Overcoming Mental Illness Stigma While Improving Treatment For All Ages

by Darcy Lewis

May 30, 2017

Most people are learning that mental health issues like depression and anxiety are rooted in biology, not personal weakness. This realization benefits everyone, from the person affected to their family, friends, and even colleagues.

Similarly, there is an emerging understanding that physical health and mental health are closely connected. Just as people seek medical attention when they have diabetes or a sprained ankle, they should do the same for mental health issues.

According to the National Alliance on Mental Illness, more than 1 in 5 U.S. adults live with a mental health condition. This includes nearly 15 million adults who live with major depression. Approximately 20 percent of boys and girls ages 13 to 18 have experienced or will experience a mental health condition. And according to the American Psychological Association, 15 percent to 20 percent of older adults have experienced depression.

Given these numbers, it’s no surprise that health plans have stepped up to create innovative ways to treat mental illness across the age spectrum.

Cigna Integrates Medical and Behavioral Health

Cigna’s goal is to help both patients and providers change their view of health and well-being to include mental and physical health. The health plan recently published a white paper that details the benefits of an integrated approach, such as decreased costs, higher quality of care, and better experiences for both patients and providers.

One example is the Cigna Collaborative Care program, which integrates behavioral and pharmacy services with providers who have value-based contracts, such as accountable care organizations. Cigna’s value-based cardiology program includes depression screening and its value-based OB/GYN program includes maternal mental health screening. These providers offer consumers telephone access to Cigna Behavioral Health and can refer patients to Cigna’s specialty behavioral care management services.

The company is also using predictive analytics to identify plan members at high risk for behavioral conditions through the Cigna Health Matters program. These members receive targeted outreach by a behavioral specialty coach and free online seminars to help educate them about behavioral health issues.

Additionally, Cigna participates in Stamp Out Stigma, an Association for Behavioral Health and Wellness initiative that seeks to change the conversation around substance use disorder from one that assigns blame to individuals so effective solutions can be found.

SCAN “Insights” Program for Seniors

SCAN Health Plan, a California-based not-for-profit Medicare Advantage plan, recently announced preliminary results of its Insights behavioral health program.

Insights provided behavioral treatment services in home, at no cost, and in the patient’s and caregiver’s primary language. According to SCAN, the pilot program has shown promise in the use of evidence-based practices to treat depression, anxiety, loneliness, and other symptoms in its older adult population.

Independence at Home, a SCAN community service, launched the pilot in early 2016 in collaboration with researchers from the University of Washington. Insights’ therapists delivered services in English, Spanish, Vietnamese, and Korean. Program services were grounded in evidence-based practices and provided at no cost to the participant.

During the 12-month pilot, rates and severity of depression and anxiety declined among 100 program participants and quality of life scores improved. Early outcomes indicate that participants’ level of depression fell from a moderate level at the start of the program to a mild level by the time they exited the program 8-12 months later.

The company presented initial findings from the Insights program at the 2017 Annual Scientific Meeting of the American Geriatrics Society in San Antonio, Texas, earlier this month.

Kaiser Permanente’s “Find Your Words”

Much of Kaiser Permanente’s efforts aim to tackle the stigma associated with mental illness. It has teamed up with other organizations, including NAMI and the National Suicide Prevention Lifeline, to change the national conversation about mental illness and replace stereotypes with understanding.

Kaiser’s new public health awareness effort, “Find Your Words,” focuses on how difficult it can be to talk about mental health honestly and supportively. The company has created advertising spots for TV, digital, and radio featuring lyrics that talk about depression in a straightforward way. The website FindYourWords.org provides basic information about depression, offers resources, and invites the public to engage in a conversation about mental health and wellness.

Additionally, Kaiser Permanente is awarding mental health grant funding in school districts in the communities it serves. For example, five Colorado school districts will receive a combined $1.5 million in Thriving Schools behavioral health grants later this summer to increase access to mental health and wellness programs.

These efforts and others show that addressing mental health issues openly and integrating mental and physical health to treat the whole person helps health plans provide better mental health care to their members. In turn, these efforts should help improve the lives of people with mental health issues and their families, while reducing the overall burden on the health care system.