4 min read

Taking the Moment: Addressing Mental Health in the Home

By Dr. Heidi Schwarzwald, MD, MPH on 5/13/24 9:17 AM

Taking the time to care for one’s mental health is vital at every stage of life. But as people age they often spend more time at home – many times, alone – so prioritizing mental health becomes even more critical. 

As we get older, most of us will experience common yet life-altering occurrences that can deeply affect our mental health and overall well-being, such as the loss of a spouse, or the ripple effect that mounting physical health issues can have. It’s not surprising, then, that approximately 14% of adults aged 60 and over live with a mental health disorder, and the number of older adults with mental health disorders is expected to double by the year 2030. 

Despite this growing prevalence, the majority of older adults with mental health problems do not receive the treatment they need. This gap in care is extremely worrisome, given that mental health issues in older adults, such as depression or anxiety, are often present for people who have a chronic condition such as coronary artery disease, diabetes, stroke. 

Catching and closing care gaps: In-home mental health screenings

As a clinician, I recognize just how close the connection is between physical and mental health, and yet how siloed treating those conditions can be. This Mental Health Awareness Month, I want to “take a moment” to share how proud I am of the work Signify Health is doing to help older adults prioritize their mental health, including our screening for mental health issues from the comfort and convenience of their home. 

During every In-Home Health Evaluation (IHE) that a Signify clinician performs, in addition to a set of physical health diagnostics, a PHQ-4 screener is performed, which screens health plan members for anxiety and depression. If warranted, they go on to complete the PHQ-9, a screening tool for depression. In an analysis conducted by Signify, 32% of the total study population completed a depression screener and a concerning 3% were found to have Major Depressive Disorder (MDD). In another study conducted by Signify Health, 43% of members of a large, regional Medicare Advantage (MA) plan were found to have a behavioral health treatment care gap.

Not only is the identification of mental health conditions key to holistically addressing a person’s health needs, but once identified, getting connected to appropriate treatment is also key. Our clinicians get to the root of these objectives by visiting members in the comfort and convenience of their own home, conducting screenings, and when concerns are identified connecting them directly to behavioral and mental health coordination services that contract with each member’s health plan. Of 226 members referred by Signify Health to a mental health care coordination organization, 41% scheduled appointments, and 67% completed them. Clearly, there is immense value in being able to meet people where they are to address not only their health concerns but see and address the factors that contribute to their mental health as well. 

As an example, last Thanksgiving, Stephanie Simons, a Signify Health clinician, performed IHEs for several health plan members, one of which was particularly memorable. She was able to identify that the woman she was speaking with was experiencing grief, as she had lost her husband a year prior. 

Stephanie encouraged her to begin sewing, a hobby she hasn’t continued since her husband’s passing. Without Stephanie’s encouragement, this member may have had a harder time coping with her grief and while grief may not be a mental disorder, bereaved persons are at high risk for major depression. Being able to identify this in the home, allows our clinicians to make suggestions and referrals for people to get the help they need early on to prevent further symptoms. The IHE is filling a critical gap for some members that isn’t being filled in any other way.

Echoing the theme of this year’s Mental Health Awareness Month, let’s “take the moment” to recognize the people in our lives who may be struggling. If you have an older adult in your life that you feel may not be getting the behavioral health services they need, visit National Alliance on Mental Illness (NAMI) and Mental Health America to learn about their helpful resources.

Many health plans offer IHEs at no cost. If you want to see if you or a loved one is eligible for an IHE with a Signify Health clinician, just go to our online scheduling portal where you can select a date that is best for your schedule.