The new 988 Suicide and Crisis Lifeline launched on July 16, 2022. With 988, it’s now easier than ever for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress–to seek immediate help.

The new 988 dialing code operates through the existing National Suicide Prevention Lifeline (the Lifeline) network of over 200 locally operated and funded crisis centers across the U.S. People can now access a strengthened and expanded Lifeline via 988 or the existing 10-digit number (which will not go away).

In this post, we’ll continue the introduction of the new 988 Suicide and Crisis Lifeline and provide additional resources for you to learn more and be prepared if you or someone you know experiences a mental health crisis.

What is 988?

Beyond being an easy-to-remember number, 988 provides a direct connection to trained, compassionate and community-based crisis counselors for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress.

Who can use 988?

988 services are confidential, free and available 24/7/365 for anyone experiencing a mental health, substance use or suicidal crisis. And 988 isn’t just for you. People can also dial 988 if they are worried about a loved one who may need crisis support.

How are 988 services accessed?

The 988-dialing code is available for call (multiple languages) or text (English only), and chat services (English only) can be accessed at 988Lifeline.org. 988 services are available through every landline, cell phone and voice-over-internet device in the U.S.

 How is 988 different from 911?

The focus of 988 is to provide easier access to the Lifeline network and related crisis resources, which are distinct from 911, where the focus is on dispatching Emergency Medical Services, fire and police, as needed.

Why was 988 created and where can I get more information?

Congress designated the new 988 dialing code in 2020 to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency, along with Vibrant Emotional Health (operational home of the National Suicide Prevention Lifeline), in partnership with the Federal Communications Commission and Department of Veterans Affairs, to make 988 a reality in the U.S.

SAMHSA provides comprehensive resources for anyone to learn more about 988, suicide prevention and mental health crisis services at   SAMHSA.gov/988.

Is my state ready for 988?

States are at varying degrees of readiness for the volume increases expected from moving to the 3-digit code, 988. The federal government is responding to resource challenges with unprecedented levels of funding and an all-of-government approach to partner with state and local leaders to improve system capacity and performance.

Find additional information and materials on suicide prevention at MagellanHealthcare.com/Prevent-Suicide, and stay tuned for our September Suicide Prevention Awareness Month campaign and free webinar.

Sign up to receive updates a few times a month from Magellan on free behavioral health resources you can use and share with family, friends and colleagues here.

Sources: SAMHSA and the National Action Alliance for Suicide prevention

Kristen Ford, vice president of product innovation and development for behavioral health, has led many new innovative products being developed at Magellan Health. In her position, Ford is responsible for the product innovation and development activities for behavioral health solutions. Ford, who is based in Oregon, has worked for Magellan Health for 12 years on various innovation strategies focused on best-in-class services that help members live healthier lives. She is a Six Sigma Black Belt and a clinician who’s passionate about driving human-centered product development that changes lives. Most recently she’s helped to launch a full continuum population health wellbeing solution to improve population engagement into evidence-based care and improve the quality and accessibility of healthcare for those that are thriving, struggling or suffering. Continue reading to learn more about Ford’s work on these innovative products:

What cool, innovative products are you currently working on?

My responsibilities focus on new products that drive growth, leverage Magellan Health’s thought leadership, and enhance the lives of the people we serve. One example is the development of a comprehensive autism strategy where we are creating new mechanisms for timely access to autism screening with faster diagnosis to improve early intervention. We are laying the groundwork for new clinical models that intertwine technology, diagnostics, therapeutics and facilitate better coordinated care for the whole child.

We’re also working on other complex areas of healthcare such as suicide prevention. We care deeply about the recent increase in population suicide trends and our mission is to make suicide a never event. We do that through creating solutions that empower individuals with knowledge, education and tools in an environment of uninterrupted and supportive care.

Medical integration is another area of focus with our new collaborative care product which improves medical and behavioral health integration by making it easier for primary care physicians to diagnose and treat members’ behavioral health condition in the office. We’re looking at ways to solve important challenges in the delivery of behavioral healthcare by working on solutions that enable navigation, digital engagement, transform the delivery system and offer new models of care.

Can you expand on the work you’re doing with projects like Mightier, NeuroFlow and DUOS?

Mightier is a biofeedback gaming solution that teaches children emotional regulation to help them manage big emotions and teach calming strategies. This is important because it offers a bridge to care for children and families that are struggling. It’s been shown to be highly effective in randomized control trials for children with autism, ADHD, OCD or other similar conditions. It’s improved oppositional behaviors in children and decreased caregiver stress. We’re currently working with Mightier on a study through the National Institute of Mental Health to show that using this type of intervention can improve quality and cost of care.

We’re also working with NeuroFlow to deliver a collaborative care product, which expands Magellan’s value proposition with the ability to manage total cost of care. NeuroFlow brings the technology, and Magellan provides the clinical management which has resulted in a solution that is highly appreciated by our clients. We also launched the NeuroFlow population health app which provides digital wellbeing and self-care tools, including our digital cognitive behavioral therapy modules, to help members improve overall health and wellbeing, manage stress and build resilience in a confidential manner.

DUOS is an opportunity for us to address the social determinants of health and needs of older populations. DUOS provides a personal assistant for aging – a DUO – to help older adults stay healthy and age independently in their own homes. We connect older adults with social support and resources to manage social isolation, healthcare access and behavioral health needs. In our pilot results, we found that 97% of seniors were linked to resources to meet their needs and has high satisfaction with a net promoter score of 88.

Why is Magellan Health the best place to build new innovative products?

We are fortunate to have an executive leadership team that developed a culture that supports innovation. It’s part of our DNA. We have been successful in evolving our innovation strategy that positions Magellan as a thought leader and innovator in the behavioral health and wellbeing space. Our executive leadership believes that innovation is essential in treating the whole person, achieving growth and moving our business forward.

What are your thoughts on Magellan’s culture? How has that culture impacted the products you’ve worked on?

I think it’s a highly collaborative and team-oriented culture. Everyone is willing to roll up their sleeves and help achieve the best outcomes. The Magellan culture is purpose and mission driven. Everyone you encounter is focused on the best ways to support our customers, ensure members have the best experience and they’re getting the best care possible. I think that’s the picture of Magellan and it’s a wonderful place to work and drive innovation.

Currently, we have a pipeline of over 44 different products or product enhancements that we’d like to explore. People are familiar with Magellan’s culture of dedication and innovation. As a result, they are willing to collaborate and advise us as we drive towards solutions that can improve the lives of those members we serve.

What exciting trends in the healthcare industry have you noticed? What direction do you see healthcare going? What lessons are there to learn in other industries that can be applied to healthcare?

There are new trends in the field of autism related to clinical advancement and how we work with children on the spectrum as well as exciting developments and solutions in managing the total cost of care. There are new approaches that allow us to combine technology and clinical acumen deliver new care models. The pandemic created an environment where members and providers used new technologies and tools out of necessity which now provides us opportunity to continue to build and accelerate the adoption of new care models through technology. We are also seeing new and exciting opportunities to engage and activate members while reducing stigma.

Some industries can market directly and successfully engage the end user. We can learn from those industries and drive growth through that engagement.

We are fortunate that the Magellan leadership team and culture supports us in exploring those recent trends and solving for some of the most difficult challenges we see in service delivery.

Swarna Ramachandran is bringing a new digital experience to the world of behavioral health. As vice president of digital and contact center solutions for Magellan Healthcare, Ramachandran is leading a team that is redesigning the online digital experience for members, making it more intuitive when finding the necessary resources. Digital transformation, including technology, experience and Contact Center modernization, has been core to where she is today, and navigating the whole realm delivery & PMO come natural to her, says Ramachandran. Keep reading to learn how Ramachandran and her team are creating a new digital experience for Magellan Health members.

Q: What kind of projects are you working on right now?

A: Digital transformation is a key area of focus for Magellan Health. Engaging and enabling members digitally for care and self-service, helping reduce the stigma around mental health, and enabling self-service for providers and clients digitally are some of our key transformation goals.

The COVID-19 global pandemic has increased awareness and need for mental and behavioral health care for all of us. Several products have been released in the market that are either point solutions or solves for a couple areas of mental health, leaving the member with a myriad of apps and tools, leading to a dissatisfied member. One of Magellan Health’s core strengths is mental and behavioral health and with our diverse population of members across our products, we are in a unique position to provide our members with a guided approach to accessing care and address issues at their root by understanding the stressors, specific resources and community support.

Our vision is a holistic approach to member wellbeing and care. Our approach starts with member engagement and navigation to help remove the stigma towards mental health by helping the member to approach mental health and wellbeing as part of their whole health. We do this by promoting annual digital wellbeing checks in a self-service mode.

Q: How did you and your team come up with this idea? Why is Magellan Health the best place to work on this project?

A: Digital is everywhere and in everyone’s hand today in the form of mobile apps, websites and internet.  Ideas are plenty but solving for the real need is key. We conducted various design thinking sessions with members and studied the need thoroughly from the member perspective.

Magellan Health’s core strength is mental and behavioral healthcare, and we have a significant population of behavioral health members. We have members from our other products like Employer solutions, State and Federal, which puts us in a unique position to capitalize on our strengths and serve this large group of members at their doorstep and to get them healthy mentally and physically.

Learn more about the digital experience here.

Behavioral health is an important indicator of a society’s overall wellbeing, as it interacts closely with physical health. Unfortunately, most individuals do not receive the behavioral health treatment they need. Fear of treatment, shame, and embarrassment keep many from seeking care. More than one-third of Americans live in areas lacking mental health professionals.[1] Fifty percent of individuals who receive a behavioral health referral do not follow through or have only one visit.[2] Collaborative care addresses these problems by providing physical and behavioral health care in the primary care setting.

What is collaborative care?

Collaborative care is a specific type of integrated care developed at the University of Washington’s AIM Center that treats common mental health conditions, such as depression and anxiety, that require systematic follow-up due to their persistence. Based on principles of effective treatment of chronic illness, collaborative care focuses on defined patient populations tracked in a registry, measurement-based practices, and treatment to target. Trained primary care providers and embedded behavioral health professionals provide evidence-based medication or psychosocial treatments, supported by regular psychiatric case consultation and treatment adjustment for patients who do not improve as expected.[3]

Principles of collaborative care

Developed in consultation with a group of national experts in integrated behavioral health care in 2011 with the support of the John A. Hartford Foundation, The Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, and California Healthcare Foundation, five core principles define collaborative care and should inform every aspect of implementation to ensure effective collaborative care is practiced.[4]

• Patient-centered team care—Primary care and behavioral health providers effectively work together using shared care plans that include patient goals. Being able to receive both physical and mental health care in a familiar location provides patients with comfort and reduces duplication of assessments. Increased patient engagement often leads to a better health care experience and improved patient outcomes.
• Population-based care—Care teams share a specific group of patients that are included in a registry. The registry is used to track patients and ensure that no one falls through the cracks. Patients who do not show improvement are outreached, and behavioral health specialists offer caseload-focused consultation.
• Measurement-based treatment to target—Each patient’s treatment plan includes personal goals and clinical outcomes that are measured using evidence-based tools, such as the Generalized Anxiety Disorder scale on a routine basis. If patients do not improve as expected, treatments are adjusted until clinical goals are met.
• Evidence-based care—Patients receive treatments with sound research evidence to support their efficacy in the treatment of the target condition, including various evidence-based psychotherapies that have proven effective in primary care, such as problem-solving treatment, behavioral activation, and cognitive behavioral therapy, and medicines.
• Accountable care—Providers are responsible for and receive reimbursement for the quality of care and clinical outcomes, not just the volume of care provided.

Collaborative care has been proven to double the effectiveness of depression care, improve physical function, and reduce health care costs. Magellan Healthcare’s evidence-based Collaborative Care Management product, enabled by NeuroFlow, provides care management and psychiatric consults for primary care patients and augments physical health providers’ staff with Magellan staff to facilitate integrated physical and behavioral healthcare. Learn more here.

[1] https://usafacts.org/articles/over-one-third-of-americans-live-in-areas-lacking-mental-health-professionals/

[2] https://aims.uw.edu/collaborative-care

[3] https://aims.uw.edu/collaborative-care

[4] https://aims.uw.edu/collaborative-care

For our kids, disruptions caused by the COVID-19 pandemic are likely more than just that – temporary inconveniences, varying in severity, until life goes back to “normal.” Besides missing out on once-in-a-lifetime events, like graduations, birthdays and other milestones – at least in a way they would traditionally be observed – regular human interactions, part of social and emotional development, have changed. While adults may be experiencing a serious blip on the radar, children may be experiencing an interruption in brain development and/or lack the ability to fully cope in this unchartered territory.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Understanding and Meeting the Needs of Children and Adolescents at High Risk, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents.

As we think about the significance of childhood development, the following points from Magellan’s monograph provide insights:

A growing body of scientific information has confirmed the importance of the first five years of life, when the ongoing construction of brain architecture impacts youth social and emotional development, the ability to learn new behavior and skills, and how the youth evolves into adolescence.

Advances in neuroscience have contributed new understanding of adolescent development. During adolescence, the brain experiences a period of major development comparable to that of early childhood.

With much changing in our kids’ lives and environment – virtual schooling, modified in-person play arrangements with friends and reduced time with extended family – the responsibility falls on parents and caregivers, as it always does, to ensure their child’s wellbeing and adjustment. Magellan’s monograph offers the following to ponder:

While genes determine when specific brain circuits are formed, experiences actually shape their formation and are fueled by a self-initiated, inborn drive toward competence. This phenomenon depends on appropriate sensory input and stable, responsive relationships whereby adults respond to a child’s natural reaching out for interaction.

However, when parents are under unprecedented stress and often just trying to make ends meet, attending to their child’s increasing needs can understandably be overwhelming. In addition to the role of parent and full-time employee, many adults have taken on the additional roles of teacher, daycare worker and entertainer, to name a few. In some cases, however, a parent’s struggles may lead to neglect of their children. Magellan’s monograph highlights the following of child neglect:

While child abuse is more widely acknowledged and publicized, child neglect is, in fact, the most common type of child maltreatment, which frequently goes underreported. Expanding on the earlier discussion of impaired brain development, it is now understood that lack of stimulation and necessary care early in life may cause children to remain in a state of “hyperarousal” (i.e., constantly anticipating threats and/or experiencing dissociation) rather than a normal state of attentive calm. This phenomenon leads to a decreased ability to benefit from social, emotional and cognitive experiences and results in other psychosocial consequences. Together with insecure attachments, this state of hyperarousal can significantly affect normal growth and development.

Many parents are also managing their own mental health conditions and substance use disorder during the pandemic, which adds to the impact of what children and adolescents are experiencing themselves. The monograph outlines the risks for children of these parents:

There are many serious risks to children and adolescents who have a parent or both parents with mental illness. The American Academy of Child and Adolescent Psychiatry (AACAP) calls attention to the strong genetic predisposition in children for inheriting bipolar disorder, an anxiety disorder, attention deficit-hyperactivity disorder (ADHD), schizophrenia, alcoholism or other SUD, or depression. Recent studies have also demonstrated delayed brain development in young children of depressed mothers. Further, the AACAP notes the additional stress that mental illness places on a marriage and parenting abilities of the couple, and the risks that stem from an inconsistent, unpredictable family environment that can contribute to psychiatric illness and developmental delays in children.

It’s also appropriate to consider the older children and young adults who may lack the ability to cope with increased stress and instability. Magellan’s monograph calls attention to recent research:

A CDC report on mental health, substance use and suicidal ideation during the COVID-19 pandemic shows that while 11% of adults seriously contemplated suicide in June 2020, the same was disproportionately reported by young people aged 18 to 24 (26%).

During these difficult times, we’re all doing the best we can. And we know that brighter days are on the horizon. Until then, and always, as we’re helping ourselves and our children through, let’s remember that “information is power,” as they say. To that effect, we encourage you to learn more in our full children’s clinical monograph here.

Normal holiday stressors can be compounded when we miss someone we have lost or are impacted by other hardships. This year, the sense of loss – of a loved one, financial security and a sense of “normal” – has touched many of us due to the COVID-19 pandemic. As we’re making plans to celebrate the holidays in unprecedented times, let’s take a break with Magellan’s Dr. Shareh Ghani as he discusses ways to address feelings of loss, practice self-care and make the most of this holiday season.

Magellan: Dr. Ghani, thank you so much for being here with us to share your many years of expertise in helping patients with behavioral health needs. Our first question: Is it possible to enjoy the holidays when we are experiencing the pain of losing a loved one to COVID-19 or something else?

Dr. Ghani: Thank you for having me. The pandemic has taken a toll on our community as we have lost loved ones prematurely, and we continue to experience sustained emotional pressure as COVID continues to spread. It is vitally important that we celebrate the holidays, exchange gifts and cards, gather virtually, and celebrate life. Spreading love and joy in these trying times will bring much-needed respite to the brain and body and boost our immune systems.

Magellan: How can we overcome feelings of worry and anxiety due to a job loss or other financial insecurity during this holiday season?

Dr. Ghani: Losing a job obviously leads to worry, anxiety and even questioning one’s own competence. The pandemic has helped many people shift focus to the “must haves” and not worry about the “nice-to-have” luxuries in life. Some are paying more attention to their health and fitness, minimizing spend, and planning for the future. Having a good strategy will help reduce the anxiety of uncertainty. If need be, talk to a therapist.

Magellan: Do you have any tips for people experiencing distress over not being able to celebrate the holidays in the way they may have in the past?

Dr. Ghani: One needs to evaluate the reason why we are changing our lifestyle. Social distancing helps stop the spread of the virus. Those who take this threat to our lives lightly may experience distress. Understanding the gravity of the situation alleviates it. We are celebrating in smaller groups so we can defeat the virus and return to our old ways of celebrating holidays safely. Think of it as a form of delaying gratification for better outcomes.

Magellan: What is your general advice for anyone who is experiencing loss to feel better and be able to experience joy this holiday season?

Dr. Ghani: Losing loved ones is a part of our life cycle. Human beings are resilient beings. Remember – those that we have lost would have wanted us to be happy. We should think about the happy moments we shared with those that are not here today and celebrate life.

Magellan: Why is it important to practice self-care and be an advocate for one’s own mental health?

Dr. Ghani: Good eating habits and physical exercise are key to physical and emotional wellness. Sleeping at least eight hours a day, hydrating well and experiencing joy and happiness are also important. All these things help with mental health. Relationships, family, helping others and being grateful add to a joyous life experience.

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.

Telehealth services have been available for years to help remove geographical and other boundaries for people in rural and medically under-served areas; however, use has been limited. Driven by the COVID-19 pandemic, including shelter-in-place orders, social distancing, and federal agencies mandating use for certain programs, telehealth has grown exponentially since March.

While companies like Teladoc and MD Live have been operating telehealth platforms for nearly two decades, many platforms are dedicated only to physical health. Magellan Healthcare has maintained a telehealth network for behavioral health since 2014 and helps:

• Health plans offer a cost-effective alternative to traditional doctor visits, urgent care and the emergency room; provide access to valuable care that is convenient and available anytime and anywhere; expand existing programs and services focused on health and wellness; and attract new members by offering the modern convenience of an on-demand service.
• Employers improve employee access to healthcare; reduce tardiness and absenteeism; increase employee productivity; offer a competitive benefits package; improve employee satisfaction; and retain and attract the best employees.
• Members have more privacy; access a deep and specialized network; receive treatment before work, after work or on weekends; have more frequent touch points to improve compliance with treatment and avoid unnecessary hospitalizations; and avoid travel, lost time from work and weeks of waiting for an appointment.
• Providers reach out to members in remote areas or where specialties are needed; provide care to homebound members; provide behavioral health services from home, office or while traveling; reduce no-shows and cancellations; offer additional and/or non-standard appointment times; and expand the patient base and improve relationships with existing patients.

Although the benefits of telehealth are many, people may feel uncomfortable using services. That’s why Magellan Healthcare created a video called Telehealth: Get Care and Treatment Wherever You Are. This video can help people understand:

• How to schedule a telehealth visit
• What to do once a telehealth visit is scheduled
• How to get the most from telehealth

The more comfortable people are using telehealth for their behavioral healthcare, the more options they have available to them. This can lead to improved compliance and better health outcomes.

Watch the video here.