CVS Health : Aetna and Oui Health aim for significant impact on suicide

Suicide rates have been steadily increasing for two decades. For each person who dies by suicide, there are approximately 30 attempts.

To help change that outcome, Aetna, a CVS Health® company, is collaborating with Oui Health and its affiliate, Vita. The Oui team, which hails from several leading universities, developed therapies and interventions that have shown reductions in suicide attempts by up to 60 percent in randomized, controlled clinical trials. This is a key component of Aetna's comprehensive strategy to reduce suicide attempts 20 percent among Aetna members by the year 2025.

"We've grounded our approach in the notion that suicide, from a public health perspective, is preventable within healthcare systems," said Cara McNulty, DPA, President, Aetna Behavioral Health. "Unfortunately, suicide continues to be a leading cause of the death in the United States, especially among young adults, but we have an opportunity to impact that trend. Oui Health's program is a key element in our strategy and provides our members with risk reducing care that can be utilized both proactively and at vulnerable times."

At-risk members, including those being discharged from the hospital or emergency department after an attempt, are connected to Oui Health through Aetna Care Management. This can be a vulnerable time, and Oui Health generally provides appointments within 1-2 days for these members. The program is currently available to members in 16 statesNY, CT, PA, MA, VA, WV, GA, FL, IL, MO, KS, TX, UT, NV, AZ, and CA, and Aetna and Oui Health plan to expand the program nationwide by the end of 2021.

The Oui Health program, which has been published in The Journal of the American Medical Association and The American Journal of Psychiatry, includes an intensive series of telehealth sessions with specially trained, licensed clinicians who are subspecialists in suicide prevention. Members also utilize a proprietary app between sessions to augment and enhance the care. The program is structured so that the specialty clinicians provide subspecialty care while the patient continues to see their other behavioral health clinicians - similarly to how an electrophysiologist collaborates with a cardiologist for a patient managing a heart condition.

"Oui and Vita are data driven and our unmatched outcomes are based on data that suicide attempts are like cardiac arrythmias," said Seth Feuerstein, MD, JD, Founder and CEO, Oui Health, "both can lead to sudden death and require focused, proven care. The heart and brain are similar organs and should receive the same level of data driven, sub-specialty care."

Lynn Hamilton, Executive Director, Oui Health, added, "Aetna's approach recognizes that like cardiac disease we can't just talk about prevention and ignore proven interventions. We are glad to be collaborating in this effort, especially for teens, where suicide is the second leading cause of death, and in some states recently became the top cause of death."

Early indicators for the program are strong. The evidence-based model reaches over 85 percent of members within 48 hours and 100 percent within one week. More than 70 percent of referred members engage consistently with their sub-specialty providers in the program, which is very high for a complex condition. One enrolled member noted, "I learned more about myself and how to control my condition in 10 weeks in this program than in 11 years of counseling."

Aetna and Oui Health have also collaborated to launch Youth Nominated Support Teams (YST) for members nationwide. In this program, developed by the Oui team with published data demonstrating more than a 50 percent reduction in deaths, adolescents and young adults (12-25 years old) nominate adults from their family, school or community to serve in the role of support persons who are approved by the individual's parent or guardian. YST intervention specialists (a mental health professional from Oui Health) then work with the nominated adults in evidence-based ways to help reduce the risk of death for the teen. The primary role of the support person is to attend the education sessions and maintain contact with the adolescent and Intervention Specialist.

Suicide is the 10th leading cause of death in the United States, claiming the lives of over 47,000 people in 2019. It is also the second leading cause of death among individuals between the ages of 10 and 34, and the fourth leading cause of death among individuals between the ages of 35 and 54.

In addition to these initiatives with Oui Health, Aetna continues to be the only health insurer to send caring contact postcards to "touch base" with members who have been discharged from an inpatient stay after a suicide attempt with messaging to let them know that they are valued, and that support and resources are available to them. Moreover, Aetna uses suicide prevention screening and safety planning for all members seen by clinical staff, even if they are not presenting as "at risk".