Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 16;20(4):3525.
doi: 10.3390/ijerph20043525.

A Markov Chain Model for Mental Health Interventions

David Claudio  1 , Sally Moyce  2 , Tyler Albano  1 , Ekeoma Ibe  1 , Nick Miller  1 , Marshall O'Leary  1
Affiliations

A Markov Chain Model for Mental Health Interventions

David Claudio et al. Int J Environ Res Public Health. .

Abstract

Poor mental health affects nearly one billion people worldwide and can end in suicide if not treated. Unfortunately, stigma and a lack of mental healthcare providers are barriers to receiving needed care. We developed a Markov chain model to determine whether decreasing stigma or increasing available resources improves mental health outcomes. We mapped potential steps in the mental health care continuum with two discrete outcomes: getting better or committing suicide. Using a Markov chain model, we calculated probabilities of each outcome based on projected increases in seeking help or availability of professional resources. Modeling for a 12% increase in awareness of mental health concerns yielded a 0.39% reduction in suicide. A 12% increase in access to professional help yielded a 0.47% reduction in suicide rate. Our results show that expanding access to professional services has a higher impact on reducing suicide rates than creating awareness. Any intervention towards awareness or access positively impacts reducing suicide rates. However, increased access results in a higher reduction in suicide rates. We have made progress in increasing awareness. Awareness campaigns help to increase recognition of mental health needs. However, focusing efforts on increasing access to care may have a higher impact on reducing suicide rates.

Keywords: Markov chains; absorbing chains; mental health.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart describing how the actions of an individual determine the potential outcomes.
Figure 2
Figure 2
Markov chain for any mental illness with two absorbing states: get better and commit suicide.
Figure 3
Figure 3
Generalized P matrix for any mental illness (AMI).
Figure 4
Figure 4
Canonical form of an absorbing Markov chain probability matrix [21].
Figure 5
Figure 5
Current state Markov chain model for any mental illness. * Statistic obtained directly from the literature; + Calculated from statistics obtained from the literature.
Figure 6
Figure 6
Current state P matrix.
Figure 7
Figure 7
Q matrix (current state).
Figure 8
Figure 8
R matrix (current state).
Figure 9
Figure 9
Fundamental matrix (current state).
Figure 10
Figure 10
Absorbing matrix (current state).
Figure 11
Figure 11
Reductions in suicide rates when increasing awareness, access, and both by 4, 8, and 12%.
Figure 12
Figure 12
Additional improvements in suicide rates for every 4% increase in awareness and/or access.
See this image and copyright information in PMC

References

    1. World Health Organization, United for Global Mental Health, and the World Federation for Mental Health World Mental Health Day: An Opportunity to Kick-Start a Massive Scale-Up in Investment in Mental Health. 2020. [(accessed on 27 January 2022)]. Available online: https://www.who.int/news/item/27-08-2020-world-mental-health-day-an-oppo....
    1. Zhang J., Ren Y., Huang H., Kauer A.J., Liu Y., Du Q., Jiang T., Du B. Timely psychological care for patients with severe mental illness during COVID-19 epidemic. Asian J. Psychiatry. 2020;52:102178. doi: 10.1016/j.ajp.2020.102178. - DOI - PMC - PubMed
    1. Pera A. Cognitive, Behavioral, and Emotional Disorders in Populations Affected by the COVID-19 Outbreak. Front. Psychol. 2020;11:2263. doi: 10.3389/fpsyg.2020.02263. - DOI - PMC - PubMed
    1. Moyce S., Thompson S., Metcalf M., Velazquez M., Aghbashian E., Sisson N., Claudio D. Rural Latinx Perceptions of Mental Health: A Qualitative Study. J. Transcult. Nurs. 2022;33:346–354. doi: 10.1177/10436596211070592. - DOI - PMC - PubMed
    1. Esterwood E., Saeed S.A. Past epidemics, natural disasters, COVID19, and mental health: Learning from history as we deal with the present and prepare for the future. Psychiatr. Q. 2020;91:1121–1133. doi: 10.1007/s11126-020-09808-4. - DOI - PMC - PubMed