Continuity of Mental Health Care after Youth Hospitalization for Suicide Attempt

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PROJECT SUMMARY/ABSTRACT The purpose of this Mentored Patient-Oriented Research Career Development Award is to prepare Stephanie K. Doupnik, MD, MSHP for a career as an independent investigator focused on identifying health systems organizational strategies and practices for promoting engagement in mental health treatment among young people, with a particular focus on reducing youth suicide attempts and suicides. Dr. Doupnik’s immediate goal is to obtain the training, mentorship, and research experience necessary to successfully obtain extramural funding to support multicenter clinical effectiveness and dissemination studies in this area. To meet this goal, Dr. Doupnik and her mentors have developed a comprehensive career development and research plan. The plan’s 3 components include: (a) intensive mentorship from a team of mentors and advisors with whom Dr. Doupnik has a track record of prior collaboration, (b) advanced training in large dataset analysis for health policy evaluation, qualitative and mixed methods research, and operations research methods to inform hospital process improvement, and (c) an innovative research plan designed to identify how health systems can effectively use available resources to ensure young patients’ safety and continuity of mental healthcare after medical hospitalization for suicide attempt. Although youth suicide attempts result in approximately 60,000 hospitalizations annually, most inpatient medical hospital units do not currently implement practices to ensure patients’ safety and continuity of mental healthcare after hospital discharge. The proposed research studies will develop a toolkit to guide implementation of effective suicide prevention practices for youth on inpatient medical hospital units. Aim 1 uses large dataset analyses to determine which hospital, outpatient, and community structures are associated with higher rates of youth attendance at mental health follow-up after suicide attempt hospitalization and to identify hospitals with higher performance on mental health follow-up. Aim 2 uses literature review and qualitative inquiry in hospitals with different resource configurations and varying performance to develop a suicide prevention toolkit to disseminate effective suicide prevention practices. Aim 3 pilot tests the youth suicide prevention toolkit in preparation for a future multi-center cluster randomized controlled trial. The proposed research is closely aligned with the National Institute of Mental Health Strategic Priority 4.3 to develop “service delivery models to improve dramatically the outcomes of mental health services received in diverse communities and populations.”