HERLab and CHA Department of Psychiatry awarded NIMH P50 Alacrity Center

Cambridge Health Alliance’s Health Equity Research Lab has been awarded a NIMH P50 grant entitled the Center for Early Screening and Treatment of at-Risk Youth (the eSToRY Center) (PIs Benjamin Cook and Philip Wang). The eSToRY Center is dedicated to early detection of mental illness, preventing adverse outcomes, improving quality of care, and fostering equity in treatment for racial, ethnic, and language (REL)-minority youth (defined as children, adolescents, and young adults <25 years of age). Across multiple research projects, we hope to establish a learning health community in the diverse neighborhoods surrounding Cambridge Health Alliance (CHA) to address the well-recognized barriers to care for youth with mental health needs, deploying a sophisticated health data infrastructure to adapt, test, and implement evidence-based practices to accelerate health care improvements. We will hold regular training events and pilot research grant opportunities intended to build capacity to identify and reduce racial, ethnic, and gender disparities in mental health treatment.

eSToRY Center Research Projects:

R34-1: Stress and Coping among high school students

Adolescence is often when mental illness begins to emerge. Failure to detect early subthreshold symptoms of incipient disorders is a major impediment to prevention and diagnosis. Risk factors for REL-minority youth can be heightened due to their greater likelihood of experiencing discrimination and socioeconomic barriers and their subsequent impacts on access and engagement in treatment and overall wellness. This project aims to implement and test tools necessary to prevent transitions to mental illness among at-risk youth, and particularly at-risk racial/ethnic and language (REL)-minority youth. The overall aim of this project is to prevent and remediate a surge in youth mental illness and to reduce persistent treatment disparities. First, we use a remote adaptive testing technology, “K-CAT+”, to provide rapid community-based screening. Second, we will evaluate the effectiveness of a targeted, online health promotion intervention, COPE2THRIVE (C2T), to build resilience in a REL-diverse sample of school-aged youth. Third, we will assess whether this approach mitigates increased risk faced by racial/ethnic and language (REL)-minority youth. 

PI: Margaret Weiss
Point Person at the Lab: Taylor Witkowski
Team members: Eleanor Richards, Nicholas Carson, Dharma Cortés, Benjamin Lê Cook

R34-2: Real-world effectiveness of mental health interventions for suicide prevention in at-risk youth

Identifying effective suicide prevention strategies for racial/ethnic and language (REL)-diverse populations of youth at high risk of suicide has enormous public health importance. Suicide rates for persons aged 10-24 have increased by more than 50% over the last decade in nearly every state and for nearly every racial/ethnic minority group, with particularly concerning increases in suicide attempts among black youth. Little is known about the long-term effects of community-based treatment in urban safety net healthcare systems with REL-diverse youth populations. In this project, we aim to utilize a unique clinical-sociocontextual dataset of over 15,000 youth patients at high risk for suicide to conduct comparative effectiveness research (CER) to identify effective treatments for suicide prevention and how these differ across REL-diverse groups. We will assess long-term treatment outcomes through present-day follow up computerized adaptive testing with a sub-sample of patients to analyze current-day suicidal outcomes, psychopathology, and measure social determinants and quality of care. 

PI: Nicholas Carson
Point Person at the Lab: Taylor Witkowski
Team members: Phillip Wang, Benjamin Lê Cook, Gareth Parry, Rajen Aldis

R34-3: Understanding the role of trauma over the lifecourse in order to improve trauma-informed treatment

Accumulating evidence links childhood psychological trauma to increased likelihood and severity of mental illness and poor outcomes. By age sixteen, 60% of children have experienced an adverse childhood event and 30% have experienced more than one event, with disproportionately higher rates of adverse childhood events in economically disadvantaged, racial/ethnic/language (REL)-minority communities. In this study, we use a clinical-sociocontextual dataset of more than 600,000 patients, linked to insurance claims, criminal justice, and individual- and community-level social determinants of health data, to better understand the trajectories from psychological trauma to mental illness, predictors of negative and positive trajectories, and how mental health treatment mitigates negative trajectories for REL-minority populations.

PI: Michael Flores
Point Person at the Lab: Taylor Witkowski
Team members: Benjamin Lê Cook, Valeria Chambers, Katherine Grimes, Sharon-Lise Normand