Mental Health and Chronic Condition Management
May is Mental Health Awareness Month—but your patients need mental health support year-round.
When we think about managing chronic conditions—like diabetes or heart disease—we often focus on medications, labs, and lifestyle changes. But mental health plays a critical (and sometimes overlooked) role.
Anxiety, depression, and emotional stress can make it harder for patients to stick to treatment plans, attend appointments, and stay motivated.
That’s why integrating mental health into chronic condition care isn’t just beneficial—it’s essential.
Why should you address your patient’s mental health alongside their physical condition?
Mental health and physical health conditions are closely connected and impact each other. A chronic condition doesn’t just take a physical toll on your patient, but a mental one as well.
Patients may struggle with remembering to take their medications at the right time, coping with lifestyle limitations, or even fear and uncertainty of the future. To help them manage their physical health effectively, you also need to help them take care of their mental health.
Patients with chronic illness commonly face a range of mental health challenges, from anxiety to depression. However, care management support between visits can help them cope with day-to-day concerns. And care managers can also identify and escalate symptoms of mental health that require clinical intervention.
Common mental health challenges and care management interventions
Care managers who have frequent, consistent check-ins and conversations with their patients can provide a range of support, depending on licensure scope.
| Common Condition | Patient May Struggle With | Care Management Intervention |
|---|---|---|
|
Anxiety |
Fear of the unknown, or of how condition might progress |
Asking questions to better understand patient fears and providing appropriate condition-specific education and reassurance |
|
Social Isolation, Loneliness |
Feeling like they are the only ones going through this, or that no one else will understand |
Uncovering the root causes, providing support networks, and social engagement |
|
Chronic Stress |
Juggling the demands of work, life, family, and illness. Dealing with financial and social burdens. |
Connecting patients with resources, services, and education |
|
Depression |
Sadness, long term pain, disability |
Regular screenings |
The impact of high-quality care management
A patient managing a chronic condition may only be seen in your office every few weeks or months. During that time between visits, their physical health may deteriorate—and so could their mental health. This is where care management comes in.
Regular interactions (at least once a week) between a care manager and a patient can help to identify changes and or progression in the moment. By having a constant connection to a care manager, patients feel supported and feel comfortable opening up about how they are feeling. This allows them to be evaluated faster and get the help they need.
Adding mental health to your chronic care workflows
Sometimes we hear from physicians or practice administrators who feel overwhelmed by the idea of adding a mental health component to their chronic care workflows.
But patients who feel seen, heard, and supported are more likely to be compliant with their overall care. While directly managing a patient’s mental health may fall outside of your normal day-to-day practice, your care managers can still identify mental health care needs and collaborate appropriately with other providers and clinical staff to support the patient.
Mental health and chronic condition management go hand-in-hand
Managing chronic conditions without addressing mental health is like trying to treat only half the patient. By supporting both, we improve outcomes and help patients feel truly cared for.
I encourage you to think about how your practice can bridge the gap—through care management, early mental health screening, and compassionate follow-up.
Director of Clinical Solutions
As the Director of Clinical Solutions at Phamily, Mahfi leads the design of a unique model of care management that drives better patient outcomes and substantial reductions in total cost of care. She attended medical school at the University of Medicine and Health Sciences after completing her undergraduate studies at the University of Georgia (Go Dawgs!).
