Effectiveness and Implementation of a Clinician Decision Support System to Prevent Suicidal Behaviors
This project will include a randomized control trial to test the value of a prediction algorithm to estimate and return risk information to clinicians evaluating patients seeking psychiatric emergency care. It will also aim to optimize treatment for high-risk patients by developing a precision treatment rule for use by ED clinicians. This will improve the detection of high-risk patients and improve treatment optimization for such patients.
A Health System/Community Partnership for Enhanced Outreach to Prevent Suicide Attempts
The Clinical Decision Support System project’s risk stratification algorithm will be implemented to pilot a novel “enhanced outreach intervention” (EOI) in collaboration with Samaritans of Boston to deliver best practice interventions for patients in the high-risk period after ED discharge using a scalable, community-based partnership. A randomized trial will then be conducted to compare outcomes of participants assigned to EOI or care as usual (CAU) and explore moderators of intervention effects, such as age, sex, race/ethnicity, and predicted risk stratum.
Improving Suicide Risk Prediction in Racial, Ethnic, and Linguistic Minority Youth
Suicide deaths among youth aged 10 to 19 years rose 56% between 2007 and 2016, and the proportion of pediatric inpatient or emergency department visits due to SRB has doubled since 2008. This public health emergency appears to be affecting youth of underrepresented backgrounds in particular. This project will develop and implement electronic health record (EHR)-based risk algorithms across two health systems, with a particular focus on minoritized adolescents, and explore the utility of incorporating social determinants of health data for enhancing risk prediction.
Trends in suicide attempts over the past decade have remained higher or increased among Black and Latinx youth compared to white peers. The need to develop scalable, practice-based tools with near-term potential for targeting suicide risk in youth is therefore particularly acute in the case of racial, ethnic, and linguistic (REL) minority youth.
Micro-randomized Trial to Assess Brief, Just-in-Time Interventions for Reducing Short-Term Suicide Risk
The project will test a just-in-time adaptive intervention using a micro-randomized trial (MRT) design to connect at-risk patients with care. Randomly timed, brief follow-up surveys will assess post- intervention use of safety plan components and suicidal thoughts.