners:
Klinikum der Landeshauptstadt Stuttgart gKAöR, Zentrum für Seelische Gesundheit, Klinik für Suchtmedizin und Abhängiges Verhalten (Dr. med. Maurice Cabanis, overall project management)
Institutions of the Stuttgart addiction support network (including Release Stuttgart e.V., Lagaya Stuttgart e.V., Caritasverband für Stuttgart e.V., Evangelische Gesellschaft Stuttgart e.V.)
Daimler Betriebskrankenkasse (Daimler BKK)

Employees Ulm University:
Paulina Achtermann, M. Sc.
Sebastian Cornet, B. Sc.
Anna Debler, B. Sc.
Christian Götzl, M. A.
Jutta Lehle, B. A.
Ida Müller, M. Sc.
Elke Prestin, Dr phil.
Magdalena Weimer, M. A.

EmployeesKlinikum der Landeshauptstadt Stuttgart gKAöR:
Dr phil. Jeanette Röhrig
Dr oec. Vanessa-Emily Schoch
Lorenz Sutter, M. Sc.
Ariadne Katsioulis, M. A.
Lena Kiebel, B. A.

Funding: Innovation Fund of the Joint Federal Committee

Funding amount: € 2,256,000

Duration: 10/2020 - 09/2023

Summary:
For years, a variety of hurdles and problems have been described with regard to the German addiction support system. In addition to an adherence to the concept of abstinence, which has long since given way to modern concepts in countries such as the UK or the Netherlands, the poor networking of individual sectors and a lack of integrated interventions represent a central problem in addiction support. According to current studies, less than 5% of people with addiction problems in Germany receive addiction-specific therapy. Furthermore, it is often unclear which criteria are used by those providing treatment to decide which interventions make the most sense for those affected.

A regional competence centre is therefore being established as a model for the Stuttgart region, through which people with addiction problems can be referred to the various specialised services of the Stuttgart addiction support system according to their needs. To this end, those affected are first offered an internet-based screening and then, building on this, a standardised diagnostic process in personal contact. After coordinating with the individual treatment goals of those affected, a concrete treatment plan, the so-called treatment assistant, is then drawn up. Those affected are also supported in being referred to suitable facilities.

The establishment of sector-independent treatment coordination is accompanied by an evaluation by the University of Ulm. The evaluation design can be divided into four sub-studies: In the first two sub-studies, the coordination platform will be adapted to local specifics in a survey of addiction support staff and in focus groups with those affected, treatment providers, cost bearers and interest groups. The third and fourth sub-studies are aimed at evaluating the care and cost-effectiveness of treatment coordination. To this end, a controlled, randomised study will examine whether networked, online-based coordination of diagnostics and treatment allocation leads to higher treatment satisfaction among those affected and a change in the use of care services compared to standard care (sub-study 3). In addition, sub-study 4 uses focus groups to determine the subjective views of patients, counsellors, practitioners and other stakeholders on factors that hinder and promote treatment coordination.

If successful, the project can help to support treatment providers in their work and provide those affected with a low-threshold, cost-effective and personalised service for improved addiction medical care across the board.

Project management (coordination):
Prof. Dr habil. Silke Wiegand-Grefe (Medical School Hamburg)

Cooperation partners and co-applicants:
Prof Dr Martin Lambert (UKE)
Prof Dr Karl Wegscheider (UKE)
Prof Dr Franz Petermann (University of Bremen)
Prof Dr Reinhold Kilian (University of Ulm)
Prof Dr Ullrich Bauer (University of Essen/Duisburg)
Dr Doris Mallmann (Klinik Rheinhöhe, Vitos Rheingau)
Prof Dr von Klitzing (Leipzig University Hospital)

Collaborators University of Ulm:
Prof. Dr Reinhold Kilian (Project Manager University of Ulm)
Maja Stiawa M.A. soz. (Project Coordination)
Maike Gäns (Student Assistant)

External collaborators:
Artur Geis, qualified psychologist, psychological psychotherapist, employee of the Educational and Youth Welfare Association (EJV), Günzburg Counselling Centre
Jörn Eugen, qualified social pedagogue, systemic counsellor, employee of the Educational and Youth Welfare Association (EJV), Illertissen Counselling Centre

Funding:
The project is funded by the Federal Ministry of Education and Research (BMBF) under grant number O1GY1337.

Total funding amount: € 902,772.00

Funding amount University of Ulm: € 163,919.00

Duration: 01.04.2014 - 31.03.2017

Background:
In Germany, there are around 3 million children and adolescents with mentally ill parents, who are known to be a high-risk group for developing their own mental illnesses. The risk of these children becoming ill is several times higher than that of children with healthy parents. As a rule, these children do not receive professional treatment because their parents keep them away from healthcare institutions due to fears, feelings of shame and guilt.

According to needs assessments in the international literature, family-orientated interventions appear to be particularly useful because they effectively counter parents' fears and, on the basis of a trusting relationship with the parents, can prevent later abnormalities in the children and bring children with mental health problems to early intervention and early treatment.

Around half of the children of mentally ill parents already exhibit mental health problems themselves, making them a target group of high health economic relevance. From a health economic perspective, it is known that mental illnesses are associated with high individual and social costs and often have their precursors in childhood and adolescence. Recognising the need for treatment of these affected children at an early stage and initiating adequate early detection and early treatment is necessary not only for ethical but also for economic reasons. Early treatment can prevent protracted phases of illness in children and chronicity, which often leads to later illness in adulthood.

Despite the awareness of this problem, there is still no evidence-based intervention implemented in routine care for this high-risk and patient group in German-speaking countries.

Research question / objective:
The central objective of the study is to implement the manualised family intervention CHIMPs for children and adolescents with mentally ill parents aged 4-18 years in routine care at the five participating centres. This is in line with the federal policy objectives of supporting children of mentally ill parents as a known high-risk population. The intervention aims to sustainably improve the mental health and quality of life of affected children and adolescents and, in the sense of early treatment and early intervention, to provide intervention for children and adolescents who are already at risk. The long-term effectiveness of this intervention under real-life conditions will be tested in comparison to a control group receiving the usual follow-up treatment (TAU = treatment as usual), taking health economic aspects into account. The project thus implements a structurally anchored, evaluated family intervention and thus a psychosocial and clinical care structure for this target group.

Method:
This study is a prospective randomised, controlled (RCT) multicentre study comparing the intervention and control groups (TAU = treatment as usual) in a pre-post design with a 1-year case history. The perspective of the ill parent, the partner and each child (4-9 years only external assessment, from 10 years additionally self-assessment) as well as the therapists are recorded. Both indirect (pre-post measurements) and direct measurements (at the end of the intervention) take place.

Project management:
Prof. Dr rer. soc. Reinhold Kilian

Project partners:
Kliniken des Bezirks Oberbayern
AOK Bayern - Die Gesundheitskasse
AWO Bezirksverband Obb. e.V.
AWO Sozialtherapeutische Einrichtungen
Frauentherapiezentrum FTZ gGmbH
kbo Sozialpsychiatrisches Zentrum gGmbH
SpDi Schwabing des Caritasverband München-Freising e.V.
Sozialpsychiatrisches Zentrum München gGmbH
Wohnprojekt Berg am Laim
Soziale Dienste Psychiatrie gGmbH

Collaborators University of Ulm:
Prof. Dr rer. soc. Reinhold Kilian
Dipl. Annabel Sandra Müller-Stierlin, M. Sc.
Ümmügülsüm Dinc, B. Sc.
Natalie Lamp, B. Sc.
Dr hum. biol. Prisca Weiser

Funding:
AOK Bayern, clinics of the district of Upper Bavaria and the participating organisations

Funding amount: €58,235

Duration: May 2016 - November 2018

Summary:

Patients with mental illness are more likely to suffer from physical illnesses (e.g. obesity, diabetes, cardiovascular disease) compared to the rest of the population. Unhealthy lifestyle habits, side effects of medication, unfavourable living conditions and neglect of physical health are considered to be the main causes of poor physical health among those affected. The Department of Psychiatry and Psychotherapy II at the University of Ulm, Günzburg has therefore developed a health promotion programme for people with severe psychiatric illnesses. The HELPS research project is investigating whether participation in this programme to promote a healthy lifestyle leads to an improvement in the health behaviour and physical well-being of people with mental illness. The knowledge gained from this study should contribute to the further development of existing care models in the future. By establishing effective health promotion programmes in the care of people with mental illness, the aim is to prevent physical illness in this at-risk population. To this end, over a period of 18 months, a group of people with mental illness who take part in the programme (we call them the intervention group) will be compared with a group of patients who will not take part in the programme (we call them the control group). A total of 70 participants will be recruited from the Munich area. The participants in both groups will be interviewed at four survey points six months apart.

Project management: Dr Markus Kösters

Project partners:
University Hospital Munich (Department of Psychiatry and Psychotherapy) (PD Dr Alkomiet Hasan, Prof. Dr Peter Falkai)
Leipzig University (Institute for Social Medicine, Occupational Medicine and Public Health, ISAP) (Dr Uta Gühne, Prof. Dr Steffi G. Riedel-Heller)
Ulm University (Institute for Epidemiology and Medical Biometry) (Prof. Dr Rainer Muche)
Bezirkskrankenhaus Günzburg (Prof. Dr Thomas Becker)
Bezirkskrankenhaus Kempten (Prof. Dr Markus Jäger)
Bezirkskrankenhaus Memmingen (Dr Andreas Küthmann)
Bezirkskrankenhaus Donauwörth (PD Dr Karel Frasch)
Bezirkskrankenhaus Augsburg (Prof. Dr Max Schmauß)
Bezirkskrankenhaus Kaufbeuren (PD Dr Albert Putzhammer)
kbo-Isar-Amper-Klinikum (Prof. Dr Peter Brieger)

Collaborators University of Ulm:
Dr Markus Kösters
Dr Johanna Breilmann
Prof. Dr Reinhold Kilian
Natalie Lamp, M.Sc.
Katrin Mayer, M.Sc.
Tamara Waldmann, M.Sc.
Michael Bachmaier
Jasmin Buchberger
Theodor Deggendorfer
Lea Eichele
Sarah Fritz
Dr Dagmar Gröber-Grätz
Paulo Kling Lourenco
Juliane Lott
Susanna Müller-Tischmacher
Ursula Nägele
Iris Schicker
Michael Willi

Other employees:
Janine Quittschalle (University of Leipzig)
Gabriele Gaigl (University Hospital Munich)
Katharina Merz (University Hospital Munich)
Jana Nolden (University Hospital Munich)
Esther Täumer (University Hospital Munich)

Funding: Innovation Committee of the Federal Joint Committee (G-BA)

Funding amount: €2,660,000

Duration: 09/2018 - 08/2021

Summary:

Psychosocial therapies are a central component of the treatment of people with severe mental illnesses. To date, however, there has been no structured recording of the available services and the utilisation of these services by clients. The "IMPPETUS" project aims to identify gaps in the provision of psychosocial care for people with psychiatric illnesses and to help close these gaps.

In the first phase of the project, the psychosocial care situation and the current implementation of the S3 guideline "Psychosocial therapies for severe mental illness" will be analysed in ten care regions in Bavaria. In the second phase, a randomised, controlled study will examine whether the multimodal, structured implementation of the patient version of the S3 guideline "Psychosocial therapies for severe mental illness" and associated information services increases the participation of those affected in treatment, increases the use of psychosocial therapies and contributes to a better treatment outcome.

The project partners include ten Bavarian clinics in which a total of around 500 patients and their relatives are surveyed in each project phase. Patients with schizophrenia, schizotypal and delusional disorders as well as affective disorders are included.

Download GBA final report

Project management: Prof. Dr rer. soc. Reinhold Kilian

Project partners:
University of Paderborn
City of Dortmund, fire service
City of Gelsenkirchen, fire service
Robert Koch Institute
PRO DV AG
Hamm-Lippstadt University of Applied Sciences
University Hospital Ulm
City of Bochum, fire service (associated)
City of Essen, fire service (associated)
Ministry of the Interior and Local Authorities NRW (associated)
State Health Centre NRW (associated)

Funding: Federal Ministry of Education and Research (BMBF)

Funding amount: € 450,456

Duration: January 2014 - December 2016

Staff Ulm University:
Carmen Checchia
Ann-Christien Holtrup
Annabel Stierlin
Dr biol. hum. Carolin v. Gottberg

Interkom project objective:
The aim of the Interkom joint project is to strengthen the population's sense of security in order to increase the resilience of urban centres and keep them stable in crisis situations. To this end, a holistic concept with four solution components is being researched which, through their interaction in crisis management, create a high sense of security among the population.

SUSIBER project objective:
Targeted influence on the subjective sense of security of the population requires comprehensive knowledge of the dimensional components as well as the personal and environmental factors influencing the subjective sense of security. As a central prerequisite for the objectives of the joint project, this sub-project will therefore analyse the dimensional structure and influencing factors of the subjective sense of security of the population in conurbations with regard to the threat situations of power outages, pandemics and biological hazards. Furthermore, it will be investigated how differences in the perception of danger and the subjective sense of security affect potential behaviour when a dangerous situation occurs, particularly with regard to cooperation with administrative bodies and security forces.

Project partners:
PD Dr Matthias Schützwohl, Dresden University of Technology (sub-project management for the Berlin and Dresden region)
Birgit Görres, Dachverband Gemeindepsychiatrie e.V.
Kay Herklotz, Medizinisch-therapeutisches Versorgungszentrum Dresden gGmbH
Stephanie Lerf, Gesellschaft für innovatives Gesundheitsmanagement mbH AWOLYSIS
Holger Steckermaier, Gemeinnützige GmbH des Projektvereins
Gisela Riederle, KIELER FENSTER
Wolfgang Faulbaum-Decke, Brücke Schleswig-Holstein
Marius Greuèl, MVZ-Pinel gGmbH
Dr. Thomas Floeth, NiG Pinel gGmbH
Dr Nils Greve, GpG NRW PTV Solingen

Collaborators University of Ulm:
Prof. Dr rer. soc. Reinhold Kilian (overall project management)
Prof. Dr med. Thomas Becker (medical project management)
Annabel Stierlin

Funding:
Federal Ministry of Health / DLR project management organisation
Research to improve the care of people with mental disorders

Funding amount: €409,685

Duration: 2013 - 2016

Identifier: II A 5 - 2513 FSB 012

Background:
Various models for improving psychiatric care are currently being trialled in Germany. The focus is on improving the quality of life and the possibility of independent living (empowerment) of people with mental illness. This study serves to evaluate various psychiatric care concepts. The knowledge gained from this study is intended to provide a better understanding of the need for outpatient and inpatient psychiatric care and could contribute to the further development of existing care models in the future.

Method:
The aim of the project is to analyse the effectiveness and cost-effectiveness of IV contracts based on the Network for Mental Health (NWpG) model in comparison with standard psychiatric care under real-world conditions. The study takes place in five different regions in Germany (Berlin, Dresden, Schleswig-Holstein, Munich, Rhineland). As part of the study, patients and their relatives will be interviewed at four six-monthly intervals over a period of two years. The survey includes information on the patients' state of health, quality of life and assessment of their independence. In addition, information on the medical and psychotherapeutic treatment services utilised is recorded.

Expected results:
The programmes for integrated psychiatric care examined in the study are currently being tested in various parts of Germany. However, systematic data on effectiveness and efficiency are not yet available. The results of the studies should provide service providers and cost bearers with data on the extent to which these programmes in their current form lead to an improvement in psychiatric treatment, particularly with regard to overcoming existing deficits at the interfaces between outpatient and inpatient psychiatric care, thereby improving the quality of treatment outcomes from the perspective of patients, cost bearers and the national economy. In addition, the study is intended to provide information on deficits in the current NWpG model and ways of overcoming them.

Publication:

1. Stierlin A (2013) NWpG contracts for integrated care are evaluated. Psychosoziale Umschau 3, 9.

Applicant/project management:
Prof. Dr Thomas Becker, Medical Director; Department of Psychiatry and Psychotherapy II, University of Ulm
Prof. Dr Katarina Stengler, Head of Psychosocial Research Group, University of Leipzig

Coordination: Prof. Dr rer. soc. Reinhold Kilian

Cooperation partners:
All RPK facilities in Germany, coordination: Board of the BAG RPK, Dipl.-Psych. Anette Theißing, Hanover
All BTZ facilities in Germany, coordination: Member of the Board of the BAG BTZ, Dr Reinald Faß, Berlin

Employees University of Ulm:
Dipl.-Jur. Paulo Kling Lourenco
M. A. Soz. Maja Stiawa
Dr biol. hum. Carolin von Gottberg

External collaborators (Leipzig):
Lisa Leyendecker

Funding: German Pension Insurance

Funding amount: €95,900

Duration: 18 months

Background:
To date, there has been a lack of convincing data on the effectiveness of vocational rehabilitation programmes in Germany. Of particular interest is which of the many different structures, settings and methodological approaches to vocational integration show the best results in terms of regaining employment and to what extent the internationally successful SE model can be implemented under the given conditions in Germany. For people with severe mental illness, rehabilitation in RPK facilities is one of the most frequently utilised integrative services in Germany. In addition, vocational training centres (BTZ), as regional, outpatient vocational rehabilitation facilities in accordance with Section 35 SGB IX, are very well suited to supporting people re-entering the general labour market after a mental illness. Data from both BTZs and RPKs indicate good integration results following vocational rehabilitation. Against this background, a preliminary study will investigate the extent to which and how SE content is implemented in RPKs and BTZs in Germany. This should help to analyse the influence of these measures on rehabilitation outcomes and to identify individual and other context-related determinants that influence the success of vocational rehabilitation.

Research question/project objectives:
Characterisation of the type and scope of vocational integration measures based on the Supported Employment (SE) concept to examine and improve the allocation of resources in vocational rehabilitation measures in RPKs and BTZs. Character of the study: Preliminary study in preparation for a prospective quantitative longitudinal survey on the effectiveness and efficiency of vocational integration measures in RPKs and BTZs in Germany To what extent and in what form are SE elements implemented in BTZ and RPK facilities in Germany? Under which setting- and facility-specific conditions are SE-like vocational integration programmes implemented in BTZs and RPKs?

Methods:
Multicentre cross-sectional survey with quantitative and qualitative methodsQuestionnaire survey (SE orientation) - use of the modified IPS Fidelity Scale in the Delphi processin all RTC facilities (n=57) and in all BAGBTZ member facilities (n=22) in Germany. Qualitative sub-project: guideline-centred interviews in defined subgroups(facilities with high versus low SE proximity) Evaluation: Grounded Theory57 RPK and 22 BTZ facilities: Assessment of the "SE proximity" of the vocationalintegration programmes using a modified IPS Fidelity Scale questionnaire by facility employees (n= 79).

In addition, a survey instrument is to be developed to record facility- and setting-specific data that is based on the basic documentation established in the facilitiesand includes parameters such as urban vs. ruralsetting, regional unemployment, size of the facility, number of rehabilitants,outpatient and/or inpatient unit, etc.

Analysis:
The quantitative part of the study was analysed using descriptive and explorative statistical methods. Cohen's Kappa was used to assess the agreement between the two raters of the "SE-German Version1". The classification of the RPK/ BTZ Stengler/ Kilian/ Becker: Type and scope of SE services in RPK and BTZ facilities is carried out on the basis of a cluster analysis or, if application requirements are met, on the basis of a latent profile analysis including the items or subscales of the "SE-German Version1".

Project management: Dipl. Annabel Sandra Müller-Stierlin, M. Sc.

Project partners:
Dr biol. hum. Nicole Scheuing, Prof. Dr Reinhard W. Holl, University of Ulm
Prof. Dr Philipp Graf, Ulm University of Applied Sciences

Ulm University staff:
Prof. Dr rer. soc. Reinhold Kilian
Dipl. Annabel Sandra Müller-Stierlin, M. Sc.
Ümmügülsüm Dinc, B. Sc.
Ramona Hiltensperger

Funding:
Junior academy of the Baden-Württemberg Health Services Research Network (MWK - Ministry of Science, Research and the Arts in Baden-Württemberg)
Medical Faculty of the University of Ulm

Funding amount: €49,840

Duration: November 2015 - April 2016

Summary:
The life expectancy of patients with mental illness is significantly reduced compared to the general population. Among other things, this can be attributed to unhealthy lifestyle habits, such as an unhealthy diet. Prevention and intervention with regard to the diet of patients with mental illness are aimed at alleviating the mental illness on the one hand, but also counteracting associated comorbidities on the other.
Valid methods for recording the nutritional behaviour of patients with mental illness are needed in order to investigate the interaction between mental illness and nutrition and, in particular, new interventions. A digital method for recording dietary behaviour using a camera phone, which has already been successfully tested on healthy subjects, may also be particularly suitable for patients with mental illness.
In the present project, the digital method is compared with other already validated techniques for recording dietary behaviour, such as a simple food diary and an elaborate weighing protocol. While the feasibility and accuracy of this new method can be tested in patients with mental illness, an insight into the nutritional behaviour of these patient groups will also be gained.
The digital method will be tested on 40 patients with an F2 diagnosis (psychoses) and 40 patients with an F3 diagnosis (affective disorders). To determine dietary behaviour, these patients will photograph their food and drink over three days and send the photos to the study team (e.g. using a standard camera phone). In addition, a conventional weighing log will be kept on one of the days and a food diary with estimated or standardised portion sizes will be completed on another day. In addition, consumption frequencies for various food categories are to be estimated. At the end of the three days, a satisfaction questionnaire relating to the measurement methods is answered. The data collection is repeated after about four weeks with the aim of recording intrapersonal fluctuations. Based on the pictures, the food diaries and the weighing protocols, the foods and portion sizes are determined and transferred to a programme for determining nutritional values (DGExpert). The various data collection methods are compared in terms of feasibility and accuracy. In addition, the eating behaviour of the patients will be nutritionally assessed.
This should provide an important starting point for further research into the triad between mental illness, eating behaviour and metabolism-associated comorbidities. In a follow-up project, it is planned to investigate the effectiveness of a lifestyle intervention with regard to the alleviation of metabolism-associated comorbidities (e.g. obesity or lipidaemia) in patients with mental illness.
Based on the present project, a suitable method for recording dietary behaviour can be selected and the lifestyle intervention can also be adapted to the dietary behaviour of the patient clientele.

Project partners:
Joachim Szecsenyi, Gunter Laux, Antje Miksch, Stefanie Joos, Heidelberg University Hospital (overall coordination)
Hans-Joachim Salize, Central Institute of Mental Health, Mannheim
Joachim Fischer, Heidelberg University, Mannheim Medical Faculty
Monika Rieger, Tübingen University Hospital
Werner Vach, University of Freiburg

Collaborators University of Ulm:
Thomas Becker
Bernd Puschner (project management)
Suzanne Cosh
Sabine Loos

Funding:
Ministry of Science, Research and the Arts (MWK) in coordination with the Ministry of Labour and Social Affairs, Families and Senior Citizens

Funding amount: € 166,000 (1st and 2nd cohort, Ulm site)

Duration: 2011 - 2015

Summary:

The Nachwuchsakademie funds young scientists in Baden Württemberg for an 18 month period to complete a research project. At the University of Ulm, there are currently 3 young researchers with NWA funding. The NWA also provides workshops and career development opportunities to the researchers. The Universities throughout Baden Württemberg who are part of the NWA offer workshops.

Their projects cover the areas of economic analysis of health promotion programs in Primary schools, the development of software for use in economic analyses and power analyses, and an examination of how general practitioners recognise and manage depression. All 3 researchers are currently in a data collection phase and progressing well towards successful and timely completion of their projects.

In Ulm, the aim is to offer up to 3 workshops per year. The first workshop will be entitled "Scientific English writing for publication". It will be held on 26th March 2014 and will cover technical, as well as stylistic aspects of writing for publication. Future workshops are currently in the planning and development phase. There are also quarterly meetings to allow opportunities for the Ulm researchers to meet together and present their work. This also offers a forum for raising any concerns and for the researchers to meet together and provide peer supervision and support to one another. Two such meetings have been held since October 2013.

Project management: Dr biol. hum. Dipl.-Psych. Sabine Loos, Department of Psychiatry and Psychotherapy II, University of Ulm, Process-Outcome Research Section

Funding: DFG Junior Researcher Academy Health Services Research

Funding reference number: LO 2164/1-1

Duration: 12 months (start: 01/06/2015)

Introduction:
Transition is generally described as an "intentional, planned transition of adolescents or young adults with a chronic medical problem from child-centred to adult-centred health care" (American Academy of Pediatrics 2002). Due to the sectoral separation of medical service provision in Germany, under normal circumstances the age of 18 is regarded as the point at which a transfer from child and adolescent psychiatric/psychotherapeutic care to adult care should be completed. In exceptional cases, e.g. in the case of chronic illnesses or developmental peculiarities, care in child and adolescent psychiatry/psychotherapy can also be continued until the age of 21. In the psychotherapy guidelines, there is an overlap area for the 18-21 age group for treatment by either child and adolescent psychotherapists (KJP) or psychological psychotherapists (PP). The transition represents a critical phase and a challenge both for the young people themselves, for the therapists and for the healthcare system, so as not to jeopardise the successes that may already have been achieved in treatment. Continuity of treatment is of particular importance (Alpay 2009), as its success has a significant influence on the prognosis of chronic disease progression. In contrast to the increasing need for follow-up treatment, a decline in the utilisation of treatment services can be observed internationally in this age range (Singh et al. 2010). After the age of 18 and the associated necessary transition to adult-centred treatment services, mentally ill adolescents make significantly less use of care services. Little is known about the care situation in Germany.

Objectives:
The aims of the study are to survey and analyse the experiences and views of young mentally ill patients of transitional age with regard to their already completed or pending transition to psychiatric/psychotherapeutic adult care, with special consideration of intrapersonal, interpersonal and contextual factors that influence their health behaviour and thus the decision for or against further treatment. On the other hand, practitioners will be asked about structural, setting-related and organisational factors that may favour or hinder continuing care. The results are intended to form the basis for a targeted intervention to improve the transition of adolescents and young adults with mental illnesses, taking particular account of the factors mentioned.

Method:
In an explorative-qualitative study design, six group discussions with adolescents and young adults between the ages of 16 and 25 in transition between the two care systems and four group discussions with care providers will be conducted. The transcribed text material was analysed using the reconstructive documentary method according to R. Bohnsack.

Outlook:
By involving affected patients and care providers in the development phase of an intervention to improve treatment continuity in the transition to adult-centred treatment, the project aims to use the knowledge gained from experience to develop targeted measures.