Assistant Professor (Research) Mary Kathryn Cancilliere, Ph.D., has recently earned two grants for projects aimed at helping children with suicidal thoughts and self-injurious behaviors (STB) transition from the emergency department (ED) to community-based care: a John and Polly Sparks Early Career Grant from the American Psychological Foundation (APF) and a training grant from the Rhode Island Hospital Injury Control COBRE.
“We are at a breaking point with our mental health care system,” said Cancilliere, a pediatric psychologist and research scientist at Rhode Island Hospital. “There are so many different calls for action that people are now noticing the over two-decade long increase in pediatric ED rates and are willing to do something about it.”
The APF grant, awarded this month, will allow Cancilliere to interview key stakeholders – youth with STB, their families, and their clinical care team – with the goal of developing a protocol to determine which youth need inpatient care and which could benefit from a brief intervention and hold-time in the ED before transferring to less intensive outpatient care. The protocol is intended to reduce boarding, the practice of holding inpatient-ready youth in an ED until a bed opens.
“To our knowledge, this is the first perspective study on youth psychiatric boarding, as the research to date has relied on a retrospective chart review of the electronic health record,” she said. “We really need to create a thoughtful intervention from the bottom up that can lessen the burden and stress for these kids and for the healthcare system as a whole.”
In May, Cancilliere was also awarded a grant from the Rhode Island Hospital Injury Control COBRE to study the feasibility of a family navigator program for suicidal and self-injuring youth in the ED. While navigators have been used in many pediatric healthcare settings to steer families through obstacles to care, Cancilliere said this is one of the first times they have been used in an ED setting for youth in need of psychiatric services.
“One small change isn’t going to fix everything,” she said. “But we have to start somewhere, and we know the ED is one high-demand service that needs attention. Changing one thing can have a rippling effect. By working with stakeholders to reevaluate and address the youth mental health needs in this one piece of the system, we can learn more about the other pieces.”