Editor’s Note: This blog in based on a webinar hosted by Benefits and Pensions Monitor, presented by Travis Kelly and Chris Anderson* and sponsored by Medavie Blue Cross and Medaca Health Group, which partner to deliver early stage psychiatric treatment and virtual Cognitive Behavioural Treatment (vCBT). Drawing on real-life examples, they shared how their integrated model of care has been effective in treating disability claimants with a mental health diagnosis.

Meet Joan

(Actual Case Study)

Two years ago, Joan was a high performing emergency medical dispatcher. She was dedicated, hardworking, liked by colleagues, and had a great sense of humour. Joan worked well under the constant stress of her job. She was organized, focused and a team player.

Since then, Joan has struggled with cognitive thinking, concentration and short-term memory issues that affect her job. She gets dispatch calls confused, is unable to remember simple tasks and her performance suffers. She seems off, no longer has a sense of humour, becomes irritable with colleagues, and has twice fallen asleep at her desk because of her insomnia.

She loves her job but has lost hope. She knows she is sick, has been to doctors, taken medication, but nothing works. She thinks she will have to quit or will soon be fired. She is frightened and devastated. This is the job she went to school for and trained for—her dream job.

A huge and costly health issue

Joan’s story is not unique. Indeed, hundreds of thousands of Canadians come to work every day struggling with mental health issues, with related presenteeism and absenteeism costing the Canadian economy $20 billion in lost productivity every year. And this was before COVID-19!

Research shows that the coronavirus is taking a heavy toll on our mental health. Health Canada estimates that roughly 11 million Canadians will experience “high levels of stress” in family and work settings due to prolonged isolation and worry related to COVID-19 and close to two million will show signs of “traumatic stress”—estimates based on the effects of the 2003 SARS outbreak.

Upward trend in mental health claims, costs

Prior to COVID-19, our own data was showing an upward trend in benefit utilization and drug spend to treat mental health conditions. As of 2019, one in seven plan members was taking an anti-depressant, up 6% over the previous year, while the number of plan members seeing a psychologist increased 14% over the same period.

Unfortunately, 60% of Canadians won’t seek professional help for their mental health concerns because of barriers like stigma and lack of access to a medical specialist. Average wait times to see a psychiatrist across Canada range from six months in urban centres to 12 months in rural communities.

Leveraging technology to remove barriers to care

Fortunately, there are technology-enabled solutions that can remove these barriers and ensure Canadians get the expert help they need, including virtual Cognitive Behavioural Therapy.

Our disability management model combines vCBT and early stage psychiatric treatment to provide the gold standard in mental health care.

Key elements: Integrated treatment model

It is an integrated treatment model that coordinates and sequences psychiatry and psychotherapy to make sure that everything is working for the disability claimant in lockstep.

• The model involves a collaborative process and ongoing communication between two mental health specialists and the claimant’s family physician.
• Both the psychiatrist and psychotherapist are trained on early intervention and a return-to-work focus, allowing them to integrate their services.
• The psychotherapist leads vCBT sessions using a secure online video platform.
• The claimant’s family physician plays an important role, receiving information and making appropriate treatment plans based on expert advice.

Outcome measures of psychiatry-psychotherapy services

• Since our partnership began in 2012, claimants have been able to see a psychiatrist within three weeks of a referral – eight days on average.
• By intervening early, we have seen a 28% reduction in the average duration of a short-term disability claim.
• By integrating our service with vCBT, we are extending those early intervention benefits, with 75% of cases being closed as a result of our integrated treatment model.

Back to Joan

A story with a happy ending

So, what happened to Joan?

As a member of a Medavie Blue Cross-insured plan, Joan was referred to Medaca in March 2019, after having been treated by two general physicians, who misdiagnosed her illness and prescribed medications that worsened her condition.

Within 15 minutes of meeting a psychiatrist, she was diagnosed as having Bipolar II Disorder, a highly treatable form of bipolar. Joan was prescribed new medications and booked for eight vCBT sessions. She returned to work after six.

Here’s what Joan had to say about her care:

“I am so relieved to understand what my illness is; now I can be treated, I can get better and I can get my life back.”

And here’s what her psychotherapist had to say about Joan:

“Joan could have returned to work months ago or not gone off work at all with the right diagnosis and treatment at the very beginning.”

In summary

• The prevalence of mental illness in the workplace is growing and having a profound impact.
• Integrated solutions, accessed as early as possible, are key to successful health outcomes.
• Technology is opening up new opportunities to provide easier, faster access to expert mental health care.
• Integration of early psychiatric treatment and vCBT is delivering results with claimants like Joan returning to health and work, quickly and safely.

Watch the recording

To view a recording of the presentation, Mental Health Matters: Proven Disability Solutions for the Pandemic and Beyond, click here.

*Travis Kelly is Regional Director, Business Development for Medavie Blue Cross in Ontario and formerly our Director of Group Disability Management Operations. Chris Anderson is Medaca Health Group’s president.