Improving Mental Health Treatment for Individuals in Crisis Interacting with the Criminal Justice System
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Suicide Risk
- Sponsor
- Cambridge Health Alliance
- Enrollment
- 1040
- Locations
- 1
- Primary Endpoint
- Past-year medically treated suicide attempt at baseline and 12 months
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The proposed Center will leverage burgeoning real-time data linkage capabilities among health systems, Medicaid payors, and criminal legal (e.g., jail booking data, jail release data) systems, to identify individuals coming in and out of jail for suicide assessment and prevention, and to better coordinate care across these disparate systems. This Center will advance the fields of suicide prevention and criminal legal system-based mental health by solving a well-known, central problem in both fields: the inability to track and intervene with individuals moving in and out of both and often multiple systems. The goal is near-term reductions in the U.S. suicide rate.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Treatment as Usual (TAU) arm
- •Cambridge Health Alliance (CHA) patients from the cities other than Cambridge considered to be in the "catchment area" of CHA (Everett, Chelsea, Somerville, Medford, Malden, and Winthrop)
- •Ages 18-100
- •Identified as having police involvement between 2009 and
- •Treatment as Usual patients will be identified using "targeted limited chart review methods" used in our prior studies, "scraping" clinical notes in the Electronic Health Records for criminal justice involvement. Initial Identification terms, "police", "arrest", "court", "summons", "jail", and "crime" will be used to identify candidates for police involvement, downloading the sentence in which the keyword appeared and the sentence before and after. Next, an iterative process of editing of the search terms will be conducted to remove patients with negation of the keyword ("did not commit a crime"), and other sentence characteristics that generate false positives ("cardiac arrest"). Samples of the resulting dataset will be taken, accuracy assessed by examining the surrounding sentences, leading to further iterations and repetition of the process until a high level of accuracy is achieved.
- •Family and Social Justice Section (FSJS) arm
- •Cambridge Health Alliance patients from Cambridge
- •Ages 18-100
- •Individuals who have come into contact with the Cambridge Police Department (as identified in the Family and Social Justice Section data) between 2009 and
- •Family and Social Justice Section plus Navigator (FSJS+Navigator) arm
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Past-year medically treated suicide attempt at baseline and 12 months
Time Frame: Baseline and 12 months
Number of participants with a past-year medically treated suicide attempt. This will be measured at baseline and 12 months will be collected using the electronic health record (EHR) data.
Suicide Severity and Behaviors using Computerized Adaptive Test Suicide Scale (CAT-SS) at Baseline and 12 Months
Time Frame: Baseline and 12 months
The CAT-SS measures Severity of Suicide Risk will be assessed using CAT-SS, providing severity on a 0-100 point scale, and risk-stratification to negligible, intermediate and high risk. It is highly sensitive and specific to the Columbia Suicide Severity Rating Scale, and predicts future suicide events with high precision and accuracy.
Secondary Outcomes
- Number of Individual Interactions with the Criminal Legal System at Baseline and 12 Months(From enrollment through 12 months)
- Number of Individual Interactions between Hospitals and the Criminal Justice System at Baseline and 12 Months(From enrollment through 12 months)
- Frequency of Healthcare Services Used by Patients at Baseline and 12 Months(From enrollment through 12 months)