Behavioral Health Bulletin
Issue 1, November 2021
Dear MSHP Provider,

Welcome to the new MSHP Behavioral Health Bulletin! This publication will keep you up to date on all things behavioral health at MSHP. Read on for information about Mind Matters ECHO, depression screening tips, suicide prevention, and more.

Yours,
Anitha Iyer, PhD
Director, Behavioral Health Population Management
Mount Sinai Health Partners
Behavioral Health Initiatives

January 12, 2022
Barriers to Screening for Anxiety: Effective Solutions for Proactive Anxiety Management

February 9, 2022
Effective Treatments for Anxiety: Psychotherapy

March 9, 2022
Effective Treatments for Anxiety: Pharmacology

April 13, 2022
Understanding and Managing Side Effects of Commonly-Prescribed Anxiolytics

Do you have a patient case you'd like to present? Submit it here.
Mind Matters ECHO

A huge and sincere thanks to all who attended the first module of our Mind Matters ECHO series. Your participation, feedback, and enthusiasm were all invaluable in our development of this program, and our broader behavioral health goals. We look forward to sharing some survey results with you next month, and we'll see you in 2022 for our next module!
Behavioral Health Tip of the Month
Strategies for Screening for Depression

  • When discussing mental health difficulties, it is important to use plain, non-stigmatizing language.

  • As an introduction to the topic, discuss and describe a holistic approach to wellness which includes both mental and physical wellbeing. Explain to patients that everyone is asked the same questions. "We ask everyone the same questions in order to assess all areas of life." Make sure to ask for consent before proceeding with the questions/assessment. "Would it be ok if I proceeded with my questions?"

  • Use open ended questions. "What stressors do you have in your life at the current time and how does this stress impact you?"

Find more strategies in Dr. Molly Sherb's blog post on screening for depression in primary care
MSHP Behavioral Health Strategy Updates
Improving Access to Behavioral Health Referrals

We are currently piloting a new strategy to improve access to behavioral health referrals with the help of our embedded social workers and care management team. This service assists physicians in assuring their patients who need it are evaluated by Mount Sinai for referral to behavioral health care. The physician refers the patient to Mount Sinai Care Management to receive an evaluation and the patient receives help making an appointment with an appropriate behavioral health provider, plus follow-up to make sure the patient received care.

The pilot is currently being held at 5 practices. The purpose of the pilot is to test this behavioral health referral service prior to launching it across our network. Updates on the pilot will be shared in future newsletters and Behavioral Health Workgroup Meetings.

Need help connecting your patients to behavioral health resources? Contact Anitha Iyer, PhD, Director of Behavioral Health Population Management.
The Latest on the MSHP Behavioral Health Blog

While a variety of suicide risk screening tools exist, screeners lack adequate specificity and sensitivity, and reliance upon them may result in false reassurance for false negatives, and unnecessary interventions for false positives. About half of all patients who die by suicide denied any suicidal ideation or behaviors at their last visit and about half of all completed suicides are by patients identified as “low risk.” Given this reality, what can providers reasonably do to mitigate suicide risk among their patients?
Behavioral Health in the Literature
A special communication from JAMA Psychiatry

With the added physical and mental health, social, and economic burdens imposed by the pandemic, many populations worldwide may experience increased suicide risk. However, increases in suicide rates are not a foregone conclusion even with the negative effects of the pandemic.

COVID-19 presents a new and urgent opportunity to focus political will, federal investments, and global community on the vital imperative of suicide prevention. Suicide prevention in the COVID-19 era requires addressing not only pandemic-specific suicide risk factors, but also pre-pandemic risk factors. This Special Communication provides prioritized, evidence-based strategies for clinicians and health care delivery systems, along with national and local policy and educational initiatives tailored to the COVID-19 environment. If implemented to scale, these interventions could significantly mitigate the pandemic’s negative effects on suicide risk.


Provisional data for 2020 show that
despite the increase in some risk factors associated with suicidal behavior during 2020, the number of suicides in the United States appeared to decline in 2020 by 3% compared with 2019.
Suicide Prevention is Preventive Care
Working Together Toward Zero Suicides

To aid you in our shared goal of zero suicides, here are actionable strategies to help you identify and manage patients who may be experiencing suicidality:
Behavioral Health in the COVID-19 Era
Depression and Anxiety Rates Have Soared in the COVID-19 Era

STAT news reported on a study in the Lancet that found that rates of depression and anxiety climbed globally by more than 25% in 2020, a devastating ripple effect of the COVID-19 pandemic that has particularly affected women and young people. This new study is the first worldwide estimate of the impact of COVID-19 on mental health.
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