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Major Firms Discuss Strategies For Improving MH Care Access

Sandra Hass is a consultant to APA's Office of Healthcare Systems and Financing and is the executive editor of Mental HealthWorks.

APA leaders meet with representatives of major corporations and the public sector to discuss how to improve access to quality mental health care for employees and why doing so is a wise investment.

APA's support of the first World Congress Leadership Summit on Behavioral Health and Wellness paid off as more than 150 people representing major corporations and officials from the public sector gathered in Baltimore in early May to exchange ideas about how to provide quality mental health care to employees. All agreed that the current system of managing care is rapidly evolving into a new kind of health care system.

Psychiatrist Stephen Heidel, M.D., M.B.A. (center), takes a break with Paul Heck of DuPont and Tara Wooldridge, L.C.S.W., of Delta Airlines after their presentation on innovative employee assistance programs. Sandra Hass

When employers such as IBM, DuPont, JPMorgan Chase, Delta, 3M, Coca-Cola Co., Johnson & Johnson, and Daimler/Chrysler talked about the rising costs of health care and their efforts to contain costs, APA listened. When employers discussed their solutions, APA Medical Director James H. Scully Jr., M.D., noted that psychiatrists must be involved in the solution. That theme resonated throughout the leadership summit.

The World Congress is the producer of the World Congress Leadership Summit Series and other health-related conferences. World Congress events convene CEOs and senior executives from the health care industry with leaders in other related areas to explore innovative approaches to improving health care costs and quality, according to the World Congress Web site.

Keep Physicians Involved

As the conference began, Ronald E. Bachman of PriceWaterhouseCoopers reminded participants, "This is not about numbers; it's about people." He provided a perfect segue for incoming APA President Steven Sharfstein, M.D., to say, "APA is a natural ally of employers in their efforts to improve the health care of all."

Thomas Carli, M.D., of the Depression Center Workplace Initiatives at the University of Michigan Health System continued on that theme when he said that physicians must be included as "equal partners" in any discussion of future health care systems.

Then Alan Axelson, M.D., of InterCare Psychiatric Services added, "If we leave physicians out of the discussions, new systems will be doomed to fail in the same way that managed care has failed."

Employer Innovations Described

Attendees readily accepted the fact that mental disorders have a negative impact on their medical costs and their company's productivity in terms of absenteeism and presenteeism. Employers are currently focusing on two solutions—integration of all health care services and outcomes studies.

Employers are trying various ways to integrate behavioral health services into medical services that in turn are integrated with their pharmacy, disability, employee assistance, wellness, and benefits programs. Juan Prieto of IBM stated, "Mental health care at IBM is simply a part of health care."

Companies hope that integrating mental health services will help them answer such questions as, Do medical costs go down if we spend more on behavioral health services? But integration has another important benefit—it serves employees better.

Dan Conti, Ph.D., of JPMorgan Chase (formerly BankOne) emphasized that the more things are "dis-integrated," the more difficult it is for employees to know how to access care.

David K. Nace, M.D., vice president and chief medical officer at McKesson Health Solutions, said, "Diseases are integrated," which for him begged the question, "Why aren't health care services?"

The tricky part to integrating health care services is merging the many databases, which are often kept in separate "silos" in various departments or with outside vendors or both. Johnson & Johnson is one of the few companies that have successfully merged all aspects of employee health care into its worldwide Health and Safety Division (see Mental HealthWorks, first quarter 2005, at <www.workplacementalhealth.org>).

Second, employers are asking behavioral health care plans for outcomes studies. Employers made it clear that outcomes studies are not synonymous with "consumer satisfaction surveys." Instead, they talked about quality and evidence-based behavioral medicine.

Nearly all employers expressed frustration at their inability to find out what behavioral health services they are paying for and what they are getting for their dollars. According to Conti, his company's ability to calculate the amount it spends on mental health has become increasingly difficult since the 1980s. "In fact," he noted, "60 percent of employers don't even know their absentee rates."

"What are the best buys in mental health?," asked Irvin L. (Sam) Muszynski, J.D., director of APA's Office of Healthcare Systems and Financing, as he opened the conference. Muszynski said he hopes that APA and employers will work together to find the answers.

APA was a primary supporter of the leadership summit, which was co-sponsored by the Wall Street Journal. According to Norman Clemens, M.D., chair of the Committee on APA/Business Relations, "This conference was the result of my attending a World Congress conference on health care last year where no one mentioned mental health during the entire meeting."

Clemens immediately spoke to conference organizers, and they agreed to hold a leadership summit on behavioral health and wellness this year. Based on this year's success, the World Congress is committed to doing another one in 2006.

Other APA members presenting at the leadership summit were Stephen Heidel, M.D., M.B.A., Jeffrey Kahn, M.D., and Lloyd Sederer, M.D.

Clemens told Psychiatric News, "It is extremely important that as the health care system evolves, the individual doctor/patient relationship be preserved and not overwhelmed by systems. I think we got our point across."

More information about APA's Business Relations Initiative is available by contacting Clare Miller by phone at (703) 907-8673 or by e-mail at cmiller{at}psych.org. The APA newsletter Mental HealthWorks is posted at <www.workplacementalhealth.org>. APA members may receive it free by mail by calling Miller.

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