Video: Navigating behavioral health challenges in the COVID-19-era
COVID-19 Briefing - Behavioral Health Update
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UnitedHealthcare COVID-19 Briefing April 14 - Behavioral Health Update
I’m Allison Davenport from Optum Behavioral Health. We’ll spend a little time talking about the trends that we’re seeing, as Craig said, and we’ll talk about just a couple of examples of how we can respond. So I want us to reflect for just a minute on what Craig was just saying, through the lens of the lens of the whole person. As Craig noticed, we are seeing increases in these presentations of psychological distress. One of the things our team is watching very, very closely, if you’ll just flip to the data slide if we’re not there already – thank you – is the substance abuse trend that you see increasing. I want to draw out here – and you can see it on the slide but I’m going to go a little bit deeper – I want to draw out the health disparities and the inequities that you’re seeing here. And you can see them very plainly but it’s important for us all to know that the percentages of people who were reporting these symptoms have increased between August and January of this year. It's a very short amount of time but we see disparities even in how these symptoms are increasing. And this really underscores a need to ensure that our members are able to access high quality, culturally competent, and equitable healthcare. We can move on.
I would guess that many of us think and maybe dream about the conclusion of this public health crisis as an end point and as Craig said, the reality is that for our individual and collective mental health, this will be with us for a while. We’ve experienced financial stress, loneliness, isolation. We’ve been away from families. Grandparents have not been able to hug their grandchildren. All of this has a profound effect that isn’t short-term. While many of us have spent a year at home, we have to remember and at Optum Behavior Health we especially have to pay attention to the fact that home is not a place of safety and refuge for everyone. We remain concerned about domestic violence, interested in promoting awareness aware that issue, which we’re doing a little bit right here. And also providing access to trauma informed care. We can keep going.
We’ve talked about a lot of the impacts of the crisis here. I think the one that we haven’t touched on just yet is grief. So many people have lost so much and I think that the inability of us to mourn those losses in ways that are organic for us or customary for us, just compound that. So all of these factors have an impact. Let’s shift to talking about how we can respond. I would offer that what we’re creating right now and what’s essential for us is not just a series of solutions but really an ecosystem that addresses our employees, our people as the dynamic human beings that they are with needs that vary, with needs that change, and who have choices that we must honor. This visual shows just a range of assets but really just a small sample of the range of assets that we’re deploying now to create that experience for people. You can see here, we’ll talk about education and awareness in just a second. But we’re talking about coaching. Some people may prefer a self-guided coaching experience. Some people need more support to address a short-term emotional concern. And some people need support and treatment for a series and diagnosed behavioral health condition. We need an ecosystem that addresses all of that.
I mentioned education awareness and these materials invite us to think about that I think in a little bit of a new way. It’s probably really hard for you to read the words on here. It’s really hard for me without my glasses. So I’ll read you some of the words on this slide that I think are pretty powerful. Choose empowerment over shame. Adults are pictured here but that’s a really important message as we start to think about our and that’s where we’re going to go next. I know that these are concerning statistics but it’s really, really important that we talk about it because our kids are impacted too. One of the things that we can do, we must do right now and we are doing, is to simply the care for kids and for the parents who care for them. What I’ve heard from parents who are caring for children with a health concern, whether it’s medical, physical, behavioral, is that caring for them requires the parent to do a lot of navigation and a lot of work. Our family support program offers a specialized care advocate on our clinical team who’s that family’s expert guide to speed access to treatment and to eliminate dead ends for that family. If you can see on Craig’s slide, eating disorders were a condition there and we know that this often impacts people in their youth. On the next slide we’re showing a tool that clinicians, patients, families, can use to navigate all the points of care in one single recovery record. Very recently in a couple of states and a couple of products we’re offering access to virtual care for eating disorders that treats patients in their own homes through the provider Equip. And we can keep going.
I’d say finally, to conclude, if you have EAP, leveraging the digital infrastructure of EAP as your entry point to care is a great way to get there. But I want to thank you so much for allowing me to spend some time with you and I hope that you’re safe and well until we meet again.
Allison, I’m going to start with you. Could you talk a little bit about more on the behavioral health side, what we’ve been doing around tele-behavioral and some of the trends we’ve been seeing there and the access that we’ve really been working hard to create there?
Yup, happy to. Optum Behavioral Health has and has had one of the largest virtual networks, I think in the industry, and certainly in COVID a majority of our outpatient visits were conducted through telehealth. And the questions I get a lot are, is it clinically effective and is it efficient? And we’re reviewing this all the time and what our studies indicate right now is that this is a clinically effective modality for certain conditions. And is it efficient? What I hear from providers and the studies that we see show that we have higher appointment compliance so people keep their appointments. They don’t miss them, they don’t cancel them. They tend to stick with treatment, so better treatment adherence. And we see this across technologies and actually across disorders and population. So that’s some perspective for you, Phil.
Great. Thank, you Allison. I’m going to keep going with you with one more and just talk about adolescent challenges and specifically leaning in there and what we’re thinking about. I can just tell you. I know for those of you who are listening to us today, you’ve talked to so many families and what our kids have had to go through, particularly kids 14 to 20, and the challenges are just immense. Can you talk a little bit about what we’re really focusing on there and what we’re trying to do and how you think about that?
I can and I agree with the challenge. Many of us are parents, we see it. And if we just step back a second and look at the data, the CDC shows that the second and third quarters of 2019 versus 2020, we see a marked difference in kids coming to the ER, presenting at the ER for behavioral health concerns. Ages 5 to 11 increased 24%, 12 to 17, 31% increase in presenting at the emergency room for a mental health concern. We think about the response in kind of three ways. First, identify. So particularly for children who have come to that higher level of care as a first step, identifying them through our data, intervening. Ensuring that we’re getting care advocacy matched up with that family is critical. Engaging them. So how are we engaging the caregivers of those children, either through a digital experience, through care advocacy, the family support program I talked about. Helping them navigate the system and then to really ensure that we’re helping to guide people too as they go through that journey. And a special concern I think, particularly on many people’s minds right now, LGBTQ and youth of color. How are we ensuring culturally competent care for them? We actually have a partnership with the TrevorProject right now to focus more on those disparities that we see and use. So broad brush but that’s sort of some of the things we’re thinking about.
That’s great, Allison. Thanks. And I just want to pull something out that you said there for our clients here today, which is increasingly what we’re trying to do is we’re using our data sets and we’re not waiting for someone to present at the emergency room. We’re trying to look at other situations and try to be proactive in trying to engage those populations. And there’s obviously very different needs across the behavioral spectrum but we’re not waiting and we’re trying to get much more proactive.