1

The Lived Experience Factor in Fighting the Opioid Epidemic

“Strung out. Looking for the next fix. A full time job that doesn’t pay, but just takes.”

That’s how one of Magellan’s Recovery Support Navigators defined her addiction to opiates. She has since overcome the stranglehold of addiction and is now in long term recovery.  Her experiences, and those of her fellow Recovery Support Navigators, provide the credibility needed to influence their peers who are still struggling with addiction and mental illness that recovery is possible and that desperation does not have to define a life.

An estimated 20.2 million Americans live with a substance use disorder[1]. That’s the population of my home state of Florida. Of that, 2.1 million Americans live with an opioid disorder. Similar to serious mental illnesses, substance use disorders can be difficult to address. Those with the lived experience of walking the path from hopelessness to wellness are experts at engaging individuals with the services and supports that foster the recovery process. Stories of changed lives are not the only proof.

A January 2018 study of our internal recovery support navigation program at Magellan Health found statistically significant improvements for individuals living with substance use and mental health disorders. A key component of the Magellan’s internal peer support program is meeting people where they are. The first engagement with members often happens in an emergency room, inpatient setting, or on the streets. Members then choose where future meet-ups happen. Often, that choice is in the comfort of their own home.  If they are experiencing homelessness, the member chooses a safe place.

The study compared utilization of services six months prior to receiving peer support services and six months following the completion of peer support services. Seventy-five percent of the members in the study had a co-occurring mental health and substance use disorder and 50 percent had a co-occurring substance use disorder, mood disorder and psychotic disorder. The study found that members in Magellan’s internal peer support program cost the health plan significantly less in the six months following completion of the peer support program than members who only had care management or who did not receive any intervention from the health plan. The study also found that six months after completing peer services, peer support decreased emergency room and inpatient hospitalizations.

The role modeling by a peer specialist of a life lived well in recovery is evidence for the individual struggling that there can be long term sustainment of recovery. In addition, the data from this study replicates prior findings that peer support has a lasting impact on the lives of those living with substance use and mental health disorders.

[1] Substance Abuse and Mental Health Services Administration. (2017). Mental and substance use disorders. Retrieved from https://www.samhsa.gov/disorders




From Opioid Addiction to Recovery: Overcoming Barriers to Effective Treatment

The following is an excerpt from an article appearing in Advances in Addiction & Recovery

Deaths from prescription opioid abuse have more than quadrupled since 1999, prompting President Donald Trump to declare the opioid epidemic a national public health emergency.[1] But while discussions around opioid abuse prevention have intensified, numerous barriers to recovery continue to exist.

For example, one of the most effective ways to combat opioid addiction is through medication-assisted treatment (MAT), an evidence-based approach that combines medication with psychosocial intervention. MAT empowers those suffering from opioid use disorder (OUD) to recover from their addiction while rebuilding their lives.

However, the stigma often related to MAT—on the part of both the medical community and addiction support professionals as well as family members of patients—continues to limit its use across the industry. Further, the need to educate communities and legislators about the complex issues surrounding addiction treatment cannot be overstated. Addiction should be considered a chronic condition, and such treatments need to be viewed the same way.

You can read the rest of the article on pages 24-25 in Advances in Addiction & Recovery.

[1] https://www.cdc.gov/drugoverdose/epidemic/index.html

 




7 Mental health myths and facts

1. Myth: Mental health problems don’t affect me.
Fact: Mental health problems are actually very common.

Annually, about:

  • One in five American adults experienced a mental health issue
  • One in 10 young people experienced a period of major depression
  • One in 25 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression
  • Suicide is the 10th leading cause of death in the United States. It accounts for the loss of more than 41,000 American lives each year, more than double the number of lives lost to homicide.
2. Myth: Children don’t experience mental health problems.
Fact: Even very young children may show early warning signs of mental health concerns.

These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before age 24.

Unfortunately, less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

3. Myth: People with mental health problems are violent and unpredictable.
Fact: The vast majority of people with mental health problems are no more likely to be violent than anyone else.

Most people with mental illness are not violent, and only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population. You probably know someone with a mental health problem and don’t even realize it, because many people with mental health problems are highly active and productive members of our communities.

4. Myth: People with mental health needs, even those who are managing their mental illness, cannot tolerate the stress of holding down a job.
Fact: People with mental health problems are just as productive as other employees.

Employers who hire people with mental health problems report good attendance and punctuality as well as motivation, good work, and job tenure on par with or greater than other employees.

When employees with mental health problems receive effective treatment, it can result in:

  • Lower total medical costs
  • Increased productivity
  • Lower absenteeism
  • Decreased disability costs
5. Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.
Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better.

Many factors contribute to mental health problems, including:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems
6. Myth: There is no hope for people with mental health problems. Once a friend or family member develops mental health problems, he or she will never recover.
Fact: Studies show that people with mental health problems get better and many recover completely.

Recovery refers to the process in which people are able to live, work, learn, and participate fully in their communities. There are more treatments, services, and community support systems than ever before, and they work.

7. Myth: I can’t do anything for a person with a mental health problem.
Fact: Friends and loved ones can make a big difference and be important influences to help someone get the treatment and services they need by:
  • Reaching out and letting them know you are available to help
  • Helping them access mental health services
  • Learning and sharing the facts about mental health, especially if you hear something that isn’t true
  • Treating them with respect, just as you would anyone else
  • Refusing to define them by their diagnosis or using labels such as “crazy”

Help is available.

For additional information, visit MagellanHealth.com/MYMH




Mental health vs. mental illness

What is the difference between mental health and mental illness? The former refers to our emotional and psychological state, our social well–being and how we feel about ourselves and interact with others. Mental health is not the same as mental illness, although poor mental health can lead to mental and physical illnesses.

When we have good mental health, we are resilient, can handle life’s challenges and stresses, have meaningful relationships and make sound decisions. Being mentally healthy, like being physically healthy, is important at every stage of life, from childhood and adolescence through adulthood and old age.

Being mentally healthy is influenced by life experiences, relationships with others, physical health and one’s environment. Just as people may experience physical problems over the course of their lives, they may also experience emotional or mental health problems that affect their thinking, mood and behaviors. This does not necessarily mean that a person who is going through a difficult time and is experiencing poor mental health has a mental illness. Feeling miserable and socially isolated are red flags that one’s mental health needs attention.

The benefits of improving one’s mental health are well worth the effort. Being mentally healthy helps you feel confident in your worth and abilities, accept your strengths and weaknesses, set realistic goals and create a sense of meaning and purpose in your life. Emotional health and mental health are closely intertwined, and both can positively or negatively impact physical health as well.

What is Mental Illness?
Mental illness refers to a wide range of disorders that affect mood, thinking and behavior. Mental illness can affect anyone regardless of age, gender, social standing, religion or race/ethnicity. People with mental illness often experience distress and problems functioning at work, home and in social situations. Mental illness is not something the person can “overcome with willpower,” and can be caused by biological factors such as genes or brain chemistry, trauma and abuse, and family history of mental illness.

The major types of mental illness include:
• Depression
• Anxiety
• Mood disorders, including bipolar
• Personality disorders
• Schizophrenia
• Trauma disorders
• Eating disorders
• Addictive behaviors

Mental illnesses are common in America, and approximately one in five adults lives with a mental illness (43.8 million in 2015.)1 While depression and anxiety are two of the most common disorders, mental illness includes many different conditions that range from mild to moderate to severe. People who don’t have a mental illness might still be impacted by the mental illness of a friend or family member.

Signs and symptoms of mental illness vary, but may include changes in sleep, appetite, and energy level, severe mood swings, persistent thoughts or compulsions, hearing voices, social withdrawal, feeling sad, hopeless, or agitated, having trouble performing everyday tasks, or wanting to hurt oneself or others.

With the right treatment, people can and do recover from mental illness. Friends and family members can be important influences to help someone get the treatment and services they need. Primary care physicians can refer individuals to psychiatrists and other professionals who specialize in mental health treatment. Treating a physical illness might require medications and physical therapy, and treating a mental illness might also require medications and different therapies. For many people, the first step is to recognize there is a problem and be willing to accept help.

For more information on treatment resources, contact:
National Institute of Mental Health
https://www.nimh.nih.gov/health/find-help/index.shtml

NAMI (National Alliance on Mental Illness)
http://www.nami.org/

Substance Abuse and Mental Health Services Administration (SAMHSA) https://findtreatment.samhsa.gov/https://www.mentalhealth.gov/

Mental Health.gov
https://www.mentalhealth.gov/
Help is available. For additional information, visit MagellanHealth.com/MYMH

1. https://www.nami.org/learn-more/mental-health-by-the-numbersd to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned

Read more more about this topic from Magellan Health Insights




The Importance of Integrated Care in Fighting Opioid Use Disorder

The following is an excerpt from an article appearing in the American Journal of Managed Care (AJMC)

One out of four patients who receive long-term opioid therapy in primary care settings struggle with opioid use disorder (OUD), according to Centers for Disease Control and Prevention research. While conversations around opioid addiction are beginning to impact physician prescribing patterns, there is still much progress to be made around treatment and recovery solutions for those battling OUD.

One important option that requires greater attention: the need to leverage an integrated team approach in opioid treatment and recovery.

Recent research points to the value of a holistic approach to opioid recovery delivered in a community setting. Such an approach may include relapse prevention medications; group and individual counseling; physician visits for medication management; mental health therapy; and psychiatric treatment for cooccurring disorders. But there are barriers to accessing holistic opioid recovery treatment within the patient’s community. Such barriers can include lack of mental health resources, stigmas associated with certain treatment options, limited availability of specialized providers, difficulties navigating the complexities of substance abuse treatment, and insufficient capacity.

Overcoming the challenges to a holistic approach to opioid recovery is critical to engaging patients safely and comfortably and supporting sustained recovery. The following five elements contribute to a successful integrated approach.

You can read the rest of the article in the American Journal of Managed Care (AJMC).




I am a woman in technology, what is your super power?

Is it necessary to explicitly focus and call attention to the obvious fact that I am a woman in technology? You might not think so these days. Women have accomplished so much since the first bra was burned, that it would be understandable if you believed that we have established and gained enough ground to just be people in technology.

The reality is, unfortunately, there remains a staggering degree of inequality. Last month, the New York Times published an article titled “The Top Jobs Where Women are outnumbered by Men Named John.” The article reveals that there are fewer women among Chief Executives of Fortune 500 companies (5%) than there are men named James (5%); fewer female Venture capital investors in the largest tech deals of the last five years (9%) than there are men named David, James and Peter 11%.

You may giggle at first when reading the article, but its conclusion is stunning: it is more likely that the names of the men in charge will change sooner — fewer Johns and Roberts and more Liam’s and Noahs — than the number of women.

This is a reality that we cannot ignore, and one that exists all over our industry. While some of us women may not “feel it” as much as others, we are all still subject to “it.”

The World of Economic Forum’s 2016 Industry Gender Gap report recognizes that in “nearly all industries and geographies there has been a marked shift away from deliberate exclusion of women from the workplace, there continue to be cultural beliefs that lead to unconscious biases. This includes perceptions that successful, competent women are less “nice”; that strong performance by women is due to hard work rather than skills; and assumptions that women are less committed to their careers.”

We women have all felt this. The one woman that can be “tough enough” always gets through, but not all of us. We internally debate with ourselves whether to be more like our male counterpart in order to simply be heard in a meeting. Sometimes it is a question of style, but more often than not, we don’t have a seat at the table. And when we “power through it all” we still struggle to find a lot of role models to look up to.

I personally attribute my success to relentless stubbornness, shameless self-confidence (which often gets mislabeled since I am a woman) and sometimes blunt confrontation. Still, many times throughout my career I was asked to sit on the sidelines. I was encouraged to “focus on my wedding planning activities, rather than worrying about a promotion” which by the way I well deserved and earned.

At Magellan, we have decided that the only way to overcome these inequalities is to take them on proactively. That is why, in 2018, we have formed an internal ‘Women in Technology’ (WIT) change leadership group.

Being at a company that is not only willing to discuss and support a Women In Technology group, but is actually ready to “put their money where their mouth is” is refreshing.

The WIT group we established has taken off and I am so happy to see the responses, the community and the peer (gender agnostic) support we are offering to women across Magellan IT and beyond.

Our group is not exclusive to women, in fact we need everyone involved to truly make a difference, because our goals are critically important:

  • We are focused on fostering female employee development and growth across the IT organization.
  • We want to see more of us out there – we want our talent pipeline and the recruiting tactics to bring women to the table.
  • We aim to encourage young women in the middle and high schools our communities to consider, try and stick with STEAM (Science, technology, engineering, arts and mathematics).
  • We want to support each other through peer-mentoring.
  • We want to bring role models forward to provide insights into the possibilities.

Ultimately, we want a future where being a woman in technology is not a heroic accomplishment, and super powers are not needed to claim our earned and well-deserved seat at the table.




DREAMS – Automating IT in Exponential Organizations

Exponential Organizations (ExOs) deliver outcomes (or impact) that are disproportionally (10x) greater than their traditional competitors through the use of innovative business models, organizational techniques and digital technologies. Over the past two years, we at Magellan have developed, implemented and are continuously improving a new approach for managing IT in ExOs. Magellan Exponential IT (ExO IT) is a digital and cloud-first healthcare strategy that is enabled by agile operational processes and implemented by a highly engaged learning organization. These three basic components of ExO IT – Digital Strategy, Agile Operations and Learning Organization, work together in a cadence to deliver iterative technology enabled capabilities that build on each another to deliver business agility, 10x results and be adaptive to meet the evolving needs of today’s healthcare industry.

Earlier this year, we started to automate Magellan’s ExO IT model through a highly scalable, secure and always-on system called DREAMS (Digital Real-time Management System). DREAMS has six modules that are built on ServiceNow (Kingston) platform using a customer focused low-code, no-code approach. With DREAMS, we aim to deliver minimum efficient scale through the use of today’s cloud-based technologies, ubiquitous access, real time insights and lean processes. It is highly influenced by Design Thinking, Lean Thinking (The Toyota Production System), Agile Methods, and the Amazon Way (Customer first, develop press releases, two-pizza team etc.). The broad scope of DREAMS includes:

  1. Lead IT – This module operationalizes and automates our ExO IT strategy through focused and highly visible initiatives and expected outcomes. It does this through several Lean Thinking work products such as the X-Matrix, Leader Standard Work, Visual Management Systems, Initiative Press Releases, Project A3s and OKRs. At the center of Lead IT is a Digital 5S System. 5S (Sort, Standardize, Set-in-order, Shine and Sustain) is a Lean Thinking technique that makes the most frequently used and current and properly configured tools available to the right people, at the right time and at the right place. The Digital 5S is used to enable a highly engaged, productive and collaborative IT leadership team.
  2. Manage IT – This module aims to maximize the throughput of IT by continuously aligning demand with the supply of IT at the most optimal cost. Manage IT standardizes and automates IT Service Delivery capabilities such as demand, resource, capacity, portfolio and financial management. This module is built around the Magellan Asset Portfolio (MAP) and it provides an easy to use and easy to search repository of infrastructure and application assets used within Magellan. MAP is enabled and operationalized through Service Owners and Solution Owners within our ExO IT organizational model.
  3. Ask IT – This module aims to improve employee productivity by helping them request and receive IT solutions and services through simple, secure, easy-to-use, reliable and context-aware experiences. Ask IT implements a Services Portal and Services Catalog that can be used by employees to order, track and receive solutions and services in a way that is similar to leading online services such as Amazon.
  4. View IT – This module focuses on driving continuous improvement within ExO IT by providing access to real-time dashboards, interfaces, benchmarks, metrics and outcomes used to measure the effectiveness of IT and its operations.
  5. Secure IT – This module automates Security Operations, GRC, adherence to standards, audit controls and other mission critical functions related to protecting the security and privacy of healthcare information and
  6. Operate IT – This module focuses on delivering predictable, secure, always-on operations using standardized and automated IT Service Management capabilities in the areas of Incident, Problem, Change, Event, Release and Capacity Management.

We are currently in flight with rolling DREAMS V1.0 out to the leadership ranks within Magellan IT. This release provides limited scope across all six modules and represents a significant step forward. We have 4 more releases planned for 2018. These releases will add more functionality and roll these capabilities out to a broader audience within Magellan.




Digital Mental Health Care Increase Access and Deliver Positive Outcomes

Our own Seth Feuerstein spoke recently at the APA annual meeting about how Digital Mental Health Care is increasing access and delivering positive outcomes.

“Here’s what’s interesting…subjectively, patients described [the digital program] as by far the most positive experience they have when they go to that center,” said Feuerstein. “Their engagement with it was kind of off the charts.”

You can read about Seth’s comments and more at the American Journal of Manage Care by clicking here