Although the pandemichas taken a vast psychological toll on most Americans, one silver lining is that it jump-started conversations about mental health, and it’s helping to lift the stigma that has long been a barrier around people seeking professional help. The pandemic also has been a game changer for many retailers, who are becoming a tour de force in an unexpected area: providing mental health services.
Retail pharmacy’s foray into mental health services comes at a time when there is an increased need for them.
CVS Health began providing mental health services in January 2021 via its MinuteClinics and HealthHubs, where licensed social workers offer mental health screenings and counseling services to patients with mild to moderate behavioral health needs.
“We saw the need and the importance of offering this service. Fifty-one million people have a diagnosed mental health issue or illness,” said Cara McNulty, president of behavioral health at Aetna, a CVS Health company. “Everyone will have some kind of mental health disruption. Not everyone will have an illness, but we’re going to have stress, resiliency issues, situational anxiety, low-level depression or ‘the blues.’”
McNulty also noted that there are 24 million people in need of alcohol care and substance use disorder treatment. “There’s an abundant need for the industry to think differently about how we talk about mental health, how we deliver care, how we meet people in their community and how we make it easy for people to get that care,” she said.
CVS Health offers mental health services in 30 locations in Houston, Philadelphia, New Jersey and Tampa, Fla.
As retailers provide services to patients with mental health issues, they also are finding that collaborations with partners are crucial.
A prime example is Walgreens. In 2016, Walgreens launched a digital platform, via online and mobile, to provide free 24/7 access to mental health screenings through a partnership with Mental Health America. The platform also helps to connect people with local resources in their community via Mental Health America affiliates.
CVS Health also offers a virtual mental health option in which a licensed clinical social worker provides an assessment and diagnosis. “Coming in to see that licensed clinical social worker or seeing them virtually is about normalizing this conversation and checking in on how you’re doing and getting the care and support you need,” McNulty said. “We’re using technology to make it easy for people. We share tools and resources as part of the care plan.”
Walgreens also is taking this responsibility of caring for patients virtually to new heights. VillageMD has likewise moved many of its social work services to telehealth, such as screenings and assessments. “Many people are unaware that mental health services are delivered through primary care, and VillageMD is working to eliminate barriers to mental health through our services at Village Medical at Walgreens and via telehealth,” said Clive Fields, chief medical officer at VillageMD.
The Right Players
The ability to refer patients to partners when they need a higher level of care is another hallmark of successful retailers in the mental health space.
One only has to look at Kroger. The retailer elevates patients to its health system partners, academic medical centers and community-based resources, with an effort on making the transition smooth and seamless.
“We want to have a white glove handoff so we help facilitate the appointment, and we also share records when appropriate,” Watkins said. “Most patients follow up and they end up having that relationship with our NP or PA. Then they’re able to get that warm handoff. That makes it easier for the accepting provider so they’re not starting from scratch.”
Kroger also has a dedicated access line to its health systems partners, and the retailer makes appointments for patients “so these patients are not left to the wild, and not fending for themselves,” Watkins said.
“We’re part of that augmentation of care,” Brown said. “We are part of a care quality platform where we can share medical records. There are a lot of suitcase communities. Sometimes we’re the first touchpoint.”
Kroger also is a front-runner in involving its pharmacists in the mental health space. “Our pharmacists do comprehensive medication reviews on all of their patients, looking at behavioral health drugs, as well as other medications patients are taking to ensure there are no side effects,” Watkins said. “If they see a potential negative interaction between a medication, they alert us, the prescribers, the health systems or community-based providers.”
Brown said that many times the patients disclose to Kroger’s pharmacists that they have mental health problems and these pharmacists refer these patients to The Little Clinic.
Walgreens is not standing on the sidelines when it comes to utilizing pharmacists to care for patients with mental health issues. Walgreens formed a unique collaboration with the National Council for Mental Well-being and the American Pharmacists Association in 2019 to provide Mental Health First Aid training for Walgreens’ pharmacists and team members within its HR department. The training includes understanding risk factors and warning signs for mental health and addiction concerns and strategies for how to help someone in both crisis and noncrisis situations.
In October, Walgreens spearheaded efforts to make the training available for all of its pharmacists, in further recognition of the important role pharmacists can play as accessible healthcare providers in the community, Gates noted.
He also pointed out that medication adherence can also be a barrier for many with mental health conditions. “Given our pharmacists’ role as medication experts, and some of the other programs we have to help patients stay adherent to their medication regimens, this is also an area of opportunity to help achieve better outcomes,” Gates said.
People who experience anxiety or depression may not know how to start their journey or who they should see, or may not be able to be seen right away by a mental health professional. Retailers are helping on this front too.
“One of the things we know is that people often don’t know that what they’re experiencing can be helped or it’s totally normal,” McNulty said. “They don’t need to be the one diagnosing it. Someone may say ‘I don’t feel good.’ The clinical social worker does the assessment and diagnosis and then provides treatment for that individual. The patients say, ‘I didn’t have to do all the heavy lifting. You made it easy for me to come in and talk to a social worker, have an assessment, help me understand and normalize what’s happening, and either see that therapist or get me to the right level of care.’”
Gates said Walgreens continues to receive positive feedback regarding the steps the retailer has taken to help meet the growing need and demand for mental health resources both from customers/patients, healthcare partners and those within the mental health community.
In October 2021, Walgreens announced plans to open 1,000 Village Medical at Walgreens locations by 2027. “We plan to continue adding more social workers as the demand increases,” Fields said.
Watkins envisions Kroger will continue to look for ways to serve its communities better and “understanding that mental health is one of those aspects. We are providing services today through our NPs, pharmacists and dietitians. As we continue to evolve, you’ll find that nothing is off the table, including hiring psychiatrists and psychologists.”
Perhaps Brown summed up the benefits for retailers and patients best when she reflected on a patient who was thankful for the mental health services that Kroger provided: “We listened to them and got them the help they needed, but also on that journey we were able to pull in the food piece. Now this person only wants to go see that one pharmacist, that NP and this dietitian because we were able to support them fully. We’re looking at the whole health and wellness of somebody, not just the mental health part,” she said.