Dr. Tammy Malloy
Chief Operating Officer, Executive Director, Futures Recovery Healthcare
Futures Recovery Healthcare offers a comprehensive detox and residential program for substance abuse and co-occurring conditions, a residential program for primary Mental Health needs, the Orenda concierge program, the Rise experiential program, and intensive outpatient and outpatient services. Futures also offers specialized services for our First Responders and Veterans, those with chronic pain and those with trauma. Futures emphasizes individualized approaches to address the complexity of behavioral healthcare concerns, high-quality and compassionate care, the importance of establishing an ongoing continuum of integrated care, and the value of alumni involvement.
Patients who enter behavioral health settings with depressive disorders are presented with the challenge of being in residential care for a short amount of time due to personal responsibilities, insurance coverage, and financial limitations. For these reasons, and others, accurately and precisely assessing an individual for their current mental health symptoms becomes crucial. With rates of suicidal ideation on the rise, those that end their life often experience depressive symptoms for some period before suicidal thoughts are present leading to suicide attempts and completion. Largely, pen and paper assessments are subjective due to the individual’s ability to minimize and/or misunderstand the question which can lead to a disconnect and impersonal response. Proper diagnosis is critical to engaging in appropriate clinical interventions such as medication management, therapeutic approaches, and continuing care plans. AI technologies have become essential to providing quantitative and qualitative analysis that is specific to the individual and informs targeted treatment planning that is rooted in evidence-based research.
With the implementation of AI technology into our Organization, we are able to evaluate, assess and determine current level of depressive symptoms and suicide risk which leads to weekly reassessment that captures ongoing suicidality and depressive symptoms that may be decreasing or increasing. With the use of AI technology there is also a humanized AI connection between the individual and the bot that is conducting the conversational assessment that allows for honesty and naturalized responses. The daily check-ins allow for the individual to be empowered to share their daily struggle or track their improvement. Although pen and paper assessments, and other digital forms, are helpful, having the ability to connect through AI assists the providers in real time results which are essential in providing appropriate interventions, treatment planning, and ensuring that medication is efficacious.
Prior to incorporating AI assessment, clients were assessed through diagnostic interviews and initial paper-and-pencil screenings, with reassessment needs determined based on initial results. Clinicians and clients found this approach impersonal and the resulting scores to be of limited utility in treatment planning. The AI assessment protocol that was implemented included a conversational AI screening in which clients could respond naturally to questions regarding their experience and symptoms as they did in therapeutic sessions. The AI algorithms were then able to quantify these statements for the client, extracting data from words, facial expressions, rate of speech, and tone of voice. This format felt more personal and engaging, permitting our protocol to re-assess clients weekly without giving the impression that they were being “tested” on their progress. The use of multiple variables to determine suicide risk and levels of depressive symptomology also mitigated concerns regarding clients who may tend to minimize symptoms. Additionally, the results of the AI conversational assessment included not only the traditional scoring of an overall depression level and suicide risk level, but additional information on the presentation of specific depressive symptoms. These outputs provided clinicians with more robust information for individualized treatment plans targeting client’s specific symptoms and tracking the efficacy of interventions.
Prior to implementing the AI assessment, only 24% of clients were receiving an official diagnosis for a Depressive Disorder. This rose to 46% of clients after implementation, as AI assessment improved the ability of clinicians to track diagnostic criteria. Even for clients who do not meet criteria for a Depressive Disorder diagnosis, clinicians were better able to target co-occurring depressive symptoms that coincide with diagnoses including Anxiety disorders, Bipolar Disorders, and Substance Use Disorders. Individualized results provided by the AI assessment led to a 9% increase in treatment plans targeting depressive symptoms, with 68% of clients now having individualized treatment objectives for their specific presentations. These objectives were effective, with 67% of clients who scored severe for depression during their initial assessment having reduced this score to mild or minimal level by time of discharge. All clients who scored in the high or moderate suicide risk level were also at low risk by time of discharge. The AI assessment was found to be more sensitive than traditional screening methods, as 45% of clients who scored in the severe range for depression on initial AI assessment scored only moderate or mild when completing the traditional Patient Health Questionnaire (PHQ-9), indicating clients felt more connected when not confined to impersonal paper-and-pencil assessments and Likert-scale answers.
Aiberry has leveraged AI to develop a state-of-the-art software platform, which takes a video recording and breaks it down into three modalities: text, voice, and video. Aiberry then uses artificial intelligence to observe behavior and learn patterns associated with specific disorders, which then is being used to stitch together a patient’s risk level for a specific mental health disorder according to the following scale: None, Mild, Medium and Severe.
In the field of behavioral health, AI technology is just beginning to be implemented in clinical practice. With this change in how we assess our clients comes fear of what we don’t understand and an aversion to change in this direction. To open the minds of our clinical team, they were educated and trained on the strengths of AI technology and how this would assist not only our clients, but our staff as well. This did take time and effort for organizational leadership, frontline staff utilizing the technology, and our AI technology partners. These efforts are frontloaded and now assist with time management and efficiencies. Other behavioral health organizations have not yet adapted their protocols to include AI technology. Our organization is in the process of facilitating research to include the interventions of AI technology and assessment in hopes of assisting more clients and organizations across the globe and reducing fear and stigma pertaining to AI technology and mental health.
Our Veterans and first responders have historically been resistant to sharing their mental health symptoms. Through AI technology, they are now more receptive to completing their assessments and willing to understand how their symptoms are presenting and how this is impacting them on the job and in their everyday life.
About Futures Recovery Healthcare
Futures Recovery Healthcare offers a detox and residential program for substance abuse and co-occurring conditions, a residential program for primary Mental Health needs, the Orenda concierge program, the Rise experiential program, and intensive outpatient and outpatient services. Futures also offers specialized services for First Responders, Veterans, and people with chronic pain or trauma.