Targeting Social Needs to Enhance Post-Psychiatric Hospital Care for Adolescents. - Timely follow-up outpatient mental healthcare after psychiatric hospitalization is associated with improved outcomes, including better medication adherence, increased outpatient treatment utilization, reduced emergency department visits and psychiatric readmissions, and lower risk of suicide related outcomes. However, many adolescents do not receive recommended follow-up care post discharge. Social needs, defined as social and financial challenges such as financial strain and housing, food, and transportation insecurity, may be key barriers to timely follow-up care. Addressing social needs during and immediately following hospitalization may improve service engagement and mental health outcomes. This K01 project responds to a national push, endorsed by the American Academy of Pediatrics, to integrate screening and intervention for social needs into clinical settings. The proposed study aims to develop a clinical pathway that universally identifies and addresses social needs for adolescents who are psychiatrically hospitalized. The project will focus on youths 12 to 17 years with psychiatric hospitalizations at Nationwide Children’s Hospital in Columbus, Ohio and on social needs modifiable through available resources in the Columbus area. The specific aims include: 1) Assess perspectives of adolescent patients, their caregivers, health system staff and leadership, and community organizations on the health system’s role in identifying and assisting youths with social needs; 2) Examine causal associations between social needs and post-discharge mental health services utilized by adolescents following psychiatric hospitalization; and 3) Apply intervention mapping to develop a clinical pathway to identify and support adolescents with unmet social needs during and immediately after psychiatric hospitalization. This proposal will provide Dr. Llamocca with advanced training and vital skills to leverage findings from secondary data analysis to develop clinical pathways, in collaboration with clinical scientists, to address social needs and improve youth mental health outcomes. Dr. Llamocca will be mentored by an experienced team, including co-primary mentors Drs. Jennifer Hughes and Cynthia Fontanella, co-mentors Drs. Jordan Braciszewski, Susan Shortreed, and Alicia Bunger, collaborator Dr. Laura Chavez, and consultants Drs. Arvin Garg and Yunyu Xiao. The team has expertise in youth suicide prevention, pediatric social needs interventions, causal inference methodology, implementation science, and intervention development. Training will focus on: 1) acquiring qualitative and mixed methods research skills, 2) developing expertise in analyzing electronic medical record data utilizing causal inference methodology, and 3) gaining knowledge in adapting and evaluating interventions. This K award will launch Dr. Llamocca’s career as an independent mental health services researcher dedicated to developing data-driven strategies to address social needs and reduce suicide risk.
