Behavioral health is just as important as physical health – but often it’s easy to overlook symptoms that affect our mental well-being.
At BlueCross, we want our members – whether they are adults, teenagers or young children – to be aware of and have easy access to behavioral health resources. That’s why we have a care system in place to connect members to the resources they need, no matter where they are in terms of their medical diagnosis and treatment plan. Our behavioral health care is a system for our members who can enter the program at any stage of a medical diagnosis, for our providers to help ensure quality care, and for the care teams at BlueCross who communicate directly with our members.
We sat with Cheryl McClatchey, VP of behavioral health programs for BlueCare Tennessee, our subsidiary serving Medicaid members, to discuss the connection between physical and mental health, its impact on our members and how BlueCross is working to eliminate the stigma associated with substance abuse.
In a nutshell, describe the behavioral health resources BlueCross provides our members.
Cheryl: All of our behavioral health programs are fully integrated with our medical offerings, so any member can get behavioral health services. For example, a member may have a heart attack, but through that, they experience depression and seek counseling.
“We help our members find specialized providers. We also help them with higher levels of care for those really intense needs.”
What role does care management play?
Cheryl: Care managers advocate for members and guide them through the issues and goals members set for themselves. They meet our members where they are and they work together to help the members establish their goals. They also provide community resource options and coordinate those services that may be affecting their health care. For example, a member may have barriers to transportation or safe housing, and our team coordinates with resources in the community to help address those challenges.
Some of our care management programs are specialized. We support pregnant members, members who may be at high risk for a substance-use disorder, members with depression – which, again, can involve supporting them through chronic diseases, such as a cancer diagnosis, and help navigate that diagnosis and care.
How do we educate our members about behavioral health resources?
Cheryl: We make it a natural part of the conversation. For example, if we contact a member about a diabetic condition, we may say, “This situation sounds extremely stressful. Could we also help support you with that stress? We have a team that handles those issues.” So we work as a care team to assure the medical and behavioral needs are addressed seamlessly for the member.
How do we combat the stigma associated with mental health?
Cheryl: Language is incredibly important, and it’s something most people don’t necessarily think about.
“You’ll hear about “those people with addiction,” which is very shaming. It can stop people from getting the care they need. No, it is a person with a chronic disease, a person with a substance-use disorder.”
That stigma stems from our own perceptions. Do we think a person with a substance use disorder has a moral flaw or a lack of willpower, or is it a person with a brain disease who also has a chronic condition, like someone with diabetes?
At the end of the day, our attitude will show our members how we feel and we think. And I would challenge anybody to look at their own perceptions of behavioral health.
How do we help members who fear being stigmatized?
Cheryl: First, if they’re not ready to recognize the issue or accept our help, that’s OK. We meet our members where they are, not just physically, like our field case managers who visit members in their homes, but we meet them where they are in terms of readiness to deal with an issue.
“We very much focus on person-centered care planning. What are the issues that member is ready to work through? We’ll help them with that.”
We gain their trust and can come back around to other conditions they may not be willing to work on as they enter our program.
Is there a recent BlueCare member success moment you can share?
Cheryl: The motto for our team is “Be the Hope,” as sometimes our members come to us and they have none. They’re dealing with incredibly strenuous circumstances along with their health conditions, and our team carries that hope for the members until they can find that within themselves.
I remember a middle-aged woman who had a car accident about 10 years ago, and had been on opiates ever since. We were helping her transition to a new provider, and she was extremely determined to taper off the opiates. We supported her through that process. We did collaborative care calls with her new provider, and the member found alternative ways to manage her pain.
Her response to our care manager was so grateful. She said, “I have not felt this good in years.” There’s a challenge in tapering opioids, and we work with members and their providers to assist with alternatives for pain management. So this was an opportunity, through a provider transition, to really help this member work on her goals.
“Oftentimes our members may not have anybody in their life who they can lean on when working through these conditions, which makes our support so important.”
What’s key for building trust with a member?
Cheryl: Trust is going to depend on the member, on the situation, on the care manager working with them where they are in their journey.But in a big-picture sense, it’s about the member’s goals. We know we need to listen and engage to help them with their condition management, but it’s important to have them take ownership of their goals. We are there to help members – not judge them. That’s critical to building trust.
What other ways do we serve members?
Cheryl: We have peer recovery support specialists on staff, and these are professionals who have a lived experience with mental health or substance-use disorder. Their role is to engage with our members with an understanding of, “I’ve walked in your shoes, and recovery is an opportunity we all have.” People can and do recover from behavioral health conditions. Everybody’s path is different, but we all have the opportunity for recovery. And the peer specialists with that lived experience share it with our members and help them engage in the program.
We also address social determinants of health like housing and food insecurity. We recognize those have a huge impact on health care.
“It’s hard to address your behavioral or physical health needs when you don’t know when your next meal will come.”
What BlueCare member-focused changes are in store for 2019?
Cheryl: We’re expanding our telemedicine capabilities, which will help us provide support to members in rural areas and address issues like transportation that keep people from the care they need. We’re also expanding our MAT, or medication-assisted treatment, network for our BlueCare members. For those with an opiate-use disorder, MAT is an evidence-based treatment as it stops cravings and helps them maintain abstinence. When a member successfully maintains that program, they have much lower relapse rates.
What inspires you to continue serving this member population?
Cheryl: One thing that’s important to me is this is a company that is right here in Tennessee. I’ve been in Tennessee for 30-plus years, and I’ve enjoyed working at BlueCross more than anything else in my career. It serves my friends, my neighbors, my colleagues – many of whom at various points in their lives have relied on behavioral health services. Our focus really is on providing the very best holistic care we can for our members.