6800 Participants Needed

Mental Health Care Bundle for Pediatric Psychiatric Emergency

Recruiting at 7 trial locations
AN
SF
Overseen ByStephen Freedman, MDCM, MSc
Age: < 18
Sex: Any
Trial Phase: Academic
Sponsor: University of Calgary
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

The investigators will determine, in an 8-site, hybrid Type 1 cluster randomized effectiveness implementation trial, if an acute mental health care bundle, compared to standard care, improves wellbeing at 30 days in children and youth seeking emergency department care for mental health and substance use concerns.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

Is the Mental Health Care Bundle for Pediatric Psychiatric Emergency safe for children?

The research suggests that the care bundle is designed to improve safety by standardizing care and reducing safety events like self-harm or aggression among children with mental health needs. It aims to provide a safer environment for both patients and healthcare providers.12345

How is the Acute Pediatric Mental Health and Addiction Care Bundle treatment different from other treatments for pediatric psychiatric emergencies?

This treatment is unique because it standardizes a patient-centered approach specifically for pediatric mental health emergencies, which is not commonly used in emergency departments. It includes an option for assessment outside the emergency department for children without immediate medical or safety concerns, aiming to improve well-being and provide cost-effective care.12678

What data supports the effectiveness of the Mental Health Care Bundle for Pediatric Psychiatric Emergency treatment?

Research shows that using integrated care models in pediatric emergency settings can reduce hospital admissions and readmissions for mental health crises. These models include multidisciplinary staffing, telepsychiatry consultations, and psychological therapies, which are similar to the components of the care bundle being studied.12589

Who Is on the Research Team?

SF

Stephen Freedman, MDCM, MSc

Principal Investigator

University of Calgary

AN

Amanda Newton, PhD

Principal Investigator

University of Alberta

Are You a Good Fit for This Trial?

This trial is for children and teens aged 8 to nearly 18 who are experiencing a mental health crisis, such as anxiety, behavioral issues, or thoughts of self-harm. They must speak English or French. It's not for those with schizophrenia-like symptoms, significant self-harm requiring medical attention, substance misuse/intoxication, or other serious medical concerns.

Inclusion Criteria

I am between 8 and 17 years old.
Chief triage concern of at least one of the following (or comparable) mental health CEDIS triage categories: Anxiety/situational crisis and/or hyperventilation, Bizarre/paranoid behaviour, Concern for patient's welfare, Depression/suicidal/deliberate self-harm, Hallucinations/delusions, Violent/homicidal behaviour, Insomnia, Pediatric disruptive behaviour

Exclusion Criteria

I have symptoms of schizophrenia or related disorders.
I am experiencing changes in my behavior and physical health, like loss of appetite.
Substance misuse/intoxication or altered level of consciousness
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive an acute mental health care bundle, including triage-based evaluation and psychosocial evaluation, with urgent follow-up care facilitated within 24-48 hours.

4 weeks
Multiple visits as needed for urgent follow-up

Follow-up

Participants are monitored for wellbeing and satisfaction with care at 30, 90, and 180 days after the index ED visit.

6 months
Follow-up assessments at 30, 90, and 180 days

What Are the Treatments Tested in This Trial?

Interventions

  • Acute Pediatric Mental Health and Addiction Care Bundle
Trial Overview The study compares an acute mental health care bundle with standard care in emergency departments across Canada. The goal is to see if the new approach better improves wellbeing after 30 days for young people facing mental health and addiction issues.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Acute Mental Health Care BundleExperimental Treatment1 Intervention
Group II: Usual ED-Based Mental Health CareActive Control1 Intervention

Acute Pediatric Mental Health and Addiction Care Bundle is already approved in Canada for the following indications:

🇨🇦
Approved in Canada as Acute Pediatric Mental Health and Addiction Care Bundle for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Calgary

Lead Sponsor

Trials
827
Recruited
902,000+

University of Western Ontario, Canada

Collaborator

Trials
168
Recruited
320,000+

Memorial University of Newfoundland

Collaborator

Trials
73
Recruited
1,836,000+

Western University, Canada

Collaborator

Trials
270
Recruited
62,500+

University of Toronto

Collaborator

Trials
739
Recruited
1,125,000+

McGill University

Collaborator

Trials
421
Recruited
1,017,000+

Dalhousie University

Collaborator

Trials
177
Recruited
402,000+

University of Alberta

Collaborator

Trials
957
Recruited
437,000+

University of Saskatchewan

Collaborator

Trials
261
Recruited
156,000+

University of Manitoba

Collaborator

Trials
628
Recruited
209,000+

Published Research Related to This Trial

This study evaluates a new care approach for children and youth facing mental health and addiction crises in two pediatric emergency departments in Alberta, Canada, over a 29-month period.
The care bundle includes standardized risk assessments and shared decision-making strategies, aiming to improve child/youth well-being and family functioning after emergency visits, with outcomes measured at 1, 3, and 6 months post-visit.
Introducing an innovative model of acute paediatric mental health and addictions care to paediatric emergency departments: a protocol for a multicentre prospective cohort study.Freedman, S., Thull-Freedman, J., Lightbody, T., et al.[2021]
The implementation of a new care bundle in a pediatric emergency department successfully standardized mental health assessments, achieving over 80% compliance with the Ask Suicide-Screening Questions and HEADS-ED tools within 5 months.
The care bundle also provided timely follow-up for low-risk children, with 89.3% of families receiving urgent appointments within 96 hours, demonstrating an effective alternative to emergency department assessments.
Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department.Lightbody, T., Thull-Freedman, J., Freedman, SB., et al.[2023]
Innovative integrated care models in pediatric emergency settings, such as multidisciplinary staffing and telepsychiatry consultations, have been shown to reduce emergency hospital admissions for adolescents with mental health-related medical emergencies by 4 to 16%.
Psychological therapies delivered in emergency departments, including psychoeducation and risk-reduction counseling, significantly decreased admissions by 8 to 40%, highlighting the effectiveness of immediate mental health interventions in preventing hospitalizations.
Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review.Otis, M., Barber, S., Amet, M., et al.[2023]

Citations

Introducing an innovative model of acute paediatric mental health and addictions care to paediatric emergency departments: a protocol for a multicentre prospective cohort study. [2021]
Use of quality improvement methods to enhance implementation of a mental health care bundle in a pediatric emergency department. [2023]
Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review. [2023]
An Innovative Model of Pediatric Emergency Department Mental Health Care: Protocol for a Multicenter Type 1 Effectiveness-Implementation Cluster Randomized Trial. [2022]
Impact of an Inpatient Psychiatric Unit on Pediatric Emergency Mental Health Care. [2022]
Utilizing a Behavioral Health Bundle to Improve Patient and Clinician Safety for Hospitalized Children. [2022]
Evaluating a co-designed care bundle to improve patient safety at discharge from adult and adolescent mental health services (SAFER-MH and SAFER-YMH): protocol for a non-randomised feasibility study. [2023]
Dedicated pediatric behavioral health unit: serving the unique and individual needs of children in behavioral health crisis. [2013]
CARES: improving the care and disposition of psychiatric patients in the pediatric emergency department. [2015]
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