Mental health lessons learned from MemorialCare during the COVID pandemic

The increase in adverse behavioral health conditions during the COVID-19 pandemic is well-documented. Over the summer, 40% of US adults reported struggling with mental health or substance abuse. 

That same data showed that symptoms of anxiety disorder were three times more prevalent (25.5% vs. 8.1%) compared to the second quarter of 2019 and depressive disorder symptoms were four times higher (24.3% vs. 6.5%), according to the Centers for Disease Control and Prevention. 

 

 

In response to the surge in behavioral health needs, the Healthcare Leadership Council (HLC) recently hosted a conversation with experts on some of the lessons learned during the pandemic related to protecting mental health for both patients and frontline workers. 

Dr. Tanya Dansky, Senior Medical Director at MemorialCare Medical Group, kicked off the conversation with a discussion on work being done by MemorialCare to meet the behavioral health needs of patients. MemorialCare is a non-profit health system that includes over 200 ambulatory sites and 4 hospitals in the Southern California area. 

Back in 2018, prior to the COVID-19 pandemic, MemorialCare launched its Collaborative Care Pilot program focused on addressing anxiety and depression. The pilot offers patient-centered care, where primary care physicians screen for and initiate behavioral health treatment and patients work directly with behavioral health specialists, such as a social worker, to meet their goals. Through the program, there are also weekly, virtual case conferences with a psychiatrist. 

Over a two-year period, MemorialCare has been able to show that about 80% of patients who were part of the collaborative care model achieved remission for depression within 90 days. However, during the pandemic, Dansky says they’ve seen a shift in the speed of remission. 

“Prior to COVID, the average days to remission was about 38 days,” says Dansky. But now, the number has jumped to an average 76 days to remission.  

“So, it’s still within our goal. It’s about twice as long, and again, it’s not surprising…with the level of stress and anxiety that everyone’s under these days,” she says. 

About a year into the Collaborative Care Pilot, Dansky says MemorialCare launched a virtual behavioral health solution in the hopes of scaling the pilot to meet the needs of a larger patient population. The platform, SilverCloud, provides assessment and digital treatment. 

As anxiety and depression have increased since the start of the pandemic, so has the number of individuals using the SilverCloud tool. 

 

Image: MemorialCare Medical Foundation

 

Dansky says looking back, it was helpful that both SilverCloud and the Collaborative Care Pilot were well established prior to the pandemic and able to withstand an increased capacity. Behavioral health specialists were able to quickly transition to 100% virtual visits without experiencing major loss of connection to their patients. 

She also highlights that even with the increased number of individuals utilizing these programs, MemorialCare’s analyses shows a total cost of care reduction of about 16%.

“It’s shown that there’s a value to integrating behavioral health which we know makes sense clinically, but it’s nice to be able to see the data backing that up,” says Dansky. 

Looking forward, Dansky outlined the following policy considerations:

 

Image: MemorialCare Medical Foundation

 

The full Healthcare Leadership Council webinar is available here, along with speaker presentations here