- Associated Press - Monday, October 3, 2016

NEW MILFORD, Conn. (AP) - The Western Connecticut Health Network has had to get creative to find ways to deliver crucial mental health services at a time when resources are limited but demand is steadily rising.

Last December, Western Connecticut launched its telemedicine program, where patients can use an iPad to teleconference with a mental health clinician who works at the network. The service is offered at New Milford’s emergency department and in primary care practices in Brookfield, Ridgefield and Southbury.

In late October, the health network will start offering patients free therapy through a computer program that the network bought for about $100,000 from Magellan Health, an Arizona company that, among other healthcare services, provides computerized therapy for an array of mental health conditions, including depression, anxiety and insomnia.

“Shortages of behavioral health providers, health plan limitations, lack of coverage and/or inadequate coverage are all barriers to behavioral healthcare access,” said Dr. John Murphy, the network’s president and CEO. “In addition, behavioral health services are poorly reimbursed and state funding for behavioral health programs continue to be cut year after year despite growing needs.”

Since Dec. 1, 57 patients have used the telemedicine program at New Milford Hospital - 83 percent talked with a clinician within 90 minutes, a drastic decrease in wait times for consultations before the service existed.

Patients have waited several hours, sometimes up to a day, to speak to someone and, at times, had to be transferred by ambulance to Danbury Hospital, when a provider wasn’t available.

“We took them out of their home environment, brought them to Danbury and then they had to figure out a way to get back home,” said Ronald Stephens, nurse manager of the emergency department at New Milford. “That was a very challenging and very trying time for the patient.”

Now, if no clinician is available, patients are given the choice to use the telemedicine program. No one has refused since the program started almost a year ago.

“It is a great service,” Stephens added. “It gets those who are having a behavioral health crisis the ability to talk to someone in a more appropriate time period than what we were able to do in the past.”

Western Connecticut officials are also considering expanding telemedicine to Norwalk Hospital, which is part of the network, during after-hours.

At a time when more and more research is finding that medications aren’t always the most effective treatment for mental illness, providers like those at the Western Connecticut Health Network are focusing on ways to offer alternative treatments like cognitive behavioral therapy (CBT).

According to the National Alliance of Mental Illness, CBT focuses on exploring relationships among a person’s thoughts, feelings and behaviors. During CBT, a therapist will actively work with a person to uncover unhealthy patterns of thought and how they might cause self-destructive behaviors and beliefs.

But it has been challenging to find ways to offer these services during the provider shortage.

“There are few providers, but there are even fewer providers who specialize in CBT,” said Dr. Tait Michael, a psychiatrist working with the network to implement its various mental health initiatives.

Western Connecticut started exploring computerized CBT about a year ago and will roll out the program to patients, with a focus on those in primary care offices, on Oct. 24. The network will offer Magellan’s anxiety, depression and insomnia programs.

“This gives us a tool that is as effective as medicine and that patients can keep with them … they will be able to use this throughout their lifetime,” Michael said.

Those who opt into the program will each have their own unique sign-in and will be able to access the software anywhere they have wifi. Each session, or module, as Magellan describes it, lasts 30 to 45 minutes.

Patients are prompted do an array of interactive exercises. In the insomnia program, for example, they keep a sleep diary. In the anxiety program, they are asked to examine their thought patterns. All the programs include videos of people portraying experiences and scenarios that are common to those who have these mental health conditions.

Dr. Seth Feuerstein, the chief medical officer for medical/digital innovation at Magellan, was working in the psychiatry department at Yale University when he noticed that while New Haven had plenty of mental health clinicians, it was still hard “to get the right appointment with the right person.”

Feuerstein looked more deeply into the problem and came across a research paper highlighting the use of software to deliver CBT. He began working with other faculty members including the chairman of psychiatry at Yale, traveling around the world to look at similar computerized options. Eventually they launched their company, Cobalt Therapeutics, in 2009, which offered software to deliver CBT in the United States.

After Superstorm Sandy, Cobalt partnered with the state of New York to launch an online program to help those suffering from emotional distress from the storm.

Magellan, which was founded in 1969 and has offices in Avon, acquired Cobalt in 2014 and started offering computerized cognitive behavioral therapy at that time.

“Magellan’s programs offer individuals the ability to get the help they need, when they need it, in the privacy of their own home, and in a way that supports our busy lifestyles,” Feuerstein said. “The programs are engaging, and most importantly, effective.”

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Information from: The News-Times, https://www.newstimes.com

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