Cincinnati Children's Integrates Telehealth Into Suicide Prevention Study

Researchers at Cincinnati Children’s Hospital Medical Center are integrating telehealth into a federal funded study on suicide prevention.

Financed by almost $8 million in funding from the Patient-Centered Outcomes Research Institute (PCORI) the team will examine how connected health tools and platforms might be used to enhance or improve treatment options for adolescents with suicidal thoughts – one of the leading causes of death among that age group.

Cincinnati Children’s had received almost $6 million from PCORI in 2018 to study ways to improve treatment for adolescents who visit the emergency room with suicidal thoughts but who are not at imminent risk of suicide. With the nation in the grips of the coronavirus pandemic, the project has been enhanced to examine how telehealth can play a part in prevention and treatment.

"The timeliness of this research is based on the need for telehealth due to the pandemic, the mental health crisis in the adolescent population, and the dependence on technology," Drew Barzman, MD, director of the Child and Adolescent Forensic Research Program at Cincinnati Children's and the project’s principal investigator, said in a press release.

The five-year, multi-site study will compare three different types of treatment: inpatient ED, outpatient in-person and outpatient telehealth.

"What we're really wanting to take a look at is how patients are doing three months and six months out after they receive these initial services and seeing if there's a clinically significant difference among the different treatment options that are available to the teens who are experiencing suicidal thoughts," Jennifer Combs, senior research clinical coordinator and study project manager in the Division of Child Psychiatry at Cincinnati Children's, said in the release.

"Being that we're able to now look at the impact of COVID on mental health issues, it's helpful for us to share this information with the mental health community at large," she added.

Barzman said the research will also be important in developing better strategies and treatment for that critical two-week period after an initial hospital visit, a high-risk period for adolescents with suicidal thoughts.

The project is one of many to tackle the growing rates of behavioral health issues facing people of all ages in the wake of COVID-19, including stress, depression, anxiety, substance abuse and suicide. And while the times are causing these issues to increase, the fast-paced adoption of telehealth and mHealth is giving providers new ways of addressing them.

"Working with suicidal adolescents is a difficult group to work with because there's a lot of risk associated with it,” Barzman added. “Our study team has done a lot of work on identifying new safety protocols and follow-ups with families. They're getting real-time safety information about how their child is doing. It's a safety net, providing that needed extra support by monitoring the suicidal events, monitoring symptoms, and also alerting the parent when there is a safety concern in real time."

This isn’t a new strategy. Back in 2019, PCORI funded a project launched by the St. Luke’s Health System in Idaho – and monitored by researchers from the Universities of Washington, Idaho and Pennsylvania, the Idaho Suicide Prevention Hotline, Empower Idaho and the Idaho Federation of Families for Children’s Mental Health – to test whether structured mHealth messages could help patients at risk of suicide.

“Our goal is to determine which approach works best to reduce the risk of suicide, improve the patient’s quality of life and ensure they are getting appropriate mental health treatment,” the research team, led by Anna K. Radin, DrPH, MPH, said in the PCORI project summary. “We also want to see if the effect of these interventions is different for adolescents compared to adults.”