The headline of a review of recently published research said it all, “Online Suicide Intervention Works, but Most Patients Don’t Want It.” It was a review of a study of an automated, web-based program for people who were experiencing suicidal ideation – a potential precursor to suicide. In this study while the use of a web-based program was better than no treatment, 78% of the participants receiving treatment, discontinued use before the end of the study, and about 8% attempted suicide.
This wrong-headed study is like so many others. The researchers attempted to help people who are experiencing very difficult life challenges, without human intervention. There are probably hundreds of apps and many more under development that are trying to do the same thing. When there is no human component, treatments become more available, scalable and very cheap. The rationale for doing so is that this is a way to help many more individuals utilizing a more attractive business model.
The obvious problem with this fully automated approach is that it lacks the human touch. When we are struggling with one or more difficulties in our lives, we are usually not well served by a machine no matter how clever or cute. No one would ever say about a human-less service, “Thank you for being here with me in a crisis! I'm now going to be OK.” Or “You are more valuable and helpful in my life than I can express.” These are anonymous post meeting comments from individuals who have met via video with a Certified Peer Specialist – a person with similar experience who has been trained to help others.
Using peer coaches or “expert patients” as they are called in Europe, is an effective and relatively inexpensive way to provide help to others. In studies of peer support, we see some really great recipient outcomes, not the least of which are large (~70%) reductions in hospital readmissions.
The really great news about peer support is that it can be leveraged and it’s reach expanded by gathering individuals into video groups of eight to 12. In these groups, the role of the peer specialist shifts to helping the participants to help each other and backfilling the conversation as needed. These meetings also include science-based self-help information. As it turns out, the results are very strong. In our study of 142 participants in this type of video group, hospital readmissions were down 69% and use of urgent care and emergency rooms were cut in half. Participants love this way to get help. They have said, "This experience was a blessing. I came away from the meeting feeling better" or “My very first meeting and I felt safe in the room. Safe enough to talk about my issues. It made me feel better. I'm not alone.”
When we create services to try to help the growing number of people who are troubled because of behavioral health, chronic illnesses or rare diseases, we need to put their humanness first. Technology can help us to more efficiently connect individuals. Peers can help provide the social support so essential to well-being.