Workplace in Focus Podcast Episode 10 Transcript

Mental health is always important and never more so than during these challenging times. Learn about Banner|Aetna’s approach to mental health.

[ANNOUNCER]: You have questions about what’s impacting the healthcare system. From pandemics to products, we have answers. Welcome to Banner | Aetna: Workplace in Focus. And now here’s your host, Banner | Aetna Market Head of Sales, Jon Dingledine. 

[DINGLEDINE]: Welcome everybody to this addition of Banner | Aetna: Workplace in Focus. Today we’re really excited to have Dr. Bill Gillis on with us to discuss the impact COVID has had on mental health. Dr. Gillis welcome, we’re glad you’re here. 

[GILLIS]: I thank you so much just for the opportunity to have this discussion. I know all of us are you know during this time, 2020, just seems to be a never-ending experience for all of us but the topic of mental health for us is touching all of us during this period of this pandemic which will be with us for a while. It’s near and dear to my heart honestly, psychologist by training, I work with Banner to be able to continue to support you all in how we’re helping all of us with our mental well-being needs is an important topic for us today.

[DINGLEDINE]: Yes so thank you Dr. Gillis. I think we can all agree there’s been an increase in healthcare needs. Especially during this pandemic. It takes a lot of different shapes and forms I am sure. So is it an increase in previous conditions or have we seen new challenges as a result of the pandemic? 

[GILLIS]: I think the good part of this discussion is we’re going to get into later things we can actually do to support ourselves and everybody else during this time. So prior to COVID we were already dealing with some serious things as it relates to mental health. And we have been seeing just trend increases in isolation and loneliness. Unfortunately, and I don’t want to throw a ton of data at everybody, but if you can imagine 1 in 5 Americans prior to COVID we’re saying that they felt lonely and socially isolated. And then if you think about well what’s COVID done to that? Then we’ve seen across the board for all mental health conditions significant increases via the anxiety and depression, ADHD, autism. I mean there’s and unfortunately for the serious conditions and especially around substance abuse, opioids, heroine, it’s doubled. Among our population especially with young adults and this was all pre COVID and is getting worse. And suicide rates have also significantly increased and then nationwide you know with all this pent up need only fit to 1 percent of the folks that have a behavioral health condition are getting the care they need. And then we also have a provider gap. 

This is all pre COVID so pre COVID hits us and it has accelerated all of that, and now we see folks that have behavioral health conditions, when you think about them, they’re now getting worse but we also healthy people really struggling. Some other factors here though as we moved into this pandemic period we are seeing that people are delaying and deferring treatment especially people with medical conditions. And a lot of these folks have also behavioral health conditions so it’s a double impact here for these folks. So the delay of getting care for your medical condition also means you getting delays in cards also for your mental well-being and so this people are suffering as well. And then lastly for us, we all have suffered losses and were continuing in that space. You know losses just from the loss of normalcy. The idea of maybe going to a restarting and feeling comfortable or the loss of control. Loss of physical connection with loved ones, colleagues, and friends. But then we started getting to more significant issues of loss of work impacting not only you financially, but our identities are part of what we do for work. The loss of feeling safe. But then we get into loss of health. We know for our loved ones and even maybe yourself you’ve experienced COVID and your dealing with the aftermaths of that or still in it. And then also the loss of loved ones due to the deaths of COVID. So quite serious here for us, and all through we are seeing an emergence of what we’re calling now a mental health pandemic. And we have to step into this and address it where we cannot ignore this at all. On top of all of that, I live near Southern California and the fires are still around us. We’re dealing with the stress of other things, natural disasters, political unrest are just a few of the challenges that we’re all having to deal with on top of this so that is pretty bleak so looking forward to the part of the discussion where we can talk about ok what can we do?

[DINGLEDINE]: Yeah absolutely. We will get there. One thing I want to ask another question about you mentioned social isolation, social distancing, so what challenges specifically has the pandemic presented for people actually accessing proper medical care they need or proper mental health care that they need. 

[GILLIS]: Well it’s available so that’s the good news. Now people are figuring out how to make sure that where your being treated, treatment facilities, and all that we’ll talk about access. But it’s available. It now helping those people that really need it be informed and get access they don’t have to hide. You try to avoid what they are perceiving as risk. So I would recommend it you are at this place of thinking you need to get help, call your doctor they’ll figure it out with. They’ll get you to that safe place to make sure you are being taken care of 

[DINGLEDINE]: So as we think about the mental health provider community, why are the new updated resources and ways that the mental health provider community is meeting this challenge. What’s new and available to people out there? 

[GILLIS]: So let me start with primary care. Unfortunately or fortunately, a majority of treatment for mental health happens in primary care. And if you about those docs and there so busy, and that’s a lot of burden to put on them. But what we’re seeing through this pandemic is they people have delayed going to primary care and so that definitely a concern for us. Cause if they are on the front and they’re treating majority of mental health issues, if people are delaying, then they’re actually being able to be identitied and assessed and diagnosed so there’s delay and identification with getting people help. But also there’s people that are in care with a primary care on medication for maybe depression, anxiety. They’re not going or delaying care and so we’re seeing people that now they’re not refilling their medications and now there falling out treatment regimens there, and so the post risk of their mental health care is getting worse. But I think you asked what we are doing that’s unique so let me talk about that. Cause I want to make sure talking about how we are adapting to all this physical distancing and social isolation. One of the silver linings that have come out of this pandemic for mental health is that telemedicine has just exploded. 

So what we’ve had is we’ve had our current outpatient providers be a therapist or psychiatrist with their current patient panel have shifted all into a telemedicine approach. So that is great. So we didn’t have people that we’re just dropped because they couldn’t do face for face side professions, so that right there is good. In addition we have very robust set of partners already in place for telemedicine that are ready to go. And so what we saw is after March, between March and the middle of summer, we saw 87 times increase in telemedicine use for mental health. So amazing. So that’s a silver lining for us. Mental health telemedicine is here to stay. Now I’m sure people will want to go face to face at times, but personally I’d feather do it in the comfort of my home. But what we’ve also seen in this is that this access is improved people actually taking that first initial step, so we see a lot of new people go to therapy and but we’re also seeing people that start therapy for. We see lower no show dates, so we see higher just engagement in treatment and still those are things we like to see because telemedicine has made it so much easier. Some watch outs though. We don’t want providers that aren’t there regular evidence-based care was maybe kind of questionable shift now from face to face into telemedicine and do a practice that’s not evidence based. So that’s our challenge for all of us to work together is to make sure that one we provide good platforms for telemedicine but also help drive quality. So that’s one thing related to some changes that we’re seeing but with other things that we’re seeing in additions to the whole telemedicine. Digital, online digital innovations that they’ve been coming at us for a long time. Really the wild Wild West out there. 

There’s thousands if you search in the app stores you will see thousands of mental well-being apps, mindfulness, stress management apps what’s good. So we here at Aetna have been working very diligently to call out the herd per say and figure out which of these are actually evidence based in an approach, effective and based good research behind them. So what we’re finding is that there are categories of digital tools out there that meet specific ness that if you think about digital tools it’s one additional way to help people gain access to tools and supports in a much easier way. So that’s overall, that’s one of the big goals, but we have good tools out there for depression, anxiety, eating disorders, ADHD, recovery and addiction. So just tools specifically for mental health conditions. So there’s good digital tools out there about mindfulness and stress management, awareness, just relaxation. Those are super, super important in our in what we’re experiencing at this point. 

To other areas that we are seeing that we want to get activated and in place, platforms that help connect people to others. So we’re all disconnected, so there are good online platforms where you can connect and fight against social isolation and build those relationships up because as we say you know there are a lot of people out there that are just alone. And then ways to help people connect the dots on what do I need if I’m dealing with a behavioral health issue, because a lot of times people just don’t know. If you are depressed, what do I do? Do I see my PCP? Do I go to online app? Do I go see a psychiatrist or a therapist? It’s hard like it’s not like if you break your arm you know exactly what to do in the medical world not so with mental health issues. Couples more here that are emerging that are important that this whole virtual lush is helping. 

We like certified people support so if someone is coming out of a hospital for alcohol or substance abuse, we want to do everything to get structure and stability in place and peers have been great. They have lifted experience, they have trained as peers, but they’re not enough of them so we’re partnering with an organization so we can do this virtually across the United States to get that additional care or support through peers. And last thing I want to say is I’m concerned about our primary care and our specialty care that are on the front lines. They need help that are when they do identify someone with a mental health need access to quick consultation from behavioral health exports such as a psychiatrist, so then through that consultation process they can kind of figure what needs to happen and then support whatever navigation process is needed to get that person the right care. So those are the things that have been emerging right now during this period of COVID period.

[DINGLEDINE]: Yeah that is really encouraging to see all of the things are taking shape to help make sure that we take care of this very important need. So let’s make it just a little bit more personal as we wrap up here so what advice do you have for everybody on really on how to make sure they’re taking the best care of their mental health and well-being?

[GILLIS]: None of us at this point can be passive with paying attention to how we’re taking care of ourselves. Every single one of us is dealing with stress, but that stress comes in a form of anxiety, depression, being angry, sad, confused. This is all normal. 

So first of all saying okay this is normal, and from that point then being active in terms of what I consider, and you can find this in changedirection.org they promote four healthy habits for emotional well-being. The first on is absolutely take care of yourself. We kind of forget about that. We’re busy taking care of others, take care of yourself. Check in with others too cause there’s a tendency to when you start feeling stressed and coping to just kind of start pulling back, but also when you connect with others do so and connect and engage wisely. So stay away from things that you can see might stress you out like Facebook right now is probably not a good place to go if you want to be converted because there’s a lot of things going on there. But also with you and your family and friends find time to relax and reduce stress cause you’re going to need it. So that’s for healthy people. 

For people with underlying mild mental health conditions all those four things should be for all these people, but this is the point where you need to get more active in terms of ok what do I need to be doing with my mental well-being. So this is when you think about short term therapy or maybe your EAP? Maybe looking at digital tools and those wellness tools, and also discussing your concerns with your PCP. That’s really important keeping your PCP looped in there. For people with more the moderate, so we’re taking people that have moderate depression, anxiety, other disorders, the impact here and all that stress there functioning is starting to decrease and they’re not doing as well at work. They’re seeing relationships kind of suffer. More isolation and connections are getting lost. We need more formal mental health care, so this is the time to start to get to see a therapist. You can do it through telemedicine. Maybe be evaluated for medication management. These people please consider getting into treatment that’s very important there. Also consider getting connected to peer groups. Also if you need virtual peer support, online support groups, you have to be careful with them, but those are important because this is a place where this segment of the population can spiral and fat into a worse place and potentially get into a place that is more harmful for themselves, maybe family. Also suicide now becomes a risk. We need to be paying attention for those population, and so making sure that we have access for people and vin provide them with suicide prevention hotlines. And that we’re also considering caregivers. Caregivers are very important with this population. 

And the second to last population are those just struggling with severe mental health condition as and they have been just hammered on during this period. If you think about everything, I’ve said there’s so much worse, so we need to make sure we’re identifying those folks. We’re checking g in with them. We’re helping them navigate and access the care they need, and they can’t do this alone. They need people with them, and we need to step in and help guide them and make sure that we help resolve there gonna get away and there’s a lot of barriers at this point. Especially around the social determinants of health. This is why care givers and very important. 

And then lastly for those on the front lines. First responders, medical professionals, a lot of us essential workers, you all are exposed to things that are super super difficult and actively respecting and waking with your stress. Understanding g the stress so so glad so you learn how to recognize your stress. And then doing three things actively every single day. Take a break during the day. And a lot of people don’t. You just wound up. Take that break. It’s not selfish. You have to do it. Take care of your own needs, in terms of work life balance, anc then ask for help. So those are key.

[DINGLEDINE]: Great advice Dr. Gillis. Thank you very much for sharing your thoughts on the subject that really especially during this time of crises is impacting everybody in some way shape or form. So we greatly appreciate you being on with us and thanks for sharing your thoughts. 

[GILLIS]: Thank you for the opportunity everybody and I just withdrew you well. And let’s all hang together during this time. 

[DINGLEDINE]: Yep. Exactly. And thank you everybody for tuning in to this episode of Banner AETNA Workplace in Focus. Tune in again as well have another exciting guest on. 

ANNOUNCER: You’ve been listening to Banner|Aetna Workplace in Focus. Learn more at BannerAetna.com.