The COVID-19 pandemic has made mental health conditions so pervasive that, in turn, the stigma that once accompanied seeking treatment has been minimized. As a result, public attention towards psychological health has skyrocketed. Other factors such as the collective loneliness brought on by continuous isolation have resulted in a newfound willingness for people to speak more freely about their emotional wellbeing without judgment or ridicule. Individuals feel much more compelled to share their personal experiences knowing there is an increased likelihood someone else shares their sentiments.
As a physician, I believe this has created an opportunity for health insurers, employers, and care providers to increase access to mental health treatment and resources. Poor mental health and high-stress levels can cause a multitude of harmful consequences, especially at work. Those include worsened job performance and diminished efficiency, weakened contributions, muddled communication between coworkers, amplified turnover, lower retention, and lessened physical capability. However, the most damaging repercussion is the misidentification of both physical and mental illnesses. I believe we can avoid many of these adverse ramifications and mitigate misdiagnoses by promoting interdisciplinary training for primary care physicians and mental health specialists.
Additionally, the rate of comorbid mental and physical conditions is rising and, although not widely known, psychological disorders have an enormous impact on our physical health. Many patients with physical health conditions, including cardiovascular disease, diabetes, cancer, respiratory illness, and other chronic diseases, also experience mental health issues. A CDC brief reveals that major depressive disorder is found in about 23 percent of people with cardiovascular disease, 27 percent of diabetes patients, and 42 percent of patients with cancer.
A study examining the effect of cognitive-behavioral therapy (CBT) on patients with comorbid diseases demonstrates participants with comorbidities displayed larger declines in symptoms of various mental health disorders than those without. Additionally, treatment considerably decreased the amount of subsequent comorbid diagnoses. Finally, research shows the concurrent existence of two or more illnesses will compound the prognosis of all present diseases, increase the number and severity of potential complications, and cause treatment to become challenging and potentially, less successful.
Why is comorbidity of mental and physical diseases so prevalent?
The pervasiveness of these comorbidities can be traced back to an array of external factors. Firstly, these coexisting diagnoses have become progressively more widespread in people over the age of 60. Simultaneously, comorbidity is escalating expeditiously in patients of younger ages. Also, practitioners too often neglect mental disorders as a comorbid condition because physicians who do not specialize in psychiatry concentrate on diagnosing and treating the diseases in their specialty. Similarly, licensed mental health professionals focus on treating mental illnesses, often overlooking or undertreating comorbid physical illnesses. This siloed approach is not only typical in the U.S. health care system, but continues to escalate the issues.
Combining treatment for mental and physical health drives cost reduction
Providing effective mental health treatment also drastically reduces cost. In fact, the cost of care for patients with comorbid mental and physical diseases is two to three times higher than for individuals without co-occurring illnesses. By adopting a holistic care model that provides services for both physical and mental illnesses, the U.S. could save $37.6 billion to $67.8 billion every year. Employers that invest in employee assistance programs and digital mental health treatment will reduce stress in the workplace, and positively affect the lives of staff members in addition to the company.
Consumer health applications are more prevalent than ever before and have improved access to treatment across a range of health conditions. In fact, consumer disease management apps make up 47 percent of the most popular digital health apps in 2020, a 19 percent increase since 2015. Apps particularly designed for mental health, diabetes, and cardiovascular treatment represent nearly half of disease-specific apps.
How should we solve the problem?
The Copenhagen Healthy Bus Project evaluated various health interventions in bus drivers with an elevated risk of cardiovascular disease, high blood pressure, cancer, and job stress. The researchers formulated interventions addressing four main concerns: lifestyle, psychosocial factors, the physical work environment, and how work was organized. The results exposed reductions in job stress and fatigue in addition to expansions in more healthy lifestyle habits such as diet and exercise. After a while, prolonged enhancements in these realms showed the potential to lower drivers’ risk for chronic conditions and mental health disorders.
The study is a testament to the power of consolidating mental and physical health interventions and proves that unifying treatment produces lasting and life-changing results.
Reducing the occurrence of comorbid mental and physical disorders will require an integrated model combining medical and behavioral health care services. The window of opportunity is open for health insurers and employers to invest in employee assistance programs and telehealth platforms and build on a newfound acceptance of mental health services. Additionally, health care providers can mitigate the cost of care and improve their outcomes with an increased focus on interdisciplinary training that accounts for the common occurrence of both physical and mental health conditions. With a new approach to mental health services, we will see a noticeable decrease of stress levels, happier patients, and higher productivity in the workplace.
Christopher Valerian is a health care executive.
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