Communicating Care with the Vulnerable and At Risk

Communicating Care with the Vulnerable and At Risk

With 95% of Americans already connected through mobile phone , and deaths from drug overdoses and suicide rising, there’s an obvious opportunity to take advantage of mobile technology to help change the direction and improve these mortality trends. 


There are numerous factors that prevent individuals at risk of suicide from seeking help. Of them, stigma around mental health is a big one. Related to that sense of stigma is the belief therefore that, unlike physical health, mental health warrants self-help. 


Shame is a variation of stigma that stops people from getting, or continuing, treatment and professional help. In this particular group, males and young people below the age of 25 are the most at risk. 


Another contributing factor that affects seeking of help is inaccessibility to care, either because of location or exacerbated by the lack of awareness regarding mental health support services and the treatments available for it. Research has identified geographical isolation as an obvious but important physical barrier to seeking help for those at risk of suicide. Added to all that, negative prior experiences with mental health care providers, and financial difficulties have also been cited as barriers for seeking mental health related care. 


Numbers to Be Concerned About The CDC’s very recent key findings from the 2017 U.S. mortality data on deaths and death rates paint an increasingly scary picture: 

  • Life expectancy for the U.S. population dropped to 78.6 years old in 2017. There has been a steady drop since 2014. 
  • The age-adjusted death rate increased by 0.4% from 728.8 deaths per 100,000 standard population in 2016 to 731.9 in 2017. 
  • Age-specific death rates increased from 2016 to 2017 for age groups 25–34, 35–44, and 85 and over, and decreased for the age group 45–54. 
  • The 10 leading causes of death in 2017 remained the same as in 2016. 
  • Heart disease and cancer remain the leading major causes of death, followed by “unintentional injuries”. And the main driver of that? Drug overdoses. 


Suicide remains in the top 10 leading causes of death, and has steadily increased at the rate of 33% from 10.5 to 14.0 per 100,000 since 1999. 


According to Robert R. Redfield, M.D., Director of the Centers for Disease and Control Prevention, the most troubling aspect when it comes to the reduction of life expectancy in the US is that it is largely driven by increasing deaths from drug overdose and suicide. 


“Life expectancy gives us a snapshot of the Nation’s overall health and these sobering statistics are a wakeup call that we are losing too many Americans, too early and too often, to conditions that are preventable,” the CDC director warned in a statement


Though complicated issues, drug overdoses and suicide are preventable. Given the mobile connectivity of a vast majority of Americans, and the advances in health technology, there is a great opportunity to leverage the two together. 


Digital Intervention to Suicide 


When it comes to suicide Intervention and prevention, individuals at risk who may not otherwise seek help in a one to one basis, have been shown to be more comfortable when a little more anonymous reaching out and/ or helped through mobile technology, being their cell phone.


As cited in a recent study, “A survey in a psychiatric out-patient setting reported that 69% of respondents and 80% of those aged 45 years or younger indicated a desire to use a mobile application to track their mental health.” 


“mHealth or mobile health as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices. mHealth involves the use and capitalization on a mobile phone’s core utility of voice and short messaging service (SMS) as well as more complex functionalities and applications including general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology.” - World Health Organization’s Global Observatory for eHealth 


Mobile Health innovation have gone well beyond the collection of patient information and data through an app. Patient engagement platforms that connect to a multitude of devices can be used for more immediate outreach/responses, personalized interactions and delivery of relevant solutions. They can be used to process both quantitative data (vitals, activity tracking and biometrics) and qualitative data (patient reported outcomes, responses and moods) to result with more personalized interactions and insight.


In a study on “Digital Suicide Prevention: Can Technology Become a Game-Changer?”, researchers noticed that rapid advances in data science can provide useful tools for suicide prevention, and dynamically assess suicide risk in quantitative, data-driven ways.

LifeWIRE’s interactive communication platform provides numerous care options in behavioral health for patients dealing with PTSD, substance abuse, suicide to name a few: 

  • the patient chooses how he or she want to communicate 
  • automated check-ins on individual patients via text messages for ongoing mental health support 
  • personalized and relevant communication and motivational messages 
  • responses, or non-responses as the case may be, can alert mental health providers, counselors, loved ones and/or peers to reach out to patients to provide additional support. 


So for at-risk individuals who don’t want in person interaction or opt out of face-to-face consultations, care can still be provided personally and remotely. 


“Young people in particular also cite a preference for self-management as a major obstacle to help-seeking for self-harm from clinical services,” said Katrina Witt in her study on the “Effectiveness of online and mobile telephone applications (‘apps’) for the self-management of suicidal ideation and self-harm: a systematic review and meta-analysis.” 


The same study found some evidence that digital interventions can result in reductions in suicidal ideation, particularly at the post-intervention assessment. 


Mitigating Drug Overdose through Health Platforms 



In dealing with patients, particularly those with regards substance abuse, engagement is paramount. Solutions meant to help will fail, and continue to do so, if all the elements and participants of the health ecosystem – the patient, the providers, the pharmacist and clinicians – are not engaged. 


Where telehealth, beyond its power to connect all those elements and various solutions in terms of monitoring, provides event-based solutions; being here is a problem and deliver a solution. What is equally important is patient monitoring, where you get a sense over time how a patient, or patient population is doing or not. Using their individual metrics and baselines as a basis to deliver to relevant telehealth solution if and when needed. That is the power of an interaction platform. 


Drug overdose in the U.S. has killed 70,237 Americans in 2017, up from 63,632 in 2016, according to a CDC report on Drug Overdose Deaths in the United States


The opioid crisis has accounted for the significant number of deaths per 100,000 population. According to the report in West Virginia, it’s 57.8 deaths; Ohio, 46.3; Pennsylvania, 44.3; and the District of Columbia, 44.0 - the highest observed age-adjusted drug overdose death rates in 2017. 


Solutions such as LifeWIRE’ platform provides can be used to monitor patient progress and adherence to drug protocols, “delivering” the patient to an appropriate telehealth solution as and when needed . This will be a key component in combating the opioid crisis, as discussed at the recent #OpioidTechBrief on Capitol Hill


In October, a panel on Health IT Innovation in combatting the Opioid Crisis was convened on Capitol Hill where Congressional members, staffers and public were briefed by major companies and organizations, including LifeWIRE, SureScripts and Centene regarding how innovative and collaborative technologies are and can be deployed to address the opioid crisis. 


A public health epidemic that kills 100 Americans every day needs a collaboration between all stakeholders, including technology-assisted solutions. Use of Health IT, according to the US Department of Health and Human Services (DHHS) has been demonstrated to improve compliance with opioid prescription guidelines; physician adherence to treatment protocols; and improve overall safety. 


This needs to continue, for the sake of Americans everywhere.


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