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. 2022 Feb 21;12(2):e054264.
doi: 10.1136/bmjopen-2021-054264.

Premature mortality in early-intervention mental health services: a data linkage study protocol to examine mortality and morbidity outcomes in a cohort of help-seeking young people

Catherine McHugh  1 , Yun Ju Christine Song  2 , Natalia Zmicerevska  2 , Jacob Crouse  2 , Alissa Nichles  2 , Chloe Wilson  2 , Nicholas Ho  2 , Frank Iorfino  2 , Adam Skinner  3 , Elizabeth M Scott  2 , Ian B Hickie  2
Affiliations

Premature mortality in early-intervention mental health services: a data linkage study protocol to examine mortality and morbidity outcomes in a cohort of help-seeking young people

Catherine McHugh et al. BMJ Open. .

Abstract

Introduction: Understanding the risk of premature death from suicide, accident and injury and other physical health conditions in people seeking healthcare for mental disorders is essential for delivering targeted clinical interventions and secondary prevention strategies. It is not clear whether morbidity and mortality outcomes in hospital-based adult cohorts are applicable to young people presenting to early-intervention services.

Methods and analysis: The current data linkage project will establish the Brain and Mind Patient Research Register-Mortality and Morbidity (BPRR-M&M) database. The existing Brain and Mind Research Institute Patient Research Register (BPRR) is a cohort of 6743 young people who have accessed primary care-based early-intervention services; subsets of the BPRR contain rich longitudinal clinical, neurobiological, social and functional data. The BPRR will be linked with the routinely collected health data from emergency department (ED), hospital admission and mortality databases in New South Wales from January 2010 to November 2020. Mortality will be the primary outcome of interest, while hospital presentations will be a secondary outcome. The established BPRR-M&M database will be used to establish mortality rates and rates of ED presentations and hospital admissions. Survival analysis will determine how time to death or hospital presentation varies by identified social, demographic and clinical variables. Bayesian modelling will be used to identify predictors of these morbidity and mortality outcomes.

Ethics and dissemination: The study has been reviewed and approved by the human research ethics committee of the Sydney Local Health District (2019/ETH00469). All data will be non-identifiable, and research findings will be disseminated through peer-reviewed journals and scientific conference presentations.

Keywords: adult psychiatry; child & adolescent psychiatry; mental health; public health; suicide & self-harm.

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Conflict of interest statement

Competing interests: CM, YJCS, FI, JC, AN, NZ, CW, AS and NH, report no conflicts of interest. EMS is the clinical director of the St Vincent’s Youth Mental health program. She has received honoraria for educational seminars related to the clinical management of depressive disorders supported by Servier and Eli-Lilly pharmaceuticals. She has participated in a national advisory board for the antidepressant compound Pristiq, manufactured by Pfizer. She was the national coordinator of an antidepressant trial sponsored by Servier. IBH was an inaugural commissioner on Australia’s National Mental Health Commission (2012–2018). He is the codirector of Health and Policy at the Brain and Mind Centre (BMC), University of Sydney. The BMC operates an early-intervention youth services at Camperdown under contract to headspace. IBH has previously led community-based and pharmaceutical industry-supported (Wyeth, Eli Lily, Servier, Pfizer and AstraZeneca) projects focused on the identification and better management of anxiety and depression. He was a member of the Medical Advisory Panel for Medibank Private until October 2017, a board member of Psychosis Australia Trust and a member of Veterans Mental Health Clinical Reference group. He is the chief scientific advisor to, and an equity shareholder in, Innowell. Innowell has been formed by the University of Sydney and PwC to deliver the $30m Australian government-funded ‘Project Synergy’. Project Synergy is a 3-year program for the transformation of mental health services through the use of innovative technologies.

Figures

Figure 1
Figure 1
The Brain and Mind Patient Research Register–Mortality and Morbidity database. APDC, Admitted Patient Data Collection; BPRR, Brain and Mind Research Institute Patient Research Register; CoD-URF, cause of death–unit record file; EDDC, Emergency Department Data Collection; RBDM, Registry of Births, Deaths and Marriages.
See this image and copyright information in PMC

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