4 - (SYM 76) Modularity in the Context of Chronic Physical Illness: The Mental Health Intervention for Children with Epilepsy (MICE) Study

Mental health difficulties are elevated in children and young people with Long Term Conditions such as epilepsy but many of those in need cannot access evidence-based psychological treatments such as CBT. This talk will present the clinical outcome of a large RCT of an integrated mental health treatment delivered remotely by Health Care Professionals within physical healthcare services for young people with epilepsy. The study design was a multi-center, parallel group, blinded, randomized controlled trial including 334 participants aged 3-18 years, attending epilepsy clinics, who met diagnostic criteria for a common mental health disorder. They were randomized to receive a Mental Health Intervention for Children with Epilepsy (MICE) intervention based on MATCH-ADTC in addition to usual care, or assessment-enhanced usual care alone (control). The primary outcome, analyzed by intention-to-treat was the parent-report Strengths and Difficulties Questionnaire (SDQ) at six months post-randomization.  At six months the mean SDQ difficulties for 166 MICE patients was significantly lower than for 168 control patients (p< 0.01). MICE also demonstrated significant positive results for the mental health of the parents/carers compared to the control arm. The trial demonstrates that multiple mental health comorbidities can be effectively treated within a singular intervention across a wide range of age groups and in the context of additional complexities, including long-term conditions and neurodevelopmental disorders. Such an intervention benefited significantly from the modularity inherent in MATCH-ADTC and could not have been developed without significant collaborations both within CBT in terms of the MATCH-ADTC treatment developers who provided supervision to ensure fidelity to the protocol while maintaining flexibility, as well as multidisciplinary collaborations including with neurologists, epilepsy nurse specialists and pediatricians. It is hoped that the MICE intervention can serve as a model for using modular interventions to develop efficient and effective modified interventions for mental health disorders in the context of other long-term conditions.

(Funded by the National Institute for Health Research, Programme Grants for Applied Research: RP-PG-0616-20007, Registration: ISRCTN57823197).