Getting treatment for serious mental illness (SMI) is often confusing and siled. In many cases, the emergency room is the de facto gateway to care.
However, more and more health care providers across the country are trying to improve SMI care through community-based approaches. One of those companies is San Francisco-based Amae. The company uses a holistic care model to consolidate fragmented parts of the healthcare sector. It is intended to provide behavioral health care, primary care, and community support to patients.
As families of SMI patients, Amae founders Sonia Garcia and Stas Sokolin have seen first-hand the complex healthcare systems that patients must navigate in order to receive treatment. Garcia serves as Amae’s Chief Product Officer and Sokolin as his CEO.
“I started thinking about what it would be like to start a company that would provide very high quality care for people with SMI,” Sokolin told Behavioral Health Business. “And treat those who are currently receiving no care. These patients were really expensive, and the results were very bad for the health system. was.”
About 5.6% of individuals in the United States have a serious mental illness, but there are many barriers to getting treatment. The CDC reports that her 69.9% of women with SMI and her 54.9% of men with SMI receive mental health care.
According to a survey of health problems, the estimated lifetime cost of SMI is $1.85 million per patient.
amae no care model
Inspired in part by the Department of Veterans Affairs’ Mental Health Centralized Case Management Program (MICM), Ganjiang’s model includes psychiatrists, social workers, peer support, health coaches, and primary care physicians. Operators aim to combine physical care with treatment of serious mental illness.
Venture-backed Amae has opened its first center in Los Angeles. The operator plans to work with commercial, Medicaid, and Medicare plans. Its investors include Virtue, Bling Capital, 8VC, and Able Partners.
“SMI is prevalent in all three. I think too often commercial patients think SMI is unlikely,” Sokolin said. not necessarily. [covered under a commercial plan]”
Regarding outcomes, providers focus on three main areas: physical, psychological, spiritual, social and community.
Health outcomes in individuals with SMI are worse than in the general population. In fact, research shows that people with SMI live on average 10 to 20 years less than those without SMI. Amae hopes to change this paradigm by incorporating primary her-care physicians into the model.
Sokolin pointed out that many primary care physicians are not trained to treat SMI patients. Moreover, the prevalence of physical comorbidities is higher in the SMI population.
Sokolin said part of the reason comorbidities are so high in this population is the drugs they need to take to treat SMI.
Medication adherence is one of the organization’s focus areas for outcomes. Providers use long-acting injectables to help patients stay on their medication. He explained that long-acting injectables are usually antipsychotics that last for three months once administered.
“This serves two purposes. One is that patients are 90 days compliant, which is great,” Sokolin said. “Second, it actually has a much lower side effect profile for patients.”
But overall health is more than just medication adherence and physical health, says Garcia. It is also about having a purpose. The organization helps patients become part of the community while finding work.
“We’re not just saying ‘Well done, you’re following your prescription,’ we’re saying you’re a complete human being,” Garcia said. . “We are here to treat the whole person, and through these … stages of health we want to end up in a place where you feel like you are re-entering … your community as an individual.”
This provider also treats patients with SMI and Substance Use Disorder (SUD). Sokolin said this is part of the organization’s integrative medicine approach.
“We wanted to treat both at the same time,” says Sokolin. “We believe everything should be integrated. Just as we believe primary care should be integrated with behavioral health, we believe SUD treatment should be integrated.” .”
In the future, the company is also looking to collaborate on research activities. Specifically, the team is interested in how individual patients respond to specific treatments based on genetic and clinical factors.
The Bigger Perspective of SMI Care
The SMI population has historically been underserved, but many new providers are looking to take care of that population.
For example, former National Institutes of Health (NIH) mental health director Dr. Thomas Insel co-founded a new for-profit startup called Vanna to connect people with SMI to community resources.
The private sector is not alone in trying to incorporate community programs into SMI Care. The federal government invested his $300 million in two accredited community behavioral health clinics (CCBHCs) to help expand access to mental health care and SUD care.
Additionally, the Biden administration awarded 20 states $15 million in planning grants to support community-based mobile crisis intervention services for Medicaid recipients.
U.S. Centers for Medicare & Medicaid Services (CMS) also proposed upfront payments to provide small healthcare providers in rural and underserved areas with upfront funding to care for their communities doing.
“[Providers] Dr. Meena Seshamani, deputy administrator of CMS and director of the Medicare Center, told BHB in an interview in July. “There’s a lot we’re doing to think more holistically about people and connect our efforts to physical health, behavioral health, and health-related societal needs.
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