PCORI has identified the need for large studies that look at real-life questions facing diverse patients, caregivers, and clinicians. In 2014, PCORI launched the Pragmatic Clinical Studies initiative to support large-scale comparative effectiveness studies focusing on everyday care for a wide range of patients. The Pragmatic Clinical Studies initiative funded this research project and others.
COVID-19-Related Project Enhancement
The pandemic has shifted much of medicine to telehealth, including psychiatric services. Psychiatric services for suicide prevention for adolescents are included in this shift even though data are lacking regarding safety and effectiveness of services delivered through telehealth, especially for this population. In this project’s enhancement, an observational pilot study will compare telehealth delivery to in-person delivery (both inpatient and outpatient). Adolescents presenting to the emergency department or via telehealth emergency crisis service whose clinical assessment indicates they require psychiatric services will be assessed using the assessment tool employed in the main study and in clinical practice.
This study will add valuable information about the safety and effectiveness of suicide prevention treatment for adolescents delivered by telehealth during the pandemic.
Enhancement Award Amount: $244,724*
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Suicide is one of the leading causes of death among teens in the United States. After a suicidal event, such as serious thoughts about taking their own life or suicide plans or attempts, most teens get inpatient psychiatric care. Inpatient care involves staying overnight or longer in the hospital. However, some patients and their families prefer treatment outside of the hospital. Outpatient crisis intervention clinics, or OCICs, offer intensive mental health care without the need for a hospital stay.
In this study, the research team is comparing inpatient psychiatric care to OCICs for treating teens after a suicidal event. The team is looking to see how well each treatment setting reduces the risk of suicidal events.
Who can this research help?
Results may help doctors, teens, and families considering psychiatric care settings for treatment after a suicidal event.
What is the research team doing?
The study includes 1,000 teens who had a suicidal event. The research team is enrolling teens from four emergency departments, or EDs. The team is dividing the teens into two groups that are similar in terms of age, gender, and other factors. Then, the team is assigning the groups by chance to either receive inpatient or OCIC treatment.
With inpatient treatment, teens receive mental health care in the hospital. Clinicians manage their daily therapy and medicines. With OCIC, teens have crisis intervention therapy appointments outside the hospital. Therapy begins within three days of the teen’s visit to the ED and lasts for one to six weeks.
The research team is looking at health records and forms the patients complete to see if teens have another suicidal event in the six months after their ED visit and if so, how many. Every other week during these six months, teens and their guardians also complete surveys to identify suicidal thoughts and behaviors and rate life satisfaction. Two weeks after teens begin treatment, the team is asking teens how satisfied they are with their treatment. The team also wants to know whether details like age or having insurance can help identify which teens may be at risk of not going to treatment.
Teens and parents, psychiatrists, nurses, social workers, and people who specialize in providing community mental health care are helping to plan and conduct the study.
Research methods at a glance
Complementary and Alternative Medicine
Other Clinical Interventions
Other Health Services Interventions
Training and Education Interventions
Pragmatic Clinical Studies to Evaluate Patient-Centered Outcomes
*All proposed enhancement projects, including requested project plans, budgets and milestone schedules, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award modification.