Use of telehealth platform linked to higher remission rate of suicidal ideation
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Those who received psychiatric care through a telehealth platform saw a greater level of remission in suicidal ideation after 12 weeks compared with those who did not receive similar care, researchers reported in JMIR Formative Research.
“Suicide is a leading cause of death in the United States, and suicidal ideation is a significant precursor and risk factor for suicide,” Mirene Winsberg, MD, of Brightside Health Inc., a company in San Francisco that provides tele-psychiatric care, told Healio. “However, telehealth solutions have not traditionally been equipped to treat those with suicidal ideation as they often lack the structure, clinical protocols, and oversight necessary to provide safe, effective treatment to patients with severe symptoms.”Researchers aimed to examine the impact of tele-psychiatric care on changes in suicidal ideation over time and remission.
Winsberg and colleagues conducted a longitudinal observational study, which utilized patient records from Brightside to include 8,581 U.S.-based adults (8,366 in the treatment group and 215 in the control group) seeking treatment for depression, anxiety or both, between October 2018 and April 2021.
Those in the treatment group had completed at least 12 weeks of treatment and received a prescription for at least one psychiatric medication during the study period. Those in the control group completed initial enrollment data and completed surveys at baseline and 12 weeks but did not receive care. Participants additionally received decision support at treatment onset via Brightside’s digital platform.
Participant responses to item 9 of the Patient Health Questionnaire-9 were used as a gauge for severity of suicidal ideation (SI). Follow-ups were conducted at week 12 of treatment or any time before week 16.
Results showed that greater feelings of hopelessness, anhedonia and feeling bad about oneself were most significantly correlated (r = 0.24-0.37) with SI at treatment initiation. Sleep issues and feeling tired or having low energy, although significant, had lower correlations with SI (r = 0.13-0.14). Although not different at baseline, the SI expression was evident in 34.4% (74 of 215) of the participants in the control group and 12.32% (1,031 of 8,366) of the participants in the treatment group at 12 weeks.
Data additionally revealed those in the treatment group were 4.3 times more likely (OR, 4.31; 95% CI, 2.88-6.44) to have complete SI remission than those in the control group. Women and those with advanced education beyond high school were approximately 1.4 times more likely (OR, 1.38; 95% CI, 1.18-1.62) to remit than their counterparts.
“Overall, the study underscores that a telehealth platform with embedded clinical decision support like Brightside can be effective in addressing and reducing suicidal ideation, in addition to underlying symptoms of depression,” Winsberg told Healio.