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Mental health considerations

MENTALExplanation HEALTHof CONSIDERATIONS FOR RESEARCHERSRisks

DECEMBER

    2023

    EXPLANATION OF RISKS:

    • 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:

    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

    • 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:

    RESOURCES:

    Resources

    • 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/NENebraska MEDICINEMedicine PSYCHIATRYPsychiatry SERVICES: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.

    PSYCHIATRYPsychiatry SERVICESServices FORfor CHILDRENChildren

    • 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.

    PSYCHIATRYPsychiatry SERVICESServices FORfor STUDENTS: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).
    • For
    UNO

    Kearney students:Community 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.

KEARNEY COMMUNITY RESOURCESResources

  • S.A.F.E. Center: 24/7 hotline 1-877-237-2513

LINCOLNLincoln COMMUNITYCommunity RESOURCESResources

  • Voices of Hope: Crisis hotline 402-475-7273 (non-emergencies, 402-476-2110)

NORFOLKNorfolk COMMUNITYCommunity RESOURCESResources

  • Bright Horizons: call 877-379-3798 or text 402-370-8817

SCOTTSBLUFFScottsbluff COMMUNITYCommunity RESOURCESResources

  • Doves Program: call 308-436-4357 or 866-953-6837; text 515-599-6620

NATIONALNational RESOURCESResources

  • National Domestic Violence Hotline: 1-800-799-7233, TTY 1-800-787-3224
  • National Suicide Prevention Lifeline: Text or Call 988
  • Trans Lifeline: 1-877-565-8860
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