NCT02744326

Brief Summary

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.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
800

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Apr 2016

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

April 1, 2016

Completed
13 days until next milestone

First Submitted

Initial submission to the registry

April 14, 2016

Completed
6 days until next milestone

First Posted

Study publicly available on registry

April 20, 2016

Completed
12 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2017

Completed
Last Updated

April 20, 2016

Status Verified

April 1, 2016

Enrollment Period

1 year

First QC Date

April 14, 2016

Last Update Submit

April 15, 2016

Conditions

Mental Health DisorderMental and Behavioral DisorderSelf-inflicted Injury

Outcome Measures

Primary Outcomes (1)

  • Outpatient care post Emergency Department Visit

    Did the patient attend follow-up outpatient care visit(s) after visiting the ED

    3 months

Secondary Outcomes (1)

  • Emergency Department return visit

    3 months

Study Arms (2)

Text message reminder group

EXPERIMENTAL

A subset of patients discharged from the ED with an outpatient referral will be randomized to receive text message reminders to attend or schedule a follow-up outpatient referral.

Behavioral: Text message reminders

Usual Care group

NO INTERVENTION

A subset of patients discharged from the ED with an outpatient referral will be randomized to receive the usual standard of care.

Interventions

Text message remindersBEHAVIORAL

Patients assigned to the intervention group will receive a series of 7 to 10 text message reminders to schedule or attend their follow-up appointment.

Text message reminder group

Eligibility Criteria

AgeUp to 18 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • 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)

You may not qualify if:

  • Non-English Speaking parents
  • Medical condition preventing enrollment, such as a condition which requires immediated hospital procedures or admission
  • Suspected abuse

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (13)

  • 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.

    PMID: 25006117BACKGROUND

  • 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.

    PMID: 21518712BACKGROUND

  • 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. doi: 10.1097/pec.0b013e31819e3523.

    PMID: 19382317BACKGROUND

  • 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.

    PMID: 22023999BACKGROUND

  • 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.

    PMID: 19864967BACKGROUND

  • 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.

    PMID: 20370747BACKGROUND

  • 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.

    PMID: 24639270BACKGROUND

  • 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.

    PMID: 19768551BACKGROUND

  • 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.

    PMID: 25563483BACKGROUND

  • 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.

    PMID: 23187979BACKGROUND

  • 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.

    PMID: 24224667BACKGROUND

  • 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;2013(12):CD007458. doi: 10.1002/14651858.CD007458.pub3.

    PMID: 24310741BACKGROUND

  • 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.

    PMID: 25388481BACKGROUND

MeSH Terms

Conditions

Mental DisordersSelf-Injurious Behavior

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehavior

Study Officials

  • Gretchen Cutler, PhD

    Children's Hospitals and Clinics of Minnesota

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Gretchen Cutler, PhD

CONTACT

Gretchen.cutler@childrensmn.org

Kristin Frenn, MPH

CONTACT

kristin.frenn@childrensmn.org

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 14, 2016

First Posted

April 20, 2016

Study Start

April 1, 2016

Primary Completion

April 1, 2017

Study Completion

April 1, 2017

Last Updated

April 20, 2016

Record last verified: 2016-04

Data Sharing

IPD Sharing
Will not share