Telehealth to Improve Prevention of Suicide (TIPS)

Summary

The study will rigorously evaluate whether synchronous, within-visit telemental health evaluation and intervention services can successfully overcome poor access to behavioral health and substandard suicide-related care in emergency departments (EDs), including evaluating the impact on system metrics, a primary goal of RFA-MH-20-226. Notably, the study will surpass this primary requirement, because it will extend understanding of the relative added value of the ED-SAFE post-visit telephone intervention and will create knowledge about key factors related to implementation and sustainment.

Conditions

• Suicide Risk

Interventions

OTHER

Telehealth in preventing suicide (TIPS)

The TIPS synchronous telehealth protocol will consist of (a) two-way televideo evaluation with enhanced suicide risk components, performed by a Masters-level evaluator from Community HealthLink, and (b) telephone consultation and, in some cases, televideo evaluation by a psychiatrist for patients the evaluator judges should be admitted. The primary evaluation will gather data form the ED providers, patient, and any other collateral sources available. The core of the evaluation itself will consist of Community HealthLink's existing standard adult emergency mental health evaluation, which is a semi-structured evaluation focused primarily on informing a disposition decision on whether to admit the patient to a psychiatric unit. The evaluators will use this same evaluation to guide the telehealth evaluation.

OTHER

Modified ED-SAFE

Half of the ED discharged patients with suicide risk will be invited to receive post-discharge telephone counseling originally developed during the "Emergency Department Safety Assessment and Follow-up Evaluation" (ED-SAFE) study. The participant will receive three coaching/counseling calls, clustered within three months of the index visit, with some flexibility to continue beyond that if desired. These coaching calls will still follow the original structure and content from ED-SAFE, with modifications guided by study investigators.

OTHER

Treatment as Usual (TAU)

No study related intervention, just monitoring of current practices used to provide suicide-related care in the non-intervention EDs.

Sponsors & Collaborators

• Community HealthLink

  collaborator UNKNOWN

• Collective Medical

  collaborator UNKNOWN

• National Institute of Mental Health (NIMH)

  collaborator NIH

• University of Massachusetts, Worcester

  lead OTHER

Principal Investigators

• Edwin Boudreaux, PhD · UMass Medical School

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

SEQUENTIAL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-07-12

Primary Completion

2025-11-30

Completion

2025-11-30

Countries

• United States

Study Locations