Mental Health Disorder Clinical Trial
Official title:
Improving Outcomes for Youth Visiting the Emergency Department With Mental Health Issues
The investigators will conduct a prospective study and a randomized controlled trial (RCT)
involving children and adolescents presenting with a primary mental health (MH) concern to
the emergency departments (EDs) of Children's Hospitals and Clinics of Minnesota (CH). The
investigators will characterize the primary MH concerns of 800 patients and assess their
baseline access to and utilization of external resources. All enrolled patients will be
followed 3-months after their initial visit to determine ED revisits and identify factors
associated with connection to outpatient care. The RCT portion of the study will involve 200
patients discharged from the ED with a referral to an outpatient MH provider, and will test
a novel text-message communication method by which parents/caregivers can be encouraged to
complete follow-up care for their child. The experimental group will receive tailored text
message reminders regarding follow-up appointments.
Relevance: Pediatric ED visits for MH issues are increasing, but the current system of
managing these patients is not optimal. More information is needed to accelerate change and
to efficiently invest in improving services available to MH patients. Specifically,
information is needed on which MH populations need to be targeted, and on simple,
reproducible interventions which improve connection with community resources. The proposed
study will collect vital information needed to develop programs that improve outcomes and
reduce ED revisits in pediatric patients visiting the EDs at CH with primary MH concerns,
and will set the stage for future work focused on improving core and outcomes for MH youth.
Status | Not yet recruiting |
Enrollment | 800 |
Est. completion date | April 2017 |
Est. primary completion date | April 2017 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A to 18 Years |
Eligibility |
Inclusion Criteria: - Age 0-17.999 years - Assessed by social work in the ED for mental health concern - Parent present and able to consent - Phone able to receive text messages (for RCT portion only) Exclusion Criteria: - Non-English Speaking parents - Medical condition preventing enrollment, such as a condition which requires immediated hospital procedures or admission - Suspected abuse |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Health Services Research
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Children's Hospitals and Clinics of Minnesota |
Arora S, Burner E, Terp S, Nok Lam C, Nercisian A, Bhatt V, Menchine M. Improving attendance at post-emergency department follow-up via automated text message appointment reminders: a randomized controlled trial. Acad Emerg Med. 2015 Jan;22(1):31-7. doi: 10.1111/acem.12503. Epub 2014 Nov 11. — View Citation
Bardach NS, Coker TR, Zima BT, Murphy JM, Knapp P, Richardson LP, Edwall G, Mangione-Smith R. Common and costly hospitalizations for pediatric mental health disorders. Pediatrics. 2014 Apr;133(4):602-9. doi: 10.1542/peds.2013-3165. Epub 2014 Mar 17. — View Citation
Case SD, Case BG, Olfson M, Linakis JG, Laska EM. Length of stay of pediatric mental health emergency department visits in the United States. J Am Acad Child Adolesc Psychiatry. 2011 Nov;50(11):1110-9. doi: 10.1016/j.jaac.2011.08.011. Epub 2011 Oct 2. — View Citation
Dolan MA, Fein JA; Committee on Pediatric Emergency Medicine. Pediatric and adolescent mental health emergencies in the emergency medical services system. Pediatrics. 2011 May;127(5):e1356-66. doi: 10.1542/peds.2011-0522. Epub 2011 Apr 25. Review. — View Citation
Frosch E, McCulloch J, Yoon Y, DosReis S. Pediatric emergency consultations: prior mental health service use in suicide attempters. J Behav Health Serv Res. 2011 Jan;38(1):68-79. doi: 10.1007/s11414-009-9192-0. Epub 2009 Sep 19. — View Citation
Grupp-Phelan J, Mahajan P, Foltin GL, Jacobs E, Tunik M, Sonnett M, Miller S, Dayan P; Pediatric Emergency Care Applied Research Network. Referral and resource use patterns for psychiatric-related visits to pediatric emergency departments. Pediatr Emerg Care. 2009 Apr;25(4):217-20. — View Citation
Grupp-Phelan J, McGuire L, Husky MM, Olfson M. A randomized controlled trial to engage in care of adolescent emergency department patients with mental health problems that increase suicide risk. Pediatr Emerg Care. 2012 Dec;28(12):1263-8. doi: 10.1097/PEC.0b013e3182767ac8. — View Citation
Gurol-Urganci I, de Jongh T, Vodopivec-Jamsek V, Atun R, Car J. Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database Syst Rev. 2013 Dec 5;12:CD007458. doi: 10.1002/14651858.CD007458.pub3. Review. — View Citation
Mahajan P, Alpern ER, Grupp-Phelan J, Chamberlain J, Dong L, Holubkov R, Jacobs E, Stanley R, Tunik M, Sonnett M, Miller S, Foltin GL; Pediatric Emergency Care Applied Research Network (PECARN). Epidemiology of psychiatric-related visits to emergency departments in a multicenter collaborative research pediatric network. Pediatr Emerg Care. 2009 Nov;25(11):715-20. doi: 10.1097/PEC.0b013e3181bec82f. — View Citation
Newton AS, Ali S, Johnson DW, Haines C, Rosychuk RJ, Keaschuk RA, Jacobs P, Cappelli M, Klassen TP. Who comes back? Characteristics and predictors of return to emergency department services for pediatric mental health care. Acad Emerg Med. 2010 Feb;17(2):177-86. doi: 10.1111/j.1553-2712.2009.00633.x. — View Citation
Simon AE, Schoendorf KC. Emergency department visits for mental health conditions among US children, 2001-2011. Clin Pediatr (Phila). 2014 Dec;53(14):1359-66. doi: 10.1177/0009922814541806. Epub 2014 Jul 7. — View Citation
Smith MW, Stocks C, Santora PB. Hospital readmission rates and emergency department visits for mental health and substance abuse conditions. Community Ment Health J. 2015 Feb;51(2):190-7. doi: 10.1007/s10597-014-9784-x. Epub 2015 Jan 7. — View Citation
Sobolewski B, Richey L, Kowatch RA, Grupp-Phelan J. Mental health follow-up among adolescents with suicidal behaviors after emergency department discharge. Arch Suicide Res. 2013;17(4):323-34. doi: 10.1080/13811118.2013.801807. — View Citation
* Note: There are 13 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Outpatient care post Emergency Department Visit | Did the patient attend follow-up outpatient care visit(s) after visiting the ED | 3 months | No |
Secondary | Emergency Department return visit | Did the patient return to the Emergency Department for a mental health related reason, in the 3 months following the initial visit. | 3 months | No |
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