Implementing and Analyzing the Advantages of Voice AI as Measurement-Based Care (MBC) to Address Behavioral Health Treatment Disparities among Youth in Economically Disadvantaged Communities
DOI:
https://doi.org/10.30953/thmt.v9.506Keywords:
AI, artificial intelligence, community behavioral health, digital mental health, health equity, Measurement-Based Care, MBC, pediatric trauma, TQIntelligenceAbstract
Only 20% of behavioral health providers use measurement-based care [MBC].1 Two reasons for MBC’s low uptake outcomes are a need for stronger consensus regarding optimal use (in both frequency and consistency) and the absence of a widely utilized data analytics infrastructure. TQIntelligence has built and implemented a measurement-based system for community behavioral health providers, which includes the use of a novel AI-enabled voice algorithm designed to provide psychiatric decision and triaging support to pediatric populations. The success of the implementation and related outcomes varied depending on the organization and the therapist's involvement in the pilot.2 This paper will contribute to the literature on measurement care and its effectiveness. It also challenges the dominant narrative that such systems are too complicated and ineffective in community behavioral health that serve children and adolescents from low-income communities.
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Boswell JF, Hepner KA, Lysell K, Rothrock NE, Bott N, Childs AW, Douglas S, Owings-Fonner N, Vaile Wright C, Stephens KA, Bard DE, Aajmain S, Bobbitt BL. The Need for a Measurement-Based Care Professional Practice Guidelines. Psychotherapy 2022; 60(1): 1-16. https://doi.org/10.1037/pst0000439
Alemu Y, Chen H, Duan C, Caulley D, Arriaga R, Sezgin E. Detecting Clinically Relevant Emotional Distress and Functional Impairment in Children and Adolescents: Protocol for an Automated Speech Analysis Algorithm Development Study. JMIR Research Protocols 2023; 12:e46970. https://doi.org/10.2196/46970
De Jong K, Conijn JM, Gallagher RA, Reshetnikova AS, Heij M, Lutz MC. Using progress feedback to improve outcome and reduce drop-out, treatment duration and deterioration: A multilevel meta-analysis. Clinical Psychologist Review 2021; 85: 102002. https://doi.org/10.1016/j.cpr.2021.102002
Sheftall AH. The Tragedy of Black Youth Suicide [Internet]. Washington (D.C): Association of American Medical Colleges; 2023 April 11 [cited 2024, Jan 5]; Available from https://www.aamc.org/news/tragedy-black-youth-suicide
Substance Abuse and Mental Health Services Administration. HHS Releases New National Guidelines for Improving Youth Mental Health Crisis Care. [Internet].[place unknown]: SAMHSA; 2022 November 10 [cited 2024, Jan 23]; Available from https://www.samhsa.gov/newsroom/press-announcements/20221110/hhs-releases-new-national-guidelines-improving-youth-mental-health-crisis-care
Ehlman DC, Yard E, Stone DM, Jones CM, Mack KA. Changes in the Suicide Rates-United States 2019-2020. Centers for Disease Control and Prevention 2022; 71(8): 306-312. https://dx.doi.org/10.15585/mmwr.mm7108a5
Bridge JA, Ruch DA, Sheftall AH, Hahm HC, O’Keefe VM, Fontanella CA, Brock G, Campo JV, Horowitz LM. Youth Suicide During the First Year of the COVID-19 Pandemic. Pediatrics 2023; 151(3): 1-15. https://doi.org/10.1542/peds.2022-058375
Hoffmann JA, Farrell CA, Monuteaux MC, Fleegler EW, Lee LK. Association of Pediatric Suicide with County-Level Poverty in the United States, 2007-2016. JAMA Pediatrics 2020; 174(3): 287-294. https://doi.org/10.1001/jamapediatrics.2019.5678
Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global prevalence of depressive and anxiety symptoms in Children and Adolescents during COVID-19: A Meta-Analysis. JAMA Pediatrics 2021; 175(11): 1142-1150. https://doi.org/10.1001/jamapediatrics.20212482
Substance Abuse and Mental Health Services Administration. Understanding Child Trauma. [Internet]. [place unknown]: SAMHSA; 2023, March 17 [cited 2024, Jan 5 ]; Available from https://www.samhsa.gov/child-trauma/understanding-child-trauma
Scott K, Lewis CC. Using measurement-based care to enhance any treatment. Cognitive and Behavioral Practice 2015; 22(1): 49–59. https://doi.org/10.1016/j.cbpra.2014.01.010
Harding KJK, Rush AJ, Arbuckle M, Trivedi MH, Pincus HA. Measurement-based care in psychiatric practice: A policy framework for implementation. Journal of Clinical Psychiatry 2011; 72(8): 1136–1143. https://doi.org/10.4088/JCP.10r06282whi
Fortney JC, Unũtzer J, Wrenn G, Pyne JM, Smith RG, Schoenbaum M, Harbin HT. A Tipping Point For Measurement-Based Care. Psychiatric Services 2016; 68(2): 179-188. https://doi.org/10.1176/appi.ps.201500439
Kemp K. Breaking the Stigma of Mental Health: Improving the quality of Mental Healthcare through telehealth and measurement-based care. Texas State Undergraduate Research Journal 2021; 9(i):8-17. https://txstur-ojs-txstate.tdl.org/txstur/article/view/12
Chokshi S, Senathirajah Y, Yadav V, Winsberg M, O’Callaghan E, Sullivan S, Verma A, Kachnowski S. A Comparative Evaluation of Measurement-Based Psychiatric Care Delivered via Specialized Telemental Health Platform versus Treatment as Usual: A Retrospective Analysis. Cures 2022; 14(1):2-9. https://doi.org/10.7759/cureus.21219
Keepers BC, Easterly CW, Dennis N, Domino ME, Bhalla IP. A Survey of Behavioral Health Care Providers on Use and Barriers to Use of Measurement Based Care. Psychiatric Service 2023; 74(4): 331-443. https://doi.org/10.1176/appi.ps.202100735
Koutsouleris N, Hauser TU, Skvortsova V, De Choudhury M. From promise to practice: toward the realization of AI-informed mental health care. Lancet Digit Health 2022; 4:e829-40. https://doi.org/10.1016/s2589-7500(22)00153-4
Henke RM, Zaslavsky AM, McGuire TG, Ayanian JZ, Rubenstein LV. Clinical Inertia in Depression Treatment. Medical Care 2014; 47(9): 959-967. https://doi.org/10.1097/MLR.0b013e31819a5da0.
Graham A, Depp C, Lee E.E., Nebeker C, Tu X, Ho-Cheol K, Jeste DV. Artificial Intelligence for Mental Health and Mental Illness: An Overview. Current Psychiatry Report 2019; 21(116). https://doi.org/10.1007/s11920-019-1094-0
Tutun S, Johnson M E, Ahmed A, Albizri A, Irgil S, Yesilkaya I, Ucar EN, Sengun T, Harfouche A. An AI-based Decision Support System for Predicting Mental Health Disorders. Information Systems Frontiers 2022;25: 1261-1276. https://doi.org/10.1007/s10796-022-10282-5
Roberts AL, Gilman SE, Breslau J, Breslau N, Koenen KC. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Medicine 2011; 41(1): 71-83. https://doi.org/10.1017/S0033291710000401
Rariden C, SmithBattle L, Yoo JH, Cibulka N, Loman D. Screening for Adverse Childhood Experiences: Literature Review and Practice implications. The Journal for Nurse Practitioners 2020;17(1). https://doi.org/10.1016/j.nurpra.2020.08.002
Hughes K, Bellis MA, Hardcastle KA, Sethi D, Butchart A, Mikton C. The effect of multiple Adverse Childhood Experiences on Health: A Systematic Review and Meta-analysis. Lancet Public Health 2017; 2(8): 356-366. https://doi.org/10.1016/s2468-2667(17)30118-4
Anderson AS, Siciliano RE, Henry LM, Watson KH, Gruhn MA. Adverse Childhood Experiences, Parenting, and Socioeconomic Status: Associations with Internalizing and Externalizing Symptoms in Adolescence. Child Abuse Neglect 2022; 125(105493). https://doi.org/10.1016/j.chiabu.2022.105493
Herzog JI, Schmahl C. Adverse Childhood Experiences and the Consequences on Neurobiological, Psychosocial and Somatic Conditions Across the Lifespan. Frontiers in Psychiatry 2018; 9(420):1-8. https://doi.org/10.3389/fpsyt.2018.00420
Kerker BD, Zhang J, Nadeem E, Stein REK, Hurlburt MS, Heneghan A, Landsverk J, McCue Horwitz S. Adverse Childhood Experiences and mental health, chronic medical conditions, and development in young children. Academic Pediatrics 2015; 15(5): 510-517. https://doi.org/10.1016/j.acap.2015.05.005
Bickman L, Athay MM, Riemer M, Lambert EW, Kelley SD, Breda C, Tempesti T, Dew-Reeves, SE, Brannan AM,Vides de Andrade AR. Manual of the Peabody treatment progress battery. [Electronic version]. Nashville, TN: Vanderbilt University 2010.
Riemer M, Athay MM, Bickman L, Breda C, Douglas Kelley S, Vides de Andrade AR. The Peabody Treatment Progress Battery: History and Methods for Developing a Comprehensive Measurement Battery for Youth Mental Health. Administration and Policy in Mental Health and Mental Health Services Research 2012; 39: 3-12. https://doi.org/10.1007/s10488-012-0404-1
Caulley D, Alemu Y, Burson S, Cárdenas Bautista E, Tadesse GA, Kottmyer C, Aeschbach L, Cheungvivatpant B, Sezgin E. Objectively Quantifying Pediatric Psychiatric Severity Using Artificial Intelligence, Voice Recognition Technology, and Universal Emotions: A Pilot Study for Artificial Intelligence-Enabled Innovation to Address Youth Mental Health Crisis. JMIR Research Protocols 2023; 12(e51913. https://doi.org/10.2196/51912
Finkelhor D, Shattuck A, Turner H, Hamby S. A revised inventory of Adverse Childhood Experiences. Child Abuse & Neglect 2015; 48: 13–21. https://doi.org/10.1016/j.chiabu.2015.07.011
Monnat SM, Chandler RF. Long-Term Physical Health Consequences of Adverse Childhood Experiences. Sociological Quarterly 2015; 56(4): 723-752. https://doi.org/10.1111/tsq.12107
Jha MK, Grannemann BD, Trombello JM, Clark EW, Eidelman SL, Lawson T, Greer TL, Rush JJ, Trivedi MH. A Structured Approach to Detecting and Treating Depression in Primary Care: VitalSign6 Project. Annals of Family Medicine 2019; 17(4): 326-335. https://doi.org/10.1370/afm.2418
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 2001; 16(9): 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Logroño Naranjo SI, Estrada Brito NA, Núñez Vásconez VA, Rosero Ordóñez EM. Analysis of the use of the Python programming language for Statistical Calculations. Espirales Revista Multidisciplinary de Investigación Cientifiica 2021; 6(2):1-10. https://www.redalyc.org/articulo.oa?id=573270857001
Institute of Medicine (US) Committee on Quality of Health Care in America. (Crossing the Quality Chasm: A New Health Systems for the 21st Century. Washington (DC): National Academies Press (US); 2001. https://doi.org/10.17226/10027
Mongelli F, Georgakopoulos P, Pato Mt. Challenges and Opportunities to Meet the Mental Health Needs of Underserved and Disenfranchised Population in the United States. Focus 2020; 18(1): 16-24. https://focus.psychiatryonline.org/doi/10.1176/appi.focus.20190028
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Copyright (c) 2024 Yared Alemu, PhD, Elizabeth Cárdenas Bautista, PhD, Sarah Vinson, MD, Patrick Ohiomoba MS, Nakia Melecio PhD, Hermon Amare MD, Jaya Vivian, Harshitha Karippara
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