Executive Cara McNulty outlines the multi-point strategy—partnering with Aetna and beyond—that is helping improve quality access, equity, and treatment outcomes.
A recent commercial for Coors reflects much about pandemic coping and culture, including the role that technology plays.
In the ad, a young woman's fingertip hovers over the "I quit" email she's crafted to her boss as she prepares to join The Great Resignation. She hesitates. Her friend fetches her a beer. Liquid courage in hand, she hits send. Relief and celebration ensue.
HealthLeaders discussed the ad with Cara McNulty, DPA, president, Behavioral Health & Mental Well-Being at CVS Health, as part of our interview on the growing role of technology in mental health and substance use disorder (SUD).
"The message in that commercial is that you need to take a drink before you can take a bold step," McNulty responds. "During the pandemic, for many, self-soothing has become a dangerous equation. People are relying on substances more. They're self-medicating and need help."
Sobering statistics and the role of technology
A CVS Health/Morning Consult survey published in May revealed just how much help Americans need. Some 59% are concerned about their mental health—a number that increases to 74% for people who identified as LGBTQIA+, black, or who are among the younger and older. These and other numbers are up since the last survey in April 2020.
"We've had mental health, alcohol, and substance abuse concerns long prior to pandemic, but they've been exacerbated," notes McNulty. "Everyone has been impacted in one way or another but some populations more profoundly."
Fortunately, the survey also found that more Americans feel comfortable seeking mental health support and using technology to do it. CVS—with and beyond its employees and the members of Aetna (a CVS Health company)—has deployed multiple solutions.
CVS's Aetna programs include:
- WorkIt – Comprehensive, evidence-based virtual treatment program for SUD, including personalized therapy, coaching, MAT, digital learning, and peer support. Specialized adolescent programs are also available.
- Eleanor Health – Holistic, in-person SUD treatment in which providers proactively coordinate care related to physical, mental, and social determinants of health (SDOH). Technology is used to identify risk and supports.
- MAP – Peer support for year-one SUD recovery to help prevent relapse and promote long-term health. MAP also supports family members.
About these solutions, McNulty says: "We evangelize working on our physical health—how we eat, sleep—but we need to work on mental health, treating the head and heart together need the same attention."
Shatterproof and ATLAS
CVS, Aetna, and other health plans are also investors in Shatterproof, a nonprofit founded and helmed by Gary Mendell, who lost his own son to addiction.
Those plans are Anthem, Blue Cross Blue Shield (BCBS) of North Carolina, Cigna, Horizon BCBS-NJ, and UnitedHealth Group. Additional investors include Beacon Health Options, GuideWell/New Directions Behavioral Health, and Magellan Health.
One of Shatterproof's specific solutions is ATLAS (Addiction Treatment Locator, Assessment, and Standards), "a free online tool that helps people find high-quality addiction treatment programs."
The Robert Wood Johnson Foundation is another investor in ATLAS, which launched in July 2020 in six states (Delaware, Louisiana, Massachusetts, New York, North Carolina, West Virginia) and expanded to 10 by June 2021 (Florida, New Jersey, Oklahoma, Pennsylvania). A winter 2022 rollout is planned in California, which Shatterproof states will make ATLAS available "to just over 40% of the US population."
McNulty stresses that Shatterproof and solutions help "democratize quality access—not just access but quality access."
She adds: "The goal is to validate quality providers in specific markets and with specific areas of expertise. It's not enough to get someone in the door; they need the best person.
Shatterproof's effectiveness will be studied by validating quality outcomes while assessing both patient feedback and the broader ecosystem.
Changing payer strategies
In addition to democratization, the approaches of CVS Health, Aetna, and other stakeholders reflect shifting mental health strategy. McNulty identified the role of stigma and the importance of right speech as examples, noting the unique role large companies can play to create change.
"How we talk about things matters," says McNulty. "Saying mental well-being is so much more empowering than behavioral health, which sounds more clinical. If we want people to be healthy, we have to address it, talk about it, and normalize it."
"It's okay to not be okay," says McNulty, adding: "Companies have the power and agility to talk about and normalize mental health. COVID aside, employers, companies, and communities were already realizing the importance of destigmatizing mental health and substance abuse—why upstream solutions are better than waiting until someone is in crisis."
McNulty cites CVS Health's own employee health efforts, including a mental well-being Colleague Resource Group that began less than year ago and now includes 3,000 active employees."
"Things are so different than they were three to five years ago," says McNulty. "It's also really important to also reach beyond health plan members and employees—to have partnerships to help deploy tech solutions virtually and in person while also investing in the larger community."
In addition to Shatterproof, CVS works with multiple organizations to reach underserved and underrepresented populations in the United States. CVS notes that this support "is focused on equitable, quality access to mental health care services and resources, particularly among the Black, Indigenous and People of Color (BIPOC) community. Its specific partners include:
- American Foundation for Suicide Prevention – Includes a "first-of-its-kind education program … specifically for Black and African American communities" that will be piloted and evaluated.
- Mental Health America – Aims to "increase the number of BIPOC individuals directly served by [MHA, including] … screenings and follow-up support for two million individuals.
- National Association of Free and Charitable Clinics – Seeks to "increase the number of licensed mental health clinicians providing services to the underserved," including student training opportunities.
This latter investment is in addition to the role CVS Health's own clinic plays in providing accessible resources to support mental well-being.
"We have a large footprint and can offer screening and care navigation in our retail and MinuteClinics," says McNulty. "Some of these locations include licensed clinical social workers who can help identify resources."
She adds: "Health is contiguous. Our motto is to bring our heart to your health. Our goal through all of these initiatives is to meet you where you're at."
“Companies have the power and agility to talk about and normalize mental health. COVID aside, employers, companies, and communities were already realizing the importance of destigmatizing mental health and substance abuse—why upstream solutions are better than waiting until someone is in crisis.”
Cara McNulty, DPA, president, CVS Health Behavioral Health & Mental Well-Being
Laura Beerman is a contributing writer for HealthLeaders.
KEY TAKEAWAYS
A recent survey found that while mental health concerns and substance use disorders have risen, so have comfort levels that technology can help.
CVS Health's solutions span multiple populations, platforms, and investments.
The goal is to democratize and destigmatize how communities think about and support people in need.