Eight ways care managers can support members' mental health outcomes

1. Integrating mental health into care management plans

Patients with a severe mental illness are at a 4.2% higher risk for 30-day hospital readmission. Early mental health identification and intervention for at-risk members can significantly lower the cost and severity of untreated mental health conditions by reducing avoidable tests or hospitalizations.

Care managers are well positioned to implement a touch point for mental health assessment. They can incorporate screening questions into regular interactions to identify members who might benefit from a mental health intervention by a provider. Care managers are also critical players in aligning care beyond the risk assessment stage through Collaborative Care Models, helping paint a more accurate and useful picture of a member’s care.

2. Innovating holistic support and wellness programs in mental healthcare

Care managers are the key to creating programs that meet members where they are and support whole-person mental health.

Meeting members' mental health needs will require extension beyond traditional treatment options and progress to include holistic wellness programs. These include options like:

• Wellness coaching
• Stress management workshops
• Lifestyle modification programs like asthma medication use, diabetes management, and medication adherence after a heart attack

Care managers are the heart of the scalable interactive programs that support whole-person wellness and motivate member participation.

3. Strengthening the care network through better relationships with mental health providers

Because of their relationship with both plan members and mental health providers, care managers can help build bridges between multiple stakeholders.

They have the ability to foster trust with providers through improved communication and coordination—a goal that supports a cohesive approach to mental health care. In return, this level of engagement helps managers stay informed on emerging mental health treatment options and best practices that support optimal outcomes for their members.

To take on this role, care managers need a deep understanding of how providers are addressing mental health and how their work can support these efforts.

4. Addressing gaps in care by upskilling care management

As the healthcare system continues to struggle with unnecessary utilization and widespread gaps in care, care managers will need additional training and support to improve outcomes for their members.

Successful programs will provide training and knowledge support tailored to the mental health needs of member populations. This can include topics like:

• Treatment options
• Recognizing signs of mental health challenges
• Resources on supporting members navigating potentially frustrating mental health services

Enterprise-wide training and access to evidence-based information can help unlock the full potential of care management teams.

5. Providing better member education to boost mental health literacy

Care managers are critical players in helping members work with providers to understand and manage their own conditions.

Concepts like substance abuse, suicide prevention, and treatment options can be highly stigmatized and uncomfortable for members to discuss. A survey by MentalHealth.net found that 55% of respondents believed themselves to be at least slightly informed on mental illness and only 9% felt their neighbors were. Care managers can support members in accessing culturally competent educational materials including webinars, live workshops, and one-on-one sessions.

This role will need the tools and technology to connect members with evidence-based materials and empower them as key players in their own care.

6. Leveraging technology to guide members navigating the maze of mental health services

Technology can be a valuable resource for care managers, especially in helping members address frustrating mental health needs.

In the United States, 61% of Americans report that the healthcare system is a hassle. This challenge is especially difficult for minorities, who the Centers for Disease Control reports struggle with challenges including cost, inadequate health insurance coverage, finding providers from their racial or ethnic group, and stigma about mental health. Care managers can serve as a source of support in identifying resources, scheduling appointments, and care coordination between providers.

Members need access to resources that match their needs, preferences, and cultures. Care managers can use digital content tools to build trust, support behavioral change, and drive return on investment within payer programs.

7. Improving care management decision-making around mental health emergencies

Integration of mental health into primary care is critical in a mental health crisis. Care managers are instrumental in supporting these connections.

During a time of crisis, this role can provide intervention and support through urgent care coordination, access to safety plans, and connecting members with the optimal providers and intervention services. But to do this quickly and effectively, managers need access to evidence-based content on topics including:

• Generalized anxiety
• Child and adolescent mental health
• Postpartum mental and behavioral health
• Antidepressant medication side-effects and switching
• Screening for depression and substance abuse

Clinicians used UpToDate® to search for mental health and psychiatry topics 10.9 million times in 2023. Care managers can similarly use the tool to integrate evidence-based information into their member interactions and better understand the provider experience.

8. Facilitating monitoring and follow-up that align with member needs

Care managers can be catalysts in supporting the kind of improved monitoring and follow-up that supports positive member outcomes.

Effective monitoring and follow-up requires that they have a sensitivity that aligns with a member's cultural, demographic, and educational needs. This role needs tools to support check-in and progress reviews that are inviting and comfortable for their members.

How payers can support the evolving role of care managers in mental health

In a future of increasingly complex mental health challenges, care managers are the key that will unlock higher levels of engagement with at risk members, lower cost of care, and increased payer profitability. Payers who take steps to operationalize their approach to care management today will be better positioned to navigate the needs of their members tomorrow.

Download the Point of Care Report to learn more about the opportunities to leverage care managers as a support for providers who are making strides in mental health.