A collaborative approach to mental health care in Brazil

As COVID-19 continues to impact our communities, the potential stress associated with the pandemic may be putting a new spotlight on mental health issues across the globe.

According to the World Health Organization, nearly 1 billion people are living with a mental disorder — and yet, many people with mental health issues either receive inadequate treatment or no treatment at all.

In the average emergency department, 1 out of 8 visits is for a mental health crisis. The problem extends beyond the United States. For Amil, UnitedHealthcare’s insurance business in Brazil, which serves more than 5 million members, psychiatric hospitalizations increased 30% between 2017 and 2018.

Female provider speaking with patient Female provider speaking with patient

In addition, 32% of mental health patients treated in the hospital were readmitted within the month from when they were initially treated. Together, these two factors strained the system.

In an effort to improve care delivery while prioritizing mental health services, Amil invested in a new initiative, creating mental health teams that worked together to cover the needs of each patient discharged from psychiatric services. Team members included a psychiatrist for medication management, a psychologist for therapeutic treatment, a social services assistant to cover basic needs, such as work and housing, plus a nurse to monitor clinical symptoms.

Through this approach, Amil found it could provide better quality care for the large number of patients with less severe illnesses. Patients were able to continue seeing the primary care clinician they were already comfortable with, and in addition, receive specialized support, if needed. In many cases, the primary care clinician could manage the mental health needs of most patients, freeing up the time of the psychiatric specialists.

Between the mental health teams and the inclusion of primary care within those services, Amil reported substantial improvements for patients, including:

  • With 2,700 patients enrolled, the study helped 894 patients manage a mental health crisis without having to go to the emergency department.1
  • For those who did need to be admitted to the hospital, many times, their stay was shorter.
  • Once out of the hospital, more patients managed their care from home.
  • With more patients able to be treated at home, there were more in-hospital resources available to those who needed it the most. 

This study showed that, when providers work together to manage the health and life circumstances of a patient, the patient may be able to heal quicker and it may help them stay well for longer.

Amil’s collaborative effort is just one way health care systems may be able to help improve mental health care access, which in turn, may help the health care system work better for the patients they serve.

1 Ferreira Ramos, IH, Minozzo, F, Pereira França, S. Mental Health Care in the Amil System: The Challenge of Continuity of Care. United Healthcare Global Clinical Journal. 2020;2(1):4-7.