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4 ways to help improve mental health for at-risk populations

Originally published in The Tennessean, May 2021

A study released last year by the CDC and the National Center for Health Statistics suggests that Tennesseans are more likely than adults in any other state to report “feeling down, depressed, or hopeless” for at least half the week. 

While that’s certainly not good news, I can’t help but focus on this being a positive first step for our fellow Tennesseans in need. At least many can admit to these feelings.

I never would have imagined that a global pandemic would actually play a role in helping to lift that stigma, but it’s a silver lining in a challenging era.

I recently heard the story of a member who was having trouble sleeping and experiencing feelings of hopelessness. She was referred to our behavioral health team via her nurse case manager, who was helping with her diagnosis. While the member was already seeing a therapist, she lived in an area with limited support resources.

The behavioral health case manager discussed medication options and sent her info about recovery groups. The case manager and member also talked about additional coping skills, such as journaling. Today, the member is on medication and is journaling with reminders from our CareTN app to help her process her feelings. She now feels hopeful and happy.

How we can destigmatize behavioral health care

We need to encourage openness about seeking behavioral health care — and remove barriers to the care.  That’s especially true among the traditionally underserved Medicaid populations, which our team supports each day. Here are four things we’ve learned that work.

Consider social factors. How people respond to our behavioral health needs depends on a variety of factors like housing, environment, health care access and quality, and education and awareness. We use the BlueCross social vulnerabilities index and screen for challenges when we speak to members on the phone.

Bring behavioral health into every health conversation. Even before the pandemic, the BlueCare Tennessee team integrated behavioral health care support into all of the services we provide to TennCare members.  Opening up this conversation with our members when discussing their other health conditions builds trust and results in better outcomes.

For example, a member with both diabetes and depression might experience difficulty performing tasks and thinking clearly as a result of depression. This can interfere with successfully managing their diabetes. Part of our role is to not only help members make this connection but provide best practices to improve overall health.

Demonstrate understanding. Peer support is another great tool for supporting mental health, and another way of supporting a whole-person perspective on wellbeing. A peer support specialist is a certified professional who has a lived experience with a mental illness, and who provides assistance, perspective and guidance to additional support, such as recovery groups.

We have peer support specialists on the BlueCare team, and they frequently work with members at risk of readmission to mental health inpatient units or who have substance use disorder issues.

They’re connected as part of a holistic support team through our nurse case managers or a member’s primary care team.

Promote telehealth. During the pandemic, virtual care has helped serve many people in rural areas, those who were at higher risk of contracting COVID-19, and those who don’t have accessible transportation to their doctor’s office.

As Tennesseans feel more comfortable seeking help for behavioral health needs, we have an opportunity to keep learning together — and embracing new ways to serve them. It’s another way we in the health care community can find common ground and come out of this pandemic stronger than before.


About Janice Maurizio, Vice President of Behavioral Health Programs at BlueCare Tennessee

A photo of the authorAs VP of Behavioral Health Programs at BlueCare Tennessee, a BlueCross BlueShield of Tennessee subsidiary serving TennCare members, Janice supports an empathetic and innovative treatment model that focuses on a caring, individualized approach.

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