Evidence map›Paper›PMID 42337210›Full record

ArticleThe journal of behavioral health services & research2026

Workforce Investments in Telehealth Suicide Prevention in Emergency Departments: Implementation Costs of a Centralized Behavioral Health Consultation Service.

Freya Nezir, Megan E Reilly, Michael Steinberg, Kelly L Green, Shari Jager-Hyman, Courtney Benjamin Wolk, Danielle Mowery, David S Mandell, Maria A Oquendo, Gregory K Brown

Abstract read
PubMed Publisher
In one paragraph

Article in The journal of behavioral health services & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Freya NezirDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA. freya.nezir@pennmedicine.upenn.edu.ORCID http://orcid.org/0000-0003-4323-0175
Megan E ReillyDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Michael SteinbergDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Kelly L GreenDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Shari Jager-HymanDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Courtney Benjamin WolkDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Danielle MoweryDepartment of Biostatistics, Epidemiology, & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
David S MandellDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Maria A OquendoDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.
Gregory K BrownDepartment of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Philadelphia, PA, USA.

Funding

Signature ProjectP50MH127511 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI BROWN, GREGORY K · 2021 to 2025
$14.4M
NIMH NIH HHS P50 MH127511
6 · The paper itself

Abstract

Health systems increasingly deploy telehealth suicide prevention in emergency departments (EDs), yet little is known about required organizational investments. Transparent resource estimates are needed to plan and scale behavioral health services in acute care. This micro-costing study examined implementation of a centralized Suicide Prevention Consultation Center (SPCC) delivering telehealth Safety Planning Intervention with follow-up (SPI +) to suicidal ED patients across eight hospitals. Using Time-Driven Activity-Based Costing (TDABC) from a health system perspective, implementation strategies were mapped to actions, personnel roles, and time drivers. Standardized wages were applied to calculate total and per-ED costs, distinguishing centralized from site-specific activities and classifying costs by implementation strategies and Exploration, Preparation, Implementation, and Sustainment (EPIS) framework phases. Over 14 months, implementation required 1824 staff hours costing $163,329 ($20,416 per ED). Clinician consultation, workflow development, and training accounted for three-quarters of costs. Most resources (84%) supported one-time centralized activities (e.g., EHR referral and system-wide workflow design), while 16% supported site-specific activities such as ED leadership engagement, local workflow adaptation, and go-live meetings. Preparation-phase activities comprised 62.5% of costs; implementation-phase supports comprised the remainder. Costs were concentrated among the SPCC Clinical Consultant, Implementation Lead, and SPCC clinicians (71% of total), with additional opportunity costs borne by health system leadership and clinical personnel. Launching a centralized telehealth suicide prevention service in EDs requires substantial but time-limited behavioral health workforce investments, particularly clinical consultation, workflow development, and training to build clinician capacity and fidelity. These findings provide practical benchmarks for health systems considering scalable telehealth suicide prevention services.

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.