# Recovery Bridge: A Peer Facilitated Intervention to help bridge the transition from psychiatric inpatient hospitalization to living in the community

> **NIH VA I21** · BALTIMORE VA MEDICAL CENTER · 2024 · —

## Abstract

Background: The time following discharge from psychiatric hospitalization is a high-risk period and has been
associated with a range of negative outcomes, including high rates of hospital readmission and suicide (1).
Because the evidence for transitional discharge interventions with bridging components is mixed and limited in
terms of how Peer Specialists (PS) can help support such interventions, additional research is needed. Our
proposal calls for the development and preliminary evaluation of a PS facilitated technology-supported
intervention based on the existing and frequently used My Recovery Plan program. However, to date, no
studies have examined use of this tool to improve post-hospital discharge outcomes. Given the importance of
the problem for the VA, and the fact that the VA has both a large PS infrastructure that is valued by both
professional providers and Veterans, our work offers sound justification and the unique opportunity to test the
proposed intervention in a single integrated system of inpatient and outpatient services.
Significance: The significance of this project lies in its ability to actively address an important gap in the
research, namely PS interventions focused on reducing readmission and supporting recovery-oriented
outcomes in Veterans. Further relating to important HSR&D priorities the project is designed to advance
scientific knowledge and clinical practice in the areas of access to care, mental health, and suicide prevention.
Innovation and Impact: A key innovation of the proposed research is the potential to efficiently optimize existing
resources to target the widespread challenges associated with transitioning out of acute inpatient settings and
effectively connect Veterans to preferred services (in this case peer support) in order to prevent re-admission,
and improve utilization of VA outpatient mental health services. Finally, in relationship to impact, Recovery
Bridge has potential to result in improvement across multiple clinical and functional outcomes that are
applicable to a broad Veteran population (rather than only in small select diagnostically specific
subpopulations).
Specific Aim 1: Integrate the My Recovery Plan tool and existing PS tools and strategies to develop a
manualized intervention called Recovery Bridge for use by VA PS working to help Veterans make the transition
from acute inpatient psychiatric hospitalization to community living.
Specific Aim 2: Complete an open pilot trial (n=15) to examine the feasibility, fidelity, and acceptability of the
Recovery Bridge intervention in relation to well specified benchmarks supporting continued and expanded
investigation.
[Specific Aim 3: As part of the open pilot trial: 1) explore the impact of the intervention on readmission rates
(at 30 and 90 days), and connection to outpatient care compared to a control group (n=15) identified from
administrative data, and; 2) explore the change in recovery and Quality of Life measures over time in the
inter...

## Key facts

- **NIH application ID:** 10914641
- **Project number:** 5I21HX003618-02
- **Recipient organization:** BALTIMORE VA MEDICAL CENTER
- **Principal Investigator:** RICHARD Warren GOLDBERG
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2023-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914641

## Citation

> US National Institutes of Health, RePORTER application 10914641, Recovery Bridge: A Peer Facilitated Intervention to help bridge the transition from psychiatric inpatient hospitalization to living in the community (5I21HX003618-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10914641. Licensed CC0.

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