Chronic Condition Toolkit

Behavioral Health Provider Toolkit Overview

In alignment with the mission and values of Highmark Wholecare, promoting Wholecare which is a whole health model of care in which an individual’s health and well-being is supported across behavioral, physical, and environmental factors. Highmark Wholecare is committed to promoting integrated care and to build bridges with behavioral health practitioners in an effort to improve care coordination and member health outcomes.

To support behavioral health providers in supporting care coordination for their patients, Highmark Wholecare has developed a Behavioral Health Provider Toolkit.

Purpose:

• Improve health outcomes for the vulnerable Seriously Mentally Ill (SMI) population
• Decrease health inequities and disparities that are prevalent in the SMI population
• Address the multi-factorial challenges associated with the care and treatment of chronic conditions

Mental health and physical health are fundamentally linked. People living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions. Conversely, people living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population. Co-existing mental and physical conditions can diminish quality of life and lead to longer illness duration and worse health outcomes. This situation also generates economic costs to society due to lost work productivity and increased health service use.

Understanding the links between mind and body is the first step in developing strategies to reduce the incidence of co-existing conditions and support those already living with mental illnesses and chronic physical conditions¹ .

The toolkit contains helpful information about some of the most common chronic health conditions. We encourage you to use this toolkit when discussing your patients health needs.

• Diabetes
• Cardiovascular Disease
• Hypertension
• Pregnancy and Postpartum period
• COPD
• Asthma

Research² recommends the use of interventions with characteristics associated with better outcomes:
In SMI patients:

• Longer duration (three or more months)
• Manualized, structured approach
• Focus on both health education and physical activity
• Active monitoring such as weigh-ins and food diaries
• Active monitoring of physical activity and fitness levels

In patients from the general population:

• Use of multiple components (eg, diet, exercise, and behavioral therapy)
• Personalization  
• More frequent contact
• Training for treatment providers

Recommendations for metabolic risk factor monitoring in patients with severe mental illness or on antipsychotic medication

Chronic Conditions :
Asthma
Cardiovascular
Chronic Obstructive Pulmonary Disease (COPD)
Diabetes
Hypertension
Maternity - Prenatal and Postpartum Care
Support Resources