The Intersection of Behavioral Health, Mental Health, and Health Literacy Proceedings of a Workshop (2019) / Chapter Skim
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4 Exploring Innovative Approaches
4 Exploring Innovative Approaches
Pages 37-52
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From page 37... ...
An open discussion was moderated by Teresa Wagner, a senior fellow for health literacy at the University of North Texas Health Science Center. WEB-BASED RESOURCE FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESS1 The goal of the Mental Health Bridges project, as Joanne Nicholson explained, is to provide usable and useful tools, resources, and opportunities for learning and practicing health literacy skills in an accessible online space with the aim of helping people living with serious mental illnesses overcome challenges in accessing and using health information and, ulti 1 This section is based on the presentation by Joanne Nicholson, a professor in the Institute for Behavioral Health at Brandeis University, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 38... ...
. For the Mental Health Bridges project, Nicholson and her collaborators formed six focus groups across the country that included both individuals with a serious mental illness -- all of whom reported using their cell phones and the Internet daily -- and health information specialists; these specialists included medical school librarians, academic reference librarians, and clinicians who routinely provided health information.
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From page 39... ...
"For general information, they go to the professional sites, but for real dayto-day coping and management, they go to social media," Nicholson said. Nicholson offers a list of design suggestions for websites targeted at people living with serious mental illness: • use vivid, warm colors and consistent formatting; • include infographics; • incorporate videos, audios, and images of "people who look like me" and role models; • make navigation simple; • present information chunks on the same screen; • do not use too many columns; • include tabs at the top of a page with drop-down menus; • enable pages to scroll slowly; • include options for multiple languages; • add a search box; and • make the web pages printable.
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From page 40... ...
. Furthermore, Black said, two-thirds of primary care physicians report not being able to access outpatient behavioral health care for their patients as a result of shortages of mental health providers, health plan barriers, and lack of coverage or inadequate coverage.
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Recently, the program has been expanded to treat patients with anxiety disorders, substance use disorders, and other behavioral health conditions as well as to serve pediatric clinics at four facilities and one of the system's women's health clinics. Black said that 61 percent of the adults enrolled in the Collaborative Care program have experienced significant improvement in depression symptoms.
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From page 42... ...
One of the core components of the program is universal screening for behavioral health conditions using standardized instruments, such as the Patient Health Questionnaire-9 for depression. Primary care clinics at NYC Health + Hospitals are not yet screening universally for anxiety and drug or alcohol use with the Generalized Anxiety Disorder 7-Item Scale, the Alcohol Use Disorders Identification Test, and the Drug Abuse Screening Test, but they do screen the Collaborative Care patients when they are referred.
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From page 43... ...
Relapse prevention planning is an important piece of the Collaborative Care model, she said, and NYC Health + Hospitals would like to provide more training on it to Collaborative Care clinicians. Black explained that once a patient's depression has improved significantly, the care team and patient start to develop a relapse prevention plan.
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From page 44... ...
Black added that her health system's providers have found the Mayo Clinic's depression medication decision aid cards, which outline the different side effects of specific anti-depression medication, can help patients choose the right medication for them. MOBILE INTEGRATED HEALTH MANAGEMENT3 MedStar Mobile Healthcare is a government agency providing emergency and non-emergency ambulance service for more than 1 million residents of Fort Worth, Texas, and 14 surrounding cities, Brandon Pate said.
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The partnerships with community organizations have developed into a substantial network over the years that includes almost every hospital in its service area as well as insurance companies, physician groups, care management organizations, home health agencies, hospice agencies, and mental health agencies. These relationships are integral to the success of the patients, Pate said.
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From page 46... ...
USING LARGE SOCIAL MEDIA DATA FOR UNDERSTANDING MENTAL HEALTH4 Albert Park explained that the goal of his work is to use various technologies to reach wider audiences and to obtain what relevant information individuals with behavioral health issues might not share with clinicians. 4 This section is based on the presentation by Albert Park, a National Institutes of Health– National Library of Medicine postdoctoral fellow in the Department of Biomedical Informatics at the University of Utah, and the statements are not endorsed or verified by the National Academies of Sciences, Engineering, and Medicine.
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From page 47... ...
Social media users, for example, believe that e-cigarettes can help people stop smoking and that using e-cigarettes is a fun experience (Park and Conway, 2017b)
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Jennifer Dillaha commented that she read a book called Flourish that has a chapter describing how many people with chronic conditions suffer from a psychological condition called learned helplessness that leaves them unable to help themselves even though they potentially could. After reading this book, she said, she became interested in the idea that improving health literacy could be an antidote for learned helplessness, and she asked the panelists if they had seen evidence of this in their work.
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From page 49... ...
She noted that the program does not yet have any Collaborative Care clinics at any of its school-based health enters, but if they are established, any information gathered about treatc ment will likely be documented in the student's EHR. Lawrence Smith commented that his institution, Northwell Health, has an extensive program of embedding behavioral health workers -- either social workers trained in psychiatric counseling or behavioral health nurse practitioners -- in primary care offices that are both amenable and large enough, and he said that he was intrigued that Black's Collaborative Care program used registered nurses, who are less expensive, to deliver care.
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From page 50... ...
Currently, the program is going through the same education process to get primary care providers comfortable prescribing anti-anxiety medications. Ellen Markman from Stanford University asked Park to reconcile the idea that depression is contagious with the fact that interacting on social media with others who have depression appears to improve depression symptoms.
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2017. Characterisation of mental health conditions in social media using informed deep learning.
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From page 52... ...
2008. Long-term cost effects of collaborative care for late-life depression.
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