Technology and Behavioral Healthcare
Recently, John M Murphy, MD and CEO Western Connecticut Health Network in Danbury CT (a patient-centered system of care formed in 2010 by Danbury Hospital, New Milford Hospital and their affiliated organizations) wrote a compelling article, “A Future-Focused Approach to Behavioral Healthcare” ** about how to address the growing issues in behavioral health. Behavioral health is defined as promoting well-being by preventing or intervening in mental illness such as depression or anxiety, and also aims at preventing or intervening in substance abuse or other addictions. But behavioral health and physical health have been found to be deeply intertwined.
According to BEHAVIORAL HEALTH: FIXING A SYSTEM IN CRISIS SPECIAL REPORT: Breaking down stigmas and building new models of care are essential for tackling healthcare’s overlooked disease
By Steven Ross Johnson and Harris Meyer https://www.modernhealthcare.com/reports/behavioral-health/#!/ An estimated 44 million adults live with a mental illness, and nearly 60% don’t receive treatment for it in a given year. There is growing data that directly links behavioral health to physical health. For years, behavioral health was ignored when it came to its involvement in one’s physical health. More than one-quarter of adults in the U.S. experience some type of behavioral health disorder in a given year, according to the Centers for Disease Control and Prevention. Twenty Nine percent of adults with a medical condition also have some type of mental health disorder and close to 70% of behavioral health patients have a medical co-morbidity (the simultaneous presence of two chronic diseases or conditions).
The link between behavioral and physical health is strong: 43 Million Americans experience mental illness in a year (National Alliance on Mental Illness) and 68% of adults with mental disorders have medical conditions (Robert Wood Johnson). For example, 15％ to 30％ of people with diabetes also have depression, which can result in higher body-mass index and increased risk of other conditions.
33％ of those who suffer a heart attack later experience depression. Co-morbid (2 behavioral disorders) depression affects 15% to 25% of people with cancer. Studies show it can cost three times more to treat the physical health of a patient with underlying behavioral health issues than it does to treat the same physical health issues in a patient without a mental health disorder.
Technology can assist in treatment of patients who have both physical and behavioral conditions. In his article, John Murphy, MD notes the four components of behavioral healthcare for good outcomes are:
1. Use of Behavioral Health Consultants- there must be an integrated approach to population health including primary care team and behavioral health working together and the sharing of information.
2. Telepsychiatry-due to complicated medical issues with behavioral issues in a primary care office, with telepsychiatry, patients can be immediately evaluated by a psychiatrist using videoconferencing, thus shortening time for diagnosis, treatment and next steps in one visit.
3. Computerized Cognitive Behavioral Therapy-Psychotherapy is utilizing online therapy for changing thought patterns, behaviors, and improving mental health. The online platform gives patients access to care through their personal computers and smartphones. More than 60% of WCHN patients using this program experienced improvement for depression, anxiety and insomnia.
4. Community Care Teams- these are wrap around services for patients visiting ED frequently who have complex social needs that were not being addressed. CCT includes a combination of social, medical and behavioral health “navigators” for high risk individuals. With CCT in place there was a reduction of more than 30% in visits to the ED in the first year.
**Journal of Healthcare Management Volume 63 Number 1 January/February 2018