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Mental health problems : insurers explore new solutions

by

Susan Yellin

9 April 2018 07:00

Photo : Freepik

Life insurance companies are scrambling to find solutions to bring back to work employees on sick leave due to a mental health problem.

Financière Sun Life, Manulife and Green Shield Canada have focused on a variety of projects, in particular in the field of therapy of mindfulness and pharmacogenetics, which measures the influence of genotype on drug treatment.

If we take into account the cost of healthcare and loss of productivity, mental health would represent an economic burden of $ 51 billion per year in Canada, writes the Centre for addiction and mental health (CAMH). Each week in the country, at least 500,000 employed cannot work because of a mental health problem.

Last summer, the Sun Life has begun a partnership with CAMH and Assurex Health by focusing on the pharmacogenetics to help people with a mental health problem to find the medication suits them best. CAMH and Assurex have developed a study that uses the saliva of a subject to determine how our genes will react to certain drugs.

JeanMichel Lavoie, assistant vice president, product design, group benefits, at Sun Life Financial, said his company has been interested for some time in pharmacogenetics. The company has created a pilot program to help employees struggling with a mental health problem to identify the drug suits them best and have the least side effects in order, to all intents and purposes, to facilitate their return to work.

A personalized medicine

Pharmacogenetics is a type of personalized medicine that focuses on the person as such, and not on the disease. Thus, instead of developing a drug that will work with a large number of people, as is currently the case for many drugs, this type of medicine is based on the science of drug development of the individual.

«It is here that there is real change, says Mr. Lavoie. The new drugs that come out are very targeted. They are aimed at conditions very precise or specific genes. The time when everyone consumes a blockbuster drug which we merely change the dose is gone. «

Mr. Lavoie noted that the participation in the clinical trial of Sun Life’s voluntary. Among the insurer, the case manager is free to identify people who, according to him, would benefit from the genetic test. If the person agrees, it is put in relationship with CAMH, which performs the test in the laboratory. The results of each one are not communicated to Sun Life, but the treating physician. If it is necessary to do or change anything, the plan member and the physician caring for them.

Sun Life assesses a deployment of the pan-canadian

Sun Life, however, has access to the combined results to establish some percentages-that is, those people who agree to take the test, which is present, in which one decides to make a change of diet or dosage and going back to work. Mr. Lavoie says he does not expect to have a test statistic exact mid-2018, or even later. If the program proves successful, he said it could be deployed throughout the country, perhaps in collaboration with another partner.

«As an employer, Sun Life financial has been testing ways to do it that we may share with other employers and employees facing a mental health problem,» says Mr. Lavoie.

He pointed out that in 2016, Sun Life financial has expanded the protection of its own employees in the field of mental health. The insurer increased the amount they have available each year through their benefit plan to see a psychologist, a psychotherapist, a therapist or a counselor.

Sun Life is currently trying to establish a standard that most SMES apply to their staff in terms of spending in mental health. Remember that large companies, such as banks and some insurance companies have benefit plans that are flexible by virtue of which the client decides how it will spend its envelope.

Manulife has announced the arrival of a number of pilot programs across the 12 months to help plan participants achieve a more rapid treatment of problems, both musculoskeletal to mental health – the two major reasons for absence at work.

Cori Lawson-Roberts is assistant vice-president, national disability, with Manulife. She explains that the insurer aims to partner with the appropriate supplier who will be able to communicate quickly with the employees experiencing difficulties at work, so that they can resume normal life as quickly as possible. One of the clinical trials includes pharmacogenetic testing aimed at both the mental health and the relief of chronic pain.

Manulife builds on a therapy

Manulife is also conducting a clinical trial allowing patients direct access to a cognitive behavioural therapy virtual. It is a therapy that helps people to develop skills and strategies to become and stay healthy, focusing on difficulties that arise in their everyday life. Ms. Lawson-Roberts explains that, in the context of this clinical trial, participants will have access to a psychologist by phone or by computer.

In Ontario, Manulife has piloted a program that includes either therapy, in person, a virtual therapy or assisted by a therapist provided by a program called Beacon. This program allows patients to do exercises on paper and evaluate their results in the context of their treatment plan. Everything is done by phone or computer confidentially and securely. Manulife will allow patients to communicate by text with their therapist during 12 weeks.

The insurer is also testing a pilot project to provide people suffering from major depression care collaborative. The goal is that they get them earlier.

Ms. Lawson-Roberts mentions that Manulife compares the claims of the pilots to those of other programs. In order to determine if the partnership with these specialists will shorten absences for disability benefits and help employees to regain their normal life and return to work. «We are constantly looking for programs that will help our clients and their employees recover from a disability and return to work. «

Green Shield put on the full awareness

Green Shield Canada is attacked with chronic pain and depression by focusing on the therapeutic approach of mindfulness. The company has launched in December a programme of preventive mental health accessible online. It consists of six components of mindfulness offered free of charge to the 1.2 million members of his regime. Initially proposed by buddhism, mindfulness has become a convenient west that leads us to take a different approach with the seeds of life in order to better reduce the stress, anxiety, chronic pain and depression.

Peter Gove, innovation manager, health, Green Shield, explains that people are more and more anxious, especially the young. This can lead to larger problems later on, especially if no treatment is instituted.

The results of the research on mindfulness are mixed, said Mr. Gove, but generally positive. Green Shield was launched two years ago, the health portal Change for life, a reward system that recommends changes in behavior to encourage participants to improve their health. One of the programs that are currently accessible from the portal is a series of six sessions on full consciousness.

Mr. Gove mentioned that we should consider the program as part of a treatment associated with the use of antidepressants. «There is good evidence that antidepressants are targeted towards certain disorders. The rate of consumption of these drugs is much higher than the prevalence of the disorders in question, » he said. We do not claim whatsoever that it is a substitute for antidepressants. What we are saying is that it is a complement to be adequate. «

Mr. Gove states that Green Shield will retain the data from the program. They will be reviewed in approximately six months.

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