If you are a New York Times reader, chances are you know adolescents are in the midst of a mental health crisis. In April, the Times began publishing a series of articles about adolescent mental health, including:
- ‘It’s Life or Death’: The Mental Health Crisis Among U.S. Teens
- Hundreds of Suicidal Teens Sleep in Emergency Rooms. Every Night.
- Teens in Distress Are Swamping Pediatricians
The reporter, Matt Richtel, spent a more than a year interviewing adolescents, their families, and their friends, concluding, “The decline in mental health among teenagers was intensified by the Covid pandemic but predated it, spanning racial and ethnic groups, urban and rural areas and the socioeconomic divide.”
Teenagers aren’t the only ones.
The National Institute of Mental Health reports an estimated 52.9 million U.S. adults – or 21 percent of all adults – had mental illness in 2020. As you can see in the chart below, young adults (18-25 years) had the highest prevalence (30.6 percent) compared with adults ages 26-49 years at 25.3 percent and ages 50 and older at 14.5 percent.
In other words, there is no age group that is immune from mental illness.
May is Mental Health Month
First observed in 1949, Mental Health Month is an annual observance in May designed to bring awareness to the issue. Each year, Mental Health America chooses a theme. This year’s theme, “Back to Basics,” was chosen to contend with the global pandemic’s toll and to “provide foundational knowledge about mental health and mental health conditions and information about what people can do if their mental health is a cause for concern.”
A University of California San Francisco study that used Household Pulse Survey data from the Census Bureau to determine the prevalence of anxiety and/or depression found that 48 percent of young adults ages 18-25 had mental health symptoms during the pandemic. More than a third (36 percent) reported an inability to access mental health therapy.
Young adults are not the only ones whose prevalence of mental health symptoms has increased during the pandemic. More than 30 percent of adults have “symptoms consistent with depression or anxiety disorder since April 2020.” More than one in five adults reporting poor mental health have unmet counseling and therapy needs.
How Health Plans Are Meeting the Challenges of Mental Health Prevalence and Access
Physicians understand that mental and physical health are intimately linked. For example, adults with chronic kidney disease frequently report mental illness. An observational study of 150,000+ adults showed “about 26.6 percent of participants reporting chronic kidney disease (CKD) also had a mental illness, 7.1 percent of which had a serious mental illness….adults reporting CKD were more likely to have a mental illness than those without chronic conditions…”
Likewise, health plans appreciate the negative synergistic connection between mental illness, chronic disease, and the total cost of care.
One of the nation’s largest health plans worked with NextHealth Technologies to activate 95,000 Medicare Advantage members with serious mental illness more quickly. The plan found these Medicare Advantage members with serious behavioral health conditions such as bipolar, schizophrenia, and major depression were driving significant medical utilization – a trend that had been exacerbated by the COVID-19 pandemic.
To address this challenge, the health plan retained a behavioral health company specializing in virtual mental health care and then launched marketing campaigns to educate and engage these members. The plan expected strong interest from members. But only a small number of the health plan’s eligible members responded to the initial outreach and accessed the behavioral healthcare offered.
The plan partnered with NextHealth to create and implement a three-phase study to revise their outreach and engagement efforts to boost the member activation rate.
- Phase 1: We segmented and clustered targeted members into 16 clinically-based cohorts
- Phase 2: We created cohort-specific personalized outreach strategies to activate more members
- Phase 3: We plan to use Phase 2 results to measure the effectiveness of the program.
In short, our collaboration worked.
The plan used NextHealth’s analytic insights to personalize marketing and influence member behavior, leading to a 33 percent increase in the rate at which members activated into virtual behavioral healthcare.
Mental Health and Telehealth
The relationship between mental health and telehealth has never been stronger.
The Kaiser Family Foundation and Epic Research analyzed “outpatient visits during five six-month periods between March 2019 and August 2021, using data from Cosmos, a HIPAA-defined Limited Data Set of more than 126 million patients from over 156 Epic organizations, including 880 and 19,240 clinics across all 50 states.” They concluded Telehealth Has Played an Outsized Role Meeting Mental Health Needs During the COVID-19 Pandemic.
It’s a rich study well-worth reading. For me, one of the most salient findings is: Telehealth use for mental health or substance use continues to grow as a share of all telehealth visits.
Given the prevalence of mental illness and the ongoing use of telehealth for mental health, health plans will continue to have a strong need to identify, stratify and engage members in need of mental healthcare, increasingly on a more proactive basis. I am proud to say that NextHealth Technologies is ready and willing to help.
Michael Poku, MD, is the Chief Medical Officer at NextHealth Technologies. In this role, he brings his passion for developing, implementing, and measuring the effectiveness of novel care models to the challenge of optimizing payer clinical and quality programs with descriptive, predictive, and increasingly prescriptive analytics. Dr. Poku also is a practicing primary care physician who serves as a senior medical director for Oak Street Health, a network of primary care centers that delivers value-based care to adults on Medicare. He holds clinical faculty positions at the Methodist Health System in Dallas and UT Southwestern. He holds a doctorate from Vanderbilt University School of Medicine, and an MBA from Harvard Business School.