Boosting chronic care management with mental health support | Viewpoint

Mental health touches every aspect of our lives, affecting emotional, psychological, and social well-being.

Dr. Tejaswi Kompala

Mental health is also intricately intertwined with our physical well-being, particularly when it comes to chronic conditions such as diabetes, hypertension, and obesity. In fact, people who have a chronic disease are at a higher risk of developing mental health conditions like depression. As an increasing number of people in the U.S. are dealing with multiple chronic conditions, more awareness is needed regarding the intersection of mental health and chronic diseases and how to manage them better.

Unfortunately, when it comes to delivering care, mental health is often viewed in a silo. We see, however, our members engaging in mental health solutions have overall improved outcomes for chronic conditions such as diabetes, making the case for better integration of mental health services in chronic condition management. There are several long-term benefits of digital mental health programs that work hand in hand with chronic care management initiatives to positively affect change in clinical outcomes.

Understanding the complexities of chronic care management

Chronic conditions are complex and require a multifaceted approach to care. Take obesity for example. There is a shared clinical understanding of the serious and potentially complex results of having obesity.

However, there are still many layers to consider in obesity management and treatment. It’s a costly condition that is now being treated with GLP-1s, which is an expensive new medication class. There are a lot of other costs to consider for untreated or unmanaged obesity, including diabetes or heart disease that could be related to excess weight.

Multidisciplinary support leads to better outcomes

As a practicing endocrinologist, I have spent a lot of time in my career focused on treating obesity and helping people with obesity prevent some of the downstream implications, such as diabetes. When it comes to weight loss and weight regulation, there are many behavioral components – it’s not just about calories or diet and exercise.

There is a need for flexibility and a personalized approach, as weight management is linked with behavior change. According to our studies, members engaging regularly in both mental health solutions (including digital health) and chronic condition management offerings saw an additional 10% average weight loss and 32% additional reduction in systolic blood pressure.

Two different people may have two entirely different focuses regarding weight management and obesity care. For example, one person may want to work with a nutritionist to do a deep dive into calories and macros, but another may need to work with a behavioral health specialist to focus on emotional eating or healthy coping mechanisms.

Focusing on the following four key pillars - nutrition, physical activity, sleep, and stress - is the key to a successful chronic care management program.

On top of those pillars, it’s important to give people access to the clinical support they need, including providers that have the expertise to safely manage GLP-1s or other anti-obesity medications. It’s essential to think holistically about the whole-person while providing lifestyle modification support for patients.

Patients engaging in mental health solutions have overall improved outcomes

When considering cultural preferences, social drivers, and physical and mental health, flexibility is needed in the approach, tools, and support provided to individual patients.

Virtual care and other technological advancements not only increase engagement, but the use of machine learning and AI can also help personalize care. For example, what are the reminders that will be most compelling to keep patients logging in day in and day out? Our study also revealed that engagement in mental health programs occurs during periods of decline in physical health outcomes, further emphasizing the importance of just-in-time adaptive interventions along with a continuous approach to whole-person care. Successful weight loss outcomes and behavior change are driven by finding this successful recipe for engagement.

The use of machine learning and predictive modeling in digital health has transformed the way we can support patients, provide access to chronic care and allow for seamless data exchange.

Successful behavior change comes down to building on daily actions, and digital mental health solutions also help facilitate sustained engagement over time. Incorporating mental health into chronic care has promising potential to positively affect clinical outcomes.

Dr. Tejaswi Kompala is head of cardiometabolic clinical strategy of Teladoc Health.