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

Abstract

IntroductionUnderstanding 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 analysisThe 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 disseminationThe 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.

Patterns of emergency department presentations for a youth mental health cohort: data-linkage cohort study

“…4). High utilisers were more likely to be female (429/696; 61.6%) (χ 2 (1) = 8.180, P < 0.01) with a median of 20 presentations (IQR = 14-31) over the entire follow-up period, whereas males (267/ 696, 38.4%) had a median of 18 presentations (IQR = 15, 95% CI [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27].…”

“…21,22 Clinical research data for this cohort were linked to routinely collected data from the Emergency Department Data Collection (EDDC) registry over a 10-year period, from January 2010 to October 2020. 21 A waiver of consent was granted according to the National Statement on Ethical Conduct in Human Research (2007). A master linkage key was generated for each participant to mask identifying information, including name, address, date of birth and gender.…”

“…Complete details of the data linkage approach can be found in our previous work. 21 , 22 Clinical research data for this cohort were linked to routinely collected data from the Emergency Department Data Collection (EDDC) registry over a 10-year period, from January 2010 to October 2020. 21 A waiver of consent was granted according to the National Statement on Ethical Conduct in Human Research (2007).…”

Premature mortality in young people accessing early intervention youth mental healthcare: data-linkage cohort study

“…The study used data from the Brain and Mind Research Register (BPRR), a longitudinal cohort study of 7081 young people presenting to the youth mental health clinics of the Brain and Mind Centre in the Sydney suburbs between October 2008 and October 2020. 13 , 14 The early intervention clinics consist of primary mental healthcare (headspace) and more specialised mental health services, including psychiatrists and psychologists. They are accessed by young people aged 12–30 years old, presenting at early clinical stages (non-specific symptoms) through to full-threshold disorders.…”

“…The BPRR was linked to three external databases held by the Centre for Health Record Linkage in New South Wales (NSW), Australia. 14 , 15 These databases were the Register of Births, Deaths and Marriages (RBDM), the Australian Coordinating Registry Cause of Death Unit Record File (ACR-COD URF), the Emergency Department Data Collection (EDDC) and the Admitted Patient Data Collection (APDC). Gender and age were selected from the BPRR.…”