Mental health considerations

MENTAL HEALTH CONSIDERATIONS FOR RESEARCHERS

DECEMBER 2023

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.

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 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: 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

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:
- To complete the C-SSRS Training for Clinical Practice, visit http://c-ssrs.trainingcampus.net/
- General information, go to http://cssrs.columbia.edu/

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.

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.

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.

For UNMC students: call UNO Health Center, 402-554-2374 (select option 2 to leave message for the nurse for scheduling).
For UNO students: Call CAPS 402-559-7276 (initial appointments are covered by student fees).
Gender and Sexuality Resource Center (GSRC): Confidential and free, Student Life Center 2031. Call 402-559-7276.

Revision #2
Created 12 July 2024 19:25:15 by Robert A Lewis
Updated 16 August 2024 17:04:32 by Robert A Lewis