Telepsychiatry to Enable Expedited Disposition of Psychiatric Emergencies

NCT05771545 | Active Not Recruiting Results

• 1 other identifier: HebrewUJ123
• Study Type: observational
• Target: 959
• Locations: 1 country
• Sites: 8

Brief Summary

The goal of this observational study is to examine the effect of using a video link for evaluation of patients in the psychiatric emergency room. Under current Israeli law, the attending physician must come in to physically examine the patient before they can be admitted involuntarily. Patients often de-compensate and even may become violent while waiting for the attending to arrive. Previous studies have shown that evaluation of such patients via video-link has an extremely high concordance with in person evaluation. This study will compare patients who are evaluated via video-link with historical controls evaluated under usual conditions. This is an observational study, which is taking advantage of a change in practice to collect data on two different ways of delivering care, via chart reviews. If successful, this study will show that the video-link is feasible and acceptable to patients and staff. The following hypotheses will be tested:

1. 1.The intervention will result in shorter ED time compared to historical controls.
2. 2.The intervention will result in fewer violent incidents compared to historical controls.
3. 3.The intervention will result in shorter overall hospital length of stay compared to historical controls.

Conditions

Psychiatric Emergency

Keywords

telepsychiatry; implementation science

Outcome Measures

Primary Outcomes (1)

• ED Time

  Amount of time, in hours and minutes, that the patient spends in the ED prior to disposition

  Patients arrive in the ED at a specific time and leave the ED at a specific time. We will compute the amount of time spent in the ED by each patient, up to two weeks.

Secondary Outcomes (2)

• Violent Incidents

  Patients arrive in the ED at a specific time. Those who are admitted are eventually discharged. Violent incidents can occur during the entire time spent in the hospital, whether in the ED or on the ward, up to 90 days total.

• Hospital Length of Stay

  For patients admitted to the hospital through the ED, the beginning time is their arrival to ED, the end is the time of hospital discharge, up to 90 days later.

Study Arms (2)

Pre-Innovation (Usual Care)

Patients evaluated in the psychiatric emergency department for possible involuntary admission during the year prior to the innovation in care. During this period, the attending psychiatrist was required to physically come to the hospital to examine the patient.

Innovation (Tele-Psychiatry)

Patients evaluated in the psychiatric emergency department for possible involuntary admission during the innovation period. Instead of physically coming to the hospital, the attending physician will evaluate the patient via video-link, which will be facilitated by the on-site psychiatric resident.

Other: Telepsychiatry

Interventions

Telepsychiatry OTHER

Instead of coming to the hospital physically, the attending psychiatrist will evaluate the patient via a video-link.

Innovation (Tele-Psychiatry)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients who are evaluated for involuntary psychiatric admission via the ED, who meet the above criteria.

You may qualify if:

• Must be evaluated in the psychiatric ED for potential involuntary admission

You may not qualify if:

• Not justice-involved (i.e., brought in by police after committing a crime)

Sponsors & Collaborators

• Hebrew University of Jerusalem: lead

Study Sites (8)

HaEmek Medical Center

Afula, Israel

Location

Jerusalem Mental Health Center - Eitanim

Jerusalem, Israel

Location

Jerusalem Mental Health Center

Jerusalem, Israel

Location

Shaar Menashe Psychiatric Hospital

Pardés H̱anna Karkur, Israel

Location

Geha Psychiatric Hospital

Petah Tikva, Israel

Location

Ziv Medical Center

Safed, Israel

Location

Tel Aviv Sourasky Medical Center

Tel Aviv, Israel

Location

Lev Hasharon Mental Health Center

Tsur Moshe, Israel

Location

Related Publications (1)

• Shalev L, Bistre M, Lubin G, Avirame K, Raskin S, Linkovski O, Eitan R, Rose AJ. Enabling Expedited Disposition of Emergencies Using Telepsychiatry in Israel: Protocol for a Hybrid Implementation Study. JMIR Res Protoc. 2023 Oct 17;12:e49405. doi: 10.2196/49405.

  PMID: 37847548 DERIVED

Results Point of Contact

• Title: Adam Rose
• Organization: Hebrew University of Jerusalem

adam.rose@mail.huji.ac.il

+972-55-500-1040

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: March 2, 2023
• First Posted: March 16, 2023
• Study Start: July 1, 2023
• Primary Completion: December 30, 2024
• Study Completion (Estimated): June 30, 2026
• Last Updated: January 8, 2026
• Results First Posted: January 8, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share

Locations

IL (8)