• Vicky Stergiopoulos, Agnes Gozdzik, Jason Tan de Bibiana, Tim Guimond, Stephen W Hwang, Donald A Wasylenki, and Molyn Leszcz.
• Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Canada. vicky.stergiopoulos@camh.ca.
• Bmc Health Serv Res. 2016 Aug 24; 16 (1): 432.

BackgroundFrequent users of hospital emergency departments (EDs) are a medically and socially vulnerable population. This article describes the rationale for a brief case management intervention for frequent ED users with mental health and/or addiction challenges and the design of a randomized trial assessing its effectiveness.Methods/DesignEligible participants are adults in a large urban centre with five or more ED visits in the past year, with at least one prior visit for a mental health or addictions reason. Participants (N = 166) will be randomized to either 4 to 6 months of brief case management or usual care, and interviewed every 3 months for 1 year. Consent will be sought to access administrative health records. A subset of participants (N = 20) and service providers (N = 13) will participate in qualitative data collection.DiscussionAddressing the needs of frequent ED users is a priority in many jurisdictions. This study will provide evidence on the effectiveness of brief case management, compared to usual care, on reducing ED visits among frequent ED users experiencing mental health or substance misuse problems, and inform policy and practice in this important area.Trial RegistrationClinicalTrials.gov Identifier: NCT01622244 . Registered 4 June 2012.

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