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Making Visible What Can Be Invisible During a Pandemic: Mental Health Support Through Care Coordination

Too often, worsening mental health symptoms go unreported by patients and undetected by care team members. Social distancing is an essential practice to manage our current pandemic; however, we also must address the stressors that come along with this—such as loneliness and the challenge it presents to our mental health.

At the most fundamental level, humans are social animals. We thrive off of and need social contact. Many of us are managing the best we can with apps such as FaceTime and Zoom, but for people who already struggle with their mental health at baseline, this isolation can be a major destabilizing force. Loneliness can worsen depression, bring about suicidal thoughts, and— at times—bring on psychosis. It has even been linked to increasing mortality rates by 26 percent.

Many outpatient mental health appointments are currently done over a video call and unfortunately this falls short of the true value of an in-person relationship that most therapy and counseling provides. It is much more difficult to pick up on subtle cues and nuances of a patient’s presentation of their symptoms, and the patient may not communicate as forthright and easily as in person. Further, some patients may find video meetings undesirable or uncomfortable and choose instead to not attend these meetings at all.

However, the consequences of postponing or discontinuing treatment can be significant. Here are three examples:

  • A patient with a diagnosis of Bipolar I decides to stop or modify their medication regimen, leading to a manic episode
  • A patient with Depression with a history of suicide attempts becoming suicidal again
  • A patient with Schizophrenia grows more paranoid and delusional

In each of these scenarios, patients experience worsening symptoms and are on the brink of a psychiatric crisis that can easily turn into an emergency department visit and possibly a psychiatric admission. The time right after a psychiatric hospital stay is always critical to maintain stabilization and health. In many parts of the country after such a hospitalization, patients likely return to a home with continued lack of social contact due to COVID-19, making the post-hospital phase all the more critical for timely follow-up and support by the outpatient care team.

Care team members sometimes are notified, sometimes not, when their patient’s have a hospital visit. The Collective platform has the unique ability to identify a patient’s care team and provide real-time information to care team members whenever their patients are admitted or discharged from a hospital. These alerts are an essential tool in a mental health care team’s toolkit. 

Care coordinators, care managers, case managers, and counselors all have the same shared goal to ensure that their patient’s mental health is well-supported post-hospital. Having this knowledge in real time allows outpatient mental health teams to coordinate with hospital staff during a patient’s stay, collaboratively develop a discharge plan, and ensure the patient has what they need post-hospital to address potential barriers and treatment needs.

With all eyes on the coronavirus/COVID-19 pandemic, we must not lose sight of the mental health struggles that patients and their care teams across the country continue to manage. Visibility into hospital encounters for care team members is key. It amplifies the great work that collaborating care team members are already doing—we cannot let the often invisible struggles of mental health fall through the cracks of the healthcare system.

Ian Bruce, LPC
Clinical Solutions Lead