Note: This article deals with suicide. If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-8255.
Identifying someone’s risk for attempting suicide is one way of preventing it, according to the Suicide Prevention Resource Center.
“Suicide can be preventable,” says Dr. Jessica Chaudhary, medical director for national accounts at Anthem Blue Cross and Blue Shield (Anthem). Chaudhary, a psychiatrist by training, says that knowing who is at risk means you can reach out, connect with them and give them access to care and assistance.
Determining who is at risk, in time to make a difference, is the key.
Several risk factors are powerful predictors of a potential suicide attempt. Chaudhary and a team at Anthem launched a mental health wellness program that harnesses the power of data to quantify that risk and alert Anthem’s clinical team to reach out to at-risk members. If the team can connect with these individuals, they can offer resources to improve a member’s mental health and well-being, as well as compassionate human connection.
Chaudhary says that connection is with behavioral health case managers and peer recovery specialists, or people with lived experience with mental health crises.
Predicting the risk for a suicide attempt
The data-driven model examines health insurance claims going back two years for hundreds of potential risk factors. Those can include substance use, certain behavioral health diagnoses, inpatient mental health stays and prior suicide attempts. Using that data and a technique called predictive analytics, the model predicts who has at least a 10% risk of a suicide event or attempt in the next 12 months. That triggers a specially trained care management team to reach out proactively to support the member’s mental health and well-being and potentially reduce the risk of a suicide attempt.
The model in action: helping a transgender teen develop a safety plan
Chaudhary says the program helped identify a 14-year-old transgender boy who was struggling with depression, anxiety, suicidal ideation and thoughts about self-harm. Anthem’s team reached out to the patient’s mother for permission to engage him in the program. Speaking by phone, care managers offered education about depression and anxiety. They helped the teen develop a safety plan. And they connected him to therapy, as well as gender identity resources. After working with care managers, the teen reported feeling empowered and hopeful. He felt stronger having a safety plan to follow if he felt in danger of harming himself.
He is just one example of dozens who have benefited from the program.
Promising early results mean the program could be scaled up
To determine whether the program had reduced suicide attempts, analysts looked at member data before and after enrollment in the program.
- 124 members enrolled: A preliminary analysis included 124 members who remained enrolled in an Anthem plan long enough to analyze the impact of the program.
- Approximately 50% reduction in suicide attempts: The reduction accounts for a participant’s suicide attempts before the program vs. during and after the program. Of the 124 people enrolled, 33 people had a suicide attempt before the program. During and after five months’ involvement in the program, 16 members attempted suicide.
These early but promising results led Anthem to expand the initiative to select markets, including California, Georgia, and New York, and select membership ages 10 and older within its Commercial, Medicare, and Medicaid plans.
Responding to a devastating trend
“We started this work in 2018 in response to rising rates of suicide among adolescents and young adults,” says Chaudhary. “We needed a robust mental health wellness program with an overarching goal to reduce suicide and suicide rates. Addressing mental health is a critical part of our overall approach to care for the whole person.” What they found, she says, was that they could potentially identify someone at risk and intervene five months before a suicide attempt. “That’s what our data told us, that we had this window of time to offer an intervention and try to change the trajectory.”
Anthem’s team is refining the model and evaluating outreach efforts. They continue to measure rates of depression and anxiety with evidence-based screening tools. Over time, they have seen those depression and anxiety scores decrease.
“My personal hope for this is that we can really use the type of data-driven insights we’ve been able to develop at Anthem and bring the right type of care to everyone who needs it,” says Chaudhary. “If we can identify people at high risk for these devastating types of attempts, intervene and help someone onto a safer path, I don’t know what could be better than that.”
Anthem Blue Cross Blue Shield is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.