Two approaches are better than one: mental health
June 21, 2022
For business owners, plan administrators, and sponsors
Plan members short-change themselves by limiting treatment
Often, the treatment of mental health issues calls for more than one approach. Yet, research and claims analysis show that a minority of people are following this advice 1,5. When you help plan members understand the programs and range of treatments available to them, they have a better chance to choose the best and most effective care options.
The federal government estimates 3 million Canadians, age 18 and older, have a mood or anxiety disorder. In January 2022, Mental Health Research Canada reported that almost half of all Canadian households have at least one person who’s been diagnosed with a mood disorder, a number that has increased 7 - 8% since the pandemic began2. And the prevalence of mental health issues might be far greater than that. It’s thought that up to half of all Canadians with symptoms of a mood disorder have yet to be diagnosed1.
“When adequate treatment is received, many people with mood and anxiety disorders function well, both personally and professionally,” says Dr. Georgia Pomaki, Manulife’s Director of Mental Health Best Practices: Disability and Life. “But when their treatment needs are unmet, it can be more difficult for them to work, often requiring job modifications.”
This could mean changes to the number of hours worked, the type of work they’re doing, or changes to the way the work is performed. There’s also a higher risk for unplanned absences and disability3.
Mental health supports sometimes underused
Through your organization’s benefits plan, your employees and their family members have access to supports, programs, and treatments to help them cope with these mental health challenges. But are they using them to their full extent? Manulife’s Health by Design philosophy is anchored in bringing all available supports into play when a plan member falls ill or suffers an injury, so it’s important to understand plan member behaviours.
Few Canadians are using medication and counselling in tandem
The 2 most established treatments for people with mood or anxiety disorders are prescription medications and psychotherapy (other treatments options include exercise and meditation).
Recently, claims analysis for one larger plan sponsor found that younger plan members are more likely to seek counselling to deal with their mental health issues, while other age groups are more likely to use prescription medications. “These demographic preferences are interesting and insightful,” says Dr. Pomaki. “They point to potential education opportunities for plan sponsors and the healthcare system.”
“There are groups of people who are more comfortable sharing their stories and their struggles with a trusted counsellor, but less open to the idea of taking medication long-term. Other plan members might find it easier to talk with their family physician and receive medication as a treatment. But for optimal results, in many cases, both approaches need to be considered.”
It doesn’t have to be one or the other
This finding isn’t entirely unexpected. In a Public Health Agency of Canada study, researchers found that only 27.3% of people suffering from a mood disorder receive treatment through medication and psychotherapy, even though that approach is understood to be an effective first step in treatment. Sadly, the study found that 18.2% of people do neither1.
Amongst the group of people (47.6%) whose mood disorders are being treated only with medications, the reasons given for not attending counselling included ‘I prefer to manage on my own’ and ‘I’m already managing through medication.’
The number of people who are treating their condition through counselling but without medication was much smaller - only 6.9%. Some of the top reasons this group gave for not including medications in their therapy included ‘I’m controlling my mood disorder without medication’ and ‘I’m worried about the side effects of medication.’
Dr. Pomaki says it’s easy to guess at the reasons why the number of people seeking counselling is lower. “Counselling can be difficult. It takes time to find the right therapist and build trust and rapport. It can require a good deal of emotional strength and courage to talk openly about your problems and start making changes to improve mental health. But it’s also incredibly effective. It’s worth the effort.”
More treatment options mean easier access
Fortunately, the effort needed to seek and receive psychotherapy is becoming more manageable. New technologies are allowing people to interact with their plans in more convenient and effective ways.
The digital and virtual delivery of health care means that time and location no longer limit the kinds of services available. Now, thanks to a growing number of programs, patients can be paired with experts across the country. These caregivers support and guide the plan member to recovery, offer relevant education, and provide the coaching support needed to help them take the next step in their journey.
For example, Manulife’s Therapist Guided Program, powered by MindBeacon, delivers personalized support for a range of mental health-related issues, including anxiety, depression, panic disorder, stress management, alcohol use and others.
“Care is delivered through the Internet, so there’s no added pressure to schedule appointments, miss work, juggle schedules, arrange for child-care, or find transportation,” says Dr. Pomaki. “Patients interact with the program at their own pace, while a therapist monitors their progress in the background and messages with the patient when appropriate.”
Convenience and improved results
After participating in Manulife’s Therapist Guided Program, 73% of members saw clinically significant improvements in their symptoms. This translates into a 17% overall reduction in the length of disability claims, and a 4.7% improvement in return-to-work rates4.
There’s no question, treatment decisions are best made by patients in consultation with their doctors. However, the data suggests plan members might not realize they can receive more than one treatment at a time for their mental health conditions. They also might not fully understand the range of coverage available to them through their group benefits plan.
Creating awareness in your organization about all the coverage and treatment options available to them (and the better odds for improved health outcomes) could go a long way to helping members find the best combination of treatments for their unique situation.
1 Public Health Agency of Canada, Use of medication and psychological counselling among Canadians with mood and/or anxiety disorders, May 2017. Siobhan O’Donnell, MSC; Maria Syoufi, MSC; Wayne Jones, MA, MSC; Kathryn Bennett, PhD; Louise Pelletier, MD.
4 MindBeacon Insights Report, 2021 and The Effect of Depression Treatment on Work Productivity – American Journal of Managed Care, 2014, and Manulife and MindBeacon TAiCBT Pilot Report, 2020.
5 Manulife claims analysis, 2022