A research team led by Ambrose Wong, MD, MSEd, MHS, from the Department of Emergency Medicine (DEM) at Yale School of Medicine, has been approved for a $6.9 million research funding award by the Patient-Centered Outcomes Research Institute (PCORI). The project, “Peer Support Enhanced Behavioral Crisis Response Teams,” will be the first study to evaluate the impact of introducing peers into the emergency department (ED) workforce to help patients in emotional and psychiatric distress. Peers are individuals with lived experience of mental illness who will collaborate closely with staff members working on a behavioral crisis response team by assisting in therapeutic de-escalation and providing effective communication, compassion, and support. The study's inclusive approach will give individuals with lived experience an opportunity to contribute to improving the management of agitation.
This study is a multidisciplinary collaboration including key co-investigators in DEM, Drs. Bidisha Nath, Rebekah Heckmann, James Dziura, and Seth Powsner, along with Dr. Chyrell Bellamy from the Yale Program for Recovery and Community Health, Yale New Haven Health System leaders, peer specialists, and representatives from multiple community partners and state agencies. It will use a community-based participatory research approach and involve stakeholders from the community at every stage of the project including study design, implementation, and dissemination of findings. The project aims to decrease the use of physical and chemical restraints during visits, improve patient experience and recovery, help connect patients to proper follow up, and decrease their need to return to the emergency department.
Mark Sevilla, Vice President, Behavioral Health and Emergency Services at Yale New Haven Hospital, and Arjun Venkatesh, MD, chair of the Yale Department of Emergency Medicine, are excited to support this project. "We look forward to working with Dr. Wong and his team to bring more behavioral health resources to our ED patients,” said Sevilla. “This is a vastly underserviced area of great need in emergency departments throughout the country. Hopefully more departments will focus on targeted efforts for this patient population as well as implementing processes like this to better manage patients experiencing behavioral difficulties."
One of the peers involved with the study design was also excited at the news of the award: "Approaching mental and emotional health crises in emergency room settings with restraints can have a long-term traumatic impact on people. Peers with lived experiences can be the change needed to help de-escalate the crisis or prevent it from worsening. Also, peers can be the liaison between doctors or nurses and patients going through some of the most stressful times in their lives."
Pastor Dana Smith, executive director of New Life II Ministries, said, “I am thrilled to participate in this project. It fits well with our belief in the importance of equitable healthcare for all. I believe that together, we can make a difference in the health of our community and beyond, especially in the stressful emergency department environment”.
“This project was selected for PCORI funding not only for its scientific merit and commitment to engaging patients and other healthcare stakeholders, but also for its conduct in real-world settings. It has the potential to answer an important question about comparative effectiveness of peer services in mental health emergencies and fill a crucial evidence gap,” said PCORI Executive Director Nakela L. Cook, MD, MPH. “We look forward to following the study’s progress and working with the Yale team to share its results.”
Wong’s funding award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.
PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better informed healthcare decisions.