I-CARE digital program to teach coping skills during psychiatric boarding

I-CARE: Efficacy of a Digital Health Intervention to Reduce Suicidal Ideation During Psychiatric Boarding

This project will test whether the I-CARE digital program helps adolescents (ages 12–17) boarding in the emergency department for suicide risk learn coping skills and feel less distressed.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 173 (estimated)
• Ages: 12 Years to 17 Years
• Sex: All
• Sponsor: Dartmouth-Hitchcock Medical Center (other)
• Locations: 4 sites (New Haven, Connecticut and 3 other locations)
• Trial ID: NCT07150832 on ClinicalTrials.gov

What this trial studies

I-CARE is a modular, web-based intervention of seven animated videos and workbook exercises delivering brief, evidence-based psychosocial skills grounded in cognitive behavioral therapy. The program is facilitated one-on-one by non-clinical staff (licensed nursing assistants) who provide standard safety supervision while youth await inpatient psychiatric transfer. Youth presenting to the ED with suicidal ideation, suicide attempt, or self-harm who are medically stable and English-speaking are randomized at the patient level to receive I-CARE plus standard safety supervision or standard safety supervision alone. The trial is conducted at participating academic hospital sites in New England.

Who should consider this trial

Good fit: Adolescents aged 12–17 who are medically stable, English-speaking, present to the ED with suicidal ideation, suicide attempt, or self-harm, and are awaiting inpatient psychiatric transfer or disposition are the intended participants.

Not a fit: Patients with active psychosis, cognitive or developmental delays that prevent participation, behavioral limitations that preclude engagement, non–English-speaking caregivers, or who are medically unstable are unlikely to benefit from this program.

Why it matters

Potential benefit: If successful, I-CARE could help youth learn coping skills and reduce acute suicide-related distress during boarding while adding minimal new resources for hospitals.

How similar studies have performed: Brief CBT-based skills interventions have shown benefit for suicidal youth in other settings, but delivering a digital, facilitator-led program specifically during ED psychiatric boarding is largely untested and represents a novel application.

Eligibility criteria

Inclusion Criteria:

* Adolescents of any sex and gender, aged 12-17 years at ED visit or hospital encounter
* Presenting with suicide attempt or ideation, or self-harm
* Medically stable
* English-speaking
* Awaiting transfer for inpatient psychiatric care or disposition.

Exclusion Criteria:

* Cognitive or developmental delays precluding participation (intellectual functioning \<12 years of age)
* Behavioral limitations that preclude program participation
* Active psychosis
* Legal parent/caregiver unable to speak English or unavailable to provide consent (e.g. Wards of the State)

Where this trial is running

New Haven, Connecticut and 3 other locations

• Yale — New Haven, Connecticut, United States (RECRUITING)
• Dartmouth College — Hanover, New Hampshire, United States (NOT_YET_RECRUITING)
• Dartmouth Health — Lebanon, New Hampshire, United States (NOT_YET_RECRUITING)
• Weill Cornell Medicine — New York, New York, United States (RECRUITING)

Study contacts

• Principal investigator: JoAnna K. Leyenaar, MD, PhD, MPH — Dartmouth College
• Study coordinator: Stephanie C. Acquilano, MA

Conditions: Mental Health Disorder, Suicide Attempt, Suicidal Ideation, Emergency Psychiatric, Children, Adolescents, Emergency Department, Mental Health Boarding