Use of an Integrated Self-Care Digital Platform to Reduce Co-Occurring Substance Abuse and Mood Disorder Risks

Introduction: Substance use disorders (SUD) are complex in nature, requiring easy access to effective treatments targeting all of the individual’s needs. The stigma and shame associated with SUD can prevent treatment-seeking behavior among those who are open to working on a path to recovery. Untreated comorbid depression may further inhibit sobriety. myStrength is a highly-personalized, evidence-based, digital self-care behavioral health and well-being platform developed to expand access 24/7/365. The platform enables users to acquire skills to manage these behavioral health concerns at their own pace or under the guidance of a mental health professional. This study intends to demonstrate the real-world, population-level impact of myStrength utilization on SUD and comorbid depression among a commercially-insured adult population.

Methods: Over 25,000 users who were provided access to myStrength through their commercial insurer or employee assistance program participated in the study. Users were prompted to complete three assessments administered at baseline and again on/around days 14, 60, 180, and 365. The Two-Item Conjoint Screener (TICS) measures risk of problematic alcohol and drug use. The 4-item, internally developed Symptoms to Strengths scale fosters motivation towards healthy behaviors while assessing the clinical criteria of SUD. The depression subscale of the Depression Anxiety Stress Scales 21 measures self-reported symptom severity.

Results: At baseline, 10% of commercially-insured myStrength users endorsed 1 item on the TICS, indicating elevated risk for SUD and 12% endorsed two items, corresponding to the highest risk of experiencing problematic substance use. Among users with TICS scores indicating the highest SUD risk, 55% showed reduced risk by their last follow up measure. Among those users at elevated risk for SUD, 80% dropped to no risk or remained stable by their last follow up assessment. Mean levels of baseline depression were identical for those at highest risk for SUD and the general user base. However, users at highest risk for SUD as measured by the Symptoms to Strengths scale showed reductions in depressive symptoms double those of the general user base (10.6 points vs. 5.6 points, which corresponds to an effect size of 1.0 vs. 0.59).

Conclusions: Study findings suggest that myStrength’s integrated platform of self-care tools are effective for addressing both SUD risk and symptoms of depression, particularly among those at highest risk for SUD. Effective evidence-based digital tools are scalable and have the ability to reach unserved and untreated populations.