October 10, 2020

How Integrated Care Can Minimize Stigma and Improve Mental Health

By Accolade

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With World Mental Health Day this weekend, it’s a good time to note that Americans have come a long way in recent years when it comes to perceptions of mental health problems. It wasn’t too long ago that the treatment of mental illness was hidden away in asylums and psychiatric hospitals. Back then, only a minority of the population was being “treated” for psychological or emotional pain, many of whom weren't really ill at all. Patients who were suffering from mental health issues were subject to what we’d now consider incomprehensible and cruel procedures and 'insanity' was an official diagnosis.

These days, mental health care is so commonplace that, in some circles, it’s considered weird if you haven’tseen a therapist. The self-improvement industry is worth employee health solutions $11 billion annually in the U.S , and it’s not uncommon for people to volunteer that they suffer from ADHD or anxiety in social contexts. As more of us are diagnosed with some sort of mental disorder, or know someone who is, we become less likely to see individuals with a similar diagnosis in a negative light.

It’s as if the stigma of mental illness has gone. But has it?

We’ve come far, but not far enough

If it’s generally true that the stigma of mental illness has decreased in society generally, it’s not necessarily true that it’s dissipated in many workplaces. It’s one thing to share with a friend that you have OCD. It’s another to say the same to a professional colleague. People exposed at work as having mental health issues risk being unfairly judged or turned down for promotions. When your livelihood is at stake, you can’t take that sort of risk.

One could argue that because society as a whole is much more open to treating mental health issues, it shouldn’t matter that the workplace isn’t a totally safe space. It’s not like you need your employer to know about your mental health issue in order to seek help. It’s not like you can’t pay out of pocket and see a professional online, or read a self-help book in the privacy of your own home.

But stigma doesn’t work that way. Stigma isn’t a mildly unfortunate experience that you can easily work around. Stigmatization can threaten a person’s sense of social belonging, thereby threatening their ability to rely on others for basic needs. Protecting one’s reputation from stigma can feel like a life or death cause, and once the worry is triggered, it sticks: if you experience stigma in one area of your life – especially in an area of life like work, which takes up a lot of time and energy and is where you make most of your social connections – that stigma could weigh you down in all aspects of life.

In other words, workplace stigma can put a chill on an individual’s desire to get help, even that help could be private.

A holistic approach to wellness could reduce the threat of stigma

For too long, mental and physical wellness in the U.S. were handled separately. Medical doctors treated ailments of the body while mental health professionals treated ailments of the mind, often with little communication between the two. And despite the many changes to mental health treatment over time, its detachment from general health care largely remains in place. Though primary care physicians can help treat anxiety or depression, most people suffering from behavioral health issues are likely to go to a therapist for these issues instead, keeping their healthcare needs siloed. Unless medication is prescribed and patients report taking it, medical doctors usually won’t know if their patients even have mental health problems to begin with.

But what if it were part of a primary care physician’s job to stay on top of their patients’ mental health? What if therapists were treated like specialized physicians, coordinating with PCPs like other specialists do, to ensure that the total patient is cared for? Being healthy is, after all, a total-body affair. For example, research has tied anxiety and poor diet chronic pain to depression

But more than this, integrating mental health treatment into an overall wellness program can alleviate the stigma of mental illness. Treating psychological and emotional wellness as though it’s removed from physical health reinforces its place outside of mainstream care. Integrated care can alleviate shame involved in seeking mental health care, and helps signal to patients that addressing their mental health concerns is a normal part of being well.

What’s more, people want their mental health treatment to be integrated into their overall wellness treatment. Over half (56%) of Americans surveyed by Accolade in late July said they’d bemore likely to seek mental health care if it were integrated with their physical health care, or if it were connected with thecare they receive from their medical physician. That’s a lot of people who are willing to let go of the stigma, as long as medical professionals take the lead.

If there’s nothing wrong with it, why put it in a box?

How the medical profession frames care can seriously sway patient decisions regarding seeking the care they need. If patients are presented with mental care as a side option, they’ll treat it as a side option, especially if there’s a stigma attached. But if patients are presented with a choice of architecture hat combines physical and mental health care under a single choice, chances are they’ll select to receive mental health care. It’s up to physicians to take the step toward integration.

You can’t force patients to make better choices. But you can make it easier for them to choose what’s best by offering mental healthcare options – such as Accolade’s Mental Health Integrated Care - that are integrated with their standard healthcare benefits.