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Plugging into mental health care: Digital mental health in Colorado

Beacon Health Options is building a lot of bridges to ensure that its members get the quality care they deserve, bridges that span both oceans and mountains.

Beacon has partnered with Ieso Digital Health, a United Kingdom-based firm with a unique digital mental health delivery platform, to provide mental health services for members in Colorado’s Medicaid program, many of whom live in remote rural and frontier areas, stranded from accessible services. Ieso’s platform enables these members to receive counseling from licensed mental health therapists from anywhere and at any time, including evenings and weekends.

But the platform does more than provide services remotely. It also lets us know how our members are doing by comparing before and after scales of clinically validated questionnaires, such as the PHQ-9 for depression and the GAD-7 for anxiety. The platform enables true person-centric care.

As the behavioral health management partner for Colorado Health Partnership, a public/private partnership that provides mental health services to Medicaid-eligible members in southern and western Colorado, Beacon can offer this innovative service through its affiliation with Ieso.

A new kind of plugging into health care

The service is primarily for individuals with common mental health disorders, such as depression, anxiety and PTSD. It delivers cognitive behavioral therapy (CBT) in a secure virtual therapy room, during a live online appointment using typed conversation. Members are assessed, provided a treatment plan and then evaluated at the conclusion of their treatment, which most people complete in eight to 10 sessions, unless their condition requires more. Ieso recruits the in-network providers to perform this online CBT and also provides their training and supervision.

Solving transportation and barriers is the obvious benefit to online therapy, but there can be other plusses as well. There’s the convenience of time management – having therapy at home or during lunch break in a private place. All that is necessary is an internet connection, computer, tablet or smartphone.

‘Having therapy in my home environment helped me keep my business private. I felt I could open up and be honest.’

A less obvious benefit may be what is described as the “disinhibition effect” – when people feel more comfortable opening up about their thoughts and concerns virtually rather than face-to-face. Therapy, therefore, becomes more effective. In the words of one Colorado patient, “Having therapy in my home environment helped me keep my business private. I felt I could open up and be honest.”

It’s easy and it works

In addition to these benefits, the service seems to be working. Members are getting better. As of the end of April, 507 patients completed registration (which does not mean they also received services) since the contract start date in Fall 2016. Of those members who are considered eligible for outcome evaluation, 65.1 percent have achieved statistically reliable improvement.

More specifically, patient scores on the PHQ-9 (depression scale) reduced on average from 13.4 to 7.0, and from 13.4 to 6.0 on the GAD-7 (anxiety scale), before and after treatment, contract to date.

Beacon and CHP are currently in a pilot phase with the service, and if outcomes were the only measure, then the program seems to be on the road to success. However, there are fiscal and administrative realities around funding that will determine the program’s future.

As the health care landscape evolves, across the state and across the country, the industry can no longer be treading water. The Ieso service is just one example of bridges that need to be built and crossed. The role of Beacon and its partners, like those in the United Kingdom and Colorado, is to seek innovative ways to accommodate ongoing change that promises to confound health care as we know it. And that’s a good place to be – for Beacon, our partners and the members we serve.

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