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Breaking the Stigma: Why Discovery is introducing a New Mental Wellbeing Programme

10 October 2019 Discovery

In 2018, the Scheme paid a total of R2.6 billion for the treatment of mental health conditions, an amount that has increased by 224% since 2009.

Depression will be the world’s leading contributor to the global burden of disease by 2030, based on mental health risk statistics. This is reflected in the latest Discovery Health Healthcare Claims Tracker, which reveals key trends in mental health related claims by members of the Discovery Health Medical Scheme (DHMS, or the Scheme), and confirms that depression is the most prevalent mental health condition. In 2018, the Scheme paid a total of R2.6 billion for the treatment of mental health conditions, an amount that has increased by 224% since 2009.

Dr Noluthando Nematswerani, Head of the Centre for Clinical Excellence at Discovery Health says, “The increase is due to a combination of factors including an increased prevalence of mental health conditions, an increase in the cost of treatment for mental health conditions as well as an increase in the absolute number of DHMS members.”

“It is concerning that within DHMS, depression had the highest prevalence for both males and females in 2018 followed closely by bipolar mood disorder in adult females,” she adds. The most expensive hospital claim was R235 272 for an adult male, aged 47, hospitalised for a bipolar mood disorder and rehabilitation for alcohol and drug dependence.

Of the R2.6 billion spent on mental health claims, 61% of the total cost to the scheme was spent on out-of-hospital treatment in 2018. The bulk of this was for medication, followed by consultations to psychiatrists, psychologists and occupational therapists.

“Overall, the cost of treating mental health conditions accounts for 4.5% of all DHMS claims in 2018 and the scheme’s spend has increased by 15% since 2009. However, in-hospital treatment has increased at a faster pace of 31% since 2009,” says Nematswerani.

A growing, global problem

“In 2017, 13% of the global population had a mental health or substance use condition, which correlates to local DHMS data,” says Nematswerani.

In addition, members are being diagnosed at younger ages. “A higher number of mental health condition diagnoses, particularly in women, is seen between the ages of 16 and 30. This is different to what was experienced in 2009 where the incidence reached a peak at age 40,” she says.

“There has also been a distinct rise in the proportion of members being admitted for a mental health condition, particularly at younger ages,” says Nematswerani.

The new Discovery Vitality mental wellbeing programme

Discovery Vitality’s mental wellbeing programme is based on personalised mental health goals that will be added to Vitality Active Rewards for every Vitality member in early 2020 at no additional cost. It will encourage regular mental wellbeing screenings, recommend risk-based interventions, and reward members for reaching their goals.

Discovery Vitality CEO Dinesh Govender says, “Discovery’s core purpose is to make people healthier, and mental health is a key health risk, and one that is leading to an increasing cost burden. There is a strong link between mental health and physical health - people suffering from mental illness are 60% more likely to be diagnosed with preventable chronic conditions, so Vitality interventions to assess and improve mental wellbeing could have a profound impact on our members and on society.”

Members will be prompted to earn 1,000 Vitality points annually for taking the mental wellbeing assessment every 6 months. “We use an online clinically-robust questionnaire to assess anxiety, depression, sleep, substance abuse, resilience and happiness. Based on the outcomes, we provide tailored recommendations and interventions that include telephonic counseling, as well as clinical referrals (in accordance with their medical scheme benefits),” says Govender.

These tailored recommendations and interventions, based on the clinical risk score reflecting a members risk of developing depression and anxiety, include:

• Reassessments every 1, 3 or 6 months.
• Access to telephonic counselling through a dedicated support line with the South African Depression and Anxiety Group, available 24 hours a day.
• Additional appropriate clinical referrals based on medical scheme benefits.

From a Vitality perspective, members will get rewarded with Discovery Miles for achieving their weekly personalised mental wellbeing goals to improve their sleep and mindfulness, both of which aid mental wellbeing. Discovery Miles is Discovery’s ubiquitous rewards currency that can be spent on Active Rewards (such as coffees, smoothies, charitable donations and shopping vouchers), or can be spent online or instore within Discovery’s retail partner network, and can also be used to pay for flights, or can be converted into cash or a travel partner currency.

The Vitality mental wellbeing goals will be personalised based on the individual’s risk profile.

Members will receive weekly goals to improve sleep and mindfulnessthrough partner apps. These will include interventions such as:

• Engaging in mindfulness activities for at least 10 minutes a day, 3 days a week to achieve the mindfulness goal.
• Recording at least 7 hours of sleep a night, 4 times a week to achieve the sleep goal for poor sleepers.
• Encouraging healthy eating and physical activity.

Quick Polls

QUESTION

No developing economy has ever built a single-payer complementary NHI equivalent covering the entire population. NHI promises comprehensive care but it is also 100% free at the point-of-service. Is this practical?

ANSWER

It is doable but collaboration is key
South Africa is not in a position to build NHI
The only conclusion possible is that the private healthcare sector is not going to disappear or change
There is little chance that the NHI will be able to receive significant government funding
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