The issue of behavioral health – and deficiencies in effective treatment solutions – is a critical problem in the country’s healthcare system. And what pretty much all stakeholders agree is that there’s much needed in the way of improvement.
That idea was the organizing idea behind a panel at the MedCity Engage conference sponsored by SilverCloud Health featuring SilverCloud Health CEO Ken Cahill, Quartet Health founder Arun Gupta, Vida Health CEO Stephanie Tilenius and Jeremy Maynor, vice president of product innovation for Optum’s Behavioral Health division.
Moderator Thomas Lee, an author and journalist who has opened up about his own struggles with depression and anxiety led the discussion with his own personal story and the question of whether stigma still remains a barrier to determining better solutions.
Cahill pointed out that the standardized way the healthcare community understands mental health is a historically recent phenomenon and society is still in the process of acceptance of behavioral health conditions.
In order to battle that stigma Tilenius, the CEO of health coaching startup Vida Health said the company has reframed mental health as chronic condition much in the vein of hypertension or diabetes, which people are more familiar with.
She highlighted that one in three people will have a chronic physical condition and one in four will face a serious mental health or neurological disorder in their life.
“Our system doesn’t really look at it that way, there’s not claim codes for therapy in every health plan,” Tilenius said. “If you look at other systems around the world, there’s more reimbursement and understanding about the importance of these preventative measures for lowering healthcare costs.”
One aspect shifting the momentum toward preventative treatment has been an understanding from employers that mental health has a major impact on productivity and absenteeism.
The panel generally agreed that an increasing openness to mental health care and screening, in conjunction with a growing shortage of specialized professionals positions technology as a key part of creating a better system for dealing with mental health issues.
“There’s a big unsolved problem in behavioral health and that’s a gap between the demand for services and supply for services,” Maynor said.
“There’s a lot of barriers in the way of patients, including stigma, but affordability and access too. This market in a lot of ways is decades behind physical health so its a great opportunity for innovators.”
One major barrier is the lack of coordination across physical and mental health professionals and treatments, even as mental and physical health conditions often affect each other.
“When folks have a mental issue and are suffering from chronic disease, the activation energy they have to the physician or take their medication or take the walk they’re supposed to is very low,” Maynor said.
Gupta’s New York-based startup Quartet Health takes the strategy of giving the primary care provider the tools to perform better shared care planning and do mental health screenings along with regular diagnostics like blood pressure.
“If we could just find a better way to resource and support the ability of primary care physicians to screen for these mental health conditions then we thought that would be more of an upstream way to solve the problem,” Gupta said.
However, the preponderance of technologies directed at mental health does raise the question of how to separate the wheat from the chaff and identify actually effective solutions.
Both Tilenius and Cahill spoke about the importance of using clinically validated screenings like the Patient Health Questionnaire and Generalized Anxiety Disorder questionnaire to determine what technologies are actually having positive impacts.
Maynor said from his position at a large payer system like UnitedHealthcare, incorporating those kinds of tests as a key part of the technology provides greater confidence in potential reimbursement.
While there are concerns about viewing technology as a potential panacea to solve mental health issues, the panelists underscored the foundational issue that people aren’t getting into any treatment pathways at all for their mental health issues.
“There’s stigma, there’s cost, there’s quality and we’re all collectively solving those problems. Just solving those problems would go pretty far. People just aren’t getting the treatment,” Tilenius said.