Blog Post

Healthcare Upside/Down: Destigmatizing Mental Health

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ECG’s radio show and podcast, Healthcare Upside Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone

Medicine has been progressive on many fronts, from being able to transplant major organs to developing vaccines for new viruses in record time. But in some areas, our understanding of disease remains rudimentary—none more so than mental health.

Joining us on episode 35 of Healthcare Upside Down is Jay Spence, Chief Strategy Officer for Uprise Health.

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The term “mental health” is variably used to describe a person’s physiological, emotional, and social well-being, but it has long been associated with a wide range of disease states, many of which present in different forms and severity with distinct and unique behaviors. For example, schizophrenia encompasses a broad range of symptoms linked to thoughts, emotions, and individual perceptions and leaves people inhabiting a world that is disconnected from reality. This gets grouped together with anxiety, sadness, and even depression.

Simply put, we lack the tools to visualize the brain and its functions and struggle to comprehend how this complex organ works—let alone explain what’s happening when it does not.

Against this backdrop, it is no surprise that society has struggled to handle individuals who are suffering from a mental health disease. Our lack of understanding has led to stigmas associated with people who variously suffer mild, moderate, and sometimes severe forms of disease that prevent normal functioning in our world.

“It used to be that mental illness was something about schizophrenia, something that happens to someone on a street corner,” explains Jay Spence. “‘It’s over there, it’s not me.’ Now everyone knows it’s in the workplace.”

Jay Spence is the chief strategy officer of Uprise Health. On episode 35 of Healthcare Upside Down, he describes employers’ growing acceptance and awareness of mental health, and what organizations can do to destigmatize mental health problems and empower their employees to use the resources that are increasingly becoming part of total wellness and healthcare packages. Here are a few excerpts.

Measuring value in mental health solutions.

“One of our findings was that about one in three companies don’t have any mental health solution installed. To be fair, part of the reason is that mental health solutions, in particular, have not been able to really demonstrate return on investment. It’s different than, say, a diabetes program where you can point to a very clear metric of ‘pounds lost in weight’ or something like that. But when it comes to mental health, it’s a lot trickier to say what the improvement is in somebody. ‘Pounds lost’ is easy to get. But what does it mean when somebody is improving in terms of their mental health?”

Pandemic changing the conversation around mental health.

“It’s always been the stigma problem. The good thing is that the stigma conversation has changed so much, and so rapidly, and I think the gains that we’ve made around this are night and day. Before the pandemic, I had conversations with employers, and the one that stuck out to me most was an HR leader who was talking to me about her own mental health. And then at the end of that conversation, as we’re transitioning over to my pitch for the mental health solution, she says, ‘there’s no one at this company that has any mental health problems. I’ve never seen anyone with a mental illness.’ This was pre-pandemic. Nowadays, you can go in and have a much more sophisticated conversation about prevalence rates. They know what’s happening, the medications their employees are taking, and what they need to pay attention to in terms of trends. It’s completely different.”

Role of technology in overcoming the stigma.

“What I’ve seen is the emergence of digital tools as a gateway, and people adopting them that didn’t used to. Men are traditionally very hard to reach, especially certain ages and demographics. Digital technology has allowed them to feel more comfortable to come in and maybe start a conversation with a chatbot and then move to higher levels of care.

“The way that most modern mental health technology companies work is that there’s a digital platform that performs a couple of key functions. The first function is usually some type of assessment and triage mechanism. For someone who doesn’t want to jump in with a therapist, it might recommend starting through a digital pathway. For individuals who have moderate levels of stress, they might be ideal for coaching. For people who are seeing emerging or even diagnosable mental health issues, they obviously need higher-intensity treatments like counseling. And then you’ve got the services that have been plugged into the platforms as well—coaching appointments, video scheduling, and all of those types of things.”

On the podcast, Jay talks more about the employers’ changing attitudes toward mental health and the resources available to patients.

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