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Mental and Behavioral Health Support for Chronic Disease Patients Means Better Health Outcomes

Posted by Chantelle Marcelle

May 22, 2018 9:16:54 AM

Mental and behavioral health support for patients with chronic disease or conditions could lead to better health outcomes.When it comes to treating your patients who have chronic disease or condition, a solid chronic care management plan should take into account the need for mental or behavioral health support that could improve their patient experience and translate to better health outcomes.

The mind and the body are inextricably tied to each other, so creating a care plan that only takes into account treatment of your chronic disease patients’ physical health or conditions misses an important opportunity for a proactive approach that also includes mental or behavioral health needs. A number of studies been shown that a patient’s overall health will be negatively impacted in the event of the comorbidity of mental health illness.

Mental health illness is a common diagnosis in patients with or without other chronic conditions. According to the Centers for Disease Control (CDC), one in five adults and one in five children in America will experience a mental illness at some point in their lives. Seven out of 10 patients visiting a doctor’s office are there for mental or behavioral health concerns. Not to mention, suicide is among the top 10 leading causes of death in the U.S., and the World Health Organization (WHO) states major depression is the global leading cause of disability.  

These statistics are daunting, but as a healthcare provider, you can play a significant role in making sure your patients are provided with adequate behavioral health support, even before concerns become a debilitating issue.

Mental Health Illness and Chronic Conditions: A Look at the Numbers

Statistics regarding the comorbidity of mental health conditions and physical chronic conditions are dismaying.

  • About a third of patients with a serious physical condition develop or display depressive symptoms.
  • Chronic disease patients have a higher risk of depression than other patients.
  • Thirty-three percent of heart attack patients end up with depression.
  • About a quarter of patients with diabetes and up to 40 percent of cancer patients are diagnosed with depression.
  • Up to half of patients who experience chronic pain are identified sufferers of depression.
  • Healthcare costs for chronic disease patients with depression are higher on average than those who do not have untreated mental health concerns. For instance, treating patients who had both diabetes and depression cost 4.5 times more than treating diabetes patients who did not exhibit such symptoms.

Many of these figures don’t take into account those chronic disease patients who suffer from other forms of mental health concerns, such as anxiety or extreme stress, so the actual number of chronic disease patients who also suffer from some form of mental or behavioral health condition could actually be higher.

In some cases, patients develop depression as a result of the chronic condition, but in others, the depression occurs irrespective of their chronic disease. The relationship between depression and other mental or behavioral health issues and chronic diseases can be complex, so as a provider, you will have to perform a case-by-case analysis to determine what course of action you believe will lead to the best health outcome.

Mental or behavioral health support is a necessity for a complete chronic care management plan.

Monitor Your Patients for Depressive Symptoms or Signs of Mental or Behavioral Health Concerns

There isn’t a definitive physical test that can be performed to check for mental or behavioral health concerns, but an attentive provider can be on the lookout for important depressive symptoms or signs of mental or behavioral health concerns in patients.

Recognizing signs of depression, stress, substance abuse, anxiety, and hopelessness in chronic disease patients can be essential to their treatment plans and can also help identify possible risk factors that might impede patient care.

For instance, depression and hopelessness in cancer patients has a strong correlation to a patient harboring a desire to die, which could impact adherence to treatments or other provider directives.

There are a number of mental or behavioral health screening tests available for providers to take advantage of to improve patient care, and leveraging these can help you improve the patient experience and result in better outcomes through a more complete view of your patient’s overall health status.

A useful guide, pulled from the Diagnostic and Statistical Manual of Mental Disorders, is to identify chronic disease patients who suddenly demonstrate “five or more of the following symptoms during the same two week period:”

  • Depressed mood
  • Decreased interest or pleasure
  • Substantial weight loss or weight gain
  • Psychomotor retardation or agitation
  • Insomnia or hypersomnia
  • Fatigue or loss of energy
  • Feelings of worthlessness or inappropriate guilt
  • Diminished ability to think or concentrate
  • Recurrent thoughts of death or suicide or suicide attempt

These patients have a higher likelihood of being depressed.

Over time, training yourself to remain vigilant when it comes to recognizing even the subtle signs of mental or behavioral health concerns, can also be invaluable to developing stronger doctor - patient relationships.

Determine the Best Mental or Behavioral Health Support Options for the Patient’s Care Plan

Incorporating mental or behavioral health support into a patient’s care plan is an important step in providing patients with the complete set of tools they’ll need for a better health outcome. This can be complicated, though, because of the need for consideration of individual patients and their specific needs.

Finding the right mental or behavioral health support options is a case-by-case process.

For example, patients who suffer from chronic pain but also have a genetic predisposition to or personal history of substance abuse would have higher risk of addiction when given an opioid or benzodiazepine prescription. They would potentially require more intensive monitoring and a different approach than other patients without the same risk factors.

Medications are not the only option when it comes to mental or behavioral health support.

Senior hematologist Ulrich S Schuler writes of his experiences with depression in his patients, “Fortunately, most patients with cancer and depressive adjustment disorders respond to a supportive environment and counselling and do not need drug treatment. The observed depressive reaction—for example, after the disclosure of malignancy—should not be taken as an excuse to withhold the truth from patients or to overmedicalise the condition.”

Options for providing mental or behavioral health support for patient care includes:

  • Talking openly with patients to help them identify realistic goals for behavioral health self management
  • Connecting patients with mental or behavior health support groups
  • Referring patients for mental health counseling resources
  • Providing patients with education to help them build confidence when it comes to managing health needs in between doctor’s visits
  • Providing care coordination support for patients, such as the 24/7/365 access to Health Assistants received from CareSync

If you’re a healthcare organization member or provider looking for ways to improve outcomes among your patients with chronic conditions through proactive healthcare support, CareSync offers a variety of ways for you to do so. Learn more about our care coordination services on our website by clicking here.

For more information about Medicare Chronic Care Management, care coordination, MACRA, MIPS, and other CMS requirements that impact reimbursement and healthcare, download this free CCM white paper by CareSync.

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