National Healthcare Quality Week is a vital time to recognize the dedication of healthcare professionals who strive to improve the quality of care. From October 20 through October 26, healthcare organizations can emphasize the need for innovation, collaboration, and accountability in healthcare practices. This week also serves as an opportunity to reflect on successes, address challenges, and foster a culture of quality improvement that benefits patients, members and communities alike. In honor of National Healthcare Quality Week, we’re spotlighting three Magellan Health employees:

• Vivian Fain, senior manager, quality improvement
• Brandi Smith, director of quality
• Maria Brachelli-Pigeon, quality improvement director, Magellan Behavioral Health of Pennsylvania

Continue reading to learn more about Vivian, Brandi and Maria’s work in healthcare quality:

Are there any initiatives with healthcare quality that you’re currently working on?

Vivian: I am currently working on performance improvement initiatives related to the identification and submission of critical incidents. This is a major undertaking that unites local providers, care coordinators, and utilization management. This is particularly significant when it comes to securing the safety and welfare of the most vulnerable populations we serve.

Brandi: I am currently partnering with the continuous improvement team and the overall data management plan. I work with the data management and data analytics team to help identify the correct metrics and data elements to build out our scorecards. These scorecards will be essential to reporting our data with a higher consistency and quality. These scorecards will not only be accessible to the employer team but will be built with filters that will make other business units more accessible in Magellan and ensure consistency in reporting across the company.

Maria: As part of the quality team, we often have many healthcare quality related initiatives running concurrently. I appreciate that in my current role I have ability to help shape the scope of projects and measure outcomes of the activities. However, as a healthcare quality professional, I’d argue that most, if not all, discussions we step into benefit from a healthcare quality lens. This means that whether we’re participating in a single discussion or supporting a larger initiative, the principles of healthcare quality can be leveraged to support improvements internally and externally.

How did you get involved with the healthcare quality field?

Vivian: I didn’t seek being involved with the healthcare quality field; the field found me. After many years providing direct care service, I wanted to do something more. At the time, I had no insight into the functions of managed care and how it related to the behavioral health field I was passionate about. Eight years ago, I interviewed for a completely different position than what I’m in, and I was subsequently recommended for a position in quality, that change the path of my career and led me to do what I do today.

Brandi: I got involved with the healthcare quality field by accident. I went to school for accounting and when I graduated college, I got a job in the accounting field. That job wasn’t a great fit for me, so while I looked for my next big adventure, I took temporary jobs with a temp company. One of the temporary positions was at GreenSpring Health in Columbia, Maryland. That temporary job led to a permanent position at GreenSpring in the quality department in 1996. GreenSpring was purchased by Magellan. Since then, I have jumped around to some other departments, but have always returned to my roots in the quality department.

Maria: I was fortunate that another strong quality professional took a chance on me and extended me an offer for a position on the quality team. When I accepted the role I’m currently in, I had no formalized training in healthcare quality. The learning curve was profound. I say now with confidence that it was an excellent move for me. I can also share that before I started my employment at Magellan, that I was impassioned to have a larger role in finding way to improve our community behavioral health system. I worked many years as a clinician treating families and individuals with significant trauma and other behavioral health needs. This role granted me firsthand witness to momentous challenges that my clients experienced with the system, and I came to Magellan with a desire to help triage the barriers I’d observed. I initially joined Magellan as a member of the clinical team, and deeply appreciated what I learned working in that capacity, but feel I’ve found a home working in the quality field.

What are some of the most challenging and rewarding aspects of working in healthcare quality? 

Vivian: What I love about my job is seeing the changes made to direct care services secondary to the performance improvement initiatives my team rolls out. The systemic changes we request of providers/facilities, cascade benefits not only to the members we serve, but also have a direct impact for all patients who receive services from the facilities and providers we engage through the performance improvement process. The most challenging aspect of working in healthcare quality is the fast pace in which things take place.

Brandi: One challenge of working in quality are the audits that we do. Audits are a critical piece of work to maintain our excellent level of care that we give to our members and providers. These audits provide valuable feedback to our staff and supervisors allowing us to deliver the same excellent service no matter which person answers the phone. Audits are always evolving to meet the needs of our internal and external customers. For me, the most rewarding aspect of working in quality is when someone identifies an issue, and I can find a solution. I am a problem solver at my core. This is what makes quality such an interesting place to work. We get to be involved in both the front-end work and the back-end reporting and analytics. Identifying issues before they turn into larger problems provides a sense of accomplishment that isn’t always available in other departments. It’s satisfying to send that email that says this issue has been resolved. I love working in the employer world because of the amazing partnerships quality has with our front-end colleagues.

Maria: Addressing challenges can be one of the most rewarding aspects of working in healthcare quality. Quality engages many tools to tackle barriers: the five why’s to understand root cause, we use Pareto charts to decide where impact could be most profound, Gannt charts to build out projects, Lean Six Sigma and Kaizen methods to identify steps in processes that aren’t value-added and eliminate waste, etc. We can help develop rapid cycle projects using the plan-do-study-act model to assess impact of interventions. Making processes more efficient, measuring improvements, and highlighting successes is very rewarding.

What does Healthcare Quality Week mean to you? Is there anything else you’d like to highlight about healthcare quality?

Vivian: I appreciate the recognition for what those in the field of healthcare quality are tasked to accomplish. The continuous quality improvement process we seek to replicate is no easy task for those resistant to change and is often misunderstood, while the benefits are far reaching and often taken for granted. Further, I would like to highlight the unseen nature of what we do, operating in the background of direct care, to ensure the direct care provided to patients is backed by high expectations.

Brandi: Healthcare quality week means that people get a small glimpse into the world of quality that not everyone gets in the normal day to day. Raising awareness of quality is important, as quality collaborates with every department in the organization. Quality can’t be successful without that collaboration, and whether you realize it or not, you have likely contributed to successful quality outcomes.

Maria: Healthcare Quality Week creates a dedicated time and space to reflect on how incorporation of quality principles in our work can be impactful for our staff, our customers, and our business. For me, this week is a time to extend appreciation to the individuals that are working in the background to improve workflows and outcomes. The quality teams across Magellan Health are extremely collaborative and supportive of one another. We are fortunate to have developed this network of professionals. I’m grateful to have kind and caring coworkers to partner on projects. In general, you’ll hear quality professionals share proclamations like, “quality is everyone’s job.” While it is important for a few of us to have knowledge/expertise on the quality framework to help drive strategies, all staff can have a role in quality.

If you are feeling overwhelmed by the current political climate, you’re not alone. A national survey suggests more than 60% of registered voters in the U.S. say politics are a significant source of stress, and some even say they’ve lost sleep over it. Over 25% of voters also say politics have sparked conflict among their family and friends. Political stress, anxiety or even anger you may feel over politics can be hard to cope with.

Managing what you can control during election season

These feelings can have a negative impact on your emotional and physical health. Symptoms such as low energy, insomnia, loss of appetite, mood swings and tension are signs that you should not ignore. It is important to recognize what you can and cannot control as the election approaches. You cannot control other people’s opinions, beliefs, reactions or how they express themselves. Nor can you control others’ votes. There are, however, many things you can control during and after the election:

• Limit the amount of time you spend on election news and discussions. While the 24-hour political news cycle on television, radio and the internet is almost impossible to escape, you can limit the amount of time you spend on media each day.
• Be aware of the coverage, feeds and groups you follow. When you are watching or reading election coverage, avoid negative-leaning discussions, especially if you feel frustrated or upset by them.
• Recognize how you interact on social media. Avoid giving angry or emotional responses to posts that do not align with your views. You are unlikely to change other people’s opinions; you are more likely to get unwanted and hostile feedback.
• Focus on the time you spend with people. Prioritize your relationships with positive family and friends. Strong social connections can reduce stress and help you feel happier and more energetic.
• Manage how you deal with stress. Whether it’s meditation, going out in nature, reading a book or working on a hobby, take time to do something that makes you feel good. Get enough sleep and exercise, eat a healthy diet and avoid using alcohol or drugs.
• Stick to your boundaries. Before you enter a conversation, ask yourself if you’re in the emotional headspace to have it. Are you feeling stressed out, on edge or angry? Are you prepared to have a healthy debate or do conversations around this topic tend not to go well? If you feel like you’d be better off not having an election-related conversation, express your boundaries. You could say, “This conversation is really challenging for me, and it’s bringing up a lot of feelings. Can we move on to something else?”
• Take action by using your time and talents. Give your time and skills to a cause you believe in. If you have a strong interest in a political cause or candidate, offer to help with a campaign or other event.

This article is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

SOURCE: The Jed Foundation

The Importance of Finding a Community Wherever You Land

The military lifestyle is one full of constant change and often accompanied by stress, anxiety, and loneliness. One factor that weighs heavily on many military members and their families is the isolation that comes from the nomadic nature of frequent permanent change of station (PCS) moves over the course of a Service member’s career (Tong et al., 2018).

Everyday Burdens Feel Twice as Heavy When Going it Alone

Humans are, by nature, creatures that live in groups with close familial and social bonds. Military families uproot multiple times over the course of a career, and at each new location, are faced with a choice: build a new circle of people or go it alone. While a strong sense of independence and self-reliance are strengths that most Service members and their family members develop, it is crucial that they reach out at new commands and make the effort to meet people they can absorb into their circle of people that they can rely on. Where a civilian family may have the luxury of grandparents nearby to help with picking up a sick child from school, a cousin who is a great fixer to help around the house, or childhood best friends to recharge with after a long week, a military family often finds themselves alone in a new city with no sources of support (Tong et al., 2018). Certainly, families can hire babysitters, repair companies, and take time for themselves, but there is something incredibly valuable in having an established community or group of people you belong to who become your supporters. Deployments are times when this is especially important. Having people to turn to while a spouse is away allows the spouse at home to have support and companionship. It also gives the deployed Service member the freedom to focus on their mission knowing that their family is supported by a trusted community at home.

The Military Culture is Built on Shared Experience and Supporting Each Other

There are a lot of built-in ways for military families to connect with other families. Military and Family Life Counselors (MFLCs) can support them by giving encouragement to take the first step. A command Ombudsman is an excellent resource for connecting families with each other and with important local resources! The Morale, Welfare, and Recreation (MWR) center often holds events and activities where members and their families can meet other families (Ways to Settle In to Your New Home and Community 2024). Military members and families experience many of the same challenges and are often happy to lend a hand when someone needs help. Making those initial connections makes finding support much easier. Meeting people is sometimes not the hardest part; putting in the effort to make plans and build relationships can seem daunting on top of an already busy schedule. For some, knowing that another move is inevitable makes building relationships with people they will have to say goodbye to in a few years seem pointless. While saying goodbye is difficult, life is made richer by having made connections with individuals and having experiences with others, even if only for a short time.

When working with our military members and families, MFLCs provide a source of support and encouragement but also resources that they can use to strengthen their support system and coping skills outside of the counseling sessions. So make sure to build a community circle to feel connected to wherever you land!

References

• Tong, P. K., Payne, L. A., Bond, C. A., Meadows, S. O., Lewis, J. L., Friedman, E. M., & Maksabedian Hernandez, E. J. (2018). (rep.). Enhancing Family Stability During a Permanent Change of Station: A Review of Disruptions and Policies. Rand Corporation. Retrieved July 31, 2024, from https://www.rand.org/content/dam/rand/pubs/research_reports/RR2300/RR2304/RAND_RR2304.pdf.
• Ways to Settle In to Your New Home and Community. Military OneSource. (2024, July 29). https://www.militaryonesource.mil/resources/millife-guides/settling-in-to-a-new-home/

October is National Depression and Mental Health Screening Month. Seasonal Affective Disorder (SAD) is a type of depression linked to seasonal changes, typically beginning when fall starts and intensifying during late fall or early winter.

What’s the difference between SAD and the “winter blues”?

Many people feel a little down during colder months because they are stuck inside, and it gets dark early. These feelings, often called the “winter blues,” are temporary. SAD is a clinical form of depression that affects your daily life, including how you feel and think. SAD can last up to five months of the year.

What causes SAD?

About 5% of adults in the U.S. experience SAD. It tends to start in young adulthood. SAD may be caused by reduced serotonin and vitamin D levels, altered melatonin levels, decreased sunlight and shorter days.

What are the symptoms of SAD?

If you have SAD, you may experience mood changes and symptoms of depression, including:

• Persistent sadness
• Increased anxiety
• Food cravings and weight gain
• Extreme fatigue and low energy
• Feelings of hopelessness
• Social withdrawal
• Sleep disturbances

What are treatment options for SAD?

Treatment should be tailored to you and supervised by a healthcare professional. Options include:

• Spending time outdoors—Getting more sunlight can help improve your symptoms.
• Light therapy—Using a light therapy box daily helps regulate circadian rhythms and boost mood.
• Cognitive behavioral therapy—This treatment helps identify and change negative thought patterns.
• Vitamin D—A supplement may help if a deficiency is present.
• Medication—Antidepressants may be prescribed for severe cases.

For more on Seasonal Affective Disorder, visit our website for National Depression and Mental Health Screening Month, MagellanHealthcare.com/Mental-Health, and be sure to check out the suicide prevention tip sheets and awareness campaign toolkit.

Sources

• Cleveland Clinic
• NIMH

Military and Family Life Counselors (MFLC) are key components in the fight to prevent suicide in service members and their families. With clinical expertise, collaborating with helping agencies, and connecting participants to appropriate resources, MFLCs embody the 2024 Suicide Prevention Awareness Month theme: “Joining Your Fight: Connect to Protect” (Defense.gov).

Trends of Military Suicide

There has been an increase in suicides for active-duty service members from 2011 to 2022, with 492 suicides in 2022. This was slightly more than in 2021, but less than in 2020. In addition, the rate is similar to the civilian population after accounting for population differences. Suicide data was not available for family members in 2022 however, data from 2021 showed a slight decrease from previous years (Defense Suicide Prevention Office).

Risk & Protective Factors

While the rate of suicide is similar between service members and the civilian population, there are factors unique to the military community that increase the risk of suicide. It is important to not only understand these factors, but also know the protective factors that can decrease these risks.

Suicide Prevention Resources

If you are a service member or military family, connect with a MFLC for local suicide prevention resources. Additionally, here are options for further information and support:

• 988 Suicide and Crisis Lifeline: The 988 Suicide and Crisis Lifeline, created in 2022, connects individuals to trained crisis counselors for confidential support in managing mental health related crises, including suicidal thoughts.
• Magellan Healthcare resources: toolkit, tip sheets, national resources
• Publication: Military Child Suicide: Prevention Techniques and Best Practices
• Publication: Suicide in the Military: Misconceptions, Risk Factors, and How You Can Help

In today’s fast-paced, high-pressure world, mental health has emerged as a critical public health concern. Suicide, now the 11^th leading cause of death in the United States, continues to be a major concern. After a brief decline in 2019 and 2020, suicide rates rose in 2021, with an average of 132 suicides per day—a 5% increase. The situation worsened in 2022, with an additional 3% increase, bringing the average to 135 suicides per day. By 2023, over 50,000 Americans died by suicide, marking the highest number on record. These concerning statistics underscore the importance of integrating targeted suicide prevention strategies into all behavioral health initiatives.

While Employee Assistance Programs (EAPs) and behavioral health benefits from commercial and public insurers provide support for individuals facing mental health challenges, these organizations can further strengthen suicide prevention efforts by implementing data-driven systems that proactively manage and mitigate suicide risk, including:

• Early identification—Preventing crises before they escalate is critical. Utilizing predictive analytics, organizations can identify early warning signs and intervene promptly.
• Ongoing assessment—Continuous mental health monitoring allows care to be adjusted and personalized as needs evolve.
• Proactive outreach—At-risk individuals often don’t seek help on their own. Through population engagement tactics, such as targeted emails, app notifications and direct outreach by care managers trained in suicide prevention, organizations can ensure timely support reaches those in need.
• 24/7 supportive care—Round-the clock access to support is vital for effective suicide prevention. On-demand resources like digital tools for mental health and wellbeing, educational materials, safety plans, hotlines, crisis text lines and direct connections to mental health professionals provide individuals with the help they need, whenever they need it.
• Specialized care management—Licensed clinicians trained in mental health services and evidence-based practices have the expertise to deliver essential support to at-risk individuals, including designing individualized care plans to enhance protective factors, such as building social support networks and improving problem-solving skills and using ongoing remote monitoring to adjust and personalize interventions as needs evolve.
• Sub-specialty networks—Access to clinicians specializing in mental health conditions ensures at-risk individuals receive the focused care they need. Also, subspecialty medical clinics and primary care providers should screen for mental health conditions. Some physical health conditions (e.g., traumatic brain injury and cancer), can carry a risk of suicide.
• Outcomes and data-driven approach—Using data to measure the effectiveness of suicide prevention programs allows organizations to continuously refine their strategies, ensure efficient use of resources and better target interventions.

Integrating data-driven targeted suicide prevention and risk management strategies can significantly enhance the effectiveness of EAP programs and behavioral health benefits provided by private and public insurers. Early detection of warning signs and timely interventions can reduce the risk of suicide, save lives and foster a healthier, more resilient society.

Learn how Magellan Healthcare’s data-driven approach is helping organizations safeguard lives here.

Sources:

• CDC
• CDC
• NBC News

Exploring Music in Non-Medical Counseling Sessions

Music has a long history within the military as a method of addressing morale. The consistently positive response to music has led to research seeking to determine if it can be used in a therapeutic approach for Service members. (Gooding & Langston, 2019) Although music exploration is often associated with soothing melodies and uplifting lyrics, it also provides a valuable opportunity to explore and address negative emotions through music. This is because the exploration of negative emotions via music helps normalize and transform them into something healthier. Service members often train themselves to compartmentalize negative emotions in intense situations and can sometimes have difficulty engaging with emotions. This can lead to a sense of emotional blunting where the individual is aware that they have emotional discomfort but are unable to express the depth of their emotion or engage it in a way that allows effective processing. Listening to music is an activity that can assist individuals with emotional expression and establish coping skills. From creative expressions to the increasing availability of “rage rooms,” we are seeing an increase in techniques that utilize external expression, not just internal dialogue. Here are a few reasons why you may want to incorporate music in your next non-medical counseling session.

Music Can Facilitate Emotional Expression

An “emotion” playlist can be an example of this outward expression. Encouraging an individual to develop a list of songs they associate with certain feelings can assist in creating a safe space for them to experience said emotions. Studies have shown a correlation between music and brain activation in regions associated with emotion, reward, and cognitive processes (Fuentes-Sanchez, 2021). By utilizing a format that is designed to evoke specific emotions, we can provide clients with a way to feel more comfortable in emotional engagement. This method can be effective in situations where the individual states difficulty describing their emotions, feels that they have difficulty feeling emotions to the same extent as others, or describes an emotional numbness that feels inappropriate to them. By providing a structure or atmosphere where a specific emotion is being portrayed, it gives an experiential example that can limit some of the risks that accompany vulnerability.

Music Encourages Introspection

Listening to music in a safe space allows people to, in effect, practice their emotions. A recent study with the U.S. military utilizing a phased music exploration included lyric analysis as a prompt for introspection of life circumstances. Participant comments included “moving forward emotionally,” “I found something in me that was lost.” (Vetro-Kalseth,2021, p.449) While this study included a focus on songwriting, it does provide an illustration of how we connect emotionally with music. Hartman and Conklin (2009) state that songs can be “a medium where feelings, emotions, values, dreams, fears, and hopes are expressed” and can assist those who are unable to express “eloquently and succinctly to discover and express something about their true self through the use of that music’s lyrics” (p.50).

Music Opens Lines of Communication

Music can facilitate communication by allowing individuals to process their feelings, become comfortable with emotional expression, and learn to recognize their own emotions more clearly. Writing lyrics is a unique expression of emotion that allows the Service member to creatively capture thoughts or feelings, which can be cathartic.

Additional benefits of incorporating music into a non-medical counseling session include being able to limit the time of a playlist, being able to arrange an appropriately supportive environment, and being able to have more say in when those emotions can be addressed safely. This can help prevent emotional overflow in situations that would be damaging or dangerous to the client. Music exploration is not a solution for everyone, but it’s a great alternative to try for Service members and military families.

References

Gooding, Lori F.; Langston, Diane G.; Journal of Music Therapy, Vol 56(4), Win 2019 pp. 315-347. Publisher: Oxford University Press; [Journal Article]; DOI: 10.1093/jmt/thz010, Database: APA PsycInfo

Fuentes‐Sánchez, Nieves; Pastor, Raúl; Escrig, Miguel A.; Elipe‐Miravet, Marcel; Pastor, M. Carmen. Psychophysiology. Sep2021, Vol. 58 Issue 9, p1-17. DOI: 10.1111/psyp.13884. , Database: SPORTDiscus with Full Text

Hartman, Nathan S.; Conklin, Thomas A. Organization Management Journal (Palgrave Macmillan Ltd.). Spring2009, Vol. 6 Issue 1, p48-57. 10p. 2 Diagrams, 3 Charts. DOI: 10.1057/omj.2009.7. , Database: Business Source Ultimate

Vetro-Kalseth, Danielle; Vaudreuil, Rebecca; Segall, Lorna E. Military Psychology. Nov/Dec 2021, Vol. 33 Issue 6, p446-452. 7p. DOI: 10.1080/08995605.2021.1962194. , Database: Military & Government Collection

September is Suicide Prevention Awareness Month. Sometimes, suicide may seem like the only way to escape the pain of situations such as a breakup, job loss, social exclusion, bullying or other trauma. This type of distress can be a dangerous trap. It’s vital to take immediate steps to move yourself away from feelings of hopelessness. What can you do?

Spot the triggers. Recognize worsening distress in the form of self-blame, poor self-esteem, rejection, loss of interest in activities or feeling trapped and hopeless.

Remove lethal items. Rid your home of items you could use for self-harm, like guns, knives, razors or expired, discontinued and non-essential medicines.

Get help right away. Acting quickly can make all the difference. Call or text 988 for the Suicide & Crisis Lifeline. A trained counselor will help you talk through what you’re feeling, and together you’ll develop a safety plan.

Consult with a professional. Mental health professionals can help you with concerns like depression, anxiety and suicidal thoughts.

Reach out. Talk with a close friend, loved one or spiritual advisor. If you feel you’re in a crisis, dial 911.

Recognize feelings are temporary. Your dark feelings aren’t permanent. With responsive care, you can and will feel better.

For more on suicide prevention, visit our website for September Suicide Prevention Awareness Month, MagellanHealthcare.com/Prevent-Suicide, and be sure to check out the suicide prevention tip sheets and awareness campaign toolkit.

SOURCES: Mayo Clinic and Mental Health America