e-Connect for Suicide Prevention

Recruiting at 1 trial location

Overseen By Shelly Qu

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: New York State Psychiatric Institute

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

12838 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new model called e-Connect, a digital intervention designed to identify and refer young people on probation who may struggle with suicidal thoughts or other mental health issues. The goal is to train probation staff to better understand these issues and use a mobile app to connect youth with appropriate services. Researchers are testing this model in 10 counties in New York, comparing it to the usual care. The trial seeks probation officers and new youth intakes on probation, ages 10-18, involved in probation supervision and assessment activities. As an unphased trial, this study offers a unique opportunity to contribute to innovative solutions for youth mental health challenges.

Will I have to stop taking my current medications?

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

What prior data suggests that the e-Connect service delivery model is safe for use in suicide prevention?

Research has shown that e-Connect is a digital tool designed to help probation officers identify young people at risk of suicide and connect them to mental health services. Studies have demonstrated that the system can effectively predict suicide risk, indicating its reliability in helping users make informed decisions.

Since e-Connect is not a medication or direct treatment, there is no specific data on side effects or adverse events. Instead, it is a system meant to improve communication and referrals in mental health care, eliminating typical concerns about drug side effects.

The safety of e-Connect relies on how well the staff use and maintain the system. Proper training is essential to ensure it functions as intended. The main focus is on ensuring the system is user-friendly and facilitates timely and accurate referrals. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the e-Connect intervention because it offers a new approach to suicide prevention by integrating technology and community-based support. Unlike traditional methods that often rely solely on medical or therapeutic interventions, e-Connect provides training and materials to counties, empowering them to implement a more proactive and connected strategy. This method aims to enhance community engagement and streamline access to resources, potentially making it more effective in reaching individuals in need and preventing crises before they escalate.

What evidence suggests that e-Connect is effective for suicide prevention?

Research has shown that e-Connect, which participants in this trial may receive, effectively helps probation officers identify and refer young people on probation who may be at risk for suicide. Studies have demonstrated that this system aids officers in recognizing signs of suicidal behavior and related mental health issues. It employs a digital tool to enhance the identification of these risks and ensure referral to appropriate services. One study found that e-Connect increased the likelihood of at-risk youth receiving necessary help. This could lead to better outcomes for young people with behavioral health problems. Overall, e-Connect appears promising in supporting young people in the juvenile justice system. ^{1 2 3 6 7}

Who Is on the Research Team?

Katherine Elkington, PhD

Principal Investigator

Columbia University/New York State Psychiatric Institute

Are You a Good Fit for This Trial?

The e-Connect trial is for probation officers aged 21-70 who are actively employed in juvenile justice departments. They must work directly with youth or supervise those who do, focusing on probation supervision, assessment, and referral activities in one of the selected 10 New York counties.

Inclusion Criteria

Only certain people who work in the probation system, such as leaders and officers, are eligible to participate in the study.

You are currently employed as a probation officer working with youth, or you supervise those who work with youth in a probation department. This study is being conducted in 10 specific counties. You must be between the ages of 21-70.

Timeline for a Trial Participant

Development

Development of the e-Connect service delivery model, including training materials and mobile application

Not specified

Baseline

Baseline data collection to assess current practices and outcomes before implementation of e-Connect

Not specified

Implementation

Implementation of the e-Connect intervention across all study counties, including training and use of the mobile application

18 months

Sustainment

Ongoing use and evaluation of e-Connect to assess sustainability and long-term outcomes

Monthly evaluations from end of implementation through sustainment period

What Are the Treatments Tested in This Trial?

Interventions

• e-Connect

Trial Overview e-Connect aims to improve real-time identification and targeted referrals for youths at risk of suicide within the juvenile justice system. It involves training staff, using an evidence-based behavioral health screen, and a mobile app to integrate screening and referrals.

How Is the Trial Designed?

Group I: e-Connect Experimental Treatment 1 Intervention

County receives training and materials and subsequently begins the e-Connect intervention

Group II: Standard of care Active Control 1 Intervention

Counties use the standard of care and there is no intervention in practices.

Who Is Running the Clinical Trial?

New York State Psychiatric Institute

Lead Sponsor

Trials

481

Recruited

154,000+

Columbia University

Lead Sponsor

Trials

1,529

Recruited

2,832,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Chestnut Health Systems

Collaborator

Trials

27

Recruited

24,500+

George Mason University

Collaborator

Trials

60

Recruited

50,200+

Published Research Related to This Trial

A qualitative study involving experienced suicide researchers revealed significant challenges in defining and reporting adverse events (AEs) and serious adverse events (SAEs) in suicide prevention trials, which complicates safety evaluations.

Participants emphasized the urgent need for clear and consistent definitions and reporting standards for AEs and SAEs to improve the comparability of studies and enhance safety monitoring in at-risk populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Variability in the definition and reporting of adverse events in suicide prevention trials: an examination of the issues and a proposed solution. Oquendo, MA., Feldman, S., Silverman, E., et al.[2022]

The Lifeline Crisis Chat Network significantly reduced distress among users, with two-thirds of suicidal chatters finding the chat helpful and nearly half reporting decreased suicidal thoughts after the intervention.

This study provides strong evidence for the effectiveness of online crisis interventions, which is especially important as the Lifeline prepares to expand its services with the new 988 nationwide number for mental health crises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

National Suicide Prevention Lifeline crisis chat interventions: Evaluation of chatters' perceptions of effectiveness. Gould, MS., Chowdhury, S., Lake, AM., et al.[2022]

The implementation of an electronic Web-based system at a pediatric hospital significantly improved the completion rate of interventions related to adverse drug events (ADEs), increasing from 21% to 44.7% after the system was introduced over a 5-month evaluation period.

The new system also enhanced documentation accuracy, reducing the rate of incomplete interventions from 77% to 43.7%, indicating that a streamlined electronic approach can effectively enhance patient safety in medication management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvement of medication event interventions through use of an electronic database. Merandi, J., Morvay, S., Lewe, D., et al.[2019]

The web-based adverse event tracking system (eAETS) has effectively supported 175 clinical protocols over four years, capturing 2,440 adverse event reports, including minor symptoms that could indicate serious issues.

Out of the reported AEs, 1,053 did not align with the initial risk profiles, leading to corrective recommendations in 13% of the protocols, highlighting the system's role in enhancing subject safety by identifying unanticipated patterns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of minor adverse event tracking on subject safety: a web-based system. Shenvi, NV., Gebhart, SS.[2009]

Emphasizing early intervention and ongoing low-intensity contact with individuals at risk of suicide can be more effective than solely focusing on those deemed 'highest risk', suggesting a shift in treatment strategy.

The use of advanced interactive computer programs can enhance screening and training for healthcare providers, improving access to mental health services and continuity of care for suicidal individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Suicide prevention in a treatment setting. Litman, RE.[2022]

In a study analyzing 420 messages from 149 patients who had recent emergency department visits or hospitalizations for depression or suicidality, messages from at-risk patients were significantly more likely to express a depressed mood, suicidal thoughts, or emotional distress compared to a control group.

Despite the ability of patient portal messages to convey signs of distress, only a small percentage of patients who died by suicide (23%) sent messages in the month prior to their death, indicating that portal communication may not effectively identify all at-risk individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Portal Message Language Use Prior to Suicide, Suicide Attempts, and Hospitalization for Depression. Duvall, MJ., Miller, NE., North, F., et al.[2022]

In the ED-SAFE study, structured telephone follow-up assessments were crucial for identifying adverse events (AEs), detecting 45% of total AEs that were missed by chart reviews alone.

The detection of suicide attempts varied significantly by method, with structured follow-ups identifying 59% of attempts compared to only 18% through chart reviews, highlighting the importance of using multiple detection methods in suicide research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using structured telephone follow-up assessments to improve suicide-related adverse event detection. Arias, SA., Zhang, Z., Hillerns, C., et al.[2021]

The mobile app developed as part of the SERO suicide prevention program aims to reduce suicides and suicide attempts by enhancing self-management for individuals at risk, incorporating strategies like safety planning and mood tracking.

The app's design was informed by collaboration among health professionals, individuals at risk, and their families, ensuring it addresses real needs and integrates essential suicide prevention strategies effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

SERO - A New Mobile App for Suicide Prevention. Meier, L., Gurtner, C., Nuessli, S., et al.[2022]

A pilot study of a text-messaging intervention for youths discharged from the hospital after suicidal thoughts showed it was feasible and well-received, helping to reduce suicidal thoughts and behaviors.

The positive results of this intervention led to the Maryland Department of Health expanding the program to offer similar support to all Maryland residents, highlighting its potential effectiveness in suicide prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Brief Text-Messaging Intervention for Suicidal Youths After Emergency Department Discharge. Ryan, TC., Chambers, S., Gravey, M., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10526689/

e-Connect: Linking Probation Youth at Risk for Suicide to ... This study examined the efficacy of e-Connect, a digital clinical decision-support system (CDSS), at improving STB risk identification, referral, and linkage to ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2949732925000468

Predictive Validity of the e-Connect Suicide Risk ... This paper evaluates the predictive validity of a close analogue of this algorithm for predicting STBs over the 12 months following assessment.

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37261738/

Linking probation youth at risk for suicide to behavioral health ... This study examined the efficacy of e-Connect, a digital clinical decision support system (CDSS), at improving STB risk identification, referral ...

4. psycnet.apa.org psycnet.apa.org/record/2023-78404-001

E-Connect: Linking probation youth at risk for suicide to ... This study examined the efficacy of e-Connect ... Characteristics, needs, services, and outcomes of youths in juvenile treatment drug courts as compared to ...

5. chestnut.org chestnut.org/li/research-and-evaluation-projects/profile/scaling-up-econnect-in-juvenile-probation-settings-a-hybrid-implementation-effectiveness-trial-of-a-digital-suicide-risk-behavior-identification-and-linkage-to-treatment-system-e-connect-in

Scaling up eConnect in Juvenile Probation Settings The e-Connect software allows Probation Officers to screen youth for suicidal behavior, behavioral health, and substance use problems using a modified GAIN ...

6. jaacapopen.org jaacapopen.org/article/S2949-7329(25)00046-8/pdf

Predictive Validity of the e-Connect Suicide Risk ... Conclusion: Results showed strong predictive validity of the tiered risk classification algorithm, and support its use in probation settings for effective.

7. withpower.com withpower.com/trial/phase-suicide-2023-421b3

e-Connect for Suicide Prevention in Youth Research shows that telecommunication-based interventions, like text messaging, can help reduce suicidal thoughts and behaviors in youths after hospital ...