(This article first appeared in the Australian Financial Review)
At the start of last year Michelle, an audiologist in Melbourne’s outer eastern suburbs, felt her anxiety and depression flaring up after several years of having had it under control.
Five years into her career, she had taken on more responsibility at her clinic. She was becoming “very, very anxious” and suffering from initial physical symptoms – but not the crippling panic attacks during her master’s degree in audiology in about 2009.
Back then, due to anxiety over things like assessments, she would be immobilised in her bedroom, with difficulty breathing and having to lie down and wait the symptoms out. She wasn’t absent from university, but her work was affected, she says.
The health system has struggled to cope with untreated mental health conditions, which are estimated to cost the economy about $11 billion a year. Six million days are lost to depression each year and more than 3 million Australians suffer disabling stress, worry, anxiety, low mood and depression.
Finding more effective ways to treat chronic disease is the Holy Grail of healthcare, which costs more than $155 billion a year-about 9 per cent of GDP – in Australia. Public systems have been slow to move despite countless reports urging them to do so.
Mental health imposes the second largest burden on the community after cardiovascular disease, equal to injuries and larger than respiratory diseases and cancer. Australian Unity is talking to more partners – rival insurers and employers -and targeting more conditions for a similar approach.
Around the time Michelle’s symptoms recurred a year ago, her employer emailed staff about a telephone coaching service for staff with certain health conditions, including anxiety and depression. It was provided by Remedy Healthcare, part of Australian Unity.
The insurer was alarmed at the growth in claims a decade ago, especially for chronic diseases. It cast about for programs to slow mental health claims growing at 15 per cent a year.
Remedy’s MindStep program, adapted from one used by Britain’s National Health Service, targeted anxiety and depression and has proved so successful in its first year that Australian Unity is planning to widen its embrace to post-traumatic stress disorder, pain management, post-natal depression. Amanda Hagan, head of health, would also like to tackle youth mental health.
Michelle got in touch with MindStep and – after a few getting-to-know-you emails and a history-taking session – had her first coaching session.
Coaches are not qualified psychiatric professionals but come from allied health fields and receive 12 months’ intensive training, paid for by Remedy. They follow a structured program and are supervised remotely by clinicians who scan transcripts of coaching sessions and refer anyone showing acute symptoms-such as thoughts of suicide – for immediate help.
Michelle’s coach explained how anxiety manifests in physical and emotional symptoms, and over the course of subsequent “meetings” -weekly, and then quarterly-they worked out some goals for Michelle to pursue.
One was simply to be sure to catch up with friends once a week -to try to get out of the habit of becoming a “recluse” whenever she became anxious or depressed. A second was just to keep her house clean. Michelle lives by herself in a unit, and wanted to be able to take pride in her home even during bouts of anxiety and depression.
By the time Michelle finished with MindStep in October, she had discovered a lot of things that triggered her anxiety, such as worrying about things that were outside her control.
Her coach gave her tools for coping, such as recognising when she is worrying about things unnecessarily, and nipping them in the bud before they become more serious.
“I still have my moments when I get a bit stressed but I recognise those moments earlier than I did and I am able to deal with them better than before,” Michelle says.
“I am happier than I was a few years ago and happier than I was at the start of the year . I am able to work more productively and get back to whatever it was that I was doing before those stresses came along.”
For Australian Unity, results are also pleasing. Three-quarters of those who have been through MindStep report an improvement, and 55 per cent show no clinical signs of anxiety or depression.
Claims costs have fallen $7800 per person per year for the cohort, and average days in hospital and readmissions are sharply down. The insurer has saved $4 million in the first year of the program.
If it can replicate these gains more broadly, we may just make a dent in the $155 billion healthcare bill.
Ben Potter (2016, January 10) Step to remedy mental health The Australian Financial Review Retrieved from http://www.afr.com.au
Photo: Josh Robenstone