Bridge: Proactive Psychiatry Consultation and Case Management for Patients With Cancer

It is challenging to cope with cancer. The investigators want to understand if it is helpful
for patients with serious mental illness (SMI) to be connected to a psychiatrist and case
manager when cancer is diagnosed. Many people with illnesses like major depression,
schizophrenia and bipolar disorder face barriers to receiving high quality cancer care. It
can be difficult to get to appointments, have many different doctors, and experience
depression or worry. Better communication between the patient, the oncology team, and mental
health providers may improve care. As for all patients, it is important for people with
mental illness to have access to high quality cancer treatment that is patient-centered and
coordinated. Having a case manager and psychiatrist at the cancer center who collaborates
with the oncology team starting at cancer diagnosis may help patients to receive the cancer
care that they need.

This study includes a single-arm open pilot (n=8) to pilot patient and caregiver measures and
refine the intervention manual; a run-in period (n=6) to pilot the randomized trial
procedures; and a randomized controlled trial (n=120) to compare the impact of the Bridge
model with enhanced usual care on disruptions in cancer care.

Patient Inclusion Criteria:

- Age > 18 years old

- Verbal fluency in English

- Serious Mental Illness (Schizophrenia spectrum disorder, bipolar disorder, or major
depressive disorder with prior psychiatric hospitalization) confirmed by diagnostic
evaluation of study psychiatrist

- Invasive breast, lung, gastrointestinal, or head and neck cancer (suspected or
confirmed according to documentation by the oncologist or pathology) treated with
curable intent

- Medical, surgical, or radiation oncology consultation at Massachusetts General
Hospital (MGH) Cancer Center within the past 8 weeks

Patient Exclusion Criteria:

-Have cognitive impairment severe enough to interfere with completing brief study
assessments or providing informed consent (and does not have a guardian who can provide
consent)

Caregiver Participants

- Age > 18 years old

- Verbal fluency in English

- Identified or confirmed by the patient or guardian as a caregiver

- Caregiver may be a relative, friend, or community mental health staff upon whom the
patient relies for support and who accompanies the patient to medical appointments

- The caregiver should either live with the patient or have in-person contact with the
patient once per week (on average)

- Patient participant identifies or confirms caregiver's involvement, provides
permission to contact caregiver