Sacramento, Calif.-based Sutter Health is expanding its continuum of behavioral healthcare with the launch of an accelerated transcranial magnetic stimulation protocol.
Matthew White, MD, chair of the behavioral health service line, and Dan Peterson, CEO of Sutter Center for Psychiatry and the behavioral health service line, told Becker’s the launch represents both a clinical inflection point for treatment-resistant depression and a broader signal of the system’s commitment to behavioral health investment, access and scale.
“These are patients who have otherwise not been able to see success through traditional medication regimens,” Mr. Peterson said. “We’re really excited to be able to offer them hope.”
A key piece to the continuum of care is interventional psychiatry, which includes electroconvulsive therapy and transcranial magnetic stimulation, Dr. White said. The goal is to build “tomorrow’s version” of psychiatric interventions — including accelerated TMS.
Intervention psychiatry was first launched at the Center for Psychiatry, where both traditional TMS and ECT are offered, with plans to expand.
Traditional TMS is delivered once daily for four to six weeks. The accelerated TMS protocol — known as Stanford Accelerated Intelligent Neuromodulation Therapy — provides 10 treatments per day for five days. It is intended for adults with major depressive disorder who have not improved with prior antidepressant medications.
Patients receive a functional MRI to precisely locate where to hold the magnet on the head. Dr. White was deeply impressed by the results, citing remission rates between 60% and 80%.
“[Mr. Peterson and I] are really developing what the standard package of services should look like for patients across Sutter,” he said. “We’re doing a lot of growth in primary care integration and outpatient growth, but one key piece of this is interventional psychiatry, which is particularly a large growing field.”
The biggest challenge is a lack of knowledge among frontline clinicians about how to support patients with treatment-resistant depression, Mr. Peterson said. Even when clinicians are aware of options like accelerated TMS, navigating them can feel complex and unapproachable.. Moreover, making services easy to access and refer into is key to ensuring patients receive timely care, he added.
This also benefits primary care clinicians who, Mr. Peterson said, can often get stuck managing a specific behavioral health case and need expertise. After trying a few ineffective medications, the treatment is a “lifesaver,” he said.
According to the leaders, the time to expand is now.
“There are some great clinics and great locations that are offering this in an academic setting or in a concierge, sort of private pay, limited-access setting,” Mr. Peterson said. “As a health system that’s serving 3.5 million patients, we have an opportunity to really do this at scale across all of Northern California.”
Mr. Peterson said he lives for moments when behavioral health leaders can bring cutting-edge, effective treatment to patients, while Dr. White credits Sutter Health CEO Warner Thomas with giving behavioral health leaders the “direction and permission” to expand access to behavioral healthcare across the system.
“If we’re going to be a complete health system, we have to build out a full continuum of quality mental healthcare and behavioral healthcare,” Dr. White said.
