RECRUITING

Treatment for Individuals Interacting with the Criminal Justice System

Conditions

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Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The proposed Center will leverage burgeoning real-time data linkage capabilities among health systems, Medicaid payors, and criminal legal (e.g., jail booking data, jail release data) systems, to identify individuals coming in and out of jail for suicide assessment and prevention, and to better coordinate care across these disparate systems. This Center will advance the fields of suicide prevention and criminal legal system-based mental health by solving a well-known, central problem in both fields: the inability to track and intervene with individuals moving in and out of both and often multiple systems. The goal is near-term reductions in the U.S. suicide rate.

Official Title

Improving Mental Health Treatment for Individuals in Crisis Interacting with the Criminal Justice System

Quick Facts

Study Start:2025-02-01

Study Completion:2027-09-30

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT06564948

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 100 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Treatment as Usual (TAU) arm 1. Cambridge Health Alliance (CHA) patients from the cities other than Cambridge considered to be in the "catchment area" of CHA (Everett, Chelsea, Somerville, Medford, Malden, and Winthrop) 2. Ages 18-100 3. Identified as having police involvement between 2009 and 2019. Treatment as Usual patients will be identified using "targeted limited chart review methods" used in our prior studies, "scraping" clinical notes in the Electronic Health Records for criminal justice involvement. Initial Identification terms, "police", "arrest", "court", "summons", "jail", and "crime" will be used to identify candidates for police involvement, downloading the sentence in which the keyword appeared and the sentence before and after. Next, an iterative process of editing of the search terms will be conducted to remove patients with negation of the keyword ("did not commit a crime"), and other sentence characteristics that generate false positives ("cardiac arrest"). Samples of the resulting dataset will be taken, accuracy assessed by examining the surrounding sentences, leading to further iterations and repetition of the process until a high level of accuracy is achieved. 2. Family and Social Justice Section (FSJS) arm 1. Cambridge Health Alliance patients from Cambridge 2. Ages 18-100 3. Individuals who have come into contact with the Cambridge Police Department (as identified in the Family and Social Justice Section data) between 2009 and 2019. 3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm 1. Recruited during the study period in the CHA ED 2. Ages 18-100 3. Individuals who are brought into the Emergency Department under police supervision (excluding individuals currently incarcerated) * involuntarily brought to the Emergency Department for psychiatric evaluation because they are considered to be a risk to themselves or others (MA Law 123(12)); or * the subject of a police call for service for a mental health issue who are willingly admitted to the Emergency Department 1. Treatment as Usual (TAU) arm 1. Cambridge Health Alliance patients residing in the City Cambridge are excluded from the TAU arm 2. Under the age of 18 3. Individuals with no identified criminal legal system contact during the study time period (no criminal legal involvement found in the targeted limited chart review method). 4. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019). 2. Family and Social Justice Section (FSJS) arm 1. Cambridge Health Alliance patients outside of Cambridge will be excluded from the FSJS arm 2. Under the age of 18 3. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019) 3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm 1. Under the age of 18 2. Any individual who becomes incarcerated during the course of the study 3. Individuals who enter the Emergency Department not under police supervision * For example, individuals will be excluded who voluntarily come to the ED seeking psychiatric care because they feel they may be a risk to themselves or others * Individuals brought to the ED from a jail or court ordered to the ED as an alternative to jail or prison	Pregnancy or breastfeeding Severe psychiatric disorders Active substance abuse Unstable medical conditions Inability to comply with study requirements

Inclusion Criteria

Exclusion Criteria

1. Treatment as Usual (TAU) arm
1. Cambridge Health Alliance (CHA) patients from the cities other than Cambridge considered to be in the "catchment area" of CHA (Everett, Chelsea, Somerville, Medford, Malden, and Winthrop)
2. Ages 18-100
3. Identified as having police involvement between 2009 and 2019. Treatment as Usual patients will be identified using "targeted limited chart review methods" used in our prior studies, "scraping" clinical notes in the Electronic Health Records for criminal justice involvement. Initial Identification terms, "police", "arrest", "court", "summons", "jail", and "crime" will be used to identify candidates for police involvement, downloading the sentence in which the keyword appeared and the sentence before and after. Next, an iterative process of editing of the search terms will be conducted to remove patients with negation of the keyword ("did not commit a crime"), and other sentence characteristics that generate false positives ("cardiac arrest"). Samples of the resulting dataset will be taken, accuracy assessed by examining the surrounding sentences, leading to further iterations and repetition of the process until a high level of accuracy is achieved.
2. Family and Social Justice Section (FSJS) arm
1. Cambridge Health Alliance patients from Cambridge
2. Ages 18-100
3. Individuals who have come into contact with the Cambridge Police Department (as identified in the Family and Social Justice Section data) between 2009 and 2019.
3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm
1. Recruited during the study period in the CHA ED
2. Ages 18-100
3. Individuals who are brought into the Emergency Department under police supervision (excluding individuals currently incarcerated)
* involuntarily brought to the Emergency Department for psychiatric evaluation because they are considered to be a risk to themselves or others (MA Law 123(12)); or
* the subject of a police call for service for a mental health issue who are willingly admitted to the Emergency Department
1. Treatment as Usual (TAU) arm
1. Cambridge Health Alliance patients residing in the City Cambridge are excluded from the TAU arm
2. Under the age of 18
3. Individuals with no identified criminal legal system contact during the study time period (no criminal legal involvement found in the targeted limited chart review method).
4. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019).
2. Family and Social Justice Section (FSJS) arm
1. Cambridge Health Alliance patients outside of Cambridge will be excluded from the FSJS arm
2. Under the age of 18
3. Any individual incarcerated at the Middlesex Jail/Prison that has not been released by the end of the period of data collection (December 31, 2019)
3. Family and Social Justice Section plus Navigator (FSJS+Navigator) arm
1. Under the age of 18
2. Any individual who becomes incarcerated during the course of the study
3. Individuals who enter the Emergency Department not under police supervision
* For example, individuals will be excluded who voluntarily come to the ED seeking psychiatric care because they feel they may be a risk to themselves or others
* Individuals brought to the ED from a jail or court ordered to the ED as an alternative to jail or prison

Pregnancy or breastfeeding
Severe psychiatric disorders
Active substance abuse
Unstable medical conditions
Inability to comply with study requirements

Contacts and Locations

Study Contact

Benjamin Cook

CONTACT

617-806-8741

bcook@cha.harvard.edu

Taylor Witkowski

CONTACT

617-806-8751

twitkowski@challiance.org

Study Locations (Sites)

Cambridge Health Alliance

Cambridge, Massachusetts, 02141

United States

Collaborators and Investigators

Sponsor: Cambridge Health Alliance

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2025-02-01

Study Completion Date2027-09-30

Study Record Updates

Study Start Date2025-02-01

Study Completion Date2027-09-30

Terms related to this study

Additional Relevant MeSH Terms

Suicide Risk
Psychiatric Disorders