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Navigating mental health care

Not long ago, Andrea Stubbs – a Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Medicare Advantage care manager – reached out to a member who was looking for help finding a therapist. The member is in his 60s, and his life has been marked by change recently. When he began experiencing depression and loneliness, he knew he needed extra support for his mental health. 

That’s a scary moment for most people, no matter their age. Most of us have at least some experience with annual checkups and keeping tabs on physical health. Far fewer know where to start when it comes to mental health and substance use disorders. In addition to just getting over the stigma that’s too often still attached to mental health care, members face other significant hurdles to that first appointment. Many of us live in areas with a shortage of mental health care providers. Others might not know exactly what kind of help they need. In this member’s case, he was feeling lost in a jumble of automated phone systems and electronic forms he didn’t know how to access or fill out.  

Acknowledging that you need and want mental health support is an all-important first step to well-being. When someone takes it, they should have a clear pathway to resources – even the slightest barrier to care could end up having serious consequences. Personalized support that helps members understand what’s available to them and how to navigate the terrain ahead can be key to long-term success improving well-being.  

That’s why Blue Cross NC implemented our own Behavioral Health Care Navigation service for members with non-urgent mental health needs and challenges with substance use. It’s been running for less than a year, but already it’s proven to be a valuable resource. 

Help finding the right provider

For many of us, the natural place to begin looking for providers is to search online. But that can be a frustrating experience when it comes to finding mental health care.  

More than 90% of our state’s counties are designated as health professional shortage areas (PDF) for mental health. Finding someone who’s in-network and accepting new patients can take a lot of time and effort. The back-and-forth process can feel overwhelming, and it can lead to long delays getting that all-important first appointment. That translates into increased risk that a health situation will grow worse.  

Our Care Navigation service simplifies the process of finding mental health support and helps members get care quickly. Members have 2 options to request a referral:

  1. use the Find Care tool in Blue Connect 
  2. call the Care Navigation line at 800-755-0798

Our response time will be rapid. When the member contacted the Care Navigation team, Andrea reached out and quickly matched him with a therapist.  

This program does more than identify who’s taking on new patients, because we know provider availability is only part of the challenge when it comes to finding quality care.  

The patient / provider relationship is an essential component of effective treatment. Anyone seeking support will have specific needs, and they’re looking for someone relatable. For example, some might prefer a female counselor with experience treating substance use disorders. Others might need someone with experience helping older patients or veterans. Some might specifically want in-person services.  

Our team focuses on steering people to care that is both available and appropriate. They take member preferences into consideration and work to match the member with the right provider. Within a just few days, the process can deliver several options for treatment. 

Andrea didn’t just set our member up with a therapist. She also connected him to one of his Blue Cross NC Medicare Advantage supplemental benefits: an in-home caregiver to come once a week to help around the house and provide support. 

“Part of the benefit of the in-home aide is companionship,” she said. “With the transitions that come with aging, with the loss of independence and changing relationships, members often feel alone and just need help navigating the system.” 

The value of following up

Goal-setting and reflective dialogue before, during, and after that first visit leads to positive and long-lasting outcomes. It’s important for members to talk about whether the provider was a good fit and know they have other options if it’s not. A positive patient-provider relationship is crucial for sustained benefit and better outcomes.  

With Care Navigation, patients don’t have to be the only ones driving these conversations. That’s especially important when someone might have lost a spouse or their closest confidant and no longer have a trusted partner they can talk with. Engaging members in follow-up discussion is a critical component of our Behavioral Health Care Navigation service – it’s an opportunity for our team to make sure the referral was a success.  

Our Care Navigators don’t just call back once to check in. Care Navigators remain accessible throughout the duration of care and provide their direct line number so members can reach them without having to go through customer service or spend time in a phone tree trying to get back in contact with the person who knows their case and who understands what they need. 

Sometimes the pathway to well-being is complicated. If a member doesn’t respond positively to the first visit, the Care Navigator can help find a different provider who’s a better fit. In especially complex situations, they can refer members to our case management team for help coordinating multiple layers of care. 

Follow-up communication isn’t just an opportunity to acknowledge difficulties and readjust. It’s also an occasion to celebrate what’s working and incentivize continued perseverance. Andrea helped our member many months ago, and he still calls her every once in a while just to thank her and give her updates on how much his life has changed for the better. 

Behavioral Health Care Navigation is available to members of all ages, but Blue Cross NC recognizes that older members face special challenges. That’s why we have Care Navigation team members who specialize in helping those older than 65 to assist with their specific needs.  

No problem can be solved with a single appointment. Our Care Navigation team works carefully with members so that a first appointment isn’t the last, and that they stay on track toward well-being. 

Mental health support for all

There’s been a lot of public dialogue around our national mental health crisis recently, and that’s a good thing. I’m optimistic that the tide is starting to turn and awareness of our collective mental health crisis is growing. Stigma is gradually diminishing. More people are asking for care. 

Now it’s important to help them plan for what happens next. As demand for care grows, so will questions (and probably confusion) around where to turn for support.  

As a resource that provides clarity around how to start the journey toward well-being, Care Navigation isn’t just an essential tool for those members who need support – it’s also critical to the forward momentum in our collective efforts to strengthen the health and well-being of our communities. 

authors photo

Stephen Friedhoff, MD

Stephen Friedhoff, MD

Senior Vice President, Health Care Services

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