About us
The statewide Texas Youth Depression and Suicide Research Network (TX-YDSRN) was created as a part of the Texas Child Mental Health Care Consortium (TCMHCC) to establish a state-wide research network, focused on youth depression and suicide, across all 12 Health Related Academic Institutions in Texas.
Each institution represents a TX-YDSRN Study Node within the network. UT Southwestern Medical Center serves as the TX-YDSRN Hub, under the leadership of the Scientific Lead, Madhukar H. Trivedi, M.D., and Medical Co-Lead, Sarah Mallard Wakefield, M.D., of Texas Tech University Health Sciences Center.
Objectives
Established the Texas Youth Depression and Suicide Research Network (TX-YDSRN)
Funded by the 86th Texas Legislature in 2020, the TX-YDSRN was established. The Network was developed through collaborative partnerships between 12 major academic medical centers (Nodes) across Texas. Regulatory, operational and research functions required to support high-quality scientific investigations were developed to support future youth depression research. UT Southwestern serves as the Network Hub, overseeing the entirety of the project. The Network continues to launch activities to support youth mental health by utilizing the robust research infrastructure to support grants, measurement-based care initiatives, and expand the mental health workforce.
Trained Research Staff
The Network Hub has trained more than 180 research staff using a standardized, evidence-based best-practice model. A rigorous training plan is implemented to ensure all research staff possess skills to effectively engage in research procedures with youth and their families. Educating TX-YDSRN partners is expanding through the Training Academy initiative, involving a diverse set of role and program-specific online training modules, cementing TX-YDSRN's role as a Learning Health Network.
Developed Participant Registry
The TX-YDSRN Participant Registry study has enrolled 1700+ youths and completed more than 12,000 research visits. The Registry will continue to enroll and collect data from youth for up to 10 years. Currently, survey data on the first 1000 participants is being used to produce scientific papers on a diverse group of youth with depression to better inform clinical practice and improve outcomes.
Collecting Information on Systems of Care
Data is being collected across the Network to characterize the current systems of care and intervention approaches for depressed and suicidal youth, and to examine statewide population health. Information gathered has identified areas of potential growth and expansion of measurement-based care (MBC) to additional providers to improve outcomes for youth with depression. Presentations by experts across the Network educate mental health clinicians on effective MBC practices. MBC training modules designed specifically for clinicians, researchers, and students are in development.
Implemented Activ8
TX-YDSRN created and implemented Activ8, an 8-week telehealth behavioral activation program for teens and their caregivers. Activ8 is designed as a skill-building approach to break the cycle of depression. Interventionists attend a two-day course given by the HUB that certifies them to lead sessions. Expansion of Activ8 into the community to expand the mental health workforce in underserved areas is planned.
Overall Potential Impact and Benefit of the TX-YDSRN Research Efforts to the People of Texas
The TX-YDSRN and associated TX-YDSRN Participant Registry will impact Texas youth and families in several ways
- Improve Early Detection and Evidence-Based Treatment
- Support Clinicians in Identification and Treatment
- Conduct Science to Better Understand Youth Depression and Suicide
- Enhance Opportunities for Texas Researchers
- Sustain a Texas Research Infrastructure to Address Youth Depression and Suicide Prevention
Problem
Many Texas communities lack the education, resources, and infrastructure needed for early detection and evidence-based treatment for youth with depression and/or suicidal thinking or behavior.
Solution
The TX-YDSRN Hub and Study Nodes provide training and support to partnering clinical sites in methods to implement evidence-based depression and suicide prevention care for youth, including universal screening for depression, use of the collaborative care model, and use of measurement-based care (MBC).
Impact
The activities of the Network will improve patient outcomes, save money, and reduce stigma related to mental health.
Problem
Many pediatric providers are hesitant to treat mental health concerns, leading to inconsistent identification and treatment of depression.
Solution
The TX-YDSRN Hub team, in collaboration with Study Node leadership, offers educational and consultation opportunities for partnering clinics. In addition, clinic-level data will be provided in reports and dashboards to partnering clinics.
Impact
These trainings and collaborations lead to enhanced engagement and provide real-time feedback to improve identification and treatment processes to address youth depression and suicide prevention.
Problem
Substantial gaps exist in knowledge related to clinical, functional, behavioral, social, and biological mechanisms of depressive disorders and suicide as related to an individual’s risk of developing depression, risk of developing suicidal thoughts or engaging in suicidal behaviors, ability to cultivate resilience, and response to treatments.
Solution
Data from the TX-YDSRN Participant Registry will allow for the identification of risk markers, indicators of onset, long-term (natural) course of disease, and treatment-associated outcomes for youth depression and suicidal ideation and behavior.
Impact
Results from this study will lead to improvements in early and accurate response to depressive symptoms and suicidal ideation and behavior in youth.
Problem
Large grant opportunities are highly competitive and are often awarded to those with significant past proven research experience, to those with significant pilot data, or to those with access to a large population so that the results might provide more generalized data to be utilized across the nation.
Solution
Leverage expertise and experience of the TX-YDSRN Hub and Study Node leadership and combined population across participating sites.
Impact
By merging high level research expertise and mentorship for junior researchers, Texas researchers are better situated for obtaining future grant funding and results will be more generalized.
Problem
While Texas has several large research institutions, many of the Academic Health-Related Institutions across the state are focused primarily on clinical care and do not have significant research infrastructure.
Solution
Establishing The TX-YDSRN, comprised of the Academic Health-Related Institutions across the state, leveraged the infrastructure and expertise of larger Health-Related Institutions to support smaller Health-Related Institutions. Each Study Node received significant training and will continue to receive support and maintenance training from the TX-YDSRN Hub to ensure high fidelity to research methods.
Impact
Establishing the TX-YDSRN across a state as varied as Texas will allow for investigation of a more diverse population and provide specific information that can be applied more accurately for each region. Future efforts to support our Texas youth and families will be enriched by leveraging the cultural and economic diversity of our state.
Research
How the TX-YDSRN Research Addresses Needs in Texas
Depression and suicide impact a significant number of Texas youth. TX-YDSRN supports research to better understand depression and suicide and to improve detection and treatment through measurement-based care.
- TX-YDSRN Research Infrastructure
- TX-YDSRN Participant Registry Study
- Measurement-Based and Collaborative Care Research
- Future Research
Communication
The first step in creating TX-YDSRN was to establish the infrastructure, which included building relationships between Hub & Study Nodes, developing communication strategies, & fostering collaboration in the development and implementation of the research projects.
The TX-YDSRN Hub leads weekly Study Node coordinator meetings, bi-monthly Assessor Consultation meetings, and monthly Hub and Node Leadership meetings. Additional support includes weekly office hours for Electronic Data Capture Assistance and 1:1 meetings between the Hub and Study Nodes.
Website
This website includes a Secure Portal Log-in where Study Nodes and affiliated clinicians can access additional information, including dashboards to support measurement-based care efforts.
Data Management
The Electronic Data Capture (EDC) system was developed exclusively for TX-YDSRN.
Study personnel are provided access to multiple data capture sites, including the Training Tracker, with information about onboarding and training for all TX-YDSRN research personnel, the Certification Environment, which is a mock version of the data management system where research personnel can create mock participants to familiarize themselves with the EDC system, and the Production Environment, where data collection is conducted for TX-YDSRN research projects. This is only accessible to research personnel have completed all training requirements and are approved by the Institutional Review Board as personnel for the corresponding research study.
Regulatory Management
To streamline regulatory activities for TX-YDSRN, the UT Southwestern Institutional Review Board was used as the single IRB of record. The TX-YDSRN Hub worked closely with the Study Nodes to establish best practice regulatory and compliance processes.
Training
Assessors across Texas have been trained and certified in conducting standardized research assessments to collect data on psychiatric diagnoses, depression, suicide, and trauma. TX-YDSRN research staff have been trained and certified in research methodologies and data collection and management.
Aims
Develop the TX-YDSRN Participant Registry to collect data to characterize a sample of youth with depression and/or suicidal ideation or behavior to build predictive models for treatment outcomes trajectories of disease course and treatment selection to benefit youth with depression and/or suicidal ideation or behavior.
Methodology
Youth patients of participating TX-YDSRN clinics (ages 8-20) and their parents are being recruited for participation in the TX-YDSRN Participant Registry Study.
Upon informed consent/assent, baseline data is collected regarding mood symptoms, suicidal ideation and behavior, associated comorbidities, treatment history, services use, and social determinants of health. Youth participants and parents are sent monthly measures. Additionally, measures are given at provider visits to support delivery of measurement-based care within the clinics.