Suite of telehealth tech tools seek to support addiction treatment
By Jason LangendorfSeptember 18, 2020
More than half of Americans suffer from a mental illness at some point in their lives, and most commonly that illness takes the form of depression. Often, those in need of care won’t seek it out or don’t receive treatment because of a perceived stigma around mental health, a lack of resources, or uncertainty about where to find help.
IntelliCare is attempting to bridge that gap and help ease the burden on caregivers with a suite of apps designed to assist depression and anxiety patients in recognizing and managing their symptoms. Because mental health is closely related to addiction—20% of Americans with anxiety or a mood disorder suffer from substance use disorder (SUD), and vice versa—IntelliCare’s app suite may also have implications for those suffering from addiction.
In an eight-week clinical trial conducted at the University of Arkansas, using a combined clinician- and self-referred patient population, researchers found that IntelliCare “achieved greater reductions in depression and anxiety and higher odds of recovery compared with treatment-as-usual wait list control individuals, and effects were sustained at follow-up. Engagement with apps was high throughout the intervention period.”
Because mental health is closely related to addiction—20% of Americans with anxiety or a mood disorder suffer from substance use disorder (SUD), and vice versa—IntelliCare’s app suite may also have implications for those suffering from addiction.”
Andrea Graham, Ph.D., assistant professor of medical social sciences and preventive medicine at Northwestern’s Feinberg School of Medicine, was a co-author of the study, the third trial in the project and first featuring a control group. She was encouraged by the effectiveness of the app suite in improving individual patient symptoms, as well as its implications for supporting caregivers and care systems.
“What was really innovative about this project is, to our knowledge, it’s the first evaluation of mobile apps in primary care,” says Graham, whose Northwestern colleagues developed IntelliCare. “And the reason that’s really important and potentially relevant for other mental health problems as well is that primary care is the de facto site where people present with mental health problems. As a result, it’s an opportunity to help alleviate some of that burden of the number of people who present with mental health problems through scalable mechanisms like apps.”
How the App Works
A patient, who may or may not have been referred, downloads the free IntelliCare Hub app (from the Apple App Store or Google Play Store). They fill out a questionnaire to establish a baseline mood and levels of worry and stress, and they can then begin browsing the suite’s resources. There are additional supporting apps—Daily Feats, Day to Day, My Mantra and Thought Challenger—as well as “lessons on self-care and helping others” and a “Get Help Now” link in case a patient needs urgent help.
“The reason the approach is really innovative is, typically you have one app for your mental health needs,” Graham says. “But the way this intervention was envisioned is that actually people engage with their phone differently than that.”
Graham compares the interaction to how a traveler might use their phone on a vacation: a weather app to decide what to pack, an airline app for tracking flight times, a rideshare app for getting to the hotel, and so on.
“It was really designed with the user in mind,” says Carolyn J. Greene, PhD, associate professor at the Center for Health Services Research and Psychiatric Research Institute (PRI) at the University of Arkansas for Medical Sciences, and another co-author in the study. “It’s structured the way that we actually use apps, and so it doesn’t require the user to learn a whole new different way of interacting with their device. It’s really intuitive.”
Although anyone can download and use IntelliCare’s features, study patients received some initial and ongoing coaching from a care manager (which would require a clinician’s referral and reimbursement through the healthcare system in a real-world setting).
Apps May Help Address U.S. Health Disparity
Greene believes engagement and accountability are important elements in the effectiveness of technology-based interventions, but she considers any interaction with a platform like IntelliCare a step in the right direction toward connecting underserved populations with care and addressing the “health disparity across the country.” She also believes it could be applied to SUD treatment.
“I think that there are some elements of it now that could be very helpful for people with substance use disorders, and I think there could be additional components that are more specific to those kinds of skills,” Greene says.
“It’s about having someone there to easily reach out to with bumps in the road. It’s about knowing what is it that you need to do on a daily basis and getting positive reinforcement for that.”
Photo: Barry Weatherall