Health equity in motion with Alexis Evans

Through conversations with Point32Health colleagues, our Health Equity in Motion series shines a light on health inequities happening within our communities and across the United States, as well as ways that we’re aiming to advance health equity for our members.

According to a JAMA Health Forum study, mental health visits increased nearly 39% between March 2020 and August 2022. And as the demand for behavioral health care has continued to grow, the challenges in accessing care—including stigmas, provider shortages and financial limitations—have become more evident.

Alexis Evans, a behavioral health service navigator at Point32Health, which is the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, sits down with us to share the barriers she sees in the behavioral health care space and how she works with members to push past those barriers:

Q: At Point32Health, you currently work as a behavioral health service navigator. What does your role entail?

Alexis Evans: I provide what’s called short-term personalized, non-clinical, non-urgent behavioral health support for members. That entails us reaching out to behavioral health care providers on behalf of members who are looking for outpatient treatment whether that be to start therapy, meet with a psychiatrist, etc. We ask the member questions to understand what they’re looking for in a provider, like their specialty, geographic location, preferred gender or cultural background. From there, we reach out to providers on their behalf to access and schedule the appointment. After the first appointment, we follow up with the member just to make sure that the provider is a good fit. And if for some reason the member feels that the provider is not, then we’ll go back to the drawing board and start the process over again until a good fit is found. We can also connect members with specific contracted behavioral health vendors that may meet a more personalized need, as well as help to educate on behavioral health topics including how research is showing how effective virtual therapy like telehealth can be.

Q: Why is it important for a health plan to offer this kind of support to members seeking behavioral health care?

AE: The process of an individual seeking help for behavioral health issues, which includes mental health and substance use disorders, can be difficult and frustrating to navigate, especially if you don’t know where to look or understand what providers are covered through your health plan. Our program walks the member through the process, which can make a difference in whether they follow through with seeking help, seeing the right behavioral health provider to meet their needs and hopefully increasing their quality of life. We really want our members to succeed and are here to advocate for each person’s behavioral health needs, which is why we feel it’s very important to offer this kind of support to our members.

Q: Access to behavioral health care is an ongoing issue across the country. In your opinion, what are some of the biggest barriers to accessing behavioral health care?

AE: One of the biggest barriers I’ve seen in my day-to-day is around availability. Nearly half of the U.S. population lives in an area where there is a shortage in behavioral health providers. I see the effects of that daily. I can reach out to 15 to 20 providers and it’s possible that none will have availability, or they won’t answer. And if a member is calling providers on their own and not hearing back, this could be a reason why someone stops trying to access needed care. When a member is assigned to a behavioral health service navigator in the program, we take the time to make these calls on the member’s behalf until we find a provider with availability that meets their needs.

And while the pandemic has brought telehealth to the forefront as a great resource to combat the provider shortage, it’s also been an initial barrier for some. A lot of therapists only use virtual platforms and no longer offer face-to-face visits in an office setting. And for some members, the in-person visits are preferred. In this situation, when accessing in-person visits becomes a barrier to getting needed treatment, the behavioral health service navigators will educate the member on the benefits of telehealth as an option. Having this conversation has benefited many members to getting care. When we follow up with them after their first telehealth visit, they are satisfied with the service and will continue with it. We find that these educational conversations can really help to remove this barrier for our members.

Q: In addition to getting members set up with the behavioral health care they’re looking for, could you share some of the resources related to social determinants of health that are available to support members?

AE: We have some great teams within the Point32Health family that we stay connected with so that we can best support members with varying needs. For instance, our community health workers  will arrange, coordinate, evaluate and advocate for safety net services that provide for basic needs such as education, housing, healthcare, health harming legal issues or transportation. Our community health workers are members of the communities they serve so they are able to navigate culturally competent community resources alongside our members.

In some cases, we may also refer members to our care management team if a clinician or nurse’s support is needed in managing certain chronic conditions. Point32Health also offers additional support for those struggling with substance use disorders. Our program can refer members to our peer recovery specialists who advocate, educate and support members in their recovery journey.