Care Coordination and Passive Mobile Data Monitoring to Improve Mental Health Care

Recruiting

Care Coordination and Passive Mobile Data Monitoring to Engage Veterans and Improve Mental Health Care

Who can join

Ages 18 and older · All sexes

Full eligibility criteria

Inclusion Criteria:

* a medical record diagnosis of Serious Mental Illness (SMI)

  * defined as schizophrenia, schizoaffective disorder, or bipolar disorder
* receipt of care at the VA site during the prior 9 months
* a Care Assessment Need (CAN) score over the 75th percentile, indicating high risk for hospitalization or death in the upcoming year
* ownership of a smart phone

Exclusion Criteria:

* none

About the study

Providing care to individuals with serious mental illness can be challenging, requiring ongoing monitoring, treatment adjustments, and coordination of various medical and social services. Rates of emergency service and hospital use are high due to unexpected social, medical, and mental health crises. Stressors and poor adherence with treatment are common and can lead to rapid worsening in symptoms, job loss, homelessness, incarceration, or suicide. Clinician visits can be infrequent. Patient-clinician contact between visits is challenging and often nonexistent. As such, illness exacerbations usually occur with no clinician awareness in real time, leaving limited opportunity to provide services. Clinicians need interventions that are capable of monitoring and quickly detecting worsening behaviors and illness, to improve care coordination, outreach, and treatment. This project studies the effectiveness of enhanced care coordination using passive mobile data monitoring and support from peer specialists, with the goal of improving outcomes and reducing the need for acute care.

What is being tested

Care Coordination Mobile (behavioral)

Sponsor: VA Office of Research and Development · Participants: 400 · Started: Aug 10, 2026

Contact the study team

Ronald Calderon, MSW · Phone: (310) 478-3711
Alexander S Young, MD MSHS · Phone: (310) 268-3416

Official record on ClinicalTrials.gov — NCT07549178

Locations in the U.S.

California	VA Greater Los Angeles Healthcare System, West Los Angeles, CA, West Los Angeles
Pennsylvania	Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, Philadelphia

Conditions

From ClinicalTrials.gov, data retrieved Sep 30, 2026. Each study sets its own eligibility; the study team decides who can join.