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Originally appeared in The Tennessean, March 2019

In 2005, I helped evacuate more than 200 patients in New Orleans during the flooding and aftermath of Hurricane Katrina.

I saw the urgency of the situation weigh heavily upon patients who were facing physical ailments, a toll that led to severe cases of stress and depression. More than any other, this situation reinforced for me the vital connection between physical and behavioral health.

Today, those memories inform my work as Chief Medical Officer for BlueCare Tennessee – a subsidiary of BlueCross BlueShield of Tennessee that servesTennCare members, a population traditionally underserved when it comes to behavioral health services.

Our priority is improving the health of the people and communities we serve. So we not only look at the TennCare population as a whole, but at each person as an individual.

We have learned that social determinants have a profound impact on physical and mental health.  Many of these members are on a fixed income, or don’t have steady access to transportation, or don’t even know where their next meal is coming from. It’s hard to prioritize seeking treatment for stress or depression when you’re just trying to pay bills or set the table.

In Tennessee, 20 percent of adults experience mental illness, and 10 percent of high school students reported attempting suicide at least once in the past year.

Mental health challenges do not discriminate based on age, gender, ethnicity, location or prosperity,  but socioeconomic factors can make them more challenging to address.

While behavioral health services can always be accessed through a primary care provider, it’s critical to build a system where any person can enter a behavioral health program at any time and receive needed care and access to resources.

Consider an adult with diabetes; the need to monitor blood sugar and diet can be a major stressor, resulting in the onset of depression. This is especially true for someone who lives alone, does not have the support system of friends and family, survives on a fixed income or may have mobility issues. The same goes for a single parent who works two jobs while caring for a child who has a chronic illness. That child can experience behavioral health issues, as well.

Helping members manage their care 

To support the whole-person care concept, all of our behavioral health programs are fully integrated with our medical care management programs.  Our care managers assist and educate members, families and health care providers on decision-making, processes and treatment options. They also:

• Communicate directly with community resources that can assist with meals, transportation to medical appointments or utilities
• Check on members recently discharged from the hospital to make sure they have what they need, and follow up with those who have missed medical appointments to see if there are barriers to care that need to be addressed
• Help coordinate the integration of mental and physical health care treatments to work toward better overall health.

Behavioral health care that results in a healthier whole person depends on meeting individuals where they are – and ensuring they feel welcomed, respected and not stigmatized.