Assessing Suicide Risk in the ED: Web-based MD training

DESCRIPTION (provided by applicant): Over the past twenty-five years, there has been a sharp rise in the number of children and adolescents presenting to emergency departments (EDs) for psychiatric issues. Given that youth mental health issues account for 1.6% - 5.0% of all ED visits, and that Emergency Medicine physicians are the first to interact with these youth, the assessment of psychiatric issues in young patients should be a high priority for programs educating these physicians. However, based on a survey of the current Emergency Medicine Residency Programs, there is little (28%) or no (67%) training in psychiatric issues (Santucci, Sather & Baker, 2003). To address this lack of training we developed and evaluated the first of six web-based one- hour modules on the assessment of suicidality in youth through an NIMH-funded STTR Phase I award (1 R41 MH073197). Data from the evaluation of that first module are highly encouraging. Eighty-two percent of those recruited completed the module. Respondents ranked the clinical applicability of the epidemiology risk factors module very high - 8.5 on a 10-point scale and were very satisfied with the module. As pointed out by one of our experts in Emergency Medicine and the Program Director of the Pediatric Emergency Medicine Fellowship at Rainbow Babies and Children's Hospital, the overwhelming response from the Emergency Medicine Residents was "where are the next 5 modules?" Given the physicians' requests for additional education, the positive response to and educational success of the initial module, we are requesting funds through a Phase II award to complete the remaining 5 modules, evaluate those modules for ease of use and effectiveness of content in changing knowledge, and for marketing the 6-module sequence to Emergency Medicine Physicians and Pediatricians. The Specific Aims of the proposed Phase II STTR to assess suicidality are to: 1) Refine the content of modules 2-6. Using additional clinical sources, the detailed outlines appearing in Appendix 1 will be further refined; 2) Create modules 2-6. CME Development Group will use the clinical content refined under the first aim to produce the next 5 hours of education on assessing suicidality in Emergency Departments; 3) Evaluate modules 2 through 6. Using questions based on the content of modules 2 through 6, those for evaluating educational interventions based on the work by Holloway et al. (1983; 1988) and questions previously employed by CME Development Group and its parent company MultiWeb Communications to evaluate educational programs, an evaluation section for each module will be developed and tested; 4) Market the completed 6-module educational program. CME Development Group and MultiWeb Communications, its parent company, will market the educational program to multiple national audiences. Suicide, suicidal behaviors and suicidal ideation are underidentified prevalent problems with significant morbidity and mortality. These behaviors are increasingly seen initially in Emergency Departments by physicians with little or no training in identifying and managing these behaviors. Improved training is needed to help physicians better prevent, identify, assess and manage suicide, suicidal behavior/ideation among their patients. The proposed Phase II STTR will help fill this need and may prevent considerable morbidity and mortality.