Video & highlights from “5 Slides: Impact of COVID-19 on Mental Health”

Last week State of Reform held our “5 Slides: Impact of COVID-19 on Mental Health” virtual convening with Tom Sebastian, CEO of Compass Health, Megan Gary, MD, Assistant Medical Director, Psychiatry, at Kaiser Permanente, and Jeff Hite, PsyD, a Provider Program Director for Beacon Health Options.

During the convening, the three leaders discussed the impact of COVID-19 on mental health, the outlook for mental health challenges in Washington’s future, and how their organizations are responding to challenges stemming from the pandemic.

Sebastian kicked off the 5 slides conversation with a slide detailing the expansion of telehealth service delivery at Compass Health.

 

 

In September 2019, less than 500 individuals received telehealth services through Compass Health. But by May, Compass Health provided 5,800 instances of telehealth care. Sebastian says they are using telehealth for all of the different types of services they provide and that the most dramatic expansion has been in outpatient services and for intensive services for children and youth through Compass Health’s wraparound teams.

“Those teams have made dramatic use of the telehealth platform,” says Sebastian. “We would, without it, have been unable to provide 60 instances of care every day to these kids — particularly kids with special needs that were no longer able to go to school.”

Through telehealth, the teams have adjusted the way they provide services to this population. Rather than providing services for a few hours over the course of a couple of days during the week, most of the teams have gone to daily check-ins with the kids.

“This way we get to lay our eyes on them every day and make sure that everything’s going okay for them and for their families,” he added.

During his remarks, Hite reviewed an organizing framework for crisis systems of care. Within Washington, crisis systems can be “incredible complex,” says Hite, with no two systems seeming to be alike. However, in his slide he identifies 5 phases of crisis services and 5 key components that need to work together to create a successful system:

 

 

Hite identified several issues and questions that need to be evaluated to improve crisis systems of care, particularly during the COVID pandemic. One example is looking at how racial disparities may result in a disproportionate impact on behavioral health services for communities of color.

“We need to re-examine this framework through that equity lens and be thoughtful about targeting interventions through that lens,” says Hite. “We need to consider where our crisis system continues to support systemic racism or assumptions, and then reinforce our efforts in those early phases of prevention and early intervention so that we’re not overwhelming our medical system or our emergency departments in those acute treatment phases.”

Hite also says crisis systems of care have historically been heavily reliant on 911 utilization, law enforcement, and emergency rooms. Instead, he says we should use this as an opportunity to train people in crisis response so that they can respond to people in need, rather than relying on law enforcement.

Gary brought a slide from the Dept. of Health’s report highlighting the behavioral health challenges on the horizon in Washington State stemming from COVID-19. She specifically points to a potential rise in suicide attempts and suicide completions that is expected in September/October.

 

 

In response to this, Gary says Kaiser Permanente is leading two outreach efforts. Their mental health and wellness team first did outreach to their most vulnerable members – Medicare patients 65 and over. The team sent out 1,700 letters and cards across all 8 of Kaiser’s mental health and wellness clinics in collaboration with their primary care-based mental health social workers. The letters offered support and listed support systems that these individuals could reach out to.

Kaiser Permanente was also able to develop statistical modeling to create a list of patients at risk for suicide attempt or completion of at least 3% in the upcoming 90 days. They were able to update this list to about 800 patients after outreach to these members.

“What we found on this list that really, really kept me up at night was it was very teen heavy. There were a lot of teenagers on this list,” says Gary. “We called each of these patients and we did a suicide risk assessment…and made interventions as needed.”

Gary says they are committed to doing this on a periodic basis depending on how COVID continues.

The full video of the conversation is available above.