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Q & A with Mario Cappelli

What research projects do you currently have underway?

A key focus now is in the area of how we transition care and transition youth with severe mental illness between pediatric settings and adult facilities. This study is funded by the LHIN and CHEO provides the lead in this region. We also have a CIHR-funded meeting grant, which is going to be held this fall to bring clinical scientists from the U.K., Australia, U.S. and Canada together to develop a research platform that allows us to look at different models across nations in how we transition care.

Another exciting initiative on the go is the development of an online evidence-based tool that physicians use when they assess mental health patients in the Emergency Department. HEADS (which typically stands for home, education, activities, drugs, sexual activity) is a commonly used psychosocial assessment tool. We’ve adjusted it to make mental heath assessments in the Emergency Department, so we’re looking at Home, Education, Activities and peers, Drugs and alcohol, Suicidality, Emotions and behaviours, and Discharge resources. Now the assessment itself is more systematic – which is especially useful during a crisis – but the tool is also embedded with listings of community resources that we can offer to patients and their families at the point of discharge.

What impact will this new tool have in the Emergency Department?

The HEADS ED tool has proven to be a good predictor of admission and severity. I think what’s really compelling is how simple we’re making it for physicians to recommend an action plan when a patient leaves the hospital. Say for example, if a physician learns that a patient’s home life is supportive and they have no problems with their peers, but there is some drug use and ideation, then the HEADS ED tool will grade the severity of the case and turn out a list of agencies that can provide ongoing support.

Physicians already have access to these resources; why is this ground-breaking research?

Yes, as a practicing psychologist, I also know that community resources and agency information is accessible in the Emergency Department. But never before has the information been collated online, in such a way that the reports are directly aligned to the patient’s risk assessment – and ready immediately.

Is the HEADS ED tool only available at CHEO?

Right now, we’re doing an implementation study at CHEO and the IWK in Halifax to see what we have to do to get uptake in Emergency Departments across the country. Our goal is to regionalize all of the community and agency resources within the tool. We would like to see this completed and implemented by early fall 2012.

What lesson did you learn doing this research?

I know one thing for sure: Children and youth are CHEO’s patients but our client is their parents and guardians. I am really excited that we can point to the appropriate community and hospital resources and give families a meaningful action plan when they leave the Emergency Department.

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