When we recognize the signs of a heart attack — chest pain, cold sweats, numbness — we seek help immediately. But do we recognize the early symptoms of depression, anxiety, stress? Will we get help before the condition becomes more serious? Or seek help for a colleague or loved one?

We’ve come a long way in understanding the mind-body connection. However, behavioral health conditions often go unrecognized and untreated, while our healthcare system focuses on physical health.

Brett Hart is trying to change that. 

Hart was recently named Vice President of Behavioral Health and Mental Health Parity at Blue Cross and Blue Shield of Minnesota. As a clinical psychologist with 25 years of experience with health plans, Hart wants us to become more aware of behavioral health as an essential part of overall health and wellness.

Unmet behavioral health needs and provider shortages

Studies show more than 15 million people in the U.S. have unmet behavioral health needs,¹ and half of U.S. counties do not have a practicing psychiatrist.² In Minnesota, 80 percent of counties are designated as mental health service shortage areas.³

“There's a tremendous unmet behavioral health need out there that is impacting not only the behavioral health of our members, but their physical health, as well,” Hart says. “Blue Cross is in an excellent position to lead the way in closing gaps for members and ensuring they receive high-quality, affordable behavioral healthcare.” The Blue Cross Aware^® Network already offers the broadest network with the most healthcare providers across the state. And Blue Care Advisor directs employees to behavioral health resources to help them get the care they need.

Why should employers invest benefit dollars in behavioral health? There is a strong connection between behavioral health and employee productivity. “Studies show behavioral health is a key factor, not only in employee health and productivity, but in the relationships employees have with their managers and colleagues, as well as their effectiveness on the job,” Hart says.

Mental health conditions affect employee morale, productivity and absenteeism, which has a direct impact on a company’s bottom line. Working-age Americans miss more than 200 million workdays annually due to mental health conditions and lost productivity costs $16.8 billion annually.⁴

Behavioral health affects total cost of care

Behavioral healthcare also has a direct impact on total cost of care. Studies show that when behavioral health conditions are left untreated, co-occurring medical conditions may worsen, leading to increased costs. According to the report, patients with both a medical and behavioral health condition face two to three times higher medical costs than patients without a behavioral health condition.⁵ And a Milliman report showed that patients with behavioral health conditions drive 57% of all healthcare spending.⁶

As healthcare evolves from fee for service toward value-based models that reward quality outcomes, behavioral health will achieve better overall health while controlling costs. 

Primary care integration and alternative settings

On the front lines of healthcare, primary care is an important access point for behavioral health, as many patients are first diagnosed for depression and anxiety by their primary care physician. For this reason, Blue Cross has made detection and referral of behavioral health conditions in primary care a goal for 2024.

In an effort to improve access to behavioral healthcare, Blue Cross is expanding treatment options to include alternative settings like telehealth and virtual. Virtual appointments grew during the Covid pandemic, and many patients still prefer the convenience over standard office visits. They also fill a critical need for member access in rural and remote areas.

“We're now at a point where we can deliver highly sophisticated behavioral health interventions through virtual means to almost any population and location 24/7. That's a tremendous advancement,” Hart says. “It's making behavioral healthcare available to people on their terms, on their timing, and at a lower cost, with similar or even superior outcomes in many cases.”

“As a result, we're helping far more people in underserved areas than we’ve done in the past.”