How to transform care models for better mental health care

Table of Contents

1. Improve mental health data collection and analytics for better and more equitable outcomes.

While quality data collection has lagged within the traditional health care system, mental health data collection is woefully inadequate, according to interviews with executives across the globe. As a result, health organizations often lack a true sense of their population’s needs, and the insight needed to proactively intervene on an individual level.

Without that data infrastructure, health organizations are unable to apply basic analytics or artificial intelligence (AI) tools to gather insights on patient demand and needs. As health systems try to build this infrastructure, they should be guided by governance policies that acknowledge the unique data privacy regulations over health and mental health data, and determine how to use the data in ways that ensure trust. When integrating systems and applying AI, that governance will be important to avoid the introduction of bias or hallucinations that could exacerbate already existing challenges.

The survey also found that global consumers are open to digital tools that can help with mental health, as long as health organizations are transparent and help them see the value of using digital health technologies to connect them with providers, peer groups and other supports. Sixty percent of respondents said they would feel comfortable using genetic tests that show whether they are predisposed to have certain mental health conditions; 59% would feel comfortable using digital technologies that collect and share their mental health data with providers. Health organizations need to embed privacy and security in their design of all infostructure, apps and algorithms. Patients want to know their data is encrypted end to end and that it will not leave the systems they have approved to access their data.

2. Transform care models for better triage, more prevention and integration.

Interviews and survey results highlight the barriers to accessing timely mental health care, and these barriers can result in inefficiency and waste. When people are not routed appropriately, too many progress to a crisis situation, focusing the system resources on inpatient beds and acute care. Meanwhile, issues that could be resolved earlier with less suffering, cost and burden to the system go unaddressed.

Global survey respondents said they are open to preventative mental health care. Eight in 10 respondents (81%) indicated they would undergo an annual mental health screening if it is offered at no or minimal cost, slightly lower than the percentage who reported they would take annual preventative physical health tests like blood tests (87%).

Health leaders also voiced a desire for more standardization in the delivery of mental health care, such as has been done clinically with conditions such as high blood pressure and diabetes. “We have really care-focused clinical practice guidelines and support for primary care doctors and teams to be able to assess, identify, screen and then decide and initiate treatment with clear escalation pathways for folks,” said Dr. Sacha Bhatia, vice president of primary and community-based care for Ontario Health in Canada. “We don’t have that in the same way with depression and anxiety, and that’s critical.”

Interviews highlight the ability of integrated mental health care teams to provide the right level of care when consumers need it, stepping care up and down, especially when many who are struggling don’t know what they need. Across the globe, health systems have turned to different integrated models that bring primary care, mental health, sexual health and other providers together under one roof.

The survey suggests health care providers can be an entry point to the mental health care system, with 61% of consumers already seeking help from their primary health care provider for mental health concerns. Nearly 70% of respondents said they were very or somewhat comfortable addressing mental health care with their primary care doctor, with older generations being more likely to both have a doctor and be comfortable with them. But taking advantage of this opportunity would require integrated data platforms and a more coordinated ecosystem focused on prevention.

Payers and governments have a role to play in incentivizing a shift to more preventative, predictive, affordable mental health care that provides consistency in care quality. “Eventually what drives innovation is reimbursement. As long as insurance companies are not picking up on the roadblocks, we will not be moving forward,” said Luisa Wasilewski, founder of Berlin-Germany based Pulsewave Digital. “It is the regulators that change the system, not technology.”

Another digital avenue for health organizations to pursue is to build intuitive, helpful digital front doors via online portals or apps that help make the mental health care experience better and more effective, connecting them to care when they need and clarifying how to get help.

3. Show value and progress to consumers, payers and stakeholders.

More than half of global survey respondents (55%) report that financial or insurance issues have caused them to stop or consider stopping the use of professional mental health services. If they are already concerned about affordability, and not convinced of the value, health organizations could make gains by educating consumers and other stakeholders about the value of mental health care, helping them understand treatment decisions and how realistic progress looks.

Kirsten Horthe, head of psychiatric unit, Vestre Viken Hospital Trust in Norway, highlighted how her organization uses technology to help patients understand their progress. Through a program called “Share with Me,” the team deployed a form that each patient receives before treatment and during treatment that provides consistent feedback on progress. “If the patient actually feels that there is no progress here, then it is given back to the therapist,” she said. “It’s a way we use technology in a smart way, to slowly get better at systematizing the feedback. If not, then it is a closed room – the therapy room. If things go badly, then it is not certain that the therapist is doing the right things. If you get warning signals through these forms that it is suicidality then that escalates, then you also get the opportunity to intervene earlier.”

The lack of measurement-based care hampers the ability of providers to make the case to consumers and payers that mental health care services are valuable. And other stakeholders point to a lack of accountability when it comes to delivering quality mental health outcomes.

Without data, providers also have struggled to show payers the value of these services. “Payers want to have an ROI, the reality is that mental health care delivery has lacked structure, accountability, measurability and transparency for a long, long time,” said Brad Kittredge, founder and CEO of Brightside Health, an online provider of mental health care services. “With cardiac disease or diabetes, providers can show much more rigorous outcomes. There is a lot of science behind mental health care despite the subjective decisions sometimes made,” he said.

4. Invest in the areas where consumers say health organizations are failing in important ways.

The survey suggests consumers are overwhelmed with information and don’t know what type of provider they need. They struggle to access care in a timely fashion, and to understand their financial costs, leading to inequities.

A third of global respondents (32%) cited a lack of mental health professionals with skills specific to their needs; 50% of those who have used mental health services changed their mental health professional, with the top reasons cited as lack of personal connection or compatibility (42%), or not satisfied with progress (37%).

EY consumer research spotlights the points in mental health journeys where health organizations have the most opportunity to improve interactions that consumers deem the most important, but also find the most difficult. Those points are: