Reducing the Cost of Care for Patients with Chronic Illnesses Through Better Mental Health

Research has demonstrated that the presence of a mental health disorder among people with a chronic medical condition was associated with higher rates of hospitalization and emergency department visits, including when considering only visits associated with chronic disease and ambulatory care–sensitive conditions. This study found a 41.8% lower cost of care for chronically ill adults without a mental health problem.

The entire ecosystem of patients, providers, health systems, and health plans would benefit from addressing the physical and mental health needs of those with chronic conditions. 

The Link Between Chronic Illness and Mental Health

Coping with the symptoms, treatments, and overall impact of a chronic illness can be emotionally challenging and lead to various mental health concerns such as depression, anxiety, and stress. Research has shown that there is a strong link between chronic illness and mental health. For instance, Americans with diabetes are 2 to 3 times more likely to develop depression than people without diabetes. 

Chronic illness can also affect an individual’s social life, relationships, and overall quality of life, which can contribute to feelings of isolation, hopelessness, and low self-esteem. Furthermore, chronic pain and physical limitations can also contribute to mental health issues.

On the other hand, mental health conditions such as depression and anxiety can also increase the risk of developing chronic illnesses such as cardiovascular disease, diabetes, stroke, pain, and Alzheimer’s disease. There are several theories for this causal relationship including:

• Many people with depression may experience barriers in accessing medical care.
• Mental health problems can make it more difficult to manage self-care such as finding a provider, taking prescribed medication, eating well, and exercising.
• The body may function differently in response to mental health problems such as higher levels of inflammation, changes in heart rate and blood circulation, abnormal levels of stress hormones, and metabolic changes.

Understanding the Mental Health Needs of Patients with Chronic Illnesses

Living with a chronic illness can be a challenging and often isolating experience and these patients have distinct mental health needs that may require specialized care. Here are some of the key areas to consider:

1. Coping with stress and uncertainty: Patients may need support in developing coping strategies to manage their stress and anxiety, such as mindfulness practices or relaxation techniques.
2. Addressing social isolation: Health care providers can help patients connect with support groups or other resources to combat isolation and build social connections.
3. Managing the impact of pain on mental health: Patients may need support in managing their pain through medication, physical therapy, or other treatments.
4. Screening for and treating mental health conditions: Health care professionals should screen for these conditions to provide appropriate treatment and referrals as needed.

Supporting the Mental Health of Patients with Chronic Illnesses

The healthcare system is generally structured to diagnose and treat chronic illness and mental health conditions as separate and discrete manifestations, which creates complexity for frontline providers. Furthermore, the greatest challenge in the holistic treatment of these comorbid conditions is a declining number of providers amidst rising demand – 37% of Americans live in a state facing a shortage of mental health professionals. Health care providers and health plans must figure out ways to address these unmet mental health needs, potentially avoiding future comorbidities and saving near-term and long-term costs. Here are some strategies:

1. Encourage open communication: Patients should feel comfortable discussing their mental health needs with their health care provider in a supportive and non-judgmental environment.
2. Address stigma: Health care providers should work to promote mental health as an integral part of overall health.
3. Connect patients with resources: Patients should have access to support groups, mental health professionals, digital mental health programs, and educational materials. 
4. Consider evolving your program from an acute medical model to an integrated chronic care model: Incorporate mental health specialists to see patients living with chronic diseases and formalize care coordination processes.

Digital Mental Health Eases Provider Burden, Improves Outcomes 

Digital technologies can be used to prevent and manage mental health problems in people living with chronic conditions. There are a wide variety of digital interventions that may be employed to support your patient cohort including mindfulness training, guided meditation, cognitive behavioral therapy programs, and teletherapy. Digital mental health resources facilitate access to a broad population with very little human resource requirements and are:

• Accessible from anywhere with an internet connection.
• Affordable
• Anonymous
• Personalized based on an individual’s specific needs and preferences.
• Available 24/7
• Connected to enable communication of treatment progress.

It’s Time to Stop Mental Health Suffering for Patients with Chronic Illness

Living with a chronic illness is a challenging experience that impacts both physical and mental health. By understanding the unique mental health needs of patients with chronic illnesses, health care providers can offer a more holistic approach to care for and support the overall well-being of their patients. They can lower barriers to mental health care for their chronically ill patients by providing a supportive and non-judgmental environment, addressing stigma, and connecting patients with accessible resources.

By Carlene Anteau, MS, RN, Senior Vice President of Marketing at Learn to Live