August 17, 2021

It’s Not Just Physical: Integrating Mental Health & Primary Care

When you visualize what a healthy person looks like, what do you see? Probably someone who’s in good shape, eats well, and is generally free of chronic health conditions. But does that person you’re picturing have a healthy mind, too?

The mind and body are often viewed as separate entities, with very different types of problems that are treated by care providers with their own unique specialties. But in reality, mental and physical health are actually closely related and can impact one another — positively and negatively.

Maintaining good mental health can keep you healthy and help prevent certain conditions. Conversely, poor mental health can put patients at higher risk for many serious health issues. For example, depression has been linked to chronic illnesses like diabetes, asthma, cancer, cardiovascular disease, and arthritis. One 2018 study suggested that adults over age 45 with high levels of anxiety and depression have up to 30% greater risk of heart attack and 44% greater risk of stroke.

poor mental health can put patients at higher risk for many serious health issues

People with mental health conditions are also more likely to suffer from sleep disorders, like insomnia or sleep apnea. Sleeping poorly has a profound impact on overall health and puts patients at risk for a variety of health conditions. Since sleep problems can also make existing mental health conditions worse, this ends up becoming a vicious cycle of poor health.

Managing poor mental health can also make managing a chronic illness more difficult. Our Chief Clinical Officer Andy Ellner, MD, MSc often tells a story about a former medical student of his who wanted to know why some patients in his clinic had an easy time getting their diabetes under control while others struggled to do the same. When Andy and the student investigated further, they found that most of the patients who were struggling to manage their condition typically had something going on in their personal life that made it hard for them to focus on eating the right foods and taking their medications as prescribed. One had been going through a nasty divorce, and several others were struggling with loneliness and social isolation. Andy also suspected that most, if not all, of them may have been suffering from depression or another mental health condition.

“I had expected the student would find that social challenges contributed to poor health. I was shocked, however, that such challenges appeared to account for nearly all the differences between the two groups. If patients’ emotional and psychological health had such a profound effect on their physical health, why weren’t we doing more to address them?” – Andy Ellner, MD, MSc

Due to stigma and other barriers like lack of access to quality care, more than half of people with mental illness do not seek help for their disorders. These conditions are at epidemic proportions and are incredibly important to both employers, who purchase health care for about half the country, and to the patients who suffer from them.

While the Affordable Care Act requires that insurance plans offer mental health care coverage, treatment can still be costly for patients. Depending on your insurance plan, the cost of your visit may be completely covered by insurance, or you may have to cover a copay of up to $50 or more. If you have a high deductible plan, you may need to pay out-of-pocket until that deductible is met. Check your insurance plan’s enrollment materials to determine what your plan covers. Health insurers are required to provide you with an easy-to-understand summary about all of your benefits.

In addition to seeking support from a mental health specialist, there’s evidence that mental health symptoms can be greatly improved by implementing a Collaborative Care Model (CCM) in which behavioral health services are integrated into primary care. One study concluded that depression symptoms could be reduced by as much as 50% within a year — without patients ever having to schedule a separate appointment with a psychiatrist.

So we’ve established that addressing and treating mental health issues is necessary for supporting our patients’ whole health. But how do we do it?

A proactive, personalized, evidence-based approach to supporting our patients’ emotional and psychological health

We’ve built a technology platform and team-based model to scale a proactive, personalized, evidence-based approach to supporting our patients’ emotional and psychological health. Our care team is modeled after this Collaborative Care Model. As a patient, your care team will have a designated behavioral health specialist (typically a licensed clinical social worker). We also have a consulting psychiatrist that supervises the BHS, reviewing all cases and making recommendations about treatment.

>> Read more about how it works

We also screen all of our patients regularly for depression, anxiety, and SUD. For anyone who screens positive or reports that they’re struggling, we set up a same-day video visit, setting in motion scientifically-validated protocols for ongoing assessment and support, including the best medications when indicated, therapy, and regular check-ins. And as part of our annual whole health assessments, our health guides work with patients to create personalized goals and plans for behavior change.

we screen all of our patients regularly for depression, anxiety, and SUD

At Firefly, we believe that mental illness is no different than any other medical illness. There's no shame in seeking guidance and support. From medications to supporting changes to your habits and lifestyle, we're here to support you on your journey to better mental health.

If you’re interested in incorporating behavioral health support in your primary care, consult with your care team today through the Firefly app. Not a member yet? Get started by signing up below, take our quiz, or call us at (855) 869-9284 to see if our continuous, coordinated care model is right for you.

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