Following the COVID-19 pandemic, the rising tide of mental health concerns—particularly among children and adolescents—has been a major focus in the industry.
But it's not a new problem. Behavioral health needs have been on the rise for some time, and that's why in 2018 the team at Elevance Health's Carelon established the Suicide Prevention Program, which deploys data and predictive models to identify people at risk sooner and avoid potential self-harm or suicide events.
Suicide is the second-leading cause of death for young people, and rates have increased by 56% in the last 20 years. Through the prevention program, Carelon saw a reduction of more than 20% in suicidal events among adolescents and young adults with commercial coverage.
In addition, this corresponded to a 30% decrease in per member per month behavioral health spending.
Jessica Chaudhary, M.D., a medical director at Carelon Behavioral Health, told Fierce Healthcare said that nearly 4,200 members have engaged with the program, and it's seen a 16.2% net drop in self harm, which equates to 678 fewer people attempting suicide per year.
"We saw a problem and we really wanted to make a difference," she said. "We created this program to offer an intervention proactively to prevent these devastating types of attempts and events from occurring so we could really change the trajectory of somebody’s life for the positive."
The program initially launched to reach patients between the ages of 12 and 26 but was expanded in 2021 to include children aged 10 and 11, Chaudhary said.
The program's predictive analyses are based on several risk factors ranging from substance abuse to specific behavioral health diagnoses to inpatient mental health stays.
Chaudhary said individual symptoms are also often indicators—a recurring headache, for example. Certain physical health conditions, such as asthma, are also linked to increased suicide risk, she said.
"Psychiatric symptoms can often present in the body," Chaudhary said.
Once a patient is identified to be at risk for a suicide attempt or event, their case managers are brought into the fold and they're connected with peer wellness and recovery specialists, who have experience themselves in managing mental health issues.
The patient is provided resources to manage their condition more proactively, Chaudhary said, and armed with tools they can use to manage challenges like stress and anxiety or to identify unhealthy relationships that may be making their mental health worse.
Chaudhary said young people are especially vulnerable to mental health challenges as their brains are still in development, they have lower impulse control than adults and they face a slew of societal pressures that can make things worse.
Social media, for example, is a major factor in the equation. The surgeon general issued an advisory in May about the effect that social media has on youth mental health, warning that adolescents who spend three hours or more per day using social media face double the risk of poor mental health outcomes.
Young people also tend to be self-reliant and may hesitate to reach out if they're having problems, Chaudhary said. Behavioral health care is also still stigmatized, and increased isolation caused by COVID-19 is also driving this rising tide of mental health issues.
Chaudhary said the tide will continue to push toward bringing more patients in need into the program, as the growing conversation around behavioral health won't fade anytime soon.
"We really began to think about how, as a payer, we could respond and try to intervene," she said. "It’s really become a national crisis now."
If you are experiencing suicidal thoughts or need help for a friend or loved one, call the national Suicide and Crisis Lifeline by dialing 988 to receive professional, confidential support 24 hours a day, seven days per week.