The Fourth Pillar of the Benefits Stack
Both Modern Health and Spring Health provide mental health services through digital platforms. Watson and Lande-Shannon discuss how the pandemic has impacted mental healthcare and how the digital space can be used to advance care.
Watson:The world is facing a global mental health crisis—one that has been mounting for some time, has come to a head during the COVID-19 pandemic, and will last long after. The issue with mental healthcare today is there’s a major shortage of clinically trained therapists per capita in the U.S. and globally relative to the extreme need. This means that access to therapy is primarily based on who can pay a premium hourly rate, and there’s little incentive for the client to stop visiting. We believe that everyone, regardless of how much they can pay, should have access to quality mental healthcare and that our mental health resources can be used far more sustainably.
Lande-Shannon:What groups have done before is someone seeking a therapist would have to go through their health insurance, look through a catalogue and call around, hoping to find the right fit. We believe in precision mental health: the more precise you can be about having the right care and right therapist, the faster you can recover. We deliver a solution and care plan that matches the circumstances someone is facing.
Watson:We think of mental health on a spectrum from green to red. When you’re in the green, you’re feeling well and healthy; yellow means you might be dealing with challenges or want to improve aspects of your life; and red means you have a clinical need for therapy or support. Many people paying for therapy find themselves somewhere in the yellow; they may have subclinical levels of stress or anxiety and could benefit from seeing a mental health coach. Therapy is often viewed as the only tool to combat mental health struggles, hence why the supply is so low and the demand so high.
We’ve cultivated an extensive global network of licensed therapists and certified coaches, paid and managed by Modern Health. One of the advantages to our model for these providers is that we act as a distribution channel, connecting them with new clients and making sure their schedules are full but not over capacity.
Our approach expands the pool of high-quality mental health resources by introducing our network of certified mental health coaches and focusing our network of top psychotherapists toward those who demonstrate a clinical need. We triage users to the right level of care, delivering a support system personalized for every step of the journey all in one cohesive app.
Lande-Shannon:Therapy is not necessarily an industry that has always benefited from the use of technology. Therapists take notes in a notebook and review them over time. But all of our providers are taught to use the platform to capture what is happening in each session and use it as a repository for tracking progress.
We have a care navigation model where staff check in over time, so we can map someone’s progress over time. We can share with employers, showing them that their people are getting better. For a huge company, we may be able to show them that 30% of their population that took an initial assessment showed up with signals for depression and, six months later, half of those people are in care programs and the number with issues has decreased by 50%.
Tracking progress over time also allows us to look at which providers are getting people better faster. We can send more members to those that are performing better than other people in the network. It also allows us to be more precise with our care plans because we can see what is and isn’t working. So someone may listen to five mindful exercises and have a particular type of therapy and it worked for them; when someone else comes in and scores similarly on an assessment, we can build programs for them based on ones that have been successful already.
People go through a lot of suffering while trying to find the right care, and the more challenging and more clinical it gets, the more they are suffering. When it comes to Western medicine, a lot is trial and error. We are trying to reduce that through more precise care.
Lande-Shannon:We have an app called Moments, which is a series of modules a person can listen to and watch, and there are exercises around mindfulness and education around sleep and anxiety, which are common challenges people face. There are tons of practical tips, for instance, on sleep and sleep patterns—how to get better sleep, how much to get, and things that can get in the way of good sleep patterns.
Watson:Despite being more connected online than ever before, some people are actually feeling more isolated than ever. We, as humans, are biologically wired to get endorphins from being vulnerable in front of other humans. Our therapist-led group sessions, Circles, allow one therapist to provide clinical outcomes for more people and are fostering community and engagement across the board—a win-win.
If someone has a clinical need for one-on-one therapy, we want that option to be available for them so they can get the support they need. Unlike other platforms in the industry, by combining digital programs, coaching and therapy in one platform we are able to always effectively support employees as they ebb and flow up and down the spectrum from green to red throughout their lives.
Watson:The group therapy model is used to treat a wide spectrum of clinical needs, from depression to substance use disorders. However, it is also beneficial for individuals with a shared experience, such as individuals who have experienced trauma, survivors of a chronic illness, or people struggling with the stress of an upcoming event. In fact, we launched the Circles format as a way to provide a safe space for the black community to process the traumatic events of 2020, members or not. This format of care was successful both in terms of attendance and feedback, and as a result we launched additional Circles and opened these up to not just customers but also members of the general public. Modern Health is the first company in the mental health space to offer the virtual therapist-led group model for free to non-customers. It was important for us to open Circles to non-members, because everyone deserves accessible and clinically validated mental health support, whether they’re an employee at a company or an individual looking for alternative care options.
We have continued to expand our Circles offering to include a wider range of topics that could benefit from a group format, including managing political anxiety, healing Asian communities, and pandemic parenting. Ultimately, group therapy is flexible and can be used to supplement one-on-one treatment if that’s what works best for the individual.
Lande-Shannon:We have care navigators who check in with people over time during their care to make sure they are getting the help they need. They are full-time Spring Health employees. Over 80% of our care navigators identify as black, indigenous or people of color (BIPOC). That is about five times the national average. If you are someone who needs a therapist or psychiatrist, almost 50% of ours are BIPOC. That’s three times the national average.
We have been very intentional in building our company; diversity is important in our organization. To build a company that matches the world we live in, it has to be intentional. It wasn’t by happenstance; it was about making sure we had that representation.
The reality is we all face different challenges based on our cultural backgrounds and upbringing and access or privileges we have or are excluded from. We are making sure this audience, which is incredibly underserved, has people they can rely upon and trust. Care navigators and therapists deal with very sensitive information, and it requires a high level of empathy, which is easier to tap into when you have had a similar experience. Being understood by a therapist is part of what helps healing.
Watson:Both employers and employees are recognizing mental health as the fourth pillar of the benefits stack: employees now expect their employers to offer mental health benefits just as they would with medical, dental or vision. According to Modern Health’s 2020 “State of the Industry” report, 67% of employees feel it’s their company’s responsibility to provide access to mental health services. It shouldn’t take a pandemic for company leaders to begin investing in employee mental health. It should be an always-on focus for any thriving organization.
Lande-Shannon:With all of these things we were hit with over the past year—from riots at the Capitol to social unrest to natural disasters like wildfires—the more leaders acknowledge that these issues interrupt our daily lives and that these are part of our human experience, the easier it is for people to recover. There is not a shortage of challenging things happening in the world, and if it has taught us anything, it’s that leaders have a responsibility to acknowledge and create a support system. One in four people faces a diagnosable mental health challenge, so that’s real. One in four people on a leader’s team is struggling.