New trial to assist patients with severe and enduring mental health illnesses

The pandemic has made it more difficult for the 430,000+ Australians living with severe mental illnesses who are highly vulnerable to acute illness relapses when their habitual routines and standard health care arrangements are disrupted.

With telehealth solutions now responding to the rising demand for mental health services across the board, a new project led by Flinders University is targeting this more vulnerable group with a digital solution created with their special needs in mind.

The AI² (Actionable In-time Insights) project aims to change the way healthcare is delivered – both for better mental health service delivery and for wider chronic disease management in the community. Regular remote checks on these patients aim to reduce the number who end up in hospital or emergency departments, adding $2.6 billion to hospital care costs every year.

After extensive research and trials, the AI² software model is now rolling out across Adelaide and South Australia in partnership with public mental health services linked to the Local Health Networks of Southern Adelaide, Northern Adelaide, Central Adelaide, Barossa Fleurieu and Adelaide Hills, as well as the State Government's Digital Health SA.

The project is led by Flinders University Associate Professor Niranjan Bidargaddi who says that the current monitoring, management, and treatment of chronic mental illness across different parts of the health system is poorly coordinated and inadequate.

"In Australia there are about 600,000 people living with a chronic mental illness with multiple morbidities." says College of Medicine and Public Health Associate Professor Bidargaddi, an expert in human-centric digital informatic systems.

Once a patient has sought an initial consultation with a clinician they might be provided with a diagnosis, a mental health care plan and then they are sent off with instructions for treatment such as taking medication or trying therapeutic techniques. Multiple ongoing medical appointments and medications are burdensome for patients to manage on their own."

Niranjan Bidargaddi,  Associate Professor, Flinders University

"The problem is that most clinicians don't have the resources to keep track of every patient manually. This can lead to the patient relapsing and potentially becoming hospitalized."

Some estimates suggest that more than 80% of patients with severe mental illness will relapse several times within the first five years of their initial treatment.

Under the latest trial, funded by the $200 million national Digital Health CRC with participants Flinders Uni, SA Health and goAct, mental health services will be transformed to remotely and timely identify and target interventions to mental health patients who may be falling through care gaps, and potentially at increases risk of relapse.

Notably, the AI-squared software will be enhanced to algorithmically trawl through integrated health care interaction data sourced from My Health Record and Electronic Health Records, to flag care gaps and nudge interventions.

Digital Health CRC CEO Dr Terry Sweeney says the Flinders University project is vital research in bringing digital technologies to the forefront of mental health care.

"Our new operations in South Australia will extend our work with world-class research partners, working collaboratively with Flinders and our other local and national partners to make an impact to the community and economy," Mr Sweeney says.

The tools and resources developed in this AI² project will enable mental health services to run remote check-in on mental health patients and ensuring they are receiving the continuum of care in the community.

The program will help people with severe and enduring mental health illnesses who aren't confident or don't have access to the internet or smart technologies, Associate Professor Bidargaddi adds.

The tool was tested previously in an eight-month trial involving 304 patients with serious mental health disorders in a Gawler community mental health clinic to put in place interventions, like medication reviews or compliance aids, to prevent deterioration or relapse of their condition. Results of this trial published in the Australia and New Zealand Journal of Psychiatry suggest digitally automated monitoring is feasible, and the program could be integrated into clinical workflows in mental health services without over-burdening health practitioners.