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Executive Summary of Patient Services

Breaking Down Barriers to Treatment for Mental Illness

Present Situation

People with mental health conditions often go undiagnosed, misdiagnosed, or are diagnosed long after the initial onset of their symptoms. For example, in people with depression, the average time from disorder onset to first treatment is approximately eight years.i

People resist seeking treatment for three key reasons:

  1. Stigma: The label of a mental illness prevents up to 75% of people with treatable mental health conditions from seeking care.ii
  2. Cost: Challenges navigating health insurance and figuring out how to afford treatment overwhelm many people.
  3. Accessibility: Difficulty screening providers and getting an appointment discourage people from seeking help before they have started.

Problems with Present Situation

  • Reoccurring hospitalizations for serious mental illnesses (SMIs)
  • Overutilization of healthcare services for physical health complaints that originate from SMIs (drives healthcare costs)
  • Excessive burden on primary care physicians (PCPs) to manage mental health conditions and the chronic health conditions that are associated with them


1. Stigma

Anonymous entry point to care: Voices for Health combats stigma and empowers patients to seek treatment by allowing them to anonymously chat online with a Patient Engagement Advocate (licensed social worker). This personal advocate guides the patient to resources and functions as an additional source of support throughout their journey of treatment. This includes working with the patient’s family, if appropriate. E-Support networks and in-person support groups will also available.

2. Cost

Advocates help patients understand their health insurance and can do the leg-work of finding an appropriate provider who is in-network, if possible. The Advocate can help the patient switch to a new insurance plan, if needed.

3. Accessibility

Advocates interview and screen providers to see if they are a good potential fit for the patient. Only providers who are responsive to calls and meet the patient’s preferred criteria are recommended for the patient to contact on their own. Advocates can also schedule the initial appointment for the patient, if requested.

Patients who are placed on waiting lists are offered referrals to support groups, online therapy, and evidence-based complementary therapies (such as yoga). Advocates work with the patient’s PCP to follow up on specialist referrals, if needed.


More patients receiving timely and appropriate access to quality mental health care will result in:

  1. Fewer re-hospitalizations for serious mental illnesses (SMIs)
  2. Less overutilization of healthcare services for physical health complaints that originate from SMIs
  3. Less burden on PCPs to manage mental health conditions and the chronic health conditions that are associated with them
  4. People functioning better in society—able to work, socialize and lead fully successful lives

Venue for Providing Services

Voices for Health seeks to offer the above services as a program within a large hospital or comprehensive community health center in the metro Boston area. The ideal provider organization will have a commitment to integrating mental health into primary care as well as an interest in reducing stigma and improving access to timely, quality care for all people with mental health conditions.

Recruitment and Referral Strategies

Voices for Health’s initial source of patients will be PCPs who refer patients to us who are already in the healthcare system. We will also recruit new patients via social media, Google ads, MBTA ads, and community outreach. A family member or close friend may seek help on a patient’s behalf instead of the patient themselves.


Navigation and Care Coordination Strategies

  • Some patients will have a diagnosis and some will not. Of those who do not have a diagnosis, Voices for Health will find a clinician who can make an initial diagnosis and develop a treatment plan, which may involve referrals to additional specialists.
  • Patients who already have a diagnosis, but are struggling to find an appropriate specialist can skip the initial diagnostic evaluation. Patient Engagement Advocates will follow up with PCPs to assist with obtaining referrals and ensuring patients get off of waiting lists. Advocates check in with patients after their first visit with a behavioral health provider to make sure it’s a good match. If not, the Advocate finds a new provider.
  • Advocates stay in touch with patients and family members during the course of their treatment to provide an additional source of support. Once a patient is successfully treated, the Advocate will follow up to ensure the patient does not relapse.



Voices for Health will be financially supported by a combination of grant awards obtained from federal, state and private funding sources for applied research programs and projects; major gifts from individual donors and philanthropists; revenue from fundraising events; profit from the sale of organizational materials and items; and other sources such as corporations, trusts and foundations and possibly pharmaceutical companies.


Download Executive Summary of Patient Services PDF

Works Cited

i Olfson, Mark. “Building the mental health workforce capacity needed to treat adults with serious mental illnesses.” Health Affairs. Vol. 35, No. 6, (June 2016), p. 983.

ii S. Clement et al. “What is the impact of mental health related stigma on help-seeking? A systematic review of quantitative and qualitative studies.” Psychological Medicine, Vol. 45, Issue 1. Jan. 2015, pp. 11-27: https://www.cambridge.org/core/journals/psychological-medicine/article/what-is-the-impact-of-mental-health-related-stigma-on-help-seeking-a-systematic-review-of-quantitative-and-qualitative-studies/E3FD6B42EE9815C4E26A6B84ED7BD3AE