The Quake and the Tsunami

June 19, 2020

Alex Bitoun, CEO - HealthPersonas

The Quake and the Tsunami

Early in the morning on December 26, 2004, millions of people in the coastal regions of Indonesia, Sri Lanka and Thailand were beginning their day – going to work, visiting markets, or enjoying the peacefulness of a Sunday morning. In addition to the resident population, thousands of tourists from around the world were enjoying the beaches in the midst of the holiday season.  Suddenly, at 7:59am, one of the largest earthquakes in recorded history struck just off the coast of Sumatra, and was felt in countries throughout the Indian Ocean basin.

Because the epicenter of the quake occurred 10 kilometers from land, initial damage was presumed to minor with few known casualties from the tremor itself.  Most resumed their normal course of daily activity shortly thereafter. However, over the ensuing hours multiple enormous waves of water inundated the coasts of many countries that rim the Indian Ocean.  When it was over, an estimated 227,000 people had lost their lives, some as far away as Africa. And almost every single one perished not from the effects of the quake, but from the ensuing catastrophic result that is common with large undersea tremors – a tsunami. While the immediate quake was felt by millions, it was the aftermath of the tsunami had the true historic impact.

In the first half of 2020, our world has felt the earthquake of COVID-19, and it has shaken the foundations of society as we know it.  In times of uncertainty, it is natural to seek certainty. However, in that focused effort to address the immediate challenge, it is easy to overlook other risks, perhaps equally or more devastating - which leads to the analogy of the Quake and Tsunami. The Quake arrives unannounced, can be terrifying, and deserves our immediate attention.The Tsunami catches force in the distance. Some have not felt the tremors,others are feeling it, others yet wondering when and if they will feel it. Our thoughts and energy remains focused to a large degree on the quake - our businesses,the health and safety of our loved ones, and ourselves.

While the initial impact of the virus itself has been significant, it is the resulting tsunami that is more destructive.  Lives have been lost, economies devastated,populations socially disconnected, and the wave that we can be assured will come is the significant consequences to mental health of millions in our society.

What is Mental Health?

Mental health refers to cognitive, behavioral, and emotional well-being. It is all about how people think, feel, and behave.  It includes a wide array of positive and negative states around the mind. On one end we have an athlete looking to improve his mental strength for higher performance, on the other we have cognitively impaired persons struggling for relief, and everything in between.

Unfortunately, the term is often stigmatized, and people may not seek the help they need as they too often feel it is not ok to not be ok.

Mental health struggles also from being hard to quantify. Unlike blood glucose,temperature, cholesterol, and many other physical indicators, there are no direct biometric measure of mental state. We instead rely on subjective assessments that may not tell the whole picture. While absolute measures elude us, there are meaningful ways to measure variance over time giving us many clues on whether someone is improving or not.

What is the cost?

The mental health impact on our healthcare industry and our greater society as a whole are undeniable. According to the National Alliance on Mental Health, it is estimated that untreated mental illness costs the US upto $300 billion each year in productivity. The mental health focus has been mostly on more advanced behavioral health, while support for mild mental health struggles is not yet widely pursued.Many people could use some additional support along the way, but we need to ensure that taking steps to access that support is a normal course of action when taking care of themselves.  

As people work through the uncertainty of the pandemic and its aftermath, one thing is certain – the Tsunami will impact significant numbers of us, and it is approaching ever so quickly. Our anxiety and our stress levels are growing at an unprecedented rate,and our lack of access to medical care is increasing.  

Quantifying any savings based on a change in mental health is lacking larger scale validation. But we should not wait for the aftermath of the Tsunami to measure the extra costs generated. It is not just about the cost, ithas serious impact on our lives and the way we feel.

What can we do?

Better prepare to address the mild to moderate anxiety segment of the mental health spectrum

This is the great untapped area.  This is best defined as stress and anxiety at impeding levels, but not the paralyzing conditions more common to severe mental health.  Similar to carrying a heavy backpack over long periods, the strain lowers our emotional well-being and can have negative effects on our physical health. The impacts of physical distancing, stay-at-home orders, increased unemployment, and the more recent societal upheavals is where the Tsunami will create the greatest challenge.  

Remote-access solutions like telehealth and mobile support applications have become more prevalent since the COVID-19 crisis began. The market is evolving and sometimes confusing, but there is increasing awareness and acceptance to both the provider and the patient, and provides a more accessible, safer channel for those to seek the help they need.  We need to provide the capability to help people manage mild anxiety, and mitigate against further progression to more severe mental health problems and compounding clinical complications.  

Solutions like HealthPersonas, which provides a combination of a simple, accessible, mobile platform with 1-1 personalized emotional support using telehealth tools, have been focused specifically on this segment of the mental health spectrum even prior to the pandemic.  And this space will be even more important to providing protection against the coming Tsunami.  

How can it be done?

Adoption and education

There is a need for greater adoption from employers, health plans, and individuals to prioritize this as a fundamental layer for everyone’s mental and economic well-being, and recognize the importance of preventative mechanisms to address the mild to moderate anxiety segment before those cases become more severe.  Private investment in innovative use of technologies to address the need is increasing and companies with a variety of platforms, such as HealthPersonas, are positioning themselves to support the various channels – direct-to-consumer, payer, and provider.

As part of that prioritization, education is key:

1. Reduce the stigma around emotional and mental health.  It’s ok to not feel ok all of the time, and sometimes that needs to be addressed to stay healthy.

2. Message the importance of overall well-being instead of sick care.

3. Acknowledge that biometrics and traditional measures of care do not provide a fully accurate picture of overall health.  Indicators of whole person health need to incorporate emotional measures such as psychometrics. 

4.  Provide non-judgmental, accessible solutions that build trust to enable people to improve their emotional health.

Conclusion - will we act?

 Humans have shown the tendency to put little emphasis on longer term health events regardless of high probability and severity.  We often refuse to change our daily health habits in the hope to be an exception to the statistics, and never be affected by the complications of diabetes, cancer, and other chronic conditions.  On the other hand, we tend to react strongly, and even overreact, to low-probability adverse health events that may take place in a very distant future.  It could be that we can visualize them more easily, or maybe our self-preservation nature is trying to save us from the long term stress worrying about everything could cause.

The wave is coming, and the impacts are already beginning to manifest themselves.  Will we ignore the signs and assume we will not be affected, much like those who stood on the beaches and watched the sea recede on that fateful December morning?   Or will we recognize the threat and begin acting now to lessen the effects to ourselves and to society?

We can make a difference and reduce the impact of the incoming wave by changing the dialogue to ensure people know they can ask for help,  investing in solutions that provide that assistance, and making those solutions accessible to all via remote non-judgement and non-invasive technologies.  Let’s support this effort and each other.  We all stand to benefit from it.