Opinion: Health Execs Take a Community-Based Approach to Mental Health


To help build a stronger community support system and strategy around mental health, here are three tips for managed care organizations.



Lack of access to healthcare resources continues to impact too many Americans suffering from complex medical and/or behavioral health conditions. Fortunately, the call to improve population health is increasingly being addressed by many payer and provider organizations actively working to provide more person-centered care.

That’s especially true for the complex patient populations managed at Cardinal Innovations Healthcare. As the largest specialty plan in the country, Cardinal Innovations serves one of every four North Carolina Medicaid enrollees-more than 500,000 people. Since our inception, one incredibly valuable lesson we’ve learned is this: It takes everyone in the community to help address and improve member health.

That fact is doubly important when it comes to addressing mental health needs, especially when you consider that only about four in 10 people experiencing a mental illness (39.2%) received mental health services, according to one report.

To help community partners better understand mental health in a comprehensive way, Cardinal Innovations has committed to offering a series of Mental Health First Aid (MHFA) training programs. It is a good way to help educate agencies in law enforcement, schools, health departments, corrections and public safety, as well as those serving veterans, service members, and families.

Teaching the community

The MHFA programs are an example of community-based models of care management. Trainers certified in adult and youth MHFA facilitate a bigger conversation around mental health. Classes are designed to help reduce the stigma surrounding mental illness, while increasing community agency employees’ effectiveness at recognizing when a person may be experiencing mental health issues.

MHFA classes give various agency employees the skills they need to recognize, understand and support people in crisis. They explain how to know when to reach out and provide help for those who may be experiencing a crisis, or may be in an escalating situation. Instructors teach MHFA attendees to follow their instincts; if they think there is something wrong, react to that instinct, ask if there is distress, and intervene on behalf of the client.

Courses include information about community resources available to continue to support people in need, including Cardinal Innovations’ own 24-hour crisis referral line. Ensuring that community partners understand how to respond to people who may be experiencing mental health crisis helps encourage healthier members overall.

Making MHFA actionable

As we work to overcome the stigma of mental health, MHFA should be considered just as important as the CPR training that’s mandated for many agency employees.

To help build a stronger community support system and strategy around mental health, here are three tips other managed care organizations can use as well:

  • Consult your teams. Find out what previous mental health encounters agency staff have had. Ask what they wish they’d known to help them respond. Almost every agency Cardinal Innovations has come across is aware that they need more insights around mental health training. The key is to demonstrate effectiveness. The goal of the MHFA program, for instance, is to help build protocols for responding to and supporting members with mental health needs, as well as ensuring the safety of agency employees. Offer evidence-based training, and agencies will be more likely to commit the time needed for a successful educational program.
  • Build on available resources. Take advantage of best practices and trainings community partners have already created. This will not only save time internally, it will help keep your teams focused on their core specialties, rather than having to build awareness and response training on their own. Since training from Cardinal Innovations is provided to a variety of agencies throughout communities in North Carolina, sessions are tailored to each agency’s unique mission.
  • Make it personal. Training should focus on how to provide the right intervention at the right time for the right person. Emphasis should be placed on early intervention and prevention of true crises, which offers the best possibility for a positive outcome.

Often these efforts involve addressing social determinants of health. These include the available community resources that can contribute to and influence a person’s ability to pursue well-being-things like having access to a safe place to live, transportation to get to the doctor’s office, or even a cell phone or other technology to make appointments and communicate their health needs. These all greatly affect a person’s ability to engage in their health and follow their care plans.

Taking a partnership approach to health

Through Mental Health First Aid and other programs, Cardinal Innovations is strengthening the community and improving the lives of members. Across the board, Cardinal Innovations shares one key truth with all its partner agencies: it takes a community- and member-focused approach to effectively help complex populations.

It doesn’t take a special skill set to assist members with mental health needs, but it does take community-wide awareness training. Ask yourself: Who might interact with someone facing a mental health issue? The answer is anyone who is around other people-in other words, anyone. And that means everyone has the potential to help save a life.


Emily Bridge is director, community engagement, Cardinal Innovations Healthcare.

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