A Deep Dive: Working to Reduce Suicidality with An End-To-End Safety System

In May, we announced that of the patients who come to Cerebral with suicidal ideation (SI), 49.7% no longer harbor suicidal thoughts after treatment for an average of 6 months. Since publishing that data, there has been a lot of interest in this study, and we wanted to provide additional insight and call attention to its significance.

We conducted an analysis of the “before” and “after” results of 60,000 patients’ responses to the PHQ-9, the gold standard assessment scale for depression severity. Our data scientists examined all Cerebral patients’ responses from their initial intake through the present to determine if they reported an improvement in their experience of having suicidal thoughts. We found that 49.7% of these patients had indeed reported lower levels of SI at present compared to where they were during their initial intake appointment. 

Intuitively, this data makes sense. At Cerebral, we are committed to providing our patients with high-quality care that improves their overall mental wellness, and many of our programs strive to find ways to actionably decrease SI. For example, we recently conducted a randomized quality improvement study in which we compared targeted interventions (text messages, phone calls, etc.) aimed at improving follow-up care for patients who express SI. We found that patients who received a caring text scheduled a follow-up in less than half the time compared to those who didn’t receive the text, indicating that proactively reaching out to patients can be critical in improving patient engagement and health outcomes. 

However, it is also important to note that these data points are preliminary, and our findings still need to be validated further. Suicidal thinking is not static, and fluctuates with time, so it will be important to determine which specific factors are driving this decrease in suicidal thinking. In terms of next steps, we will work with leading researchers at Harvard to better understand and establish causality, and we are working to get our work published in peer-reviewed journals.   

Still, gathering and analyzing data like this is an important first step in measuring mental health issues and treatment. Typically, the vast majority of traditional mental health providers do not keep records of clinical outcomes, much less data on suicidal thinking, in a systematic way. Our early results can start to improve our understanding of how our patients think and feel over time, allowing us to track the level of suicidal thinking, or suicidal ideation, they are experiencing as well. 

In the past, we’ve asked many clinics a simple question: do you continually track the level of suicidality for your patient panels? 100% of responses were ‘No’. Some say they don’t have the technology, and others candidly reported that they are worried about legal liability: you can’t be liable for what you don’t know. This is a problem. We believe that sharing this kind of self-reported patient wellness data is critical to advancing our profession and advancing outcomes for patients. 

The U.S. mental health system is failing patients, in large part because patients continue to be evaluated only subjectively, when objective measures do exist. We are working to establish a baseline where no baseline exists.

This is actually a topic we hope to discuss at SXSW early next year. Data from this preliminary study, and other studies like it, can help advance precision psychiatry – which will improve the standards of care in the mental health industry by personalizing treatment, reducing suffering, and saving lives.

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National Suicide Prevention Hotline:
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Text Home to 741-741
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