We sat down with Brian Wong, MD, MBA, and medical director of population health at Accolade to ask him what he sees as the most pressing mental health issues facing employees and their families, and what employers can do about it.
Accolade : Tell us a little bit about yourself — how did you become interested in psychiatry and what led you to Accolade?
Brian Wong : I went to Temple University and completed their combined MD/MBA program. Two of the most important lessons I learned were the importance of listening and collaboration. To me, these translated nicely into the field of psychiatry where both skills are critical for successful treatment with patients.
Before I joined Accolade, I worked at Montefiore Medical Center in the Bronx where I created and operationalized a behavioral health integrated system where we co-located psychiatrists and social workers into primary care practices. The benefit was that our staff could provide mental health support right there in the office.
I’ve also done extensive work in value-based purchasing — moving from volume to value. The evolution of changing traditional models is what drew me to Accolade’s mission to reinvent healthcare. Accolade can do just that with the additional infrastructure now in place with expert second medical opinions and virtual primary and mental health care .
A : Is that type of integrated system commonplace?
BW : More so today than previously. We refer to it as the collaborative care model and it’s what Accolade’s Mental Health Integrated Care (MHIC) program is predicated on.
It was initially started by a team at the University of Washington and has really gained traction in the last 10 years or so. It’s one way providers and healthcare companies, like Accolade, are trying to break down the silos between physical and mental health. This model encapsulates our view of treating our members holistically.
A : You’re the medical director of population health at Accolade. Can you tell us how this supports individuals that need mental health care?
BW : The foundation of population health is supporting the needs of the entire population, not just one segment — it’s looking at how entire communities intersect directly with mental health well-being. It really takes a broader view of our members and addresses mental health for everyone. That includes universal screening and supporting every condition, no matter the severity.
A : Historically, mental health was focused on clinical diagnoses, like depression and schizophrenia or other psychosis. How do you think mental health has evolved to encompass the so-called “everyday person” who deals with anxiety, depression or other conditions? What’s brought us to the understanding we have today of mental health?
BW : Over the past 10 years, there’s been a huge destigmatization of mental health . We’ve seen this in the media where people are more open about their mental health struggles, which has opened the door for conversations surrounding these conditions. Twenty years ago, people were certainly more reluctant to talk about issues such as post-partum depression or trauma-based anxieties.
For example, let’s say you have a patient with diabetes and depression. If they’re tremendously depressed, they’re going to have a hard time checking their blood sugars, maintaining a log or being compliant with their medication. This illustrates that physical and mental health have a symbiotic relationship and can’t be treated separately.
A : We’re coming out of one of the most turbulent times people have experienced in decades — or their lifetime. And the statistics are incredibly telling: According to the Centers for Disease Control and Prevention (CDC), 31% of people report having anxiety or depression, 26% say they have trauma-related symptoms, substance abuse is on the rise and more than 10% of people say they’ve seriously considered suicide.
Given all that, what do you see as the immediate and long-term effects this will have on people?
BW : Those statistics are a primer to what the immediate effects are likely to be. Unfortunately, with the Delta variant we have yet to cross the finish line.
One of the few positives that we can garner from this pandemic is re-imagining the way people receive health care, and specifically virtual care. Thankfully, mental health providers had a little bit of a head start because they’ve been using virtual care for a while, especially in rural areas where there’s a shortage of psychiatrists. We’ve been able to learn from what they’ve done and adopt best practices in order to rapidly expand and operationalize virtual care for patients during the pandemic.
It’s impossible to hypothesize what the long-term effects are going to be. However, what I can say is that an important lever in addressing this is going to be expanding access to mental health and primary care. That’s why programs like MHIC and Accolade Care are so imperative.
A : How should employers address stigma attached to mental health issues?
BW : Accolade has really created a blueprint to do exactly this, especially during the pandemic.
First, emphasizing to employees that mental health illness is a condition just like a physical one. It’s a disease that either they or a family member might struggle with at some point in their lives. Secondly, normalizing and destigmatizing mental health by ensuring employees have a safe place to have these conversations. Lastly, helping employees understand that mental health is a spectrum where some people may experience symptoms they've never felt before or are unable to recognize.
This is why company-wide education is so important. For instance, what we’ve done at Accolade is start a Slack channel where employees can talk about what mental health support services are available or just chat about how they’re coping with things and how they’re feeling.
A : Now that we’re in the next phase of people going back to the office, visiting their parents or sending kids back to school, what do we need to do to help people re-adapt again?
BW : It’s undoubtedly going to be a challenge, but we’ll get through this together. The Delta variant highlights the importance of how flexible and nimble we must be, whether that’s adapting to practices such as re-masking or other measures, until we’re past the variant.
Employers should know what resources are available and normalize the use of them . Candid and open conversations are really important.
Accolade has used a multimodal approach — Slack, email, etc. — in communications and it’s been tremendously effective. Finding ways to disseminate information so it’s accessible to every employee regarding mental health to normalize it and educate are paramount.
A : Is there anything you’d like to add?
BW : I want to highlight two key differentiators that Accolade has over other health companies.
One, we take a holistic approach in helping people with their physical and mental health well-being. We want to understand the context of their lives — how their job may impact them or where they live, for example — which can affect their access to care. Essentially, we look at more than just symptoms to help people make the best decisions about their care.
Two, our technology helps us make data-driven decisions to guide people to the right care. With this data, our Frontline Care Team can gather a comprehensive view of each member and provide personalized options for them. This could be suggesting getting a second medical opinion or helping them find a more affordable prescription .
Our technology also helps people help themselves. For example, our mobile app is easy to use so that members can look up their benefits, message an Accolade Health Assistant directly or upload a bill to get support.
It’s all part of our overarching mission to help people get the right care and at the right time to be able to live their healthiest lives.