New center uses technology to identify, mitigate suicide risk

Aim is to integrate best practices into clinical settings

A new UMass Chan Medical School center plans to use technology to assist with identifying and mitigating suicide risk.

Funded by a five-year, $17 million National Institute of Mental Health grant, the Center for Accelerating Practices to End Suicide through Technology Translation (CAPES) will collaborate with UMass Memorial Health, UMass Lowell, UMass Amherst, Worcester Polytechnic Institute, Zero Suicide Institute, and more than 100 other institutions.

According to CAPES Co-Director Edwin Boudreaux, Ph.D., psychologist and professor of emergency medicine, the initiative is focused on finding ways to accelerate best practices into clinical care settings such as emergency departments, inpatient units, outpatient settings, and primary care practices.

Boudreaux noted that all settings at UMass have built evidence-based screening instruments into the electronic health records. “This, along with training on how to perform a good screening by focusing on rapport and human-centered care, has improved the overall screening process,” Boudreaux said.

He emphasized, however, that a good screening system in the electronic health record is not enough if the clinician does not know how to use it in the best way with a patient.

“We don’t want to focus entirely on the technology; instead, we want to promote both a high-tech and high-touch approach,” Boudreaux said.

He said that in addition to evaluating technology-based interventions, CAPES will concentrate on implementation, patient-centered care, business development, and ethics.

The first suicide prevention technology, the Jaspr Health digital platform, is anticipated to go live in December or January.

Boudreaux said the software “stood out,” following a review of available literature and commercially available technologies.

“Jaspr has multiple components intended to help transform unproductive waiting time in the ED with productive time that helps the patient,” he explained. “Rather than sitting for hours for care, bored and agitated — which is very common in most EDs — the patient can be engaged in therapeutic activities and distract and entertain themselves with content that is positive and healthy.”

The tool performs a suicide risk assessment, helps the individual build a safety plan, provides lethal means restriction counseling, and allows the patient access to a large library of comfort and coping skills, according to Boudreaux.

Jaspr also provides a library of videos of real people who have also struggled with and overcome their suicidal thoughts. The website is https://jasprhealth.com/.

He said computerized adaptive tests (CATs) are another example of a technology that could be used in outpatient practices.

Boudreaux said CATS can quickly perform “sophisticated, psychometrically valid assessment” for screening and treatment monitoring purposes across a wide variety of symptoms or diagnoses.

He thinks the tool should be used more frequently as part of mental health treatment. The center’s team intends to study why it significantly has not caught on and try to develop methods to improve its adoption and implementation across a spectrum of settings.

Other projects under exploration include ADAPT (Automated, Data-driven, Adaptable and Transferable) learning for suicide risk prediction), which uses artificial intelligence to transfer suicide risk to other health care systems and clinical sites. It has dashboards to help college health centers and expands on work done by researchers at WPI.

Because they are studying “implementation into practice,” Boudreaux said the technology they are focusing on was chosen because it is “evidence-based and robust.”

“Once technologies have been through adequate development and validation, and the field is now ready to study their deployment and implementation, they become potential candidates for us to study,” he said.

Work over the past 15 years laid the foundation for the creation of CAPES, Boudreaux said.

“The center pulls together diverse researchers across several institutions,” he added, resulting in stronger research efforts that are “truly trans-disciplinary.”

Boudreaux noted his original interest in suicide prevention was born from his desire to tackle some of the biggest mental health challenges.

“It occurred to me that suicide could be viewed as the single most preventable cause of death, but at the same time is an end result of an enormously complex interplay between chronic and acute personal factors, as well as family, societal, and healthcare system-based factors, which makes it very difficult to predict and mitigate,” Boudreaux added.

Boudreaux co-directs CAPES with Catarina Kiefe, M.D., Ph.D., the Melvin S. and Sandra L. Cutler Chair in biomedical research and professor of population and quantitative health sciences.