On March 27, 2025, Faith Best, LCSW, Director of Clinical Services at NeuroFlow, led an energizing 15-minute webinar, Invest in Rest, exploring the critical role sleep plays in overall wellbeing. This dynamic session offered practical insights to help participants recognize the signs of poor sleep and discover simple, effective strategies to improve bedtime routines.

Whether you joined us live or are catching up now, this recap highlights key takeaways from the session, empowering you to prioritize sleep to improve your daily life and long-term health. Let’s get started!

What is the connection between sleep and mental and physical health?

The importance of sleep cannot be overstated. Approximately one-third of Americans are chronically sleep-deprived, a number that continues to rise as screen time, working hours and stress levels increase. As a result, both the duration and quality of sleep are declining, impacting physical and mental health in expected and unexpected ways.

During sleep, the body undergoes essential maintenance processes that cannot occur while awake. This includes memory consolidation, cognitive processing, immune system strengthening and hormone regulation, including stress hormones.

Chronic sleep deprivation has been linked to health conditions such as heart disease, high blood pressure and stroke. It can impair brain function, decision-making and reaction time. The fogginess and fatigue from inadequate sleep are well known, and poor sleep has also been shown to increase anxiety and depressive symptoms. This can create a vicious cycle where heightened stress and low mood further disrupt sleep, worsening overall mental health.

A recent study by NeuroFlow found that deteriorating sleep was even associated with an increased risk of suicidal ideation. Sleep deprivation can feel torturous, and its effects on the body and mind are profound. Prioritizing sleep is essential for overall wellbeing.

What are some ways to improve sleep quality if getting more hours of sleep isn’t an option?

When it’s time to sleep, the mind can start racing, or restlessness can make it difficult to relax and take advantage of the time available. Here are two techniques—one focused on the mind and one on the body—that can help improve relaxation and sleep.

The first technique is called “worry time.” It’s common for anxious thoughts to surface at bedtime, even if they do not appear throughout the day. A proven method to reduce nighttime worry is to schedule a specific time to focus on those thoughts during the day. Choosing a consistent time, such as during a commute or another daily routine, can help. Setting a reminder can also reinforce this habit. During that scheduled time, allow worries to come, acknowledge them, and reflect on them. Then, if those thoughts arise at night, it becomes easier to remind the mind that time has already been set aside for them, reducing their intrusion at bedtime.

The second technique is progressive muscle relaxation, which helps the body release tension before sleep. Even when lying down, muscles may remain tense due to stress, pain or habitual posture. This method involves consciously relaxing different muscle groups one at a time. Starting from the toes and moving upward, tense each muscle group for a few seconds while inhaling, then release the tension while exhaling. Continuing this process through the entire body can significantly improve relaxation. For those new to the technique, guided videos can be found online to walk through the process. This practice not only helps relax the body but also serves as a mindfulness technique, increasing awareness of physical sensations and creating a sense of calm that prepares the body and mind for restful sleep.

How can I calm down for bed, so I wake up rested?

Many adults expect to easily fall asleep after a long day of working, parenting, watching TV or scrolling through social media. However, just like children benefit from a bedtime routine, adults also need a way to transition into restful sleep.

Consistency is one of the most important factors in quality sleep. While it’s widely known that seven to nine hours of sleep per night is recommended, the consistency and quality of that sleep are just as crucial. A regular bedtime and wake-up time help the body establish a rhythm, allowing it to function optimally.

Building a bedtime routine that promotes relaxation is key. Just as children wind down with a bath or bedtime story, adults can incorporate activities that calm the mind and body. This could include progressive muscle relaxation, stretching or other relaxation methods that work best for individual needs.

For those who experience discomfort, such as back or hip pain, incorporating a short stretching routine before bed can be beneficial. A simple 10-minute stretch can not only relieve physical tension but also help signal to the mind that it’s time to unwind. When a routine becomes a habit, the body begins to recognize the cues and prepares for sleep more effectively.

Preparing the mind for sleep is just as important as preparing the body. Activities like journaling, meditation or scheduling time to process thoughts can help clear the mind before bed. Writing down worries or reflections can create a sense of closure for the day, making it easier to relax.

Keeping routines as simple as possible increases the likelihood of sticking to them. Mobile applications can be valuable tools for guiding activities like stretching or relaxation, eliminating the burden of planning your next steps. The NeuroFlow app is particularly effective, offering guided videos for yoga, meditation and breathing exercises to support relaxation. For those seeking structured sleep improvement techniques, digital cognitive behavioral therapy programs like Magellan Healthcare’s Restore provides step-by-step guidance, including proven techniques and exercises designed to improve sleep quality. Finding the right tools to simplify and support a sleep routine can make all the difference in achieving restful, restorative sleep.

How does technology like screen time impact our ability to get quality rest and what can we do to minimize its quality?

Many apps and videos are designed to be engaging and stimulating, encouraging continued use rather than promoting relaxation. This can make it more difficult to fall asleep. The most effective approach is to avoid screens for about 30 to 60 minutes before bed. Utilizing phone settings to limit notifications or restrict access to certain apps can help minimize distractions and reduce the temptation to use screens at bedtime.

The connection between sleep and both mental and physical health is undeniable. Quality sleep is essential for the body to perform vital maintenance processes, from cognitive functioning to immune support and stress regulation. Chronic sleep deprivation can lead to a range of serious health issues, both physically and mentally, including heart disease, impaired brain function and mood disorders like anxiety and depression. While factors such as stress and screen time may disrupt sleep, there are strategies to improve both the quantity and quality of rest. Techniques like “worry time” and progressive muscle relaxation, along with consistent bedtime routines, can significantly enhance relaxation and readiness for sleep. Reducing screen time before bed further supports this process. Prioritizing and improving sleep habits is an investment in overall wellbeing, making it essential to incorporate restful practices into daily life for better health outcomes.

If you missed the Magellan Minute, listen to the recording here.

Source: CDC

Influenza (flu) season can be unpredictable. In the United States (US), flu activity typically begins in October and peaks between December and February, but activity can even continue into May. Australia recently finished their winter where they experienced the most severe flu season in five years, and the season started earlier than usual. Although flu forecasting is not perfect, the Southern Hemisphere serves as a barometer for what might happen in the Northern Hemisphere. In the US, flu activity is elevated across the country.

COVID-19, which is still circulating, is generally mild for children. During the pandemic flu was virtually non-existent. This can be partly attributed to mitigation measures such as handwashing, masking, distancing, as well as remote school, work, and limited travel. The flu hiatus also translates into less pre-existing immunity to influenza due to lack of exposure – from natural infection or vaccines – particularly notable in younger children who may have never been exposed to flu. Further, there is currently a surge in pediatric respiratory syncytial virus (RSV) cases and hospitalizations. Children and the elderly are among the populations at higher risk of influenza complications. With pre-pandemic activities resuming and school back in-person, flu is making a comeback this season.

According to the Center for Disease Control and Prevention (CDC)’s FluView (a weekly US influenza surveillance report), influenza-like illness (ILI) activity is elevated across the country. The CDC’s interactive map offers a visual picture of outpatient ILI activity in the US and links out to state-level information. Additional data such as hospitalization and mortality surveillance are also captured on the CDC’s site.

The best protection against the flu is prevention. The CDC recommends an annual flu vaccine for everyone ages ≥6 months old with rare exceptions. The ideal time for the flu shot is in September or October, and it can be offered throughout the season, as long as flu viruses are circulating. It takes about two weeks after vaccination to develop protection against the flu. New this year, all available flu vaccines in the US are quadrivalent, meaning they contain two influenza A and two influenza B virus antigens, thus designed to protect against four flu viruses. The dominant strain is currently influenza A (H3N2), which is especially tough on the elderly. Also new this year, is a preferential recommendation from the CDC Advisory Committee on Immunization Practices (ACIP) for high-dose, adjuvanted, or recombinant vaccine over other flu vaccines for adults ≥65 years old.

To find a flu vaccine provider, visit vaccines.gov. The flu and COVID-19 vaccines can be given at the same time. Prescription flu antiviral medications to treat flu are currently available. Remember, good hygiene and self care are critical in fighting the flu and a number of other viruses, so wash hands, cover your cough, rest, and stay home when sick.
As the flu continues to unfold this winter, prevention, awareness, and health literacy are key to being prepared.

Disclaimer: The content in this blog is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

Today, Centene Corporation announced that it has completed the acquisition of Magellan Health, Inc. Through this transaction, we are establishing a leading behavioral health platform during a critical time through the COVID-19 pandemic.

“Magellan will expand Centene’s reach to provide increased access to behavioral healthcare for our members at a time when so many Americans are struggling with mental or behavioral health issues,” said Michael Neidorff, Chairman and Chief Executive Officer of Centene. “This transaction establishes a strong foundation from which we will innovate and reimagine behavioral and specialty health to provide comprehensive and integrated healthcare to our members, while generating value for our state partners and shareholders.”

And the need for holistic, comprehensive health management only continues to grow as the pandemic continues.

In December 2020, the Government Accountability Office (GAO) stated in a new Government Accountability Office (GAO) report more than four out of 10 adults, 43 percent, suffered from anxiety or depression. In addition, the Centers for Disease Control and Prevention (CDC) 2021 study said 13 percent of adults responding to their survey admitted “having started or increased substance use to cope with stress or emotions related to COVID-19.”

As the nation’s largest managed health care organization, Centene is well-positioned to continue its focus on member-centered care – especially during this time of such great need and demand. The Magellan acquisition enables Centene to provide whole-health, integrated healthcare solutions to deliver better health outcomes at lower costs for complex, high-cost populations.

Centene remains focused on our commitment to shaping a better world of healthcare for our members, providers, state partners, employees, and the communities we serve as we lead the world to a healthier future. Magellan Health will operate independently under Centene’s Health Care Enterprises umbrella. Additional details regarding this transaction are available in this press release.

Total cost of care is challenging to define. In general, we consider total cost of care to be the total cost of what it takes to treat a population. Is it direct provider fees and hospital fees? What about labs? Medications? Caregiver burden? Time away from work?

When I was in clinical practice—whether internal medicine or psychiatry out-patient clinics— I commonly saw what I called the Ziploc phenomenon—the arrival of a patient carrying a Ziploc bag of prescription drugs. We would spend time going through that bag to help me understand what the patient was actually taking. There would be medications from an ER visit, from an in-patient stay, and those that had been in the medicine cabinet at home. There would be brand names and generics of the same medication or different doses with different instructions. And despite all these medications, some patients invariably had ended up with higher total cost of care due to medication-related issues such as confusion, side-effects, falls, or just from not taking the medication at all because they did not feel better.

Typically, the total cost of care is the sum of in-patient, out-patient, clinic, ancillary, pharmacy, and all other types of direct care services and is defined as a per member per month expenditure. Members continuously enrolled in the health plan for at least a year make up the denominator. Groups who receive an intervention, like case management, are compared against a like-group that does not. The challenges really come when trying to attribute whether the intervention or some other occurrence made the difference in lowering the total cost of care. In order for comparisons to be statistically valid, techniques such as risk adjustment, case-matched controls, trend analyses, and regression analyses are used.

A couple of years ago, I took a role that focused on developing innovative clinical programs for Magellan Rx Management, a pharmacy benefits management company. The CEO challenged me with bringing forward clinical programs that looked different than what typical PBMs offered. I went back to my roots in med/psych and epidemiology. We drew on the interventions more commonly used in health plans. Surely, in the data, we could find the groups of people who needed support, whether in dealing with the Ziploc bag or in other areas at the intersection of medication and well-being. My teams focused on providing the right kinds of interventions to bring better clinical outcomes. As a side effect, we saw improvements in the total cost of care for those members.

Here are two innovative strategies to manage total cost of care

1. Having access to data is critical to address the total cost of care.

Unfortunately, it is often the case that PBMs don’t have access to medical claims or other data, including medical pharmacy spend. To hone in on the populations that could benefit from clinical programs, a combination of medical, behavioral, and pharmacy claims is necessary. My team works with a data science company, Arine, to support our work. Arine ingests all sorts of data, including the typical claims data and information from health risk assessments, social determinants factors, and remote monitoring data from devices such as blood pressure monitors. Arine’s technology includes hundreds of algorithms that can help identify individuals at risk for gaps in care, non-adherence, and even heightened suicide risk.

2. Identifying at-risk individuals and offering provider academic detailing services

Navigate Whole Health is one of our signature programs directed at improving quality and addressing spend. The original idea behind Navigate Whole Health was to find individuals who were prescribed potentially lethal combinations of opioids and other drugs, high doses of opioids, or poly-pharmacy with behavioral health medications. Using a set of algorithms running through pharmacy, behavioral and medical claims, we can identify individuals who fall into one of the target groups. With Arine’s support, we have expanded the number of algorithms we use to identify at-risk individuals and prescribers.

In fact, provider outreach with academic detailing is the salient intervention. The pharmacists providing the academic detailing have nearly universally found that the providers welcome our input. Our approach has never been threatening or punitive. Rather, the team approaches each case with an attitude of “How can I help you?” Many providers do not know all the medications an individual is taking, including prescriptions written by other providers, medications coming from an in-patient stay, an ER visit, or even the dentist. For one Medicaid client, the team’s work with providers resulted in significant reductions in combinations of opioids and benzodiazepines, reduction in the number of prescribers, and reduction in pharmacy spend, in-patient spend and emergency department utilization during the measurement period. This is one program that I unequivocally believe saves lives. And here is the thing, in doing the right thing, the positive outcome is that we also save total cost of care dollars.

I have a hard time supporting the logic that buckets cost in such a way that could adversely affect overall health outcomes. It is a privilege to bring forward clinical programs that save total cost of care dollars which in turn promote positive health outcomes. What is even better is knowing that these programs positively affect the well-being of those we serve.

Depression is a disease. It’s caused by changes in chemicals in the brain that are called neurotransmitters. Depression isn’t a character flaw, and it doesn’t mean you are bad or weak. It doesn’t mean you are going crazy.

People who are very depressed can feel so bad that they think about suicide. They may feel hopeless, helpless, and worthless. But most people who think about suicide don’t want to die. They may see suicide as a way to solve a problem or end their pain.

What to watch for

It is hard to know if someone is thinking about suicide. But past history or events may make suicide more likely.

Things that can make suicide more likely for those suffering from depression include:

• Being male
• Having had a family member attempt suicide or kill himself or herself
• Having access to a firearm
• Having been sexually abused
• Drinking a lot of alcohol or using drugs
• Having attempted suicide before
• Feeling hopeless
• Other mental health problems, such as bipolar disorder or schizophrenia

Warning signs of suicide include someone:

• Planning to or saying he or she wants to hurt or kill himself or herself or someone else
• Talking, writing, reading, or drawing about death, including writing suicide notes and speaking of items that can cause physical harm, such as pills, guns, or knives, especially if this behavior is new
• Saying he or she has no hope, feels trapped, or sees no point in “going on”

Find additional information and resources on suicide prevention here.

For information about Magellan events during National Depression and Mental Health Awareness and Screening Month, downloadable materials and more, visit our website here.

Adapted with permission from copyrighted materials here from Healthwise, Incorporated.  Healthwise, Incorporated and Magellan Health disclaim any warranty and all liability for your use of this information.

Untreated mental illness costs the United States up to $300 billion every year.[1] It is the leading cause of disability and the third most expensive medical condition in terms of total health spending, behind cancer and traumatic injury.

Given that one in five Americans suffers from a mental illness in a given year[3], and that the average delay between the onset of mental illness symptoms and treatment is 11 years[4], mental health screening should be considered just as important as regular medical exams.

Many physicians integrate screening to diagnose mental health conditions as part of primary care. It gives a PCP a picture of the patient’s emotional state and helps determine if symptoms they are experiencing are an indication of a mental health condition or an underlying physical health condition. Magellan Healthcare supports primary care screening and treatment with our Behavioral Health Toolkit at MagellanPCPtoolkit.com

Online screening and digital screening are two of the quickest and easiest ways to determine if a patient is experiencing symptoms of a mental health condition. A PCP may ask a patient to complete a questionnaire online before a visit, or a PCP may ask a patient to answer a few questions on a tablet or form while you they are at the office.

Based on the results, the PCP can recommend treatment options, such as digital or in-person therapy, a referral to a psychiatrist or psychologist, or a referral to the patient’s health plan’s case management team.

Early identification and intervention lead to better outcomes and can reduce long-term disabilities and prevent years of suffering.

To learn more, visit magellanhealthcare.com/mental-health. You’ll find information about mental health conditions and links to evidence-based screening tools you can do yourself. If any screener indicates a problem, consult a healthcare professional immediately.

[1] National Alliance on Mental Illness. (n.d.) FY 2018 Funding for mental health. Retrieved October 7, 2020 from https://www.nami.org/getattachment/Get-Involved/NAMI-National-Convention/Convention-Program-Schedule/Hill-Day-2017/FINAL-Hill-Day-17-Leave-Behind-Appropriations.pdf

[2] Soni, A. (2015). Top five most cCostly conditions among adults age 18 and older, 2012: Estimates for the U.S. civilian noninstitutionalized population. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. Retrieved September 18, 2020 from https://meps.ahrq.gov/data_files/publications/st471/stat471.shtml.

[3] Centers for Disease Control and Prevention (2018). Learn about mental health. Retrieved September 18, 2020 from https://www.cdc.gov/mentalhealth/learn/index.htm.

[4] National Alliance on Mental Illness. Mental health by the numbers. (2019, September). Retrieved September 22, 2020 from https://www.nami.org/mhstats.

The U.S. Preventive Services Task Force recommends that all people, starting at age 12, be screened for depression. Screening for depression helps find depression early. And early treatment may help you get better faster.

Depression is a disease. It’s not caused by personal weakness and is not a character flaw. When you have depression, chemicals in your brain called neurotransmitters are out of balance.

Depression causes adults and children to feel sad or hopeless much of the time. It’s different from normal feelings of sadness, grief, or low energy. Always tell your doctor if you feel sad or have other symptoms of depression. Many times, people are embarrassed by these feelings and say nothing. Depression can be treated, and the sooner you get treatment, the better your chance for a quick and full recovery. Untreated depression can get worse, cause other health problems, and may last for years or even a lifetime. It can have a serious impact on both you and the people you care about.

Adults

To find out if you are depressed, your doctor may do a physical exam and ask you questions about your health and your feelings. Some questions may not seem related to your mood. But your honest answers can help give the doctor clues about how depression may be affecting you. Your doctor may ask you about feelings of sadness, changes in hunger or weight, energy level, concentration, guilt, thoughts of death and suicide, sleep, general interest in everyday activities, and more.

Some diseases can cause symptoms that look like depression. So your doctor may do blood tests to help rule out physical problems, such as a low thyroid level or anemia.

Children and teens

Symptoms of depression in children and teens can be different from adult symptoms.

To find out if your child is depressed, the doctor may do a physical exam and ask your child about his or her health and about how he or she thinks, acts, and feels. The doctor may ask your child about grouchiness, temper tantrums, headaches, stomachaches, social withdrawal, and more. It is common for children with depression to have other problems, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. The doctor may ask questions about these problems too.

The doctor may also ask you or a teacher to fill out a form about your child’s symptoms.

Some diseases can cause symptoms that look like depression. So the doctor may do blood tests to help rule out physical problems, such as a low thyroid level or anemia.

For information about Magellan events during National Depression and Mental Health Awareness and Screening Month, downloadable materials and more free resources, visit our website here.

Adapted with permission from copyrighted materials here from Healthwise, Incorporated.  Healthwise, Incorporated disclaims any warranty and all liability for your use of this information.

Written by Thomas Lane, NCPS, CRPS

Every 40 seconds someone dies by suicide somewhere in the world.[1] The human tragedy of death by suicide is getting worse, with global suicide rates increasing 60% in the past 45 years.[1] Most people reading this article will know someone who has been impacted by suicide. One group of folks especially at risk for a suicide attempt are those who have tried to complete suicide previously. Data suggests that 20% of attempt survivors will make another attempt.[2]

I am one with personal experience. I am part of that 20%. As a double attempt survivor, I have haunting memories of those periods in my life when I was more fearful of living than I was afraid of dying. For me, those were the darkest, loneliest, and longest days of my life. After my second attempt in the winter of 1998, I wound up on a ventilator. I was in a coma for 12 days and when I woke up, I felt like someone was choking me. And I was angry. At the time, when I was literally regaining consciousness and coming back to the land of the living, my mom was downstairs with hospital administrators signing an agreement to discontinue life support for me.

As the saying goes, timing is everything.

After a lengthy and very shaky period, I began to get better. I was receiving good mental healthcare, redefining my circles of support, and I had a purpose. I came to believe I still had work to do. Now. On this planet. I had twice crossed the line of deciding I could not be here. Despite my best efforts, I was still here, facing my life. I decided I would seek meaning from as many of my experiences as I could. For the past 20-plus years, I have worked to build and advance peer support, particularly within the context of publicly funded healthcare systems, but also at the grassroots level and through public/private partnerships. I am more convinced than ever of the value, importance and unique perspectives folks with lived experience bring to the table, specifically those who choose to pursue careers as peer specialists. It has been and continues to be a transformative movement, even more so when we understand that many folks who make a choice to work in the peer support field, in the same delivery systems that may not have served them well, do so out of a passion for the work and to give back, to pay it forward.

I share this very personal experience as context for my next point.

In a 2016 survey of Magellan members receiving peer support services, 98% reported their certified peer specialist helps them to, both, improve their quality of life, and feel hopeful about their recovery.[3] Knowing what we do now about the effectiveness of peer support, and understanding the value of lived experience, I believe we can agree about the importance of connecting attempt survivors with peer supporters who have had similar experiences. For most, if not all, attempt survivors, there is a crucial time period after an attempt; I needed intensive support in the days following my second attempt. Sadly, intensive support is not always available, let alone offered by a peer who is also an attempt survivor. I can’t help but wonder, what would universal referral to, or at least an orientation about, peer support opportunities by and for attempt survivors, look like? Considering the COVID-19 pandemic, we have seen a rapid, albeit sometimes rocky, migration to technology-enabled service delivery. Interestingly, peer support has been “technology-enabled” for years in the form of peer-operated warmlines. If you’re not familiar with warmlines, check out the National Empowerment Center at https://power2u.org/peer-run-warmlines-resources/ for great information.

When we consider suicide, we know it is all about prevention, that is, preventing people from attempting to take their own lives. I don’t believe there is a higher calling. Many of my peers with the shared experience of being an attempt survivor have expressed to me this is the most important work they do. We see the positive impact of attempt survivors speaking out about their experiences. We see the importance of eliminating shame associated with the topic of suicide. We know suicide is preventable. We understand that prevention requires dialogue, and dialogue isn’t always comfortable. Nonetheless, the topic of suicide must be brought out of the shadows and recognized as the public health crisis it is, one that we can do something about through evidence-based prevention and education practices. We know it does not increase a person’s likelihood of attempting suicide to talk with them about what they’re feeling. Fortunately, there are many, many organizations pledged to this work. From grassroots organizations founded by survivors of suicide loss to nationally recognized organizations, the conversation is changing. We must continue to be intentional in our approach.

National Suicide Prevention Awareness Month helps shine a light on this often misunderstood and taboo topic. Let’s keep the conversation going for the other eleven months of the year. As peers, let’s renew our commitment to offering support, speaking out and holding the hope for someone until they are able to hold it for themselves. As fellow human beings, let’s take inspiration from Emily Dickinson, and tap the eternal hope perched in all of us.

“Hope is the thing with feathers, that perches in the soul

And sings the tune without the words

And never stops…at all.”

For information about Magellan events during Suicide Prevention Awareness Month, suicide prevention downloadable materials and more free resources, visit our suicide prevention website.

[1] https://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

[2] https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1317-z

[3] Magellan Peer Support Services Outcomes in Pennsylvania, 2016