Prepared by My Therapy Network LLC
Chicago, IL

June, 2001

Executive Summary

Each year in the United States, one in five of us will experience a mental health disorder or a mental health problem requiring professional attention. 

Yet, accessing the care we need for our mental health problems may be more difficult than accessing care for our medical needs.  Approximately three quarters of us, more than 177 million people, are enrolled in managed care programs: programs which give us less protection for our behavioral health risks than for our medical needs.

In our workplaces, our communities and our families, the costs of untreated mental problems are great: One study estimates that productivity loss totals $63 billion in a year’s time.  In the workplace, depression is the single largest cause of worker compensation claims.  Among the elderly, a rapidly growing segment of the population, many suffer from chronic depression.

What prevents access to good care?  Stigma, the fear of an admitted problem’s impact on our employment and on our relationships, inhibits us.  So does the present system of delivering care.

My Therapy Network LLC suggests that solutions will come from four influences:

1. Diagnostic quality and the efficacy of treatments are leading to general recognition that mental illness varies, just as medical illnesses vary in intensity and impact.  Mental conditions have gradations of seriousness, just as other medical conditions have gradations of seriousness.
2. Modern communication technology, in tandem with modern methods of care, permit treatment to begin immediately, at the moment of need – no appointment required.
3. When individuals with emotional/psychological problems have immediate access to care, it reduces the burden on a system designed to serve general medical needs and severe and chronic mental disorders.
4. Growing awareness of the causal relationship between untreated behavioral health care needs and subsequent medical expenses of employees and their families will lead to design of new treatment offerings.


With a network of licensed, insured therapists in each state, My Therapy Network LLC gives individuals immediate, confidential, telephone access to professional assistance.  The service, reached at 800.XXX.XXXX, augments and improves traditional mental health care by providing service within moments of an individual’s need.

Report authors:

Chris E. Stout, Psy.D, is President of My Therapy Network. He is also Illinois Chief of Psychological Services for the Department of Human Services/Office of Mental Health. Dr. Stout has published or presented more than 300 papers and authored 19 books/manuals on various topics in psychology.

Ralph C. Musicant, Chief Executive Officer, is a Harvard Law School graduate who has founded and operated companies in a variety of industries.  His academic career includes an appointment as the Martin C. Remer Visiting Distinguished Professor of Finance at the Kellogg Graduate School of Management. 

My Therapy Network LLC, tel. 312-372-1500, will be glad to discuss the report.  Please contact:

Dr. Chris E. Stout
President
chris@mytherapynetwork.com

Ralph C. Musicant
CEO
ralph@mytherapynetwork.com

 

Bridging the Gap in Mental Health Care

One in five of us will need care

This year, according to data in Mental Health: A Report of the Surgeon General, one in five of us will experience a mental health disorder or a mental health problem requiring professional attention.  Our needs will range from diagnosable mental illnesses such as clinical depression to the alleviation of situational anxiety, stress, and emotional discomforts professionals categorize as mental health problems.[i]

According to the Report of the Surgeon General, 15 percent of the adult population use some form of mental health service during a year: eight percent have a mental disorder such as clinical depression or schizophrenia; seven percent have a mental health problem.[ii]

For some of us, the mental distress will be fleeting.  For others, the mental disorders will be intense and recurring.  Definitions provided in the Surgeon General’s report demonstrate the variety of mental conditions endured briefly or permanently by so many U.S. residents:

“Mental illness refers collectively to all diagnosable mental disorders.  Mental disorders are health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.”[iii]

“This report (of the Surgeon General) uses `mental health problems’ for signs and symptoms of insufficient intensity or duration to meet the criteria for any mental disorder.  Almost everyone has experienced mental health problems in which the distress one feels matches some of the signs and symptoms of mental disorders.  Mental health problems may warrant active efforts in health promotion, prevention, and treatment.  Bereavement symptoms in older adults offer a case in point.”[iv]

Care for our psychological health problems may not match care for our other medical health problems

Many of us will not receive the behavioral health care we need.[v]  Few may access care equal to the quality of assistance received when we break a bone, become short of breath, or bleed.  That is, because of the way we use services and the way we regard mental health, our behavioral health needs often will receive less attention than when we suffer from other physical diseases and maladies.

Untreated problems cost our employers and our community

Because the 20 percent of us requiring mental health assistance each year are found in every family, neighborhood, workplace, age group and ethnic group, the disparity has a broad societal impact.  Failure to improve mental health care also saddles the U.S. with significant costs:

Loss of productivity in the workplace is great.  One study concluded that productivity loss caused by a single problem – stress – totaled $7500 per worker per year.[vi]  Another study estimated that the indirect costs of all mental illness includes a productivity loss of $63 billion.[vii]

Untreated mental health disorders frequently lead to increased medical and societal costs.[viii]  Many, perhaps half of the people with serious mental illnesses, develop alcohol or other drug abuse problems.[ix]  A study cited in BusinessWeek magazine found that “the risk of certain mental illnesses triples in children whose parents are excessively harsh or abusive, or provide inadequate supervision.”[x]

An individual’s untreated mental illness affects the health - and increases the subsequent health care expenditures of the person and the person’s family.[xi]  An additional cost burden comes from the sheer disparity between benefits plans for medical/surgical insurance and for mental health insurance: a study cited in the Surgeon General’s report modeled the out-of-pocket cost burden for families with varying levels of annual mental health treatment expense.  A family with $35,000 of mental health treatment expense, according to the model, incurred an average out-of-pocket burden of $12,000.  A family with similar medical/surgical treatment needs would incur an out-of-pocket burden of $1,500.[xii]

In addition to the problem, we worry about the stigma of a mental condition

All of us are to blame for some of the disparity between behavioral health care and other types of medical care.   We seem to prefer the suffering of a problem to the stigma of mental illness; in the words of one managed care physician, “A person would rather die than have his car seen on the parking lot of a psychiatrist’s office.”  Though behavioral health disorders are as real as any other medical problem and are, furthermore, just as treatable as other medical problems, we believe that the stigma of mental illness subjects us to risk in our employment and in our personal relationships.

In addition, the structure of modern behavioral health care confuses many of us when we seek services.  One in five of us needs services each year; but only one in six of us obtains services.  We obtain them from a mix of sources: the emergency room, our private physician, mental health specialty care providers, volunteer programs, and public programs. 

Solutions coming from four beneficial influences

Though annual expenditures for treatment of behavioral disorders and problems are substantial – approximately $99 billion of the nation’s $943 billion health care cost in 1996 – the resources are finite.  While behavioral health professionals have refined diagnostic precision and developed new methods of treatment (e.g., case management) for improvement of care, expenditure on mental health is not keeping pace with society’s need.  Solutions may come from examination of four beneficial influences on behavioral care:

1.  Psychological problems and disorders vary - the same way other maladies vary in seriousness (e.g., a common cold and pneumonia)

Modern medical care’s success in diagnosing and treating psychological disorders and problems is equal to and often exceeds other specialists’ success in treating other types of medical problems.  Still, we persist in defining mental health in absolute terms: a person is either completely psychologically fit or completely mentally ill.  Specialists in behavioral health care prove each day that psychological conditions are diagnosable, treatable, manageable and varied in their impact on individuals.

The implications for treatment of mental health disorders and problems are tremendous.

As appreciation for the variety of mental conditions takes hold, the stigma of mental illness is certain to change, too.  We treat a family member with a cold differently than we treat someone with pneumonia.  Our care and our concern will differ, too, when we distinguish between a person feeling anxiety about performance in an upcoming work challenge and a person coping with a bipolar condition.  Both require intervention for optimal outcome.

Almost as significant will be the impact on the cost of medical care.  Imagine the impact on total health care cost if early, relatively inexpensive assistance to an employee feeling depressed curtails the bloom of alcoholism and other medical costs so often incurred by families and employers.

If we can reduce the stigma of behavioral illness and address mental illness in all its variety of severity, we can improve the application of our mental health care resources.

Just as we self-medicate for some mild physical illnesses and send ambulances in response to others, we can make appropriate resources available when individuals suffer emotionally.

2.  Modern communication and modern methods of care are altering the definition of treatment:

A time gap between an individual’s wish for care and the application of care is diminishing.

Common definitions of care presume a traditional meeting of a professional with a client in person, usually in an office or other healthcare setting.  Such service, which includes the cost of the setting, also delays the provision of care sought by an individual.  A 1998 telephone survey cited in the Surgeon General Report found that “inability to obtain an appointment soon enough” inhibited 59 percent of those with Medicaid and a lesser number of privately insured individuals from seeking behavioral health care services.[xiii]  While complete programs of treatment for individuals diagnosed with mental health disorders are certain to require examination and in-person care during programs involving combinations of medication and psychotherapeutic assistance, good systems have simplified the initiation of care.  Systems used by organizations such as My Therapy Network LLC meet a community-care standard of the modern practitioner by matching callers with therapists licensed and insured in the same state of residence. 

3.  Individuals with mental health problems can receive treatment that does not burden a system designed for response to patients with diagnosed, severe mental disorders (e.g., bipolar disorder).

According to the Report of the Surgeon General, 15 percent of the adult population use some form of behavioral health service during a year: eight percent have a mental disorder such as clinical depression or schizophrenia; seven percent have a mental health problem.[xiv]

At present, significant populations seek mental health assistance from hospital emergency rooms and from private physicians.  The requests place a burden on our traditional healthcare systems and do not provide immediate access to desired treatment.  Exhibit 1 displays the present impact of a disorder such as depression on medical costs borne by the individual, his family, and his employer.  We believe that simplified access to appropriate care will have two impacts on total health care cost: early treatment of mental problems will mitigate the severity of the condition and reduce the attendant medical costs borne by the individual, his or her family, the person’s employer, or state and federal government.  Second, simplified, efficient access to appropriate care will conserve health care resources.

Growing recognition of behavioral disorders and mental health problems as conditions of great variety will ease access to services that appropriately match response to types of need.  Alternatives are available.  Individuals are increasingly able to receive assistance from professional therapists.  An individual who is experiencing a temporary symptom of a mental disorder wants and can receive professional attention at almost the instant of discomfort.  Through My Therapy Network, based in Chicago, IL, callers have immediate access to licensed, insured therapists from the caller’s state of residence.  Addressing the gap that previously existed between need and a scheduled appointment, the confidential, professional telephone conversation initiated from any part of the United States can help a troubled individual deal with a problem (or provide immediate counsel and an appropriate referral). A variety of other services on the Internet provide Yellow Page-like registries of therapists available for Internet-based counseling. 

In addition to quickening an individual’s access to professional mental health care, the technology employed by My Therapy Network alleviates concerns about mental health stigma by preserving a caller’s anonymity.  Unless a caller wishes to provide his name, the professional therapist only knows the caller by an ID number.    

4.   Recognition of a relationship between mental health care and employee medical expense.

As employers gain experience and understanding of the efficacy of behavioral health treatments and managed care companies gain experience with the impact of mental health care on control of related medical charges, new benefit program designs are likely to address behavioral and physical medical needs in unison.  The impact of behavioral health problems on a growing number of employee households and the increasing pressure on managed care companies will lead to new solutions.[xv]

My Therapy Network LLC, with a network of therapists in every state, has approached managed care companies with various options that allow telephone-based response to become part of the managed care company’s answer to behavioral health needs.  For example, in one program, My Therapy Network will allot each enrolled plan member, without a diagnosis of mental illness, a certain number of counseling minutes each year on a nominal co-pay basis.  

My Therapy Network LLC and Mental Health Care

With a network of licensed, insured therapists in each state, My Therapy Network LLC gives individuals immediate, confidential, telephone access to professional assistance.  The service, reached at 800.XXX.XXXX, augments and improves traditional mental health care by providing service within moments of an individual’s need.

A caller seeking assistance with a behavioral health or emotional problem ranging from anxiety before an important business meeting to a problem in parenting or a relationship to mastery of a troubling addiction will quickly reach a professional therapist from the caller’s state of residence.  Unless the caller reveals himself or herself by name, the caller’s identity will remain confidential within the strict and full scope of state and federal laws.

Network Providers are fully credentialed by My Therapy Network personnel, to ensure the quality of the specialists available. 

By coordinating callers with credentialed Network Providers licensed in the caller’s state, My Therapy Network LLC provides community-based, accountable care at a time of great importance to each caller. 

Report authors:

Chris E. Stout, Psy.D, is President of My Therapy Network. He is also Illinois Chief of Psychological Services for the Department of Human Services/Office of Mental Health. Dr. Stout has published or presented more than 300 papers and authored 19 books/manuals on various topics in psychology.

Ralph C. Musicant, Chief Executive Officer, is a Harvard Law School graduate who has founded and operated companies in a variety of industries.  His academic career includes an appointment as the Martin C. Remer Visiting Distinguished Professor of Finance at the Kellogg Graduate School of Management. 

Office Address:

My Therapy Network LLC
120 North LaSalle Street
38th floor
Chicago, IL 60602
312-372-1500
www.mytherapynetwork.com

Thomas Figel or Kevin Deany
tom@figelmurphy-pr.com or kevin@figelmurphy-pr.com

Figel Murphy Public Relations, LLC
208 South LaSalle Street
Suite 727
Chicago, IL 60604
312-223-9536 
 

Footnotes:

[i] U.S. Department of Health and Human Services.  Mental Health: A Report of the Surgeon General – Executive Summary. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.  “The current prevalence estimate is that about 20 percent of the U.S. population are affected by mental disorders during a given year.  This estimate comes from two epidemiologic surveys: The Epidemiologic Catchment Area (ECA) study of the early 1980s and the National Comorbidity Survey (NCS) of the early 1990s.” Chapter 2, p. 2


[ii] Ibid, Chapter 6, p. 408


[iii] Ibid, Executive Summary, p. 8


[iv] Ibid, Executive Summary, p. 8


[v] Ibid, Chapter 2 “Bearing in mind that 28 percent of the population have a diagnosable mental or substance abuse disorder, only about one-third with a diagnosable mental disorder receives treatment in one year.”


[vi] U.S. News & World Report, Dec. 11, 1995 “Time Out – Plagued by stress”, John Marks


[vii] Mental Health: A Report of the Surgeon General, Chapter 6, p. 411


[viii] Wall Street Journal, June 13, 2001, “Mental Illness: A Rising Workplace Cost”, “What Happens When It’s the Boss Who’s Suffering?”, Tanouye, Elyse; “A Colleague’s Suicide Has a Lasting Impact on Fellow Employees”, Shellenbarger, Sue.


[ix] Mental Health: A Report of the Surgeon General, Chapter 4, citation of studies by Meuser et al., 1990; Regier et al., 1993; Drake & Osher, 1997


[x] BusinessWeek, June 11, 2001,  “Troubled Kids: It’s Nurture, Not Nature”,  p. 99, citation of report in the current Archives of General Psychiatry


[xi] Stout, Dr. Chris E., Psychological Assessment in Managed Care, John Wiley & Sons, Inc., 1997, pp. 182-183 (cites Georgia Psychological Association research pertaining to health care expenses of patients and family members)


[xii] Mental Health: A Report of the Surgeon General, Chapter 6, p. 427, citation of 1998 study by Zuvekas, S.H., Banthin, J.S. & Selden, T.M.


[xiii] Ibid, Chapter 6, p. 409


[xiv] Ibid, Chapter 6, p. 408


[xv] Wall Street Journal, May 8, 2001, “Managed-Care Firms Handling Mental Health Trigger Complaints”, Milo Geyelin


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