# Rapid Referral to Suicide Specific Intervention in Psychiatric Emergency Care

> **NIH VA I01** · VA SAN DIEGO HEALTHCARE SYSTEM · 2020 · —

## Abstract

This revised proposal responds to HSR&D's Targeted Solicitation for Health Services Research on Suicide
Prevention. Same-day psychiatric emergency clinics are increasingly implemented and are a best practice in
increasing access to mental health care and in suicide prevention. Our preliminary data indicate a high
frequency of suicidal ideation and recent suicidal behavior among Veterans accessing same-day mental health
evaluation, and yet fewer than half of Veterans with these risk factors engage in outpatient mental health
appointments that are set following their initial acute evaluation. To reduce risk of suicide during the
transition from acute to outpatient care, it is unclear if models that “bridge” the transition should emphasize
telephone outreach, as delivered by Suicide Prevention Coordination teams, or suicide-specific psychotherapy,
such as Collaborative Assessment and Management of Suicidality (CAMS). CAMS is a brief transdiagnostic
evidence-based psychotherapy that is recognized by the Joint Commission and Zero Suicide Framework as
indicated for Veterans experiencing active suicidal ideation and/or recent suicidal behavior. This single-site 4-
year randomized clinical trial addresses pragmatic questions regarding the relative impact of rapid referral to
CAMS versus compared to outreach delivered by Suicide Prevention Coordinators for Veterans who are
accessing same day mental health evaluation and who are gauged to be at elevated risk for suicide. In a Hybrid
Type 1 research design, we propose to recruit Veterans from the same-day clinic setting who report recent or
current active suicidal ideation and/or suicide attempt within the past 3 months. Veterans will be randomized
to timely initiation of CAMS or to telephone outreach from Suicide Prevention Coordinators. The primary
outcome (Aim 1) is the 12-month rate of suicide-related behavior or psychiatric hospitalization. Aim 2
contrasts indicators of operational efficiency between randomized conditions, including Veterans' rate of
missed appointments at referred ongoing mental health care and urgent care re-presentation. We will also
evaluate secondary outcomes (e.g., suicidal ideation severity). Aim 3 will examine the mediating impact of
outpatient mental health treatment engagement on primary outcomes. Aim 4 evaluates fidelity to CAMS and
its association with outcomes. Fidelity and in-person outcomes are measured by use of information
technology, called eScreening, that is integrated with the electronic medical record and is used coordinate rapid
referral and measurement-based care. This project builds on our preliminary data which indicate that research
recruitment and rapid referral to CAMS therapy in same-day setting is highly feasible, acceptable and
potentially impactful. This project is innovative in its focus on transitional care interventions in the same day
clinic setting and its integration of health information technology to facilitate rapid referral, extensible to the
...

## Key facts

- **NIH application ID:** 9786072
- **Project number:** 5I01HX002468-02
- **Recipient organization:** VA SAN DIEGO HEALTHCARE SYSTEM
- **Principal Investigator:** Colin A. Depp
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-10-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9786072

## Citation

> US National Institutes of Health, RePORTER application 9786072, Rapid Referral to Suicide Specific Intervention in Psychiatric Emergency Care (5I01HX002468-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9786072. Licensed CC0.

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