NeuroFlow CEO Chris Molaro interviews Magellan Health’s Dr. Caroline Carney in the Bridging the Gap interview series.
Welcome to Bridging the Gap, a new interview series that brings together thought leaders in healthcare to discuss innovations impacting behavioral health. In this episode, NeuroFlow CEO Chris Molaro sat down with Dr. Caroline Carney, President of Behavioral Health and Chief Medical Officer at Magellan Health. Dr. Carney is a board-certified internist and psychiatrist who has spent much of her career elevating mental health and whole person care. She and Chris discussed the connection between mental and physical health and how new technologies are making a positive impact and in what areas they might fall short.
Tune in below, and check out some of the top soundbites from this episode. And don’t forget to subscribe on Apple Podcasts and Spotify to hear our future installments!
On the connection between mental and physical health [3:15 – 4:40]:
Dr. Carney: Some of those common conditions [that have co-occurring mental health needs] include pain disorders, a diagnosis of a fatal or life-threatening illness, and other conditions in which the medications used to treat those illnesses themselves can cause mental health symptoms
Molaro: Wow, so what you’re saying is mental health and physical health are not separate?
Dr. Carney: They have never been separate. The distinction between the two is really artificial, especially if you think about an example of our gastrointestinal tract. Our gastrointestinal tract is lined with serotonin receptors which are thought to play a significant role in depression and anxiety in the brain. So you see conditions like anxiety that cause people to feel nervous, queasy, and maybe they get diarrhea or vomit before a large performance or some big expectation. That is largely due to that mind-body condition working together. It’s hardwired into us. You can’t separate the two.
On the role of mental health apps in healthcare [7:40 – 10:45]:
Dr. Carney: I’ve looked at a lot of the apps, and I think the app-based services definitely have a role in our lives but should not be conflated with treatment, should not be conflated with sound evidence-based practice, depending on what the app is. Certainly, we have to be careful about whether or not the apps produce the kind of outcomes that are the same as having a clinical diagnosis and clinical care.
Molaro: Can you speak more to that?
Dr. Carney: Let’s take a large national app, very famous for meditative and mindfulness activities. In many research studies, mindfulness shows tremendous effects on mental health symptoms, but those studies are typically done in research settings; they’re in controlled environments with other supports. It’s terrific when you look at using tools that can help support other treatments or other diagnoses, or maybe they are just aimed at helping control symptoms, but to say an app that treats or promotes mindfulness is going to treat bi-polar disorder is something completely different.
I think a lot of the apps have been confused with substitutions for evidence-based mental healthcare treatments. If they are part of a plan of care, part of a group of services, they’re tremendous. For people who have occasional symptoms or they need to learn mindfulness, app-based care are tools that are really fantastic. We always say in medicine, right time, right service, right place. App-based services are the right service aligned to people that may have mild symptoms. As we go up the intensity of symptoms and the need for evidence-based care becomes really evident, then apps can be a nice support or part of an overall structure of care, but they aren’t meant to replace it.
On innovation in mental health since COVID-19 [17:54 – 18:49]:
Dr. Carney: I have seen a lot of interesting innovations and a lot of changes in the federal and state landscape toward funding more programs for the symptoms or conditions of mental health. We can talk about some of the innovations first in terms of screening innovations. They do actual clinical delivery of care through telehealth services. That has been the biggest thing of all. The pendulum went to over 90% of visits being through telehealth. It will never go back to how it was before because the convenience is so great and the regulations around doing telehealth care during the pandemic supported that delivery model better than it ever had before.
Check out a preview of the discussion in the video below!