Health
Forcing our hand on mental health

By - Integrated Care Journal

Journalists will hesitate to use the term “unprecedented” to describe the events of this year but finding alternative terms can often become a fruitless endeavour. Dr Peter Mills, Associate Medical Director for Cigna, and I struggled to do so when discussing the impact of the pandemic upon the wellbeing of populations across the world. “It’s not just the sheer scale of the pandemic,” says Peter, “in our lifetimes we have not seen anything with such a consistent, ongoing impact upon our lives, and upon our state of mind.

“Even at the best of times, it is difficult to balance the many aspects of life that contribute to our health and wellbeing, but the pandemic has had a profound impact and influence that will continue to occur over the months and years to come. ”

Over the past six years, Cigna has been tracking the health and wellbeing of global populations in the form of its Global Impact Study, in partnership with Kantar Hong Kong, a leading data, insights and consulting company. Over the course of the pandemic, this study has provided a critical infrastructure for monitoring the effects of the pandemic upon the health and wellbeing of populations around the world.

Findings from Cigna in recent months are stark: of those surveyed in June, 18 per cent believe that their lives will “never be the same again”, up from 13 per cent in April this year. Some 40 per cent of those surveyed are also particularly concerned with financial considerations. Being involuntarily out of work will have a significant impact upon mental health, and people are seriously worried about their ability to exist in society. “The pandemic has shaped people’s perceptions of their financial stability,” says Peter, who harbors particular concerns about the added stress this economic uncertainty is placing upon mental wellbeing.

“The global workforce is feeling stressed, they feel vulnerable and are under considerable pressure,” he adds. This is also accompanied by an increasing feeling of loneliness, with 31 per cent of those surveyed feeling isolated throughout the pandemic and the continued lockdown in many parts of the world.

As Peter highlights, what we are seeing is an assault upon each major dictator of wellbeing: our physical health, our work life, family relationships, societal bonds and, crucially, our financial stability.

That so many people already believe their lives have permanently changed means that we now have a new and ever-changing normal to adjust to. This means our healthcare system must adjust accordingly – and nowhere is this more relevant than with regard to mental health.


Does virtual healthcare hold the key?

A clear finding from the Cigna survey is that people are becoming more open to the concept of virtual care, with 54 per cent of survey respondents saying they were now likely to use virtual health as an option for consultation or diagnosis. We know that usage has skyrocketed over the past five months, and some GP practices are now operating with over a 90 per cent virtual consultation rate – something unthinkable at the start of the year. Worldwide, Cigna has found that 17 per cent of respondents started using virtual healthcare during the pandemic, with China showing the highest adoption rate at 27 per cent. Many of the solutions now being used have, in fact, been available for some time, but only now are we seeing truly significant adoption rates.

“For too long there has been too much vested interest in the status quo,” says Peter, “and too much priority has been given to investing in bricks-and-mortar institutes where patients have physically been required to attend. ”

Peter is certainly not proposing a total replacement of the "old way" of doing healthcare, but rather using digital technology to supplement and indeed improve it. It is becoming increasingly clear that a greater blend of digital and virtual healthcare will enhance the offerings of health providers. Still working one day a week as an active clinician, Peter is acutely aware of the number of people who he does not need to see face to face, and has long advocated the increased use of digital tech to help segment patient pathways. “It is not a question of either or,” he says, “it’s a question of how we can bring these elements together and improve overall quality of care. ”

Among other time-saving factors, virtual health offers the opportunity to spend better-quality time with the patient. This is particularly helpful in the realms of mental health considerations. “We know that talking-based therapies are very effective for mental health treatment, and CBT and psychotherapy are ideally suited for delivery in bulk by this medium,” explains Peter. "We have a massive opportunity in virtual care, to enhance what we had before and not simply replace it. ”

While the pandemic continues to pose serious challenges to our mental wellbeing and, in turn, to our health and care system, Peter remains optimistic about the reforms it is encouraging. The full-frontal assault of Covid-19 upon our society has forced us to move the dial of discussion on mental health, to think of it differently and to appreciate its nuanced links to all aspects of life and physical health – the solidarity with which we have experienced and suffered Covid-19 has breathed new life into the mental health conversation.

“For too long mental and physical health have been considered in siloed settings. In the past, in my lifetime, the medical profession has perpetuated the idea that you have physical and mental health separated, located in separate buildings, and I think that Covid-19 will prove to be a catalyst to really think about psychological wellbeing, what are all the critical elements in our society to try and maximise people's psychological wellbeing and their resilience in difficult times. ”


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