Carisk is interested in helping you and your family stay healthy. We have developed an array of preventive health programs for common behavioral health conditions. These programs provide you with information that will help you stay healthy or recover more quickly from a behavioral health condition. Our preventive health programs cover the following topics:
ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
ADHD is most frequently diagnosed in children though the condition can continue into adulthood. Children with ADHD frequently have difficulty paying attention, sitting still, or focusing on one task for a long period of time. Whenever Carisk finds out that a child has been diagnosed with ADHD, we automatically send our ADHD Help Guide to the child’s parents or guardians. The Help Guide contains information on ADHD. It also explains where to find more information, such as national organizations and Internet resources. For more information on the program, or to receive the Help Guide, call Member Services at 1.855.541.5300. We strongly encourage you to take advantage of this program if you or a family member has symptoms of ADHD.
MAJOR DEPRESSIVE DISORDER
MDD is one of the most frequently seen mental health diagnosis in adults. According to the American Psychiatric Association, “depression is one of the most frequently occurring mental illnesses. In any 6-month period, nearly 6% of adults in the United States have depression.” Some people who are depressed have trouble sleeping, they lose weight, and they generally feel agitated and irritable. Others may sleep and eat too much and continuously feel worthless and guilty. Still others can function reasonably well at work and put on a “happy face” in front of others, while deep down they feel quite depressed and disinterested in life. There is no one way that people look and behave when they have major depression. Whenever Carisk becomes aware that a Member has been diagnosed with MDD, we automatically send the American Psychiatric Association’s MDD Patient and Family Guide to the Member. This Guide contains valuable information on MDD and its treatment, and provides resources to get more information on MDD. For more information on the program, or to receive a copy of the Guide, please call Member Services at 1.855.541.5300. We strongly encourage you to take advantage of this program if you or a family member has symptoms of MDD.
The mission of the MDD Preventive Program is to promote Member understanding of MDD, to educate Members about the disorder, and to provide assistance and guidance to those Members who have been diagnosed with MDD.
- Educate the Member about MDD.
- Improve adherence with treatment, as well as adherence with recommended prescribed first-line medications.
- Improve quality of life and levels of adaptive functioning of the targeted population.
- Provide a source of support, information, and education to the Member diagnosed with MDD.
The target population is adult Members (18 years of age or older) who have been diagnosed by a Carisk practitioner with MDD. As identified in Carisk’s Member Profile, Major Depressive Disorder is a high volume, high-risk diagnosis for Carisk adult Members.
The MDD Preventive Health Program is under the direction of the Medical Director who obtains assistance from faculty of the Department of Psychiatry and Behavioral Sciences. These individuals provide consultation and guidance in their areas of expertise. Carisk is responsible for managing the day to day functioning of the program. Member Services, Quality Improvement, Clinical Operations, and MIS staff provide administrative support.
Intervention and Frequency
This secondary prevention program is based on the American Psychiatric Association’s Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition which was adopted by the Carisk Quality Improvement Committee (QIC) as a means to educate Carisk practitioners. The guidelines are distributed to all practitioners. A list of medications recommended for treatment of depression is available here.
Carisk developed educational information for Members called A Guide to Depressive Disorders (English). It is written for easy comprehension. A Guide to Depressive Disorders is available to all Members via the Carisk website. Paper copies are available by request. Through the website, meetings and other communications, the practitioners and Members have been informed of the availability of A Guide to Depressive Disorders.
All Carisk adult Members diagnosed with MDD are enrolled in the program and are sent the Guide to Depressive Disorders.
For a Spanish version of the Guide to Depressive Disorders click here.
A Guide to Depressive Disorders (English) (Spanish):
- Provides consumer-level information about MDD and its treatment.
- Provides the Member with information that supports his or her efforts to obtain a professional evaluation in order to determine a diagnosis.
- Assists the Member in obtaining counseling and treatment from a mental health professional who is knowledgeable about MDD.
- Emphasizes that medication needs to be monitored closely in order to determine the most effective plan.
- Provides information about online support, newsletters, and support groups.
In addition to the information that is sent to eligible Members, all actively participating practitioners who have diagnosed Carisk Members with MDD receive copies of the APA’s practice guideline, along with the A Guide to Depressive Disorders and a list of their Carisk patients with the diagnosis of MDD on a quarterly basis. Practitioners are also reminded in this letter that medication compliance is important; and the first-line medications referenced in the APA clinical practice guideline for MDD are noted.
Program Assessment and Outcome
Feedback is obtained from practitioners and Members who receive the program materials through satisfaction surveys. The surveys are used to annually assess the effectiveness and relevancy of the information being provided. The surveys also serve as a means for both parents/family of Members and for practitioners to provide suggestions on how to improve the program.
TARGETED CARE MANAGEMENT
Some people who have been in the hospital for a mental illness have a difficult time staying out of the hospital. It can be difficult to complete day-to-day tasks such as taking medicine and keeping appointments. Our Targeted Care Management program is designed for these individuals. Special staff members at Carisk keep in touch with these individuals by telephone. We help remind them of appointments, assist them in keeping their appointments, and problem-solve concerning their day-to-day tasks. If you or a family member has been hospitalized for a mental illness and you think this program might be helpful, we encourage you to call Carisk Member Services Department at 1.855.541.5300 to see if the program is right for you.
Program Mission/Goals/Target Population
A. Program Mission:
The mission of the Targeted Care Management Program is to promote normalized adjustment in the least restrictive environment possible; promote increased community tenure; and avoid the lifestyle disruptions of repeat acute care admissions for those Members with severe mental illness.
B. Program Goals:
- Increase community tenure for Carisk’s most at-risk Members.
- Improve quality of life and levels of adaptive functioning of the target population.
- Improve compliance with post-discharge treatment, as non-compliance is a major contributor to unsuccessful post discharge adjustment resulting in re-admissions.
- Provide a source of support, information, and education to Members of the target population.
C. Target Population:
The target population is Members of all ages who have had two or more admissions in a 12-month (or shorter) period. Re-admissions are monitored monthly and Members are added accordingly.
The TCM Preventive Health Program is under the direction of the Medical Director who obtains assistance from faculty of the Department of Psychiatry and Behavioral Sciences. These Individuals provide consultation and guidance in their areas of expertise. The Director of Clinical Operations manages the day to day functioning of the program and supervises the Manager of the Program, who is a senior licensed clinical social worker.
Interventions and Frequency
All acute care admissions are staffed during daily rounds, which are attended by the Medical Director, MD Peer Reviewers, Acute Care Managers, Targeted Care Managers, and the Director of Clinical Operations. There is an emphasis on the early development and close coordination of the post discharge treatment plan prior to discharge. At the point of discharge the Targeted Care Managers are responsible for monitoring the implementation of the treatment plan. Member Services, Quality Improvement, Clinical Operations, and MIS staff provides administrative support. The Targeted Care Management Program coordinates with HMO’s medical-surgical care management nurses assigned to high-risk med-surgical cases.
- Aggressive coordination of discharge treatment plan developed by facility/attending, Carisk Medical Director, Acute Care Managers, Targeted Care Managers, Outpatient Provider, the Member and significant others.
- Ongoing reminder calls to Members.
- Verification of attendance for each visit as indication of compliance with treatment plan.
- Targeted Care Managers coordinate a full array of community resources to improve adjustment in the community.
- Diagnosis-specific Provider profiling facilitates referring Members to particular practitioners for optimal outcomes.
- All Members with evidence of treatment plan non-compliance are targeted for contact with the goals of early assessment of the reasons for non-compliance and removing of barriers to future compliance.
- Use of multiple Providers when indicated, including visiting nurses and injectable medications to improve compliance.
- Second and third opinions are provided faculty of the Department of Psychiatry on complex or difficult-to-manage Members.
Program Assessment and Outcome
Community tenure and number of admissions are compared for each program cohort comparing rates for the 12 months prior to involvement in the program with the 12 months following enrollment.
ADHD is most frequently diagnosed in children though the condition can continue into adulthood. Children with ADHD frequently have difficulty paying attention, sitting still, or focusing on one task for a long period of time. Whenever Concordia finds out that a child has been diagnosed with ADHD, we automatically send our ADHD Help Guide to the child’s parents or guardians. The Help Guide contains information on ADHD. It also explains where to find more information, such as national organizations and Internet resources. For more information on the program, or to receive the Help Guide, call Member Services at 1.855.541.5300. We strongly encourage you to take advantage of this program if you or a family member has symptoms of ADHD.
AVOIDING MEDICAL ERRORS
Taking medicines is not always as simple as swallowing a pill. It can involve many steps and decisions each day. To follow the treatment plan you and your doctor agree on, ask questions and tell your health professionals your needs and concerns. Use the following list created by the National Council on Patient Information and Education and the Agency for Health Care Policy and Research to write down answers you receive about your medications.
- The name of the medicine and what it is supposed to do.
- How and when to take the medicine, how much to take, and for how long.
- What food, drinks, other medicines, or activities you should avoid while taking the medicine.
- What side effects the medicine may have, and what to do if they occur.
- If you can get a refill, and how often.
- About any terms or directions you do not understand.
- What to do if you miss a dose.
- If there is written information you can take home. Most pharmacies have information sheets on your prescription medicines. Some even offer large-print or Spanish versions.
- Any concerns you have about using the medicine.
- Any concerns you have about staying with other parts of your treatment.
- If you are not taking your medicine as directed. For example, some people stop taking their medicine as soon as they feel better. Your needs to know about any changes in your treatment plan. Do not let guilty feelings or embarrassment keep you from telling your doctor this important information.
For more information about prescription medication errors, please visit the Agency for Health Care Research and Quality website at www.ahrq.gov and the National Council on Patient Information and Education at http://www.talkaboutrx.org/rxmonth2014.jsp.
Carisk also provides access to information and self-assessment tools to help you make healthy lifestyle choices.
If you have any questions or would like further information, please contact the Carisk QI Department at 305.514.5300, or send an e-mail to firstname.lastname@example.org.