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The Components of a Mental Healthcare Revolution: A Q&A with Demetrios Marousis, Director of Behavioral Health, Highmark Blue Cross Blue Shield

By Grant Stoddard

Nov 28, 20236 minute read

Rising rates of anxiety, depression, and other mental health conditions indicate a pressing need for improved access and quality of behavioral health services. At the forefront of efforts to meet this need is Demetrios Marousis, Director of Behavioral Health at Highmark Blue Cross Blue Shield. Drawing from his wealth of experience in providing strategic clinical leadership, Marousis spearheads Highmark’s innovative approaches to addressing needs in the mental healthcare field.

In sharing his insights on these efforts, he emphasizes the critical role of patient empowerment and the importance of reducing stigma around mental health issues. Demetrios also sheds light on Highmark’s strategic partnerships, such as their collaboration with NOCD to offer virtual therapy for OCD, and how technology is revolutionizing the landscape of mental health treatment.

How has your approach to addressing mental health challenges within the healthcare system been shaped by your extensive experience in providing strategic clinical leadership? Was there a pivotal moment that changed things?

There isn’t a distinct pivotal moment but a gradual and crucial realization: having resources and solutions is futile if those with mental health conditions don’t recognize and seek care. Overcoming stigma is key. It’s not just about identifying a mental health issue, but also understanding how to access care. Mental health should be treated as seriously as physical health. Recognizing when you need care is essential, just as you would for a physical ailment.

In my years of clinical leadership, the most profound insight I gained was the critical role of patient empowerment in mental health care. It’s not enough to have a robust network of providers and potential solutions for individuals with mental health conditions. The vital piece of the puzzle lies in the individual’s capacity to acknowledge their condition, destigmatize it, and comprehend how to seek help effectively. The act of seeking mental health care should be as instinctive as seeking medical attention for a physical ailment. 

Symptoms of depression and anxiety require treatment just as turning an ankle might. But everyone knows where to turn when there’s a physical problem. They know when it’s something they can treat at home; they know when they need medical help and how to get it. The same can’t be said for behavioral health, and that’s what we’re trying to change.

How has Highmark Blue Cross Blue Shield adapted its approach to behavioral health in light of the rising rates of anxiety, depression, and other mental health conditions brought on by unprecedented challenges in recent years?

In the face of these challenges, Highmark has orchestrated a strategic overhaul of its behavioral health approach. A focal point of this transformation has been the rapid expansion of telemedicine services. Recognizing the constraints imposed by face-to-face interactions during the pandemic, Highmark amplified its virtual care offerings. This adaptation not only catered to immediate needs, but also positioned Highmark at the vanguard of telemedicine adoption in the behavioral health field. The provider community exhibited commendable agility in transitioning to virtual care delivery, culminating in a substantial upswing in the availability of remote mental health services.

Simultaneously, Highmark forged collaborative relationships with forward-thinking entities like NOCD, facilitating the provision of entirely virtual, evidence-based care. This strategic integration diversifies care options and bolsters accessibility for individuals seeking mental health support.

Highmark also embarked on a concerted effort to destigmatize conversations surrounding stress, anxiety, and burnout. The emergent dialogue around mental health topics reflects a societal shift towards openness and a willingness to address these issues head-on.

Highmark’s claims data show a significant portion of behavioral health costs are related to depression, anxiety, and substance use disorder. How is Highmark working to not only treat these conditions, but also prevent them or intervene earlier to mitigate their impact on individuals and the healthcare system?

We emphasize integration, supporting primary care in identifying symptoms of stress, anxiety, and depression. This personal approach fosters trust and enables a seamless connection to mental health care across the spectrum. The objective is twofold.

Firstly, there is an emphasis on early intervention, targeting mild symptoms to prevent their progression into more severe conditions. Timely identification and intervention can significantly alter the trajectory of mental health challenges.

Secondly, for cases requiring more intensive support, Highmark is committed to delivering comprehensive care. This approach ensures that individuals receive the level of care that aligns with the severity of their condition, thereby mitigating the potential long-term impact on their overall well-being.

Within this multifaceted approach, a cornerstone principle is the integration of mental health care into primary care settings. This convergence ensures that individuals grappling with symptoms of stress, anxiety, or depression encounter a familiar and trusted environment for seeking assistance. Primary care physicians play a pivotal role, as they are often the first point of contact for individuals navigating their health journey. By empowering these physicians to adeptly identify signs of mental distress, Highmark aims to establish a continuum of care that seamlessly connects individuals to appropriate mental health resources.

How is Highmark planning to raise awareness and improve access to specialized care for those struggling with OCD?

OCD poses a unique challenge due to potential underdiagnosis and misdiagnosis. Highmark recognizes this gap and has forged vital alliances with specialized partners like NOCD. What sets NOCD apart is its organic ability to reach Highmark members grappling with OCD symptoms, effectively bridging the gap between those in need and evidence-based care.

This presents an opportunity for enhanced member and provider education regarding OCD and its symptoms—a key component of Highmark’s strategy. By fostering a deeper understanding of OCD and its nuanced symptoms, there exists a greater likelihood of expediting accurate diagnoses.

This, in turn, enables swifter access to evidence-based care using the gold standard in OCD treatment: exposure and response prevention (ERP). Highmark is steadfast in its commitment to ensuring that individuals with OCD receive the highest caliber of evidence-based care, setting them on a path toward sustained well-being.

The Meru Health Program combines clinical expertise with technology to address depression, anxiety, and burnout. How do you see the integration of technology transforming the landscape of mental health treatment, and what role do you envision it playing in the future of behavioral healthcare?

Technology offers a powerful tool for ongoing, personalized treatment. Its integration into the treatment paradigm represents a fundamental shift towards personalized, continuous care. This evolution is particularly discernible in the context of mental health treatment.

Through technology, patients and clinicians have a real-time, synchronous connection. This immediacy revolutionizes the feedback loop, providing individuals with timely insights and support. No longer confined to scheduled appointments, patients can readily access resources and guidance when they need it most. This interaction serves as a powerful antidote to the isolation and uncertainty that often accompany mental health challenges.

The capacity of technology to serve as an educational catalyst is central to this transformation. It provides patients with valuable information about their condition, its progression, and achievable recovery. This informational empowerment fosters a sense of agency and self-efficacy among patients, enabling them to actively engage in their mental health journey.

Furthermore, technology permeates the realm of self-management, equipping individuals with an arsenal of tools and techniques to navigate the terrain of their mental health. From coping strategies to mindfulness exercises, these resources empower individuals to proactively manage their mental well-being. This proactive stance not only bolsters their pursuit of recovery, but also fortifies their resilience against potential setbacks.

As we gaze into the future of behavioral healthcare, technology’s role is poised to expand exponentially. It will continue to redefine the contours of care, blurring the boundaries between clinical encounters and daily life. The integration of technology is not a mere evolution; it is a revolution poised to democratize access, personalize care, and empower individuals in their quest to be well.

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