3 Business Risk/Opportunity Human cost: No 1. killer of Americans and a leading cause of disability Financial costs: Key contributor to rising health care and disability expenditures and a prime cause of decreased productivity Heart disease is often associated with mental health diagnoses. In these cases of co-morbidity, the mental health conditions may not be properly diagnosed or may be undertreated. An integrated cardiovascular/behavioral health program must address the strong connection between heart health and mental health. Heart Disease
4 About Heart Disease and Mental Health Depression, anxiety, hopelessness, pessimism, hostility and anger have all been linked to heart disease. 1,2,3 Depression and anxiety disorders may affect heart rhythms, increase blood pressure, alter blood clotting, and lead to elevated insulin and cholesterol levels. These risk factors often predict, and are a response to, heart disease. 4 People with heart disease are more likely to suffer from depression than otherwise healthy people; conversely, people with depression are at greater risk for developing heart disease. 5 Those who have heart disease and who are depressed have an increased risk of death after a heart attack compared with those who are not depressed. 6
5 Fighting Heart Disease: The Role of Behavioral Health Experts Emotional, psychological and behavioral intervention and support is essential in helping to prevent or manage heart disease. Behavioral experts can: identify and manage behavioral health contributors that can impact heart health, such as depression, anxiety and chronic stress support those who are living with heart disease promote and sustain a healthy lifestyle
6 Workgroup Mission Senior leadership approved the creation of a multi- functional workgroup to: recommend an integrated cardiovascular/behavioral health program for our organization implement and promote the program continuously monitor the program’s effectiveness and make adjustments as necessary evaluate and report on program success
7 Program Goals Address the connection between heart health and behavioral health issues by offering programs that: Educate individuals on the lifestyle habits that put their heart health at risk Support individuals who are changing their behavior for improved health For individuals living with heart disease, encourage compliance with their treatment plan and support them in dealing with the stress and emotions surrounding their condition Help individuals identify the signs of depression, anxiety and chronic stress, and know when to seek help for them
8 Review of Tasks Assess programs and resources currently available through internal departments and vendors Assemble supportive programming Design a communication strategy Provide recommendations to senior leadership
9 Assess Current Programs, Resources Internal Health and safety Medical Food service Fitness center ? Vendors/partners Health plan(s) ValueOptions ?
10 Service Options Offered by ValueOptions Standard: 24/7 assessment and referral Employee assistance program (EAP) Stress-reduction counseling Depression screening Intensive case management Support for family and support systems Primary care physician (PCP) behavioral health consultation Educational programs Enhanced services: Lifestyle coaching Tobacco cessation Nurse line Integrated care
11 Assemble Supportive Programming Making lifestyle change Identify modifiable behaviors to target Provide information and services to motivate and sustain behavior changes for each Living with heart disease Reach out to individuals with information and services to support them in coping with emotions and in complying with an individualized treatment plan Managing depression, anxiety and chronic stress Provide screening tools and information on recognizing signs, coping strategies and resources for professional help
12 Design a Communication Strategy Support program goals Plan frequent outreach Use varied mediums Make a long-term commitment Consistently promote key messages
13 Provide Recommendations Program goals Current programs Suggested new programs Resource request (staffing and financial) Timetable Measures of success
15 Sources 1 Williams R.B. Neurobiology, cellular and molecular biology, and psychosomatic medicine. Psychosom Med, 1994; 56:308-315. 2 Denollet J., Brutsaert D.L. Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation. 1998; 97:167-173. 3 L.D. Kuzansky, K.W. Davidson, and A. Rozanski. The Clinical Impact of Negative Psychological States: Expanding the Spectrum of Risk for Coronary Artery Disease. Psychosom Med, May 1, 2005; 67(Supplement_1):S10-S14. 4 National Heart, Lung and Blood Institute 5 Nemeroff CB, Musselman DL, Evans DL. Depression and cardiac disease. Depression and Anxiety, 1998; 8(Suppl 1): 71-9. 6 Frasure-Smith N, Lesperance F, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation, 1995; 91(4): 999- 1005.