Suicide is the 11th leading cause of death in the United States. According to the CDC, 130 Americans die every day by suicide, about one every 11 minutes. Our ever-shrinking mental health professional workforce continues to decline, while demand for mental healthcare has never been more acute. We are in critical need of highly scalable suicide prevention solutions. The last several years have seen a wide array of digital mental health solutions. Still, unfortunately, the vast majority of virtual mental health services only treat patients with low-to-moderately severe conditions. This critical gap in care leaves lives at risk and increases healthcare costs due to avoidable ER visits and hospitalizations.
Traditional brick-and-mortar solutions to suicidality are not optimal. A single emergency room visit cannot properly treat suicidal ideation. The literature consistently shows that it takes at least six therapy sessions to reduce ideation, which only highlights the need for scalable solutions. While the emergency room can provide much-needed care for those in crisis, there are degrees of crisis care that are not accounted for. There is far too much demand for services, and the emergency department can not cover all patient needs. This is where digital mental health solutions fill in the gaps between standard outpatient treatment and crisis care in an ED. Creating plans for universal screening and supplementing this with effective treatment plans can drastically improve the lives of millions of Americans.
COVID-19 presented new complications to mental health, such as increased isolation, higher rates of substance abuse, family conflicts, and social media use. These factors affect people differently, resulting in higher rates of depression and suicidality in youth. Studies show that adolescence is characterized by an increased need for peer interaction, which can make isolation more harmful. Additional research shows that adolescents are more likely to act on impulse and engage in risky behavior.
Gender differences must also be taken into account when determining how to administer care. While 3/5 of adolescent girls feel persistently hopeless, in 2021, men’s suicide rates were four times higher than women’s. When determining where to increase access to mental health services, it is crucial to consider which groups are underserved to truly address the shortage of services. 45% of LGBTQ youth contemplate suicide, which is twice the amount seen in youth overall. Programs need to be customized to meet the unique needs of people.
Simply treating those already in crisis is not enough to effectively address high rates of suicide. An increase in mental health screenings is necessary to identify if a patient is experiencing symptoms of depression before they ever reach a point of crisis. While the shortage of mental health professionals can pose complications to extending care beyond its current scope, it is necessary to address the root causes in order to have effective treatment. Technology helps automate and streamline workflows with respect to screening. Natural Language Processing (NPL) and Artificial Intelligence (AI) technologies such as Crisis Care by Brightside and NeuroFlow can increase the rate of patients screened and provided with services without drastically increasing the need for personnel.
How exactly do digital mental health services treat patients at higher risk for suicide? NeuroFlow and Crisis Care by Brightside are able to integrate crisis care into a patient’s existing healthcare system. NeuroFlow uses combined suicide prevention technology and compassionate human outreach to identify and support at-risk individuals before a crisis occurs. At-risk individuals are identified through regular, remote assessments through AI-powered severity scoring models and Natural Language Processing (NLP). If triggered, the suicide prevention technology alerts the care team and immediately delivers crisis resources to the individual within the app. If care teams don’t have the necessary staff to perform these interventions, NeuroFlow’s Response Services team will reach out to at-risk individuals and help connect them to the resources they need. Suppose therapy, psychiatry, or treatment from other behavioral health specialists is the next best step. In that case, NeuroFlow works with partners who provide these services and accept a wide range of insurance plans. This referral process can also incorporate and prioritize any partners or resources an organization has already invested in.
Crisis Care is specifically designed for individuals with elevated suicide risk, including those who are actively suicidal and/or have had a recent suicide attempt and those needing follow-up care after hospitalization. This program delivers medically necessary care to patients often excluded from outpatient treatment (both in-person and telehealth) because of elevated risk. Brightside offers both psychiatric and therapeutic services to best address one’s situation. The combination of their standard treatment and the Collaborative Assessment and Management of Suicidality (CAMS) allows them to identify, target, and treat patient-identified suicidal drivers and triggers. Patients with elevated suicide risk access specialized treatment quickly and begin a structured, time-limited program that lasts between 4-12 weeks and requires them to be actively involved in their treatment. Patients are matched with a dedicated CAMS-trained clinician and provided with escalation pathways to follow-up treatment when a patient requires a higher level of care, as well as step-down pathways once the patient is no longer at risk.
Both services emphasize the integration of crisis care into standard mental health treatment. Training existing mental health professionals in these crisis care techniques can ensure that no patient falls through the cracks. Not all providers have sufficient skills and resources to develop treatment plans or next steps. Considering existing mental health professionals alongside new technologies in this strategy for expanding crisis care is vital.