Suicide remains a leading cause of death, with one death occurring every 11 minutes in the U.S., according to the CDC. At the same time, only half of those with a mental health issue receive treatment.
I recently spoke with Brad Kittredge, CEO, and co-founder of Brightside Health, a telemental healthcare company serving patients on the higher end of the clinical spectrum, including those at elevated risk of suicide. We dug into startling mental health challenges facing our society and how telehealth can bridge many of the treatment gaps.
Gary Drenik: We know declining mental health is a pervasive problem nationwide, and suicide rates are on the rise. Is our healthcare system doing enough to support these needs?
Brad Kittredge: While mental health awareness has grown in recent years, our current healthcare system falls far short of our needs. We’re experiencing a mental health crisis. According to a recent Prosper Insights & Analytics survey, nearly 24% of U.S. adults live with anxiety and 21% have depression. The CDC reported more than 48,000 deaths by suicide in 2021, and over 12 million Americans seriously consider suicide each year. The statistics for youth mental health are even more terrifying: half of adolescents are estimated to have a mental health disorder, and suicide rates have increased 52% for those aged 10-24 between 2000-2021.
If you look through the clinical lens, there are several issues that exacerbate the healthcare industry’s inability to properly treat patients at risk for suicide. This includes a nationwide mental health provider shortage, which is particularly severe among providers who have the training and tools to support patients at elevated risk of suicide. As a result, those who need timely and specialized life-saving care either have an extremely hard time getting it or don’t get care at all.
Drenik: How is Brightside Health addressing the epidemic, and why are you investing in severe mental health issues, like supporting those with elevated suicide risk?
Kittredge: Two members of our founding team lost a parent to suicide, and we’ve all seen people we love struggle to get the mental health care they need; so, we created Brightside to raise the bar on care quality and access for those who need it most.
We also know that patients on the higher end of the severity and acuity spectrums are driving a growing share of costs in the healthcare system, including rising rates at the emergency department (ED), inpatient stays, and overall cost of care. This is where technology-enabled telehealth presents an opportunity to provide timely and highly impactful care to these individuals, improving their clinical outcomes and reducing costs.
In many cases, individuals referred to Brightside Health are either at elevated risk for suicide or are stepping down from acute settings like the ED or psychiatric inpatient stays. Our Crisis Care program delivers an evidence-based approach that’s proven effective at reducing suicide risk among these individuals, lowering costly admissions and readmissions.
Drenik: Is telehealth truly equipped to provide care for those on the higher end of the severity and acuity spectrum? How do you know it’s actually safe and effective?
Kittredge: Nearly 50% of Brightside Health members start their care with suicidal ideation, and we’ve treated tens of thousands of individuals in this situation. We published our peer-reviewed results in JMIR Formative Research in 2022, showing that 77% of members who start with suicidal ideation no longer report any suicidal thoughts after 12 weeks of treatment – an impact 4.3 times higher than a control group. The data reinforces the additional nine peer-reviewed studies we have currently published – demonstrating that telehealth can be safe and effective if done right. This research also gave us the confidence to develop Crisis Care, knowing we could serve individuals with elevated suicide risk.
With Crisis Care, we built the program to align closely with the Collaborative Assessment and Management of Suicidality (CAMS) framework, which is backed by 30 years of clinical research and five randomized controlled trials. CAMS has been proven to quickly decrease suicidal ideation, suicide attempts, and self-harm behaviors and it’s shown to work seamlessly on the Brightside Health platform.
Drenik: How might telehealth and traditional providers work together to better meet patient mental health needs?
Kittredge: We’re seeing the accelerating signals of traditional providers and telehealth working closer together to deliver vital care to patients. Having a reliable, specialized mental health care partner allows providers to more confidently screen for mental health issues and refer patients to higher levels of care as needed.
Across our practice, we partner with health systems, payers, managed care organizations, and other mental health providers to ensure better care continuity for those individuals with severe depression and elevated suicide risk. For example, we collaborate closely with care coordinators at our payer partners who are working to seamlessly place members in the right level of care. We also work closely with ED and psychiatric inpatient discharge planners at our health system partners to ensure timely and effective step-down care. As a result, patients get more effective, coordinated support from their entire care team while payers and providers reduce readmissions and achieve improved quality scores.
People are still slow to seek help for mental health needs due to long-standing stigma. Evernorth recently published a study showing that, on average, people wait 11 years between their first symptoms and getting care for a mental health condition. Once they do seek help, they are often looking at monthslong waitlists. We must do a better job of screening for mental health at other appointments (e.g., primary care and OB-GYN visits) to create more opportunities for open dialogue between patients and providers. This is especially important as these settings are more heavily trafficked: 52% of respondents prefer to visit their family doctor versus 7% who prefer telemedicine services for initial care, according to a recent Prosper Insights & Analytics survey. These are the frontlines where providers can scan for – and mitigate – suicidal intent.
Drenik: It sounds like Brightside Health is doing really important work. What do you have your sights set on next?
Kittredge: We’re motivated by our mission of delivering life-changing mental health care to everyone who needs it. We’re now focusing on expanding access to include even more vulnerable populations, like Medicare and Medicaid recipients plus teens. We’re partnering closely with payers like United Healthcare, Aetna, and Cigna as well as Medicaid Managed Care Organizations to effectively support their member populations. We also collaborate with health systems, Accountable Care Organizations, and Community Mental Health Centers for seamless support.
We must reverse this suicide trend, and we’re working hard every day to ensure everyone has timely access to the high-quality mental health care they need.
Drenik: Thanks Brad, for your insights on the current mental healthcare landscape and your efforts to address the suicide epidemic. We look forward to seeing your impact.
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