May 11, 2016

Partnering with patients to improve their mental well-being

May is Mental Health Awareness Month.

Coordinated care helped Ricardo Martinez manage depression and anxiety.

Ricardo Martinez has always loved to fly-fish. He knew he was in trouble when the thought of casting that lure into a pristine mountain stream gave him no sense of joy.

“There is no worse feeling I have ever felt than waking up and not wanting to wake up,” said the longtime Kaiser Permanente member living in Northern California. “I wasn’t sure what my entire purpose in life was or what I was doing on the face of this earth.”

Ricardo told his primary care physician how he was feeling. His doctor told him he might be going through an episode of depression and arranged for Ricardo to see a Kaiser Permanente psychiatrist and a mental health therapist. Working together, the team recommended a treatment plan, including antidepressants and talk therapy.

At first, Ricardo resisted. “There is a stigma (about mental health problems), particularly in the Latino culture,” he said. “But then my doctor explained that your brain is like any other part of your body. If you have a broken hand, you get a cast and take medication. If your brain is not functioning as it should be, (sometimes) you need to take medication.”

Ricardo’s therapist gave him exercises in breathing and focus to do when he suffered anxiety attacks, often a symptom of depression. Ricardo also took steps to make sure he was leading a healthy lifestyle. After four years of coordinated care from his physician, psychiatrist and therapist, Ricardo was able to stop taking antidepressants. He no longer dreads waking up and has been able to fully re-engage in life.

“It’s a lifelong process,” he said. “But I think learning coping skills is very important, along with being able to have an open, direct dialogue with your primary care physician.”

Fighting stigma

Ricardo is not alone. According to the National Association of Mental Illness, one in four people at some point in their life suffer from some kind of mental health disorder, such as depression, bipolar disorder, dementia, schizophrenia and anxiety. Getting people to feel comfortable in talking about their mental health with their care providers is a major goal at Kaiser Permanente.

May is Mental Health Awareness month, and Kaiser Permanente’s integrated health care delivery system offers a powerful example of how mind and spirit can be healed and nurtured along with the body to achieve total health.

Addressing the stigma associated with mental health issues is the first step toward successful treatment.

“When they see symptoms, our primary care physicians make a point of asking patients how they are feeling about life in general,” said Andrew Bertagnolli, PhD, director of Integrated Behavioral Health at Kaiser Permanente’s Care Management Institute, which helps identify best practices and spread them throughout the organization. “Not everyone is comfortable talking about what makes them anxious or sad. Our physicians help patients share what’s really going on.”

When it comes to mental health care, Kaiser Permanente offers a comprehensive range of services, resources and access to highly qualified providers who practice evidence-based, integrated care that focuses on the whole individual.

“All of our care providers work together under one roof to really support patients in a way other organizations can’t,” said Kaiser Permanente psychiatrist Maribel Villarosa. “Our patients receive comprehensive care with respect, compassion and empathy, and without judgment.”

Care when and where it’s needed

Kaiser Permanente is dedicated to making sure members have access to the behavioral health care they need, when and where they need it. The organization offers an online self-assessment tool that can be used by members and non-members to help identify early signs of depression and learn more about it. Kaiser Permanente primary care physicians also use a special patient health questionnaire — called a PHQ-9 — proven effective in detecting depression and other mental health issues.

Accessing care and a provider is easy, and no referrals are needed. Kaiser Permanente’s therapists and psychiatrists treat a wide range of symptoms — such as feeling excessively sad, problems concentrating, extreme mood changes, changes in sleep habits, abuse of alcohol or drugs, etc. — through counseling, medication evaluations, medication management and more.

The effectiveness of the integrated care model is evident in the fact that Kaiser Permanente’s Northern and Southern California ratings for behavioral and mental health care are among the highest in the state, according to the California Office of the Patient Advocate’s 2015–2016 report card. Kaiser Permanente Northern California also scored three stars — higher than any other HMO in the state — in the “Getting Care Easily” category.

Last year, Kaiser Permanente’s Psychiatric Health Facility in Santa Clara was named a “Top Performer on Key Quality Measures,” an annual recognition given to hospitals for outstanding quality and safety by The Joint Commission — the leading accreditor of health care organizations in the United States.

Responding to a national shortage of mental health providers, Kaiser Permanente increased the number of its therapists by 45 percent in California between January 2011 and June 2015.

As part of its mission to continuously improve care, Kaiser Permanente has convened a multidisciplinary group of leaders to advance an integrated behavioral health model that brings together the best available clinical evidence and takes advantage of all support resources available to patients. This initiative will create the next generation of high performing primary care teams to address patients’ medical and mental health conditions and treat the whole person.

For more information on Kaiser Permanente’s commitment to excellence in mental health care, including videos of care providers, go to


A latino man talking to a therapist

Kaiser Permanente research studies advance mental health care

Kaiser Permanente is committed to conducting ground-breaking research to improve the practice of mental health care. Here are links to some recent studies:

  • A study published in the journal Psychiatric Services shows mental health diagnosis and treatment vary significantly by race and ethnicity. Examining the electronic health records of more than 7 million people across 11 health care systems, the study found that patients from most racial and ethnic minority groups had much lower rates of mental health diagnosis compared to non-Hispanic white patients.
  • Two recent Kaiser Permanente studies indicated that the organization’s screening program increases identification and treatment of depression among pregnant and postpartum women. The studies, published online in the journal Obstetrics and Gynecology, also showed that universal screening led to treatment that resulted in women experiencing significant relief from symptoms.
  • Depressed teenagers who received behavioral counseling in their primary care clinic recovered faster, and were also more likely to recover, than teens who did not receive primary care-based counseling, according to a Kaiser Permanente study published in the journal Pediatrics. This study examined a 5-to-9-week program where counselors used traditional cognitive behavioral therapy techniques to help teens challenge unhelpful or depressive thinking, and replace those beliefs with more realistic, positive thoughts.