Active Assistance for Psychological Therapy 2.0 (Actissist 2.0): Digital Intervention for Co-producing care in psychosis.

精神分裂症等严重精神健康问题影响着全世界2400万人。精神分裂症是一种严重的精神病——一个描述人们行为、思维和感觉变化的通用术语。精神病影响人们的社交、工作和执行日常生活任务的能力。它通常开始于成年早期。首发精神病是某人第一次经历这些变化。大多数精神病患者不止一次发作，所以他们有长期患病的风险。首次精神病发作后的时间对一个人的长期康复至关重要。这使得精神病的早期阶段成为治疗的重要时期。拖延治疗精神病的时间越长，病情就会变得越严重。提供有效和及时的谈话治疗精神病是一个严重的挑战，在当前的NHS气候。通过面对面预约提供治疗的传统方式会影响提供治疗的效率。我们需要增加可获得性，并在需要时及时提供新的治疗方法。智能手机现在价格实惠，很受欢迎，是我们能够安全、及时地成功提供治疗的一种方式。基于心理学理论和原理，我们开发了一款名为Actissist的智能手机应用程序，人们可以随时随地访问它。在我们之前的研究中，我们发现患有早期精神病的人在12周的日常生活中迅速完成了这款应用。我们还展示了人们喜欢使用这款应用，而且使用起来很安全。我们为这一应用提出的研究是研究途径的下一步。我们的目标是通过对75名早期精神病患者进行数字干预来改进和测试其益处。我们将比较75名使用另一款应用程序（名为ClinTouch）的患者的结果，该应用程序仅监测精神病和情绪症状，但不提供自我管理治疗。人们使用哪款应用程序是随机决定的，这样就可以在相似的人群中进行比较。基于我们之前的工作，我们希望Actissist能够改善症状和人们生活的其他重要方面。我们希望更好地了解如何使用数字技术来帮助提供日常护理。最后，我们希望Actissist应用程序将使人们能够自我管理他们的症状和治疗。我们的首要目标是改变对严重精神健康状况的社区护理，并让个人在如何接受医疗保健和与服务互动方面有更多的选择。通过这样做，我们希望减少人们精神病发作的次数，或者至少将其控制在最低限度。我们将通过将心理学思想和策略转化为用户友好的数字干预，通过大多数人拥有并喜欢使用的智能手机来实现这一点。通过这样做，我们希望我们可以帮助人们注意到他们是否在更早的时候变得不舒服，而不是依赖于参加心理健康服务。我们希望这将改善人们的日常生活，让他们远离医院。这项研究将为患者、服务机构和专员提供有关人们获得医疗保健的不同方式的信息。我们希望让有用的治疗更容易获得，并提供治疗方式的选择。我们的愿景是让人们更好地控制自己的心理健康和福祉，在维持功能结果的同时，支持药物治疗之外的恢复速度和质量，并支持自我管理。

Severe mental health problems (SMI) such as schizophrenia affect 24 million people worldwide. Schizophrenia is a severe form of psychosis - a general term that describes a change in people's behaviour, thinking and feelings. Psychosis affects people's ability to socialise, work and carry out the tasks of daily life. It usually begins in early adulthood. First episode psychosis is the first time someone experiences these changes. Most people with psychosis have more than one episode of psychosis, so people are at risk of long-term problems. The time after a first episode of psychosis is critical for a person's long-term recovery. This makes the early phase of psychosis an important time for treatment. The longer the delay in treating psychosis, the worse the illness becomes. The delivery of efficient and timely talking treatments for psychosis is a serious challenge in the current NHS climate. Traditional ways of offering therapy through face-to-face appointments can effect how efficiently treatment can be offered. We need increased availability and new, timely ways of delivering therapy when it is needed. Smartphones are now affordable and popular and are one way we can successfully deliver treatment safely and at point-of-need. Grounded in psychological theory and principles, we have developed a Smartphone app called Actissist that people can access anywhere, at the time they need it. In our previous research, we showed that people with early psychosis completed the app swiftly in their daily life over 12 weeks. We also showed that people liked using the app and that it was safe to use. The study we propose for this application is the next step along the research pathway. We aim to improve and test the benefits of our digital intervention by giving it to 75 early psychosis patients. We will compare outcomes with 75 people who use a different app (called ClinTouch), which just monitors psychosis and mood symptoms but does not provide self-managed therapy. Which app people get will be determined by chance so that the treatment can be compared in similar groups of people. Based on our previous work, we hope that Actissist will improve symptoms and other important areas of people's lives. We hope to gain a better understanding of how we can use digital technology to help provide day-to-day care. Finally, we hope that the Actissist app will empower people to self-manage their symptoms and therapy. Our overarching goal is to transform community care for severe mental health conditions and to give individuals more choice about how they receive healthcare and interact with services. By doing this, we hope to reduce the number of episodes of psychosis people have or at least keep these to a minimum. We will do this by translating psychological ideas and strategies into a user-friendly digital intervention that will be delivered through a Smartphone, which most people own and enjoy using. By doing this, we hope that we can help people notice if they are becoming unwell at an earlier point than if they relied on attending a mental health service. We hope that this will improve people's daily lives and keep them out of hospital. This study will provide patients, services and commissioners with information about different ways people can receive healthcare. We would like to make helpful treatments more accessible and provide choice about how therapy is delivered. Our vision is to give people a greater sense of control over their mental health and wellbeing, support the speed and quality of recovery over and above drug treatments while sustaining functional outcomes, and to support self-management.