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The Path Forward for Mental Health

David Wennberg, MD, MPHCEO, Quartet

Blog | Healthcare | Stories | Jun 27, 2019

 

“Dad, I need your help. I need a plan…”

The call a father never wants to receive. Your kid, in a moment of fear and desperation, reaching out to a parent as a last resort for help.

I got this call from my daughter a few years ago. She was on medication (clonazepam) prescribed by her psychiatrist as a bridge to a longer-term prescription plan. There are specific instructions she needed in order to taper from the medication over time, but this taper was not given to her (and trust me, if she had been given instructions she would have followed them). She had stopped taking the medication altogether a few days earlier, and was experiencing severe withdrawal symptoms. Her psychiatrist wasn’t responding to her calls, and her primary care physician wasn’t in the loop. My kid was left in limbo, and she’d reached her breaking point.

I picked up the phone and called the psychiatrist with an authoritative “This is Dr. David Wennberg,” and got ahold of the psychiatrist immediately. In contrast, my daughter – the patient – spent days calling with no answer. We got the psychiatrist to respond. Through our personal and professional networks, we made sure she got the care she needed.

In addition to experiencing the side-effects of her medication, my daughter was experiencing the impact of a siloed system where primary care and mental health care were completely out of sync. How many other people can fix the side effects of a deeply siloed system through a parent with a medical degree and their connections?

 

A National Problem

Most people with a mental health condition in this country aren’t getting the care they need.

There are numerous barriers to accessing quality mental health care. Some erected by the ongoing fight for parity, including disparities in reimbursements, paperwork burdens, and prior authorizations. Others by stigma, including healthcare providers fearful to talk about mental health with their patients because they don’t have the resources to get them to care. These are all barriers that can, and will, come down.

It starts by acknowledging that mental health care is health care.

When mental health care is fully integrated with primary care, and done at scale, millions of people getting little or no treatment today will finally get the help they need and deserve. One way we’ll achieve this is by combining technology and services to better utilize resources we already have in our healthcare system — and to create new ones.

I was glad that I could help my daughter in a moment of desperation. But it’s not the answer to a broken system. There are hundreds of millions of other people who find themselves in comparable situations, without the resources we had available.

As many as one in four Americans live with a mental health condition, and more than half of those people are not receiving the appropriate care. There are roadblocks at nearly every turn.

Many people don’t receive appropriate care because their physician isn’t trained to recognize psychological problems that often underlie physical illness, or they treat the physical manifestations of mental health as a physical condition. Those who do seek care often find a difficult time connecting with a provider that takes their insurance, specializes in what they need, or is geographically proximate. If lucky enough to find someone to treat them, it can take weeks — if not months — to get an appointment.

These are daunting problems, but they are problems with solutions. The key to getting past these roadblocks is to blend mental health with primary care so we can connect the right person to the right care at the right time.

 

It takes a team

Quartet is in an exciting moment. Building upon our work with Highmark Blue Cross Blue Shield, Horizon Blue Cross Blue Shield of New Jersey, Premera Blue Cross, and Sutter Health, this spring we launched with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to integrate mental health and primary care. We are excited to be a central part of the healthcare transformation that is happening in North Carolina, working with Blue Cross NC to improve mental health care statewide.

Quartet reached another important milestone in our mission to improve mental health care for millions of people in America this month. To help ensure that all people have access to mental health care, we are partnering with Centene Corporation, a leading provider of managed Medicaid. Already, we are hard at work with two local Medicaid providers, IlliniCare and Louisiana Healthcare Connections, to get patients the care they need.

We know that supporting patients with mental and physical health conditions often takes a team. That’s why we are working to expand our product so that it enables clinicians and clinically-adjacent providers — as well as community-based professionals such as care managers — to support patients and connect them to mental health care.

 

Making waves

Both of my parents were agents of change in health care. My mother, Dr. Emma Ottolenghi, is a pioneer in women’s reproductive health and was the primary care provider for women movers and shakers in Vermont. My father, Dr. John Wennberg, is the founder of the Dartmouth Institute for Health Policy and Clinical Practice, and his research uncovered major gaps in our nation’s approach to healthcare delivery.

And yet — after my years of medical training, health research, and serving as a health care executive — it was the experience of my daughter that showed me exactly where I should be directing my efforts: towards breaking down the silos between physical and mental health care in this nation.

Our vision, shared with all 200 team members at Quartet, is to ensure that one day every person with a mental health condition can get the care they need. We do this by leveraging technology and services to connect people to the right care at the right time.

We are in a mental health moment in our country. Quartet is on the frontlines working with plans, providers, and patients to rethink what mental health care looks like. There is more work to be done. For my daughter, and the millions of Americans like her, I am grateful for the work we’ve done to date with our partners, and will continue to do in the years to come.

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