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“I don’t need help!”: an Employer Mental Health Discussion with CVS Health and Target

On the main stage during NBGH’s Workforce Strategy 2019 conference in San Diego, Big Health held a panel discussion with clients CVS Health and Target.

On the main stage during NBGH’s Workforce Strategy 2019 conference in San Diego, Big Health held a panel discussion with benefits leaders from both CVS Health and Target.

The Panel

  • Dr. Michael Otto, Psychological and Brain Sciences, University of Boston
  • Lauri Tenney, Senior Director of Benefits, CVS Health
  • Leslie Pilliod, Senior Director of Benefits & Engagement, Target
  • Robert Miller, Vice President of Sales, Big Health
From left to right: Dr. Michael Otto, Lauri Tenney, Leslie Pilliod, Robert Miller

The Session

Dr. Otto lit up the stage with an introductory TED-style talk. After speaking to the true power employers have to change healthcare in this country (and beyond), he launched into an audience participation illustrating the following:

Within a given year, between 1 in 4 and 1 in 5 employees are likely to experience a mental health issue. Of those, only 9% are getting adequate guideline care, 21% are receiving inadequate care, and 70% are suffering in silence.

What keeps that 70% from getting to the care they need? Dr. Otto addressed the barriers to care:

  1. Low perceived need
    “I thought this was just part of life.”
  2. Desire to handle on one’s own
    “I’d rather take care of myself.”
  3. Stigma of condition & treatment
    “What if someone finds out I have a mental health concern?”
  4. Access to appropriate care
    “I don’t have the time or money to get help…”

Lauri, Leslie, and Robert joined Dr. Otto on stage to detail how, in their experience, employers can put strategies in place to help those suffering in silence — from creating a culture that addresses mental health stigma to introducing fully-automated solutions as an efficient first step into mental health care.

Key Takeaways

“Show me the data!”

Both Target and CVS Health looked to claims data to inform their early mental health strategies: Lauri and team found that 9% of their employees had insomnia-related claims with a high comorbidity of other mental health issues, and Leslie’s team found mental health-related claims to have the highest prevalence of all claim categories.

The stigma is real.

At CVS Health, the team launched a Stamp Out Stigma campaign to recognize, re-educate, and reduce stigma. The key to the campaign’s success was support at every level — from executive buy-in (executive sponsors included Troy Brennan, EVP & Chief Medical Officer and Lisa Bisaccia, EVP & Chief Human Resources Officer, and CEO Larry Merlo spoke at a Town Hall meeting) to peer support via campaign “pledge cards,” which were displayed by employees in high-traffic areas to show a public commitment to addressing stigma for their coworkers.

For Target, stigma was also a salient issue — they’d piloted mental health programs in the past that had ultimately failed due to stigma around use and adoption. Similarly, they launched an I’m Fine! campaign that addressed stigma head-on, featuring executives sharing their own mental health journeys and peers sharing in employee resource groups (ERGs). Ultimately, the response to the campaign also surfaced poor sleep health as a core driver of mental health issues.

Sleep as a “way in” to talking about mental health.

At Big Health, we aim to navigate stigma through communications that don’t feel “clinical” or diagnosis-driven. Instead, campaigns can appeal to a broader, shared pain point — like poor sleep or feelings of stress — think: “Feeling overwhelmed?” instead of “Do you need help for poor mental health?”

Both Lauri and Leslie spoke to their success driving engagement with Sleepio through language, emails, and posters targeting sleep. In fact, employees at both companies embraced the “What’s Your Sleep Score?” campaign to the point where it became a common, stigma-free topic of conversation around offices.

Clinical evidence: a must-have in evaluating solutions.

For CVS Health and Target’s teams, a commitment to outcomes, clinical evidence, and previous success with large employers are a prerequisite for getting “in the door” as a mental health solution.

Robert reinforced Big Health’s commitment to the body of evidence behind our productsSleepio is currently active in 25 clinical trials, on top of 8 randomized controlled trials (RCTs). Daylight, our newest program to help manage anxiety and worry, is ongoing in a single case experimental design (SCED) test and its first RCT, for which published results are expected in the first half of 2020.

What does 2020 hold for mental health?

Lauri reiterated her excitement for reaching Aetna’s employee population with benefits like Sleepio and campaigns like Stamp Out Stigma (following the Nov. 2018 CVS Health – Aetna merger).

Leslie anticipates the expansion of Target’s Mental Health Allies program — non-judgmental peer connectors to mental health resources. An ally’s “job” is to be aware of the resources that Target offers (their EAP, a substance abuse hotline, programs like Sleepio, etc.), as well as reliable resources in the community. Then, an ally can help connect their peers with those resources.

In addition to the launch of Daylight (of course), Robert most looks to 2020 for the continued development and expansion of Big Health’s industry-first partnership with CVS Health via their Vendor Benefit Management offering. Check out our press release to learn more about the benefits that employers (using CVS as their pharmacy benefit manager) can reap in pricing, contracting, eligibility, and reporting thanks to the partnership.

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During the COVID-19 public health emergency, Sleepio and Daylight are being made available as treatments for insomnia disorder and generalized anxiety disorder (GAD), respectively, without a prescription. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder and GAD, respectively.

1. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700.3. Wilson, S., Anderson, K., Baldwin, D., Dijk, D. J., Espie, A., Espie, C., … & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33(8), 923-947.4. King’s Technology Evaluation Centre. (2017, November 9). Overview: Health app: SLEEPIO for adults with poor Sleep: Advice. NICE. https://www.nice.org.uk/advice/mib129.5. Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.6. Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., … & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and Anxiety, 37(12), 1168-1178.

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