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 Welcome to this week in Health It where we amplify great thinking to Propel Healthcare Forward. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. Well, we have some, a special request here, the programming team at this weekend Health.

It would like to highlight solutions that deliver hard dollar savings to healthcare in under 12 months. This is in direct response to, uh, comments we're hearing on the show, as well as comments I'm hearing in my consulting practice. Uh, before you drop me an email, I. I need solutions that have successful client stories.

I receive about 10 emails a week from companies that wanna highlight their product on the show. And my first question is always put me in touch with a reference client. And, uh, amazingly about 90% of those requests fall away, which I find really interesting. Um, we wanna see what kinda response we get from you guys and then we will, uh, determine how we're going to.

You know, get this integrated into our programming and get it out there. So, uh, you know, send in your responses, bill at this week in health it.com. Love to hear from you. Love to hear what you guys are doing. That is showing hard dollar savings, uh, real money savings for healthcare. Uh, this episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare.

Uh, they reached out to me to see how we might partner during this time. . And that's how we've been able to produce daily shows. Uh, and you know, it's just a special thanks to Sirius for supporting the show's efforts during the crisis. Now onto today's show, this morning we're joined by Joe Grosso, the Director of Clinical Partnerships with Lyra Health.

Good morning, Joe. Welcome to the show. I. Morning. Thanks for having me. Well, I'm, I'm looking forward to this conversation. There's a, an awful lot of discussion happening about, uh, about employees, how they're dealing with the pandemic, and then going back to work at this point. And, uh, and I appreciate you offering your expertise.

I, I caught one of your, your webinars online, which is how I, I really, uh, got informed about what Lyra Health does. But for our audience, why don't you share a little bit about what's Lyra Health about and what do you guys do? Sure. So Mira is a mental health benefits provider and we work with innovative self-insured employers to transform mental health care through technology, but also with the human touch.

So, you know, we work mainly a focus on increasing access to high quality evidence-based care that has outcomes to demonstrate effectiveness for employers. Fantastic. Um, I'll tell you what, here's, here's what we're gonna try to do. Uh, I think we'll start generically and we'll talk about the, the strains, um, that really everyone's sort of dealing with, and then I really wanna focus in on what it's gonna take to, to bring people back to work.

So let, let's start with, you know, what kind of things are we seeing in the area of mental wellness right now? What are, what are people struggling with? Yeah, so right now at Lyra we are seeing a lot of increase in stress, fear, anxiety, and depression. In fact, we surveyed our provider network and what we found is that almost 60% of our, uh, practitioners are reporting that their client's symptoms have been worsening.

Over the course of their treatment. And what we're seeing is not only is that negatively impacting their quality of life, but it's also specifically impacting their work productivity. In fact, 80% of the providers that we surveyed had said that the largest poll that the pandemic was taking on their client's mental health was specifically in the realm of work.

And I think what's been most, um, surprising. Frankly concerning to us at Lyra is that we've seen, uh, an increase in the number of clients who are, uh, reporting self-harm or thoughts of suicide. In fact, it's been a 33%, uh, increase in individuals who have those indicators, and so we always. Uh, wanna be specially attuned to an increase in severity to the point of someone considering something like self-harm or suicide.

And so I think it, it just goes to show that added stress is having wide ranging effects from, you know, additional feelings of anxiety and, and worry all the way up to people feeling this increased sense of hopelessness, helplessness, and desperation. So are, so are those, are those some of the things we should be looking for in terms of just recognizing the stress itself?

Is it, is it things, uh, like, uh, I mean, depression is such a big term. I mean, I don't even know if I can qualify myself when I'm depressed. What are some things that would. Tell me that I'm really struggling with the, the added stress of this pandemic. Yeah, it, it's a fair question and I think a lot of people right now are trying to differentiate, well, what is everyday stress or feeling momentarily down and what is the kind of issue that should lead to me seeking out a mental health professional.

So I think the common thread across all conditions that benefit from something like therapy, for example. Would be an impairment in your ability to function. So, you know, if I'm feeling down or I'm feeling periodically overwhelmed or stressed out, but generally I can get through the day, I can do the things that I need to do at work, at home, in my relationships, then I'm probably functioning, you know, relatively well.

And maybe I could benefit from some support through, um, a self-care app or meeting even with a coach, a certified coach, which is something Lyra offers. But if it's reaching a point that the change in my mood or emotions or my behavior is really significant and severe and I'm not able to carry out my day-to-day tasks, or I notice that gradually over time I'm dealing with this chronic issue that's impairing my ability to function, then I wanna make sure to reach out to a mental health professional because that's starting to reach, um, the level of significance that would suggest I.

Maybe I have a diagnosable condition that best benefits from something like therapy or medication management. Yeah, I, uh, you know, I, I, I've interviewed a bunch of people today as my day for sitting in the studio and, and conducting the interviews. And, uh, I, I talked to a bunch of healthcare executives.

They're all sort of approaching this, uh, work from home and then coming back into the office thing, uh, just slightly differently. Um, and it's interesting 'cause this, we're, we're in. We're in an uncharted territory, right? So we've, we've never pushed this many people home so quickly and then potentially brought them back so quickly.

We're, we're creating this, um, you know, this effect, I think on people. Uh, what advice do you have for healthcare executives and leaders who are, um, you know, concerned with the impact of Covid 19, uh, and really their workforce's, uh, mental health just in general. I mean, we're creating a lot of, I mean, the pandemic creates some scenarios, unwilling some scenarios.

That really adds to that stress. Absolutely. I, I would first say they're right to be concerned. You know, when we look at the research on life disrupting events that might be analogous to what we're experiencing right now. It, there's no perfect comparison point, but you look at other life disrupting events and how people fare, it's clear there's.

A trajectory of mental health effects in the immediate response. We are in the acute phase, so we're very much focused on how do we deal with meeting our immediate needs and our immediate adjustment, and we're kind of rallying in an action oriented mode. But what happens over time is that as people start to recognize.

We're in a marathon, not a sprint. We're not gonna immediately return to pre covid normal, for example. Now that we're out of the acute phase, then you start to see another wave of mental health symptoms because people can start to despair a bit, or like you were pointing out, as people return to work, that brings a whole new source of anxiety.

I'm worried about my potential exposure risk. Maybe I'm noticing that I have symptoms of panic or fear just by being out and about in the world after a prolonged period at home. So what I would encourage people, leaders to think about in, um, you know, organizations that are trying to plan ahead for return to work.

Is to first make sure that you have the kind of culture that makes it acceptable and even promotes reaching out for support and having a psychologically safe workplace, which starts with people, leaders, modeling the kind of behaviors they want to see in their employees. So to the extent that. Managers, supervisors, directors, all the way up to the top of the chain can model openness around mental health.

Um, offer you. You work appropriate testimonials to how they've struggled, ways in which their emotions have been impacted, and ways that they're dealing with it, including consideration of mental health support through, um, a therapist, a prescriber, some form of, of professional support that goes a long way towards normalizing mental health at work and giving permission for employees to consider it for themselves.

Another thing I would wanna make sure, uh, people, especially in benefits leadership are thinking about is a comprehensive review of what services are available to support their employees. Now's the time to be looking at what are our mental health solutions and how are they meeting this unique need. So that means making sure that you have the kinds of solutions that are flexible In terms of modality, we.

In-person availability for a future where, you know, that's readily possible for everybody. But right now we want video capability too. We wanna make sure that people can get telehealth services for mental health needs and that we have coverage within our network. Of providers to ensure that we're able to address not only the garden variety mental health issues like depression, anxiety, um, insomnia, but also that there are specialists in the network to deal with issues like, uh, suicidality.

Um, substance use. These are issues that a lot of providers don't feel comfortable addressing, so you can't assume that just by nature of a large network in terms of numbers that you're well equipped to meet employee needs. And then the last thing I would mention is just making sure that it's easy to get access to care.

We know from extensive research that one of the big barriers to people getting the help that they need during critical moments. Are these barriers that are caused by logistics involved with access to care? So things like, um, not being able to figure out who the right provider is for me, not having a way to book appointments online so that I'm playing phone tag with providers and ultimately find out they're no longer in the network.

Or they're no longer seeing new clients or they're not the right fit for my, um, for, for my needs. So creating, um, or, or making sure that in your review of your solutions, you are, you are checking off the features of your solutions that map on to the pain points that people are most likely to face when they're trying to access care.

Yeah, I mean that's, that, that is, um, I mean, that, that is so true. I mean, having family members in, in my immediate family that have struggled with depression. Uh, you know, you, um, you know, you, you have to take down the barriers. The stigma is the first thing you take away. You've gotta make modalities such that, you know, when they are somewhere.

I, and I heard a story of, you know, somebody who is in a bathroom, uh, you know, crying and they actually use their mobile app and they got ahold of a mental health professional and they had a conversation. You know, it, it doesn't happen. When you're, you know, in, in the right place always. So making those modalities easier, uh, being aware of the stress that we're causing and all these things are good.

In fact, one of the, one of the reasons I I, I, I wanted to have you on was you guys did a webinar and you shared some tips for people. So getting down to the individual, maybe. Uh, you know, beyond the incorporation itself, uh, because we're gonna have a lot of listeners that are health IT professionals and, and, and they're looking at this, you had, you had some tips like, follow CDC precautions.

Stick to the facts, take a media break, check your thinking, prioritize self-care. I wanted to go through those, um, you know, a little bit for, for people. 'cause I know I found myself doing normal tasks going to the grocery store for the first time. Uh, I got my hair cut this week, and, and there was, it was, it was different, right?

You're, you're thinking about things that you normally weren't thinking about. So let, let's walk through those a little bit for those people who are maybe getting back into it and. Thinking about going back into the office. Um, let's, let's start with, uh, you know, how does following CDC precautions really help, uh, somebody to, to, uh, address the, the anxiety associated with this?

Yeah, absolutely. Uh, I'm, I'm glad that you bring that up because there are a lot of things that people can do on their own. To manage their own, you know, everyday worry and stresses. I also have to say I'm a little envious that you got your hair cut in the Bay Area. That's not possible right now, but, um, you know, I think you're right.

As people are going out and about into the world, they may expect, uh, they may want to expect that their anxiety level can increase and in this transition to return to work or even just returning to being in public spaces again. It's reasonable to expect that added stress will follow and there will be challenges.

And so in anticipating that, it's important that people recognize what causes stress. You know, when I ask most people, you know, what, what do you consider the biggest sources of stress? They talk about the stressor, you know. Um, a relationship, a work situation, finances, but the other parts of stress have to do with our thinking, and those are the parts that we have control over.

So my perception of a stressor, if I perceive a stressor as something that's catastrophic and terrible, and I think about it in doom and. Well, my stress level's gonna rise versus if I think about that stressor in more balanced terms, that yes, it's an inconvenience, it's a disappointment, or yes, there is a risk.

Like in, in your example, going out to the grocery store, there is an increased risk of exposure there versus me staying at home. But keeping that in perspective, making sure I'm not . Jumping to unhelpful conclusions, like just because I go to the grocery store and there's increased risk doesn't mean that it's necessarily likely that I can track Covid 19, that I become extremely ill, you know, that I end up in the hospital.

It's amazing how the mind can can jump to those conclusions. So trying to reign that in and then countering it with the third piece of, of how we perceive stress, which is our ability to cope. Reminding yourself that even if there's a stressor. And even if you perceive it to be a significant one. Remind yourself of how you're equipped to deal with it.

Don't undermine your ability to pull, you know, to pull on some resources and strengths and get through it. So again, in the situation of going back to the grocery store, you know, yes, it's true. There's increased risk of exposure, but there's also things that you can do to mitigate that risk, like following some of the CDC precautions, wearing a mask, using hand sanitizer in the store.

Keeping six feet of distance from anyone else in the store was never possible limiting the amount of time I spend in the store. So I limit my amount of exposure, and then when I go home I can disinfect, you know, all my goods, wash my hands, and, and that reminds me that I do have some control in a situation that could feel like I'm out of control.

And it's that lack of control that ultimately leads to the anxiety. You know, it's, it's, it's interesting 'cause I told somebody I got my haircut and they're like, I can't believe you're, you're doing that. And I said, you know, it was a really different experience. I mean, the, from, uh, you made your appointment online, um, they gave you a time, you didn't wait inside the facility.

You waited inside your car, then you got a text, you got a text message that said, Hey, come on in. So then you go in, you do have to wear a mask. Um, there's hand sanitizer there. They're actually cleaning the equipment just like you would in a hospital for heaven's sake. I mean it. And uh, and I think I was only in there for like, I don't have a lot of hair, but I was only in there for like 15 minutes and in and out with a mask on the whole time.

Uh, the person doing the haircut had a mask on. So that's sort of a, it's, it's interesting because that's an example of. Society has really changed. We're really taking this seriously and, uh, we're, you know, things are gonna be better, but it is different. If, you know, the first time you do it, you're like, wow, this is, you know, am I always gonna have to wear a mask?

Is this always gonna be this way? But it's, it was, it, it was interesting. But our, you talk a lot about the mind, and our mind does start to like, I don't, it starts to spiral. It starts to. Oh man. It's, you just start to, I don't know what happens, but it really is a, it really is a battle to keep from Yeah.

Escalating, you know, what's really out there. Because in reality, when we're looking at Covid, you know, we're still only talking about, you know, even with transmission rates and that, I mean, we're talking about it, uh, people are the. The, uh, the, the rate of, of really death associated with this is still in the single digits and the, the low single digits associated with it, the number of asymptomatic cases is pretty high.

Um, and, but still, because we're inundating ourselves with this information all the time, reading about it, I'm producing a podcast every day about it. Um, you might think it's, you know, it, it's, it's bad, but it, and it is, it is. I mean, there's a lot of people impacted, but, um, but at the end of the day, the, you know, the percentage risk and those kind of things.

Your mind can really escalate that pretty significantly, right? It's so easy to lose perspective, and it's a perfect storm, right? Because as human beings, our minds are already wired towards a negative bias. You know, our, our minds love to focus on the negative, filter out the positive. And then we have this inclination towards worry.

And in the absence of concrete information about the future or what happens next, my mind is gonna want to fill in the blanks and guess what? It likes to fill in the blanks with worst case scenarios. And then you add the media on top of this. And especially if you're, if you're getting media that's. A, you know, a little sensationalized, for example.

Then you, you add all those factors up and it's no wonder why we can easily spin into these worst case scenarios that provoke all of this fear and anxiety. But the good news there is we can ultimately exert some control by checking our thinking, kind of reigning it in, and make sure, making sure that we're not running away with inaccurate or unhelpful beliefs about the situation.

Let, let, let's talk about managers and, and I probably just, yeah, we're getting close to the end here, but let's talk about managers. I think one of the mistakes we make as managers is we think everyone thinks like we do and they have the same, uh, risk posture that we do, and they're handling this the same way we are.

But the reality is, if you have a staff of 3, 6, 7 gonna be on all. Points of the spectrum from, you know, I'm not worried about this at all, to really crippling fear of this. Yeah. So, uh, you know, in terms of managers, how do we, how do we, you know, take into that, take all that, that gap into account? At what point are we saying to somebody, Hey, I, I, I really recommend that you have some conversations with, with a professional about this.

Yeah, great question. And you know, managers are really well positioned to notice these signs of distress, and hopefully with this information that we talked about today, recognizing that those signs are more likely to occur, especially around return. I want them, I want managers to pay close attention to shifts in mood and behavior that seem unusual or outer character for people and and would suggest potential distress, like someone crying at their desk that's obvious, but ways where it might be less obvious.

Someone who's pulling back at work, withdrawing someone who is usually pretty engaged and participatory. Now isolating or no longer meeting their, their work performance metrics. So also recognizing that shift in work performance. I. Can be a symptom of emotional distress, which is why it's so important that we not make assumptions about employees' behavior.

So if we see an employee who's struggling in their work performance, we're not assuming it's because they willfully disregard their work or they're checked out or they don't care. It may be because of some emotional distress, but the only way to know. Is by having a conversation with them. So I think the, the broad guidance here is to keep the bar low because the ultimate intervention I'm suggesting here is a simple conversation where you're checking in, you're saying, Hey, I just want to check in on how you're doing because I've observed X, Y, or Z.

And letting them share as much or as little as they're willing. And if they do share that they're, they're facing some kind of emotional struggle. Having some ready information about your company's benefits and services that are available to point that employee in the right direction of support in the long term that, that's the last piece I'll highlight.

Some managers can feel like, well, I'm not the, I'm not a counselor. I don't wanna be their therapist. I wouldn't encourage that, but you can still follow up when you see a sign of concern. Ask open-ended questions about how someone is doing to get some additional context. But then make it your goal to point them towards the services that can support them.

You don't have to be the long-term support, but you can direct them towards things that are ultimately, you know, really useful for improving quality of life. Joe, thanks. Thanks very much for taking the time. Is there somewhere where they can go to maybe get some more information, uh, both about, you know, the things we're talking about and also about, uh, Lyra Health?

Sure. Yeah. I think our website, lyra health.com is a great resource. We have a blog that's regularly updated with . Um, you know, expanded, uh, content on topics like these. And we also have webinars that we developed specifically around the, uh, response to the mental health effects in Covid 19 that are publicly available as well.

Um, so you can find more information about Lyra and some resources that are hopefully helpful. Fantastic. Thanks. Thanks again for your time. Really appreciate it. And uh, you know, thanks, thanks for all, all the work that you guys are doing. Thanks, bill. I appreciate you having me. That's all for this week.

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