Impact of Telehealth on Emergency Department Management of Suicide Risk

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Project Summary/Abstract Children and adults in the US are increasingly seeking treatment in Emergency Departments (EDs) for suicide ideation (SI) and suicide attempt (SA), and suicide is a leading cause of death across age groups. The ED setting has become a critical point of intervention to prevent suicide in the US. In spite of this demonstrated need, most EDs lack resources to address suicide risk, and there is an urgent need to identify strategies to improve evidence-based care for this high-risk and vulnerable population. There is increasing interest in the use of technology to address provider shortages and related gaps in care. Tele-mental health, hereafter “telehealth,” relies on technologies including video- and audio-conferencing with remote clinicians and use of shared electronic health records to improve access to mental health specialists. To date, little is known about how EDs use telehealth, and specifically how telehealth services integrate evidence-based practices (EBPs) to evaluate and manage patients at high risk of suicide. Further, there is little information to dissemination and implementation efforts for telehealth. The objectives of this project are to gain a comprehensive picture of telehealth use among children and adults visiting EDs for SI/SA, including whether it increases access to treatment and improves treatment outcomes, and to gather information relevant to future implementation efforts. Using a national survey, the study team will capture detailed data on suicide prevention practices in EDs who do and do not use telehealth. Specifically, we will survey a national sample of 600 EDs and examine which hospital and service area characteristics are associated with (a) presence of telehealth services and (b) telehealth service characteristics (clinician credentials, hours of availability, technologies, billing, and clinician contracts).