Be clear in application and ICD about risks associated with mental health assessments (cognitive status assessments, IQ screens, mental health assessments, exploitation/abuse/violence assessments, and drug testing).
Describe how and by who mental health assessments and outcomes are reviewed and reported.
Remember to report psychiatric adverse events, including serious adverse events, appropriately.
Self-Report Measures
Protocols using subject self-reports that ask about depression, worthlessness/guilt, and quality of life, should include a process of review by personnel with plan to notify investigator of pertinent positives.
Protocols using subject self-report reports with items specifically addressing self-harm or suicidal ideation, or related items indicating a subject may be at risk, should have a mechanism for responses to be reviewed in REAL TIME so action can be taken as appropriate.
Protocols using remote self-reports (Ipad, EMA device, web-based, etc.) should include a mechanism for notification of the investigator or designated member of the study team when threshold responses are received so that REAL TIME management can occur.
Investigator-Administered Measures
Investigator-administered measures of psychiatric symptoms should be completed by those with appropriate training.
If the study team does not have the specific expertise, consider consultation with psychiatry or psychology colleagues.
PHQ-9:
PHQ-9: Suggestion to align with Suicide Risk BPA’s used by NM PCMH clinics rooming staff starting 8/8/2022:
if >14 and + response to question 9 = refer for emergency eval
if >14 and – response to question 9 = refer for mental health consult
if <14 and + response to question 9 = further assessment needed; refer as appropriate
if <14 and – response to question 9 = no further specific intervention
The Columbia Suicide Severity Rating Scale-Revised (CSSRS-R):
Baseline (“lifetime”) and “since last visit” versions available on-line.
Validated and available in Spanish.
Use of this scale should include training for non-mental health providers as it explores suicidality in a very thorough manner:
CURRENT – include 988 for the suicide hotline, don’t give numbers to agencies now closed (911 is still ok to use).
ACCURATE—know the policy for referral to the Department of Psychiatry, procedures for accessing ER, the Psychiatric Emergency Service (PES). Consider age- and/or diagnosis-appropriate services (e.g. Nebraska Family Help Line [1-888-866-8660]; Professional Partners-Region specific).
LOCAL—while resources are limited in some areas of the state, please make sure you list the ones close to the subject’s home.
UNMC/Nebraska Medicine Psychiatry Services
Psychiatry (ADULT) accepts referrals from PCP’s within the system.
C/A psychiatry not limited to UNMC/NE Med providers.
Behavioral Health Connections team (402-552-6007) facilitates referrals to community agencies.
When referring to the “PES” (Psychiatric Emergency Service), understand that patients still must go through the regular NE Med ER or Bellevue Medical Center ER first.
Psychiatry Services for Children
Immanuel (CHI) ER is primary location for inpatient triage for children/teens; other ER’s may transfer there if hospitalization is needed.
Bryan LGH (Lincoln) has inpatient care for children/teens as well as emergency shelter placement.
Boys Town (Grand Island) has emergency shelter placement.
Mercy (Council Bluffs) will accept NE youth (even Medicaid if no NE beds available).
Boys Town has an inpatient unit—triage through Methodist ER’s.
Psychiatry Services for Students
For UNMC students: Call CAPS 402-559-7276 (initial appointments are covered by student fees).
For UNO students: call UNO Health Center, 402-554-2374 (select option 2 to leave message for the nurse for scheduling).
Kearney Community Resources
S.A.F.E. Center: 24/7 hotline 1-877-237-2513
Lincoln Community Resources
Voices of Hope: Crisis hotline 402-475-7273 (non-emergencies, 402-476-2110)
Norfolk Community Resources
Bright Horizons: call 877-379-3798 or text 402-370-8817
Scottsbluff Community Resources
Doves Program: call 308-436-4357 or 866-953-6837; text 515-599-6620
National Resources
National Domestic Violence Hotline: 1-800-799-7233, TTY 1-800-787-3224
National Suicide Prevention Lifeline: Text or Call 988
