# Leveraging behavioral economics and implementation science to engage suicidal patients in mental health treatment

> **NIH NIH R21** · UNIVERSITY OF PENNSYLVANIA · 2021 · $203,125

## Abstract

PROJECT SUMMARY
Patients at high risk for suicide are less likely to die by suicide if they engage in mental health treatment. Suicidal
individuals have difficulty initiating and sustaining involvement in mental health services, yet no studies have
systematically developed and tested strategies to increase treatment initiation for suicidal patients. Consistent
with NIMH’s Strategic Objective 4 to strengthen the public health impact of NIMH-supported research, the
primary objective of this study is to develop acceptable, feasible, low-cost, and effective strategies that increase
patients’ attendance at a first mental health visit following identification of suicide risk in primary care. We will
partner with a large, diverse health system that has implemented collaborative care in eight urban primary care
practices to rapidly prototype and test promising strategies to achieve this objective. Rapid prototyping involves
a series of rigorous experiments to optimize operations in the early-study stages. Industries outside of healthcare
commonly use this approach to learn quickly and “de-risk” decision-making on a short timeline prior to a large
rollout. The strategies we develop and test will be informed by behavioral economics and implementation science
methods, leveraging the University of Pennsylvania’s P50 ALACRITY center, and will include strategies that
target key mechanisms that impede treatment attendance. First, we will identify characteristics of patients who
do or do not attend a first mental health visit following referral using medical records and claims data. Then, we
will apply established approaches to contextual inquiry to identify barriers and facilitators to mental health
treatment attendance for individuals at risk of suicide. We will use direct observation and brief interviews with
key stakeholders (from within and outside of the Penn health system) to understand key barriers and facilitators
to engaging patients at risk for suicide in mental health services. Finally, we will rapidly prototype and test
strategies to optimize engagement. Using established procedures from implementation science and behavioral
economics, relevant theories and frameworks and the extant literature, we will identify preliminary strategies to
support attendance at first mental health visit. Strategies will also be developed in collaboration with a team of
experts in suicide, implementation science, behavioral economics, and primary and mental health care. Based
on the literature and our previous work, we anticipate that strategies that increase motivation (e.g., financial
incentives) and foster connectedness (e.g., Caring Contacts) will be needed. We will then iteratively test and
refine these preliminary strategies. Throughout this process, we expect to uncover additional barriers and
facilitators that will allow us to further refine and optimize implementation strategies. The primary output will be
a menu of the most promising and feasible implementatio...

## Key facts

- **NIH application ID:** 10218442
- **Project number:** 1R21MH123851-01A1
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Shari Jager-Hyman
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $203,125
- **Award type:** 1
- **Project period:** 2021-07-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10218442

## Citation

> US National Institutes of Health, RePORTER application 10218442, Leveraging behavioral economics and implementation science to engage suicidal patients in mental health treatment (1R21MH123851-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10218442. Licensed CC0.

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