With the hope of a vaccine on the horizon, it is important to keep in mind that the global pandemic is still prevalent. It will take time for these vaccines to reach the general population, and the first recipients will be front-line medical workers and at-risk populations. Although the introduction of a vaccine is great news, we must stay vigilant in our efforts to end COVID-19 and that’s where social responsibility comes in. Social responsibility is the obligation of everyone in a community to make decisions that benefit society at large. It is important to remember that your actions can protect you, the ones you love and the community.

Here are five key ways to be socially responsible while we continue to fight the COVID-19 pandemic:

1. Stay home, if possible – remaining at home to keep yourself and others safe is important, but can also cause severe loneliness. Remember that physical distance does not have to mean complete isolation. Keep in touch with loved ones through phone or video calls, spend time searching for meaningful gifts or messages you can send them, or even get together and enjoy a physically distanced outdoor meal.
2. Practice good hygiene – remember to wash your hands with soap and water for at least 20 seconds to keep germs at bay. Make sure to do this before you eat, after using the restroom, and after blowing your nose, sneezing, or coughing. If you cannot wash with soap and water, hand sanitizer is a good alternative. Avoid touching your face, and regularly clean and disinfect high-touch areas.
3. Wear a mask — masks help slow the spread of coronavirus and protect both the person wearing the mask and those around you. Find a comfortable, fun mask that suits you!
4. Perform acts of kindness – support those who are most vulnerable in your community. There are many acts of kindness you can do during this time – run errands for an elderly neighbor, send handwritten cards to a nursing home, donate food to your local food bank. Helping others will put a smile on your face, too!
5. Show gratitude – many front-line workers have been working diligently since the pandemic began. Be grateful for those who serve our community, such as healthcare workers, childcare professionals, teachers, and other essential workers. You can even make a difference by offering to help provide childcare for essential workers, or making homemade masks or meals to give out.

We have come a long way in this pandemic and need to work together to bring it to an end. Do your part to stay healthy and be socially responsible.

Normal holiday stressors can be compounded when we miss someone we have lost or are impacted by other hardships. This year, the sense of loss – of a loved one, financial security and a sense of “normal” – has touched many of us due to the COVID-19 pandemic. As we’re making plans to celebrate the holidays in unprecedented times, let’s take a break with Magellan’s Dr. Shareh Ghani as he discusses ways to address feelings of loss, practice self-care and make the most of this holiday season.

Magellan: Dr. Ghani, thank you so much for being here with us to share your many years of expertise in helping patients with behavioral health needs. Our first question: Is it possible to enjoy the holidays when we are experiencing the pain of losing a loved one to COVID-19 or something else?

Dr. Ghani: Thank you for having me. The pandemic has taken a toll on our community as we have lost loved ones prematurely, and we continue to experience sustained emotional pressure as COVID continues to spread. It is vitally important that we celebrate the holidays, exchange gifts and cards, gather virtually, and celebrate life. Spreading love and joy in these trying times will bring much-needed respite to the brain and body and boost our immune systems.

Magellan: How can we overcome feelings of worry and anxiety due to a job loss or other financial insecurity during this holiday season?

Dr. Ghani: Losing a job obviously leads to worry, anxiety and even questioning one’s own competence. The pandemic has helped many people shift focus to the “must haves” and not worry about the “nice-to-have” luxuries in life. Some are paying more attention to their health and fitness, minimizing spend, and planning for the future. Having a good strategy will help reduce the anxiety of uncertainty. If need be, talk to a therapist.

Magellan: Do you have any tips for people experiencing distress over not being able to celebrate the holidays in the way they may have in the past?

Dr. Ghani: One needs to evaluate the reason why we are changing our lifestyle. Social distancing helps stop the spread of the virus. Those who take this threat to our lives lightly may experience distress. Understanding the gravity of the situation alleviates it. We are celebrating in smaller groups so we can defeat the virus and return to our old ways of celebrating holidays safely. Think of it as a form of delaying gratification for better outcomes.

Magellan: What is your general advice for anyone who is experiencing loss to feel better and be able to experience joy this holiday season?

Dr. Ghani: Losing loved ones is a part of our life cycle. Human beings are resilient beings. Remember – those that we have lost would have wanted us to be happy. We should think about the happy moments we shared with those that are not here today and celebrate life.

Magellan: Why is it important to practice self-care and be an advocate for one’s own mental health?

Dr. Ghani: Good eating habits and physical exercise are key to physical and emotional wellness. Sleeping at least eight hours a day, hydrating well and experiencing joy and happiness are also important. All these things help with mental health. Relationships, family, helping others and being grateful add to a joyous life experience.

As winter approaches, efforts in many states across the country to control a second rise in COVID-19 infections also mean continued social isolation and hardship for millions of people. High, chronic levels of stress resulting from unemployment and economic insecurity, school closures, disruption to normal routines, illness, and loss have a negative impact on mental and physical health. In addition to the burden of the pandemic, simmering political and social tensions have left many people feeling distressed and threatened.[1]

As a nation, we face a challenging winter even as coronavirus vaccination news looks promising. It will be months before a vaccine can be widely distributed across the population, and even then, life may not be back to normal. In the meantime, it is important to monitor and care for your mental health as we move through this next phase.

People at Risk

A significant number of Americans report feeling depressed and anxious as a result of the pandemic. People who are already prone to mental health problems, people with low incomes, minorities, young people and isolated older adults (especially those living in facilities) are at higher risk of depression.

If you or a loved one are struggling with persistent feelings of sadness and hopelessness that last for two weeks or more, have lost interest in things you used to enjoy, have thoughts of self-harm and/or experience sleep disturbances and changes in appetite, it is important to see a doctor for an evaluation and possible treatment of your symptoms. There are effective treatments for depression, including medication and various therapies.

Building Resilience

There are several ways to build resilience and prepare emotionally for winter shutdowns. Research shows that resilience skills can be learned and include the following:

• Social connections. A strong social support network is one of the most important parts of building resilience. If face-to-face contact is not possible, stay in touch with family and friends by phone or video. Check in on friends and neighbors who are having a hard time.
• Pay attention to negative thoughts and practice gratitude. Resilient people tend to be optimistic and flexible in their thinking. If the constant negative bombardment of news and social media makes you anxious and unhappy, limit or take a break from your screen time.
• Assess what you can and cannot change. Focus on positive actions that you can take, even if the possibilities seem limited. Tap into your talents: revisit an old hobby or try something you’ve always wanted to do.
• Take care of yourself. Maintain routines, get enough sleep and exercise and eat a healthy diet. Avoid using alcohol or other drugs to combat sadness or boredom.

Having goals and a purpose can also increase resilience. The pandemic has led many to rediscover a new appreciation for their gifts, relationships and the values that give meaning to their lives. If you are doing all the right things to build your resilience and still feeling down, make an appointment with your doctor. You will get through this.

For more information and tips, visit MagellanHealthcare.com/COVID-19.

[1] Nancy Schimelpfening,“This COVID-19 Spike Will Also Hit our Mental Health with a ‘Second Wave,’” September 23, 2020, Healthline, https://www.healthline.com/health-news/this-covid-19-spike-will-also-hit-our-mental-health-with-a-second-wave#Why-is-the-pandemic-putting-our-mental-health-at-risk?

We all need to be cautious as COVID-19 continues to spread across the United States. However, people with type 1 or type 2 diabetes need to be extra careful. According to the CDC, the risk of catching the virus isn’t greater for those with diabetes, but the symptoms could be worse. That’s especially true if diabetes is not well managed or controlled. Here are some ways to reduce your chance of contracting COVID-19 if you have diabetes.

• Keep your distance
  The best way to avoid getting sick is to stay home. However, we know that is not always possible. If you do go out, stay 6 feet away from other people and wear a face mask.
• Use good hygiene
  It’s important to wash your hands often to prevent the spread of infection. Be vigilant about washing your hands before you give yourself a finger stick or insulin shot. Also, remember to clean each area first with soap and water or rubbing alcohol.
• Keep your blood sugar under control
  When you have diabetes, your blood sugar levels may be consistently high. Many parts of your body can be affected or damaged by too much sugar including your immune system, which puts you at greater risk of infection.
• Keep moving
  Your lifestyle may have changed since the COVID-19 pandemic. You may be working remote, going out less, or avoiding the gym. However, moderate activity is still very important to your overall health and management of diabetes. Yard work, brisk walking, cycling, or in-home workouts are all safe ways to get exercise.
• Supportive family and friends
  To protect you, your friends and family should take extra precautions. Some of these may include washing their hands more often, not sharing personal items, and wearing a face mask if you’re in the same room.
• Stay positive
  Staying positive and focusing on those circumstances you can control is always a good foundation for health. Mindfulness activities and gratitude will go a long way to maintaining wellness.

If you do start feeling sick and have COVID-19 symptoms such as a dry cough, fever, or shortness of breath, call your doctor.

Source: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

The Child and Adolescent Needs and Strengths (CANS) assessment is a multi-purpose tool developed for children’s services to support decision making, including level of care and service planning, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services. It is one of the tools in the Transformational Collaborative Outcomes Management (TCOM) framework, developed by Dr. John S. Lyons, consisting of a set of Guiding Values and Core Principles, all centered on how to provide the best and most support to all those in need.

I am often asked “How does managed care use the CANS?” Managed care organizations, like Magellan, are increasingly using clinical decision support tools and implementing value-based programs; the CANS offers a common language to look at resource needs and make the balancing of resources more transparent.

John Lyons frames the use of the CANS as part of “Five Key Decisions”: access, engagement, appropriateness, effectiveness and transitions. This framework on CANS use may be helpful for understanding how managed care uses decision support tools, and the CANS in particular, as the CANS has bonus options beyond the usual clinical decision support tools.

In this post, I provide an overview of each of the Five Key Decisions to shed light on how managed care uses the CANS. I invite you to explore the topics below and follow the links to learn more in my series on the TCOM Conversations blog.

Access

Access refers to screening for a target population, such as using CANS algorithms for matching needs to services. This identifies youth who will benefit from a certain level of care or service, as well as those who will not.

MCOs, with their advanced analytics capabilities, can provide valuable insights to state and local agencies to inform ongoing adjustments to algorithms to ensure that youth have access to the appropriate level of care.

Learn more

Engagement

Key Decision 2, Engagement, is about bringing people from access — opening the door — to becoming equal partners in the helping system. Engagement is built on respect and understanding that youth and family are experts in their own lives and need to captain their own ships. Engagement uses a fully person-centered discovery and planning process.

MCOs are tasked with operationalizing engagement, often taking the form of a checklist with time-frames and standards for everything from forms, consents, plans, child and family meetings, authorization, and even how often helpers and family are required to meet.

Proper operationalizing of engagement allows for family and youth to participate as fully as possible in using the CANS for reflection, self-advocacy and self-direction.

Learn more

Appropriateness and Effectiveness

An appropriate service should be effective. These two Key Decisions are inextricably linked and are often the basis of medical necessity. Evidence-based practices assign a defined appropriate population and a set of measures demonstrating effectiveness and provide a good example of how the community at large and managed care can agree.

Standardized assessment is an established best practice for measuring appropriateness and effectiveness. The CANS in practice excels at both. When the practice is done well, youth and families flourish and successfully complete their programs.

Learn more

Transitions

Using CANS algorithms for access and transition decision support is particularly helpful when celebrating successes. In behavioral healthcare, a discharge from a program can be seen as a success, but “success” may only be based on utilization or length of stay, and not on quality outcomes for the youth and family. The CANS is a functional outcomes measure, i.e., it measures how a youth and family is functioning in real life. As value-based programming expands, the CANS will be used for evidence of discharge success.

Learn more

Barbara Dunn, LCSW, ACSW, is director of program innovation and outcomes for Magellan Healthcare. She is the Conference Program Chair for the 16th annual TCOM Conference, A TCOM Cloud Gathering. Meeting Each Other Where We Are: Collaboration in a COVID-19 World. Learn more about the event here.

For November National Family Caregivers Month, we are pleased to share our e-interview with Pat Hunt, executive director of the Family Run Executive Director Leadership Association FREDLA, on family support organizations and how they help families who are dealing with mental health issues.

Magellan: Pat, so glad to have you with us today. Tell us a little about how you came to the work of family leadership.

Pat Hunt: It’s always a pleasure to spend time with folks at Magellan. Like family leaders across the nation, my lived experience has continued to shape the pathway. As a parent, I didn’t want anyone else’s child to struggle the way mine did – or for other parents to have a similar experience as mine. I was so fortunate to have the benefit of allies in my state – other parents, people in state government, providers – all willing to be courageous and develop solutions together. I worked with 16 families across my state to develop a statewide family network with a vision toward positive change. As a family leader, I applied what I had learned from my experience as an advocate – which may be a misunderstood word today – to help other families understand the impact of policy on service array, practice, access, quality, etc. and to have the information, opportunities, skills and resources to effectively participate. This foundation took me to national organizations, such as the Federation of Families, Magellan and FREDLA.

Magellan: You became the executive director at FREDLA almost two years ago. What are you passionate about in your work at FREDLA?

Pat Hunt: Family-run organizations across the nation are the bloodline of the family experience – flowing from the heart of every family they serve. THEY touch lives in amazing ways. FREDLA is here to nourish and support their work – to ensure they have the tools and support they need to be successful, viable and sustainable. That means we also help states, counties, practitioners, health plans and management organizations by providing consultation and training – because they are interdependent in achieving the positive outcomes for children, youth and their families.

Magellan: What should we be looking forward to in the next year on developments in the family support field?

Pat Hunt: 2020 has taught us that the efforts of peer family support partners have been nothing short of herculean during the most challenging of times. They are innovative, dedicated and resilient. The results of FREDLA’s recent national survey will be released soon and used to inform workforce development, technical assistance, national advocacy efforts and research programs. In March, we will be hosting a national event to respond to the needs of parent peer support providers, their supervisors and the funders and management of their programs. Stay tuned, and we hope your audience will as well.

Pat Hunt is the executive director of FREDLA, the national Family Run Executive Director Leadership Association, a non-profit union of leaders of grassroots family-run organizations across the nation. Along with her lived experience as a parent, Pat brings over 25 years of experiences as an advocate for children with behavioral health needs and their caregivers. During this time, she had extensive experience overseeing both federal and state grants and served as the founding director of a family-run organization.

Pat’s experience includes over 10 years in a corporate leadership role at Magellan Healthcare to advance best practices for children, youth and their families, and to ensure that their experiences informed policies, practices and program development. She previously held a senior leadership position as a conduit for local grassroots experience to inform national policy decisions at the Federation of Families for Children’s Mental Health. She has served as a VISTA Volunteer, directed a federally funded rural substance abuse prevention project, managed a statewide family-run organization, served as president of the Maine’s mental health planning council, and was the only non-state employee member invited to the Governor’s Children’s Cabinet.

 This is an excerpt from the Magellan Healthcare eMpowered for Wellness November newsletter. To read the full article, go here.

Depression is a disease. It’s caused by changes in chemicals in the brain that are called neurotransmitters. Depression isn’t a character flaw, and it doesn’t mean you are bad or weak. It doesn’t mean you are going crazy.

People who are very depressed can feel so bad that they think about suicide. They may feel hopeless, helpless, and worthless. But most people who think about suicide don’t want to die. They may see suicide as a way to solve a problem or end their pain.

What to watch for

It is hard to know if someone is thinking about suicide. But past history or events may make suicide more likely.

Things that can make suicide more likely for those suffering from depression include:

• Being male
• Having had a family member attempt suicide or kill himself or herself
• Having access to a firearm
• Having been sexually abused
• Drinking a lot of alcohol or using drugs
• Having attempted suicide before
• Feeling hopeless
• Other mental health problems, such as bipolar disorder or schizophrenia

Warning signs of suicide include someone:

• Planning to or saying he or she wants to hurt or kill himself or herself or someone else
• Talking, writing, reading, or drawing about death, including writing suicide notes and speaking of items that can cause physical harm, such as pills, guns, or knives, especially if this behavior is new
• Saying he or she has no hope, feels trapped, or sees no point in “going on”

Find additional information and resources on suicide prevention here.

For information about Magellan events during National Depression and Mental Health Awareness and Screening Month, downloadable materials and more, visit our website here.

Adapted with permission from copyrighted materials here from Healthwise, Incorporated.  Healthwise, Incorporated and Magellan Health disclaim any warranty and all liability for your use of this information.

Untreated mental illness costs the United States up to $300 billion every year.[1] It is the leading cause of disability and the third most expensive medical condition in terms of total health spending, behind cancer and traumatic injury.

Given that one in five Americans suffers from a mental illness in a given year[3], and that the average delay between the onset of mental illness symptoms and treatment is 11 years[4], mental health screening should be considered just as important as regular medical exams.

Many physicians integrate screening to diagnose mental health conditions as part of primary care. It gives a PCP a picture of the patient’s emotional state and helps determine if symptoms they are experiencing are an indication of a mental health condition or an underlying physical health condition. Magellan Healthcare supports primary care screening and treatment with our Behavioral Health Toolkit at MagellanPCPtoolkit.com

Online screening and digital screening are two of the quickest and easiest ways to determine if a patient is experiencing symptoms of a mental health condition. A PCP may ask a patient to complete a questionnaire online before a visit, or a PCP may ask a patient to answer a few questions on a tablet or form while you they are at the office.

Based on the results, the PCP can recommend treatment options, such as digital or in-person therapy, a referral to a psychiatrist or psychologist, or a referral to the patient’s health plan’s case management team.

Early identification and intervention lead to better outcomes and can reduce long-term disabilities and prevent years of suffering.

To learn more, visit magellanhealthcare.com/mental-health. You’ll find information about mental health conditions and links to evidence-based screening tools you can do yourself. If any screener indicates a problem, consult a healthcare professional immediately.

[1] National Alliance on Mental Illness. (n.d.) FY 2018 Funding for mental health. Retrieved October 7, 2020 from https://www.nami.org/getattachment/Get-Involved/NAMI-National-Convention/Convention-Program-Schedule/Hill-Day-2017/FINAL-Hill-Day-17-Leave-Behind-Appropriations.pdf

[2] Soni, A. (2015). Top five most cCostly conditions among adults age 18 and older, 2012: Estimates for the U.S. civilian noninstitutionalized population. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. Retrieved September 18, 2020 from https://meps.ahrq.gov/data_files/publications/st471/stat471.shtml.

[3] Centers for Disease Control and Prevention (2018). Learn about mental health. Retrieved September 18, 2020 from https://www.cdc.gov/mentalhealth/learn/index.htm.

[4] National Alliance on Mental Illness. Mental health by the numbers. (2019, September). Retrieved September 22, 2020 from https://www.nami.org/mhstats.