Researchers conducting a pilot study using a novel automated assessment and telehealth technology for behavioral health integration as a model for suicide prevention reported a 73% reduction in suicide severity among patients at an outpatient mental health clinic, according to study results recently presented at Psych Congress 2021, held from October 29 to November 1, 2021, in San Antonio, Texas.
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According to the researchers, suicide is among the top 10 leading causes of death for people in the United States and the second cause of death for young people between ages 14 and 25. Currently, reported rates of attempted suicide are at an all-time high. Individuals in outpatient psychiatric care settings are particularly at risk. During times of pandemic, assessment, monitoring, and intervention can be inaccessible to these individuals, as well as time-laborious and cost-prohibitive, the investigators indicated.
In response to this public health risk, the Ikare Mood, Trauma, and Recovery Clinic created the Behavioral Health Integration Program (BEHIP), a care model that leverages telehealth visits and automation in assessments to reduce common obstacles to psychiatric care and offers targeted treatment for individuals reporting suicidal ideation. BEHIP employs Ellipsas, a novel, automated, digital psychometric platform created to assess and monitor patient symptom states between appointments. The BEHIP benefits patients at risk for suicide. At the same time, BEHIP also helps clinicians regain time and insight during appointments and collaborate more effectively across interdisciplinary teams to improve risk detection, deploy early intervention, and, therefore, provide protective care to patients with suicidal ideation.
A pilot study of the BEHIP treatment model included 83 patients who were first monitored and assessed upon enrollment through 11 nationally recognized and validated clinical scales and measures, such as the General Anxiety Disorder (GAD)-7 for anxiety and the Patient Health Questionnaire (PHQ)-9 for depression. Patients reporting suicidal ideation were prioritized for once-a-month, 30-minute telehealth sessions focusing on behavioral wellness. Suicidality was measured using Ellipsas’ suicide scale, which is in the process of being confirmed and validated using the Columbia-Suicide Severity Rating Scale. Target interventions for patients with suicidal ideation included psychoeducation topics such as mindfulness, sleep hygiene, and brief cognitive behavioral therapy.
The 83 of 88 patients who were analyzed for study results were enrolled in BEHIP after being referred for suicidal ideation. These patients had a minimum of 2 Ellipsas assessments completed and an average of 5.4 BEHIP visits. Five patients were excluded from analysis for not having 2 Ellipsas assessments. Patients showed a 73% decrease in suicide severity (Ellipsas Suicide Score: 3.97+/-0.62 vs 1.07+/ 0.38; P =.0001), a 30% decrease in depression severity (PHQ-9: 13.99+/-0.75 vs 9.78+/-0.66, P =.00004), and a 31% decrease in anxiety severity (GAD-7: 12.31+/-0.67 vs 8.53+/-0.61, P =.00005).
The study investigators concluded that “intervention can be offered as little as once per month and still show efficacy in patient benefit via reduction in suicidal ideation and possibly other domains. In a time when suicidal ideation is often thought of as a required liability measure achieved through time-consuming and traditional safety planning, perhaps outpatient psychiatry providers can instead pivot to a model of integrating behavioral assessments and activation in a collaborative care model with the patient.”