Changes in healthcare utilization through the digital mental health clinic and future considerations for psychiatric...

Emergency department (ED) boarding places substantial demand on healthcare systems. Digital interventions have expanded in the last decade, but their role and integration in emergency psychiatric settings remain limited. The Digital Clinic represents an evidence-based, hybrid digital intervention model that combines brief clinical sessions, a smartphone application, and a non-clinical team member (digital health navigator). Building on this model, a collaboration was established across multiple Beth Israel Lahey Health (BILH) health care departments to provide short-term mental health digital care for patients discharged from the ED at BILH-Needham.

This program evaluation examined changes in healthcare utilization among patients enrolled through the collaboration to inform feasibility and guide the design of future controlled clinical studies.

This evaluation uses a retrospective pre-post design to evaluate changes in healthcare visits of patients who were referred through the collaboration.

Across 79 patients enrolled, there was a significant decrease in healthcare visits (t = 3.87, p < .001). Notably, there was a significant reduction in high-cost visits (i.e., Hospital Admissions, ED Care, Urgent Care; t = 7.16, p < .001), and among those who had higher healthcare utilization before enrolling in the treatment (t = 3.91, p < .001). The comparison between patients who completed the treatment and those who discontinued treatment early did not reach statistical significance.

These preliminary findings offer a promising signal for further evaluation of the Digital Clinic model integrated into the ED. The digital health navigator role may offer a practical solution for future implementations of psychiatric ED interventions and customizing the program for local needs.