[R01] Pediatric Emergency Department Family Navigation, ED_REaCH, for Youth with Suicide and Self-Injurious Behavior: Increasing Support, Education, and Linkage to Mental Health Care
Ente: National Institute of Mental Health
Scadenza: 2031-06-30
Importo max: 855.638 EUR
Paese: US
Descrizione
PROJECT SUMMARY/ABSTRACT
The prevalence of youth suicidal and non-suicidal self-injurious behaviors (SSIB) is increasing
at rapid rates, where suicide is now the second leading cause of death for youth aged 10 to 18.
This surge in SSIB coincides with a 60% increase in emergency department (ED) visits related
to youth mental health (MH) disorders. EDs do not provide MH treatment, and most youth with
mild to moderate (non-urgent) SSIB are released back to their homes following an ED visit with
a range of SSIB and MH symptoms. As a result, there is often a gap in care when youth are
released from the ED to when they attend the recommended MH treatment. Caregivers of youth
discharged from the ED after an SSIB evaluation serve as the safety-ensuring adult in the
home, as well as the conduit to youth community-based MH care. In this role, caregivers are
responsible for a) contacting and securing their child’s MH services b) following a discharge
plan, c) ensuring their child’s safety, and d) identifying and responding to their child’s SSIB
symptoms and severity. Problematically, caregivers report high levels of anxiety and low levels
of self-efficacy in implementing these tasks due to lack of support and limited MH literacy and
strategies needed to effectively fulfill these responsibilities, amplify existing barriers for youth’s
MH care. The objective of this research is to conduct a Hybrid Type I trial to examine the
effectiveness and optimize future implementation strategies of the Family Navigation
intervention, ED_REaCH (Resilience, Education, and Caregiver Help; Cancilliere et al., 2024),
for youth who have been discharged from the ED for SSIB and their caregivers. Indeed, pilot
work by PI Cancilliere highlights the utility of targeting structural barriers to care, in tandem with
enhancing MH literacy and MH communication skills as critical opportunities for enhancing MH
engagement strategies for caregivers of youth with non-urgent SSIB discharged from the ED.
For this study, a total of N=364 youth (ages 8 to 17) and a caregiver will be recruited to examine
ED_REaCH across two pediatric academic medical centers’ EDs (Hasbro Children’s Hospital
and Connecticut Children’s Medical Center). This study aims to examine the ED family
navigation intervention, ED_REaCH, to improve engagement, implementation, and optimization
on primary outcomes of increasing youth linkage to community-based MH care after an ED
admission for youth with SSIB, reducing youth MH symptoms and SSIB risk, increasing
caregiver self-efficacy to complete tasks associated with successful linkage to care, as well as
optimizing future implementation strategies of ED_REaCH to set the stage for a future NIMH
R01 Hybrid Type III Trial application.
Istituzione: RHODE ISLAND HOSPITAL
PI: Mary Kathryn Melonio Cancilliere
Progetto: 1R01MH145444-01
Settori: National Institute of Mental Health
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