Combating depression and suicidal thoughts through telehealth

There may be hope for people struggling with destructive and dangerous thoughts about suicide.

Lyra Health, a behavioral coaching and therapy telehealth platform, is launching a new program that will utilize dialectical behavioral therapy to help reduce suicidal thoughts and behaviors. Lyra coaches trained in DBT will provide this skills-based treatment to users who show symptoms of mental health distress and need more intensive support.

The program, Lyra Blended Care DBT, was launched in January in response to the growing needs of the Lyra user population, as well as within the wider community struggling with severe mental health challenges, says Joe Grasso, senior director of workforce mental health at Lyra. In 2020, 11% of Americans considered suicide, according to data from the CDC, and Lyra user data found that 16% of members indicated thoughts of suicide or active self-harm in 2021, up from 10% pre-pandemic.

“Rates of suicidality, meaning suicidal thoughts, have been increasing year on year since 2012, and really reached a new and alarming peak during the pandemic,” Grasso says. “It became clear to us that we really needed a program specifically designed for this condition, and the research tells us that treatment really does need to be tailored to the condition.”

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DBT helps individuals learn skills-based coping tools to better regulate their emotions, address impulsive behaviors and improve their relationships with others. The therapy has traditionally been used to treat other mood disorders — specifically borderline personality disorder — but research has shown its efficacy in reducing suicidality, as well as alcohol-use disorders.

“DBT is really the gold standard for these conditions where the main crux of the problem is difficulty regulating emotions and impulsive behavior that can lead to risk of self harm or suicide,” Grasso says. “The goal of the therapy is to equip clients with skills to be able to regulate their emotions, tolerate distress and make decisions that are in their best interest.”

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Lyra users can tap into the platform’s network of behavioral health therapists trained in DBT for one-on-one therapy and group support, as well as access to a 24/7 crisis support team. Users will learn practical skills to help them become more present and mindful of their thoughts and behaviors in a safe and supportive environment.

For example, DBT teaches individuals to identify activities that may distract from their feelings, like taking a cold shower in times of distress. DBT also uses acronyms to guide people through difficult conversations, like following FAST: be fair, no apologies, stick to your values and be truthful.

“What DBT teaches is the ability to notice your distress when it's happening and try to do some practical skills to regulate your emotions in that moment,” Grasso says. “And then from that place of wisdom or calm, have an interaction with someone that’s going to be more beneficial in the long run. So you don't say something you regret, you don't do something that's going to damage the relationship and you don't act in a way that would be impulsive and potentially harmful to yourself.”

Making this therapy available via telehealth is also reducing potential barriers to care, Grasso says. With the average wait time to see a mental health professional between 25-90 days, having help immediately available can be a life-saving intervention.

“These programs can often have long wait lists and it can be very expensive. They're often out of network,” he says. “So our goal by creating our own DBT program was that we could expand the reach using telehealth and increase the service available to a person that meets their needs.”