Behavioral health professionals working with the nation’s 2 million veterans of the wars in Iraq and Afghanistan face a tremendous challenge: effectively treating the nearly one-in-five returning veterans who have post-traumatic stress disorder (PTSD) or a similar mental illness. Current approaches to treating PTSD are difficult as therapists rely on a veteran’s memories of emotions and symptoms days and weeks in the past to assess their progress. Because these memories are not perfectly accurate, particularly when PTSD causes short-term memory loss, it is often impossible to develop a full picture of a veteran’s mental health state. One analyst at Altarum Institute had a novel, but simple solution to the problem—use a veteran’s cell phone to track and treat their symptoms and connect them to care every day. Altarum’s Internal Research and Development (IRAD) program allowed this project to get off the ground. The technology not only helps track symptoms, but it also automatically triggers a support network when something goes wrong.

At most research organizations, an unusual idea like this never gets pursued because there is not an immediate funding source available.  As a mission-driven research institute focused on improving health and health care systems, Altarum sees the value in these projects, and is able to make use of internal funds to develop and test innovations as proof-of-concept projects. The cell phone concept behind this project was funded because Altarum saw the potential to solve a problem that has challenged mental and behavioral health providers for years.

Cell phone messaging is intended to fill the gap between patient visits to behavioral health professionals by connecting veterans to care on a daily basis. As part of this messaging, veterans receive a text prompt encouraging them to respond to a brief survey that assesses their mental state by asking them to rate feelings like their current anger level, happiness, and self-worth.

The survey has two significant results. First, it provides mental health providers with a measure to track a veteran’s feelings and symptoms, allowing them to narrow down triggers and relapses at the next appointment. The second benefit is more immediate. If a veteran indicates a certain level of anger, sadness, or another one of multiple negative emotions, the phone is automatically triggered to respond. It can send family pictures, meaningful passages or messages programmed by the veteran to help reinforce positive behaviors and self esteem. The technology also can automatically contact selected friends and family members to request that they contact the veteran to see what’s wrong and calm the emotions.

The program, which underwent a proof-of-concept study at the Pathway Home, a community-based residential program in northern California, showed positive results. It was met with excitement from the U.S. Navy. In September, the Navy Bureau of Medicine and Surgery awarded a contract to Altarum for further trials of the program. Between Altarum, its technology partner LifeWIRE, and the providers and clinicians involved, this innovative idea is coming to fruition to help veterans who continue to face the challenges of war at home.