Presented by Providence Ventures
For anyone who has experienced a mental or behavioral health issue, either themselves or via a friend or family member, there is likely nothing more frustrating than trying to find help in our fragmented mental health system. My own experience with a neighbor who needs help (but doesn’t believe so himself) is that critical information ping pongs between his family, multiple neighbors, the police, a local hospital, and the public judicial system, with stigma laced throughout.
No single source gathers, manages, or analyzes all of the data from the multitude of reported events, and no one person is accountable for finding and helping this sick individual. We all stand by on pins and needles, and await the next encounter. I don’t doubt that most everyone has experienced or heard of a similar story, and has felt complete helplessness while someone they love is suffering.
The statistics are jarring: 1 in 5 adults have a diagnosable mental health condition, while 27 percent will experience a mental health challenge in the next 12 months. Most will not receive treatment, even though it is well known that monthly medical costs more than double when a person with a chronic condition also has a mental health co-morbidity. Depression and anxiety among young people is rising; the suicide rate for teen girls reached a 40-year peak in 2015. And almost every hour of every day, a former member of our U.S. armed forces decides to end their life.
We must do better.
The challenge can seem overwhelming. Accepting that we must set our vision on audacious goals, as well as find incremental opportunities with which to advance better care, we at Providence Ventures are working closely with our colleagues at Providence St. Joseph Health (PSJH) to support scaling existing programs and technologies that work, invest in new platforms that leverage scant resources, and promote national efforts to collectively solve the country’s mental health crisis.
While behavioral science and mental health research are continually maturing — our body’s most complex organ is far from being completely understood — there are interventions that have proven highly effective in better managing patients with behavioral health conditions.
It starts with primary care
Given that 70 percent of all primary care visits involve health behaviors, The World Health Organization recommends integrating mental health into primary care as the most viable mechanism for addressing mental health conditions. There are multiple models for combining mental health and primary care, but the entire continuum of patient care must be considered.
Simply increasing mental health screenings in the primary care office will only increase the bottleneck of patients needing care from a system that isn’t robust enough to provide it. Providing better tools for self-care is one way of helping patients that present with low-acuity mental health conditions. That said, achieving consensus on the right tools in the sea of options will take concerted effort, in addition to finding viable business models. We are encouraged that some companies are demonstrating early clinical effectiveness in this space, including SilverCloud, Spring Health and Tridiuum.
Collaborative care and integrated care are well-studied models that have proven effective, yet are resource-intensive and only very recently have initial mechanisms for reimbursement. Multiple companies — including Quartet, Lantern, Mindoula, Samepage and Ginger.io — are working to prove that technology platforms can drive efficiencies of these models. Providence Ventures is collaborating closely with PSJH’s clinical leaders to find the right partners for primary care integration. We believe the winners will find the right balance between enabling effective person-to-person care while scaling technology-driven efficiencies.
Emergency departments must be shored up
The naturally chaotic environment of emergency rooms is a mismatch for diagnosing and treating mental health conditions. Yet compared with people with physical ailments, mental health patients seek care in the ED more often, and stay longer without treatment, due to a chronic shortage of inpatient mental health beds and gaps in the mental health care system. Having mental health professionals in every ED would go a long way towards helping solve the problem, but qualified providers, especially psychiatrists, are in very short supply.
Dr. Arpan Wahgray, PSJH’s Medical Director for tele-behavioral health, is leading PSJH’s efforts to leverage tele-technology to provide remote psychiatric consults to PSJH’s EDs. While beaming-in psychiatrists may alleviate immediate needs for acute situations, challenges still include finding and training enough psychiatrists to optimize their clinical expertise in an ED environment, ensuring adequate diagnosis and follow-up care in crisis situations, and figuring out how and when to best leverage counselors, social workers, case managers, and other mental health specialists.
The ED also presents a challenge in that care is provided in a complex and chaotic environment in which providers often have no history of the patients they are serving, especially those with mental health conditions due to highly fragmented and ineffective mental health care infrastructure. Providence Ventures’ recent investment in Collective Medical Technology demonstrates our belief that focused, health information exchange (HIE) is a critical component to informing EDs of patient history to better enable physicians to make informed treatment decisions and coordinate care with partner entities, improving ED efficiency and patient outcomes.
Access to evidence-based care is essential
While health systems learn and grow their existing infrastructure to better support mental health, employers have long been a forward-leaning, key payer of employee benefits. More and more, employers have realized that poor mental health of their workers contributes to sub-optimal performance and productivity. Thus employers are increasingly seeking better mental health tools and benefits offerings for their workforce, including seeking better outcomes from their Employee Assistance Program (EAP) offerings.
Lyra Health (a Providence Ventures portfolio company) is leveraging technology and direct connections with providers to build a 10X better EAP. The company’s goal to transform behavioral health care starts with removing barriers to access and ensuring that the care delivered by its connected providers is evidence-based. Lyra-built technology matches employees seeking care with the right providers quickly and efficiently, and gives behavioral health providers a more streamlined and rewarding system in which to practice and deliver care to the patients who will most benefit from their specific expertise.
A calling to serve the nation
PSJH is well aware that it cannot solve the mental health crisis alone, even as the third largest non-profit health system in the U.S. In order to bring to bear the necessary resources and expertise of key stakeholders, from individual community caregivers up to the federal government, PSJH launched the non-profit foundation Well Being Trust (WBT).
Led by Tyler Norris, MDiv., the WBT is dedicated to advancing the mental, social, and spiritual health of the nation. The audacious goal will be realized via a social movement approach, investing in and growing community and clinical initiatives that work and advocating for health-promoting public policies.
Recently, the WBT, in partnership with the Trust for America’s Health, released Pain in the Nation, an exhaustive report that brings attention to the pervasiveness of drugs, alcohol and suicide. If current trends continue, these factors will contribute to the deaths of 1.6 – 2.0 million Americans in the coming decade. To slow this horrific spiral, the authors call for the creation of a National Resilience Strategy that will comprehensively focus on prevention, early identification and effective treatment.
Providence Ventures is proud to call the WBT a partner, as we believe national leadership will pave the way for smarter investments and the ability to scale effective technology to enable behavioral health care that will turn the tide against our mental health crisis that we all hold responsibility to solve together.
If you or someone you care about is experiencing a mental health challenge, the National Alliance on Mental Illness is the nation’s largest grassroots organization dedicated to building better lives for those affected by mental illness.
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