Digital health fills care gaps for mental health patients
Comprehensive Mental Health Services in Independence, Missouri partnered with mental health IT vendor myStrength, a digital behavioral healthcare platform to help patients seeking support and care for identified behavioral health needs and struggling with the time in between appointments.
From a treatment perspective, CMHS providers were seeking to address some common questions: Do patients have adequate support and tools to incorporate skills into their daily life to better manage symptoms and stressors between visits? And at the next appointment, were patients able to accurately report or recall severity of symptoms, moods and triggers?
"It’s imperative that treatment goals are unique to every individual and that they are being met where they are at, at that time," said Gina Armitage, director of quality and compliance at Comprehensive Mental Health Services.
Mental health technology vendors include AbleTo, Psychiatry-Cloud, Quartet and Valant. Mental health is no different than physical health in its need for IT to support improved healthcare, which is why CMHS turned to myStrength with its evidence-based, self-care interventions that address depression, anxiety, stress, substance use, chronic pain, opioid risk management and sleep challenges.
myStrength can be individualized, allowing the patient to create a space specific to them, their needs, their thoughts and concerns, Armitage explained. In combination with their provider and therapeutic relationships, they can use the platform to become the driver of their treatment.
"Since incorporating the platform, our agency has found that not only is this valuable within a one on one session, it is also exceptionally beneficial for those clients in the group setting," she said. "The group educator can sign in to their professional account and pull up videos and/or utilize worksheets to be incorporated to that specific group curriculum, also encouraging individual utilization."
Patients can us a computer, tablet or smartphone to access the platform and begin by identifying questions, personal to them. This includes current symptoms, stressors and areas in their life that they want to improve. There’s also a referral option to support patients who benefit from increased support.
Further, the referring staff can have the first steps of the process emailed to them.
Armitage offered an example of how the platform worked with one patient.
"She came in presenting with symptoms of depression, anxiety and panic attacks. She had been a caregiver to her partner for many years and had not been focused on taking care of herself. This patient, at the time of intake, had some serious health conditions and was a current smoker averaging a pack of cigarettes per day."
She began individual therapy and medication services. When the patient was introduced to myStrength, she had some hesitation at first, as the idea of a technology-based tool was intimidating to her. She was open to giving it a try and began using it within her therapy sessions and at home.
"After approximately three months of incorporating the platform into her treatment, she was able to start taking control over her life," Armitage said. "She was tracking her symptoms every day and at the end of every week, reviewing her symptom and mood trackers. She created a personal binder where she stored completed modules and exercises."
She logged in to her account during therapy to get a clear and accurate picture of how the previous two weeks had been since her last appointment, Armitage recounted.
Mindfulness and deep breathing were two primary practices that became significant toward her well-being, she explained. She incorporated these into her daily life, initially to take time for herself. But it’s since become habitual and helps her re-focus throughout the day.
In addition to using the resources available for her mental health needs, she also used those specific resources for her physical health. She was able to quit smoking in two months without the use of any nicotine replacement therapies, Armitage said. She began to incorporate more physical exercise into her life as well.
"The patient's therapist would always check in on the use of myStrength, and at the beginning of every session, would start with a mindfulness exercise," Armitage said. "This supported the integration of the platform into the patient's treatment. She has since met her therapy goals and completed individual therapy."
By the numbers
"Currently, 70 percent of users scoring with clinical levels of depression report improvement and across all users there is an average of 42 percent reduction in depressive symptoms," Armitage said. "Additionally, 45 percent of users scoring with clinical levels of anxiety report improvement and across all users there is an average of 25 percent reduction in anxiety symptoms."
The clinic also has seen success with the platform in its substance use disorder program. Currently, that program makes up 66 percent (357 out of 538) of patient accounts.
"The SUD program offers education groups that many of the incoming patients attend," Armitage explained. "The platform has been incorporated in a specific group. When a client attends this group, they are able to sign up for their account with staff support if needed. During this group, the client is shown how to access myStrength and explore all the resources and educational materials available to them, supporting their individual goals."
Since the implementation of the mental health platform, the clinic began tracking the use of the platform and the correlation between successful outcomes and key performance indicators. For the SUD program, it reviewed the data for those patients who used the platform compared to those who did not.
"Based on that data, 46.5 percent of patients who used the platform successfully met treatment goals at discharge and 18.03 percent of patients who did not use the platform had successfully met treatment goals at discharge, indicating a substantial difference in outcomes," Armitage said.