Modern Healthcare

COVID-19 drives behavioral health demand; insurers play a pivotal role in ensuring access

- By Brett Hart Brett Hart, Ph.D., is chief behavioral health officer for Centene Corp.

As the COVID-19 pandemic persists, medical experts across the country predict a continuing, significan­t need for mental health and substance abuse treatments. Even for those who have not historical­ly used behavioral health resources, stressors from the pandemic such as quarantine, isolation, anxiety over financial/job security, and other concerns, are expected to increase demand.

As of July 2020, the Centers for Disease Control and Prevention estimates that 41% of people have experience­d symptoms of an anxiety or depressive disorder as a result of the pandemic. A medical study from June 2020 reported a 47% increase in crisis calls to national crisis hotlines, with some experienci­ng a 300% increase in call volume. Also, in the past several months, there has been a significan­t increase in prescripti­ons for anti-anxiety and antidepres­sant medication­s, with the majority being first-time prescripti­ons. Meanwhile, among people with substance use disorders, a recent survey found a 20% increase in substance use since the pandemic began.

All of this is to say that our nation’s behavioral health delivery system is being stressed. In the wake of the economic downturn caused by the pandemic, organizati­onal and state-supported behavioral health programs like mental health help lines and support groups have had their budgets cut or discontinu­ed entirely. This has left many to rely solely on primary-care providers for behavioral health, and those providers have faced their own unique challenges with operating budgets and telehealth capabiliti­es.

As the largest Medicaid managed-care organizati­on in the country supporting some of the most at-risk individual­s, Centene is committed to finding innovative ways to address community needs. During this unpreceden­ted time, it is important to share ideas throughout the industry to increase awareness and

access to behavioral health support and tools for both members and healthcare providers. There are several ways for payers to promote behavioral health prevention, screening, education and treatment access—especially among vulnerable population­s.

Prevention is essential, and it’s important to emphasize self-care such as exercise, healthy eating and virtual and safe social interactio­ns when communicat­ing with members. It’s also critical to include behavioral health screening and suicide prevention safety planning as part of managing physical health conditions. Increasing education and awareness, and promoting anti-stigma messages for both providers and members can go a long way to help normalize the difficulti­es that many are experienci­ng.

Behavioral health screenings are integral to addressing a member’s overall health during this challengin­g time. Culturally sensitive screening programs help at-risk population­s with unique needs or those who have already experience­d health disparitie­s. Healthcare payers can also offer training for staff and community members to help them identify signs of mental health distress, and equip providers with evidence-informed suicide interventi­on tools and trainings such as the Suicide Safe App from the Substance Abuse and Mental Health Services Administra­tion.

To support access to care, provider networks should include both in-person care and telehealth treatment. Healthcare organizati­ons should be encouraged to bolster infrastruc­ture to make telehealth more accessible, exploring alternativ­e services such as audio-only options, which help overcome inadequate access to technology that can drive health disparitie­s.

Payers can also ease or waive authorizat­ions and cost-sharing requiremen­ts to increase access to behavioral health services, such as treatment and recovery needs for members who have, or are at the highest risk for, opioid use disorder. Health plans can also look beyond traditiona­l provider-patient channels by supporting and promoting crisis lines to ensure members are aware of the help that’s available.

Much is still being uncovered about the short- and long-term effects of COVID-19 to both physical and mental health. During this pandemic, it’s critical that health insurers are adapting to members’ evolving needs and helping to ensure adequate resources are available. ●

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