Computerized Assessment and Referral System Screener for Mental Health Evaluations in the Emergency Setting

Study Overview
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Brief Summary
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This is a hybrid effectiveness-implementation randomized controlled trial which will be conducted at the emergency department (ED) at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Arkansas. The hypothesis of this study is that use of the CARS (a computerized mental health screener) will modify emergency department treatment of patients with previously undiagnosed mental illness.

Detailed Description
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This pragmatic mixed methods clinical trial will compare the intervention of providing a CARS screener report to emergency providers to not providing the report. It will also collect qualitative data regarding implementation of the CARS screener and report. Consecutive patients presenting when a research associate is available will be approached to participate. Patients will be approached after evaluation by an emergency physician. The Computerized Assessment and Referral System (CARS) is based on the Composite International Diagnostic Interview (CIDI), a validated instrument for assessing mental health diagnoses.CARS was piloted at 6 different sites in 2016, all in DUI populations. As CARS has not been specifically validated on non-DUI populations, investigators will collect alcohol history (see below). The CARS self-assessment version (CARS-SA) will be utilized in this study.

Official Title
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The Utility of the Computerized Assessment and Referral System (CARS) Screener for Mental Health Evaluations in the Emergency Setting

Conditions
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Mental Health

Intervention / Treatment
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* Behavioral: Computerized Assessment and Referral System (CARS) Self-Assessment Screener
* Behavioral: CARS-SA Summary Results


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: >18 years of age Not incarcerated English-speaking and English-writing (as translators will not be available for this study) Exclusion Criteria: Unable or unwilling to complete CARS screener Unable or unwilling to provide any history of alcohol abuse Currently presenting with a chief complaint of a psychiatric symptom Currently presenting with a substance use complaint History of a known psychiatric condition Patients taking psychiatric medication

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CARS-SA Report<br>Emergency care providers for subjects in this group will receive a copy of the subject's CARS-SA summary results. | Behavioral: Computerized Assessment and Referral System (CARS) Self-Assessment Screener<br>* Subjects will take the CARS-SA Screener.<br>* Other names: CARS-SA Screener;Behavioral: CARS-SA Summary Results<br>* Subjects will be evaluated by emergency care providers using the CARS-SA Summary Results Report.<br>* Other names: CARS-SA Report;|
| Other: No CARS-SA Report<br>Emergency care providers for subjects in this group will not receive a copy of the subject's CARS-SA summary results. | Behavioral: Computerized Assessment and Referral System (CARS) Self-Assessment Screener<br>* Subjects will take the CARS-SA Screener.<br>* Other names: CARS-SA Screener;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With CARS Mental Health Diagnoses Made in the ED; the Number of Psychiatry Evaluations in the Emergency Department (ED); and the Number of Mental Health Referrals Made From the ED | The composite measure includes: the number of CARS mental health diagnoses made in the ED; the number of psychiatry evaluations in the emergency department (ED); and the number of mental health referrals made from the ED. | Up to 12 hours |