How Kaiser Permanente Adapted swiftly to the Pandemic’s Mental Health Crisis

Cal Broker:
What makes mental health care at Kaiser Permanente so unique?

Dr. Balan: Along with our expansive mental health offerings, collaborative approach, and responsive care, our integrated system—which offers care and coverage together—is uniquely built to meet our members’ needs during this difficult moment in time.

We draw from a full spectrum of proven care. From primary care to specialty mental health care to emergency care and everything in between, our providers coordinate and manage care delivery across an expansive mental health care ecosystem. That gives our members many options—including options for getting care remotely—and they can work with their provider to select the care that’s right for them.

At the center of all of this is our electronic health record system, which allows members to manage their care online and gives us the ability to coordinate their care. Our doctors know what they need to do, and the ecosystem enables us to provide care based on what works and helps us make sure the patient experience is as seamless as possible. The ability to maintain clear communication across our care teams is particularly critical during a crisis, which can affect how and where care is delivered.

We also always try to spot concerns early, which is why providers across our network have the knowledge, training, and resources to address mental health concerns. Patients and their providers develop care plans tailored to their challenges and goals, including frequency and duration of visits. Adjustments are made as needed. Ongoing feedback from members helps us understand what tools, therapies, and self-care techniques are helping, identify additional things to work on, and decide on a path forward after achieving treatment goals.

The result is a fluid care experience that evolves with our members’ needs.

CB: What are the biggest impacts COVID-19 has had on the health of Kaiser Permanente members and the communities it serves?

Balan: The toll the pandemic is taking on us all is undeniable, and there’s no question that COVID-19 will continue to affect people’s mental health around the world. Early on, the Journal of the American Medical Association projected a nationwide increase in depression, anxiety, and post-traumatic stress due to COVID-19.

(This is according to Sandro Galea, M.D., et al., “The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention,” Journal of the American Medical Association Internal Medicine, April 10, 2020.)

Sadly, that is proving true with more recent data suggesting that signs and symptoms of mental health conditions continue to rise, particularly among young people and caregivers.

As people search for ways to cope with increasing stress and anxiety, we’re seeing startling increases in substance use and addiction. Unfortunately, the national opioid crisis has only worsened during the coronavirus pandemic.

In June, four out of 10 adults said they’ve dealt with mental health or substance use issues, while more than one out of 10 said they’ve either started using substances or increased their use.

(Mark E. Czeisler et al., “Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24–30, 2020,” Morbidity and Mortality Weekly Report, August 14, 2020.)

People who already struggled with addiction are suffering in isolation, creating dangerous and potentially life-threatening situations.

A recent study (“June Brings Some Mental Health Relief for U.S. Workers, but Risk for Mental Health Conditions Remains High,” Total Brain, accessed Sept. 23, 2020) found that 54% of employees are at increased risk of a depressive disorder, 49% have a higher risk of post-traumatic stress disorder, 41% have a higher risk of a general anxiety disorder, and 11% have a higher risk for addiction.

This confluence of problems contributes heavily to deaths due to drugs, alcohol, or suicide, also known as “deaths of despair.” These deaths have been on the rise the last decade and projections for the coming months are grim. However, we know they’re preventable.

CB: How did Kaiser Permanente continue to meet the mental health needs of its members in the face of the pandemic?

Balan: Our goal is to always be available for our members, especially when they need us most.

We moved fast to shift delivery of nearly 100% of our scheduled mental health services to telehealth options, including group visits. This helped ensure our members could receive high-quality mental health care without delay and without risking exposure to COVID-19.

We were able to quickly ramp up our telehealth offerings because we already had a robust, highly efficient telehealth system. Wealso accelerated investments that have enabled us to collect reported patient outcomes remotely, without patients having to come into the office. These things make it easy for members to get care remotely through video visits, phone appointments, e-visits, email consultations, mail-order pharmacy, and a host of other virtual support options on and the Kaiser Permanente app found at

In addition, our emotional wellness support resources have been essential during the pandemic. Whether it’s to help with sleep, stress, or relationships, we offer many digital resources for our members’ mental health and wellness, including popular wellness apps like myStrength and Calm. The myStrength app (a wholly owned subsidiary of Livongo Health, Inc.) offers a personalized program with interactive activities, in-the-moment coping tools, inspirational resources, and community support. Calm is a meditation and sleep app designed to help lower stress and reduce anxiety.

CB: How does Kaiser Permanente use patient     feedback to improve mental health care outcomes?

Balan: The mental health industry is still in the early stages of being able to say whether someone is improving or not, but patient progress is essential to guiding decision-making. That’s why we’ve invested in a powerful diagnostic tool that provides real-time insights into the member’s emotional vital signs. This tool combines the results of validated screening tools and rating scales into a dashboard that the member and provider can use to make treatment decisions, monitor progress, and adjust treatment plans. Research has found that with feedback-informed care, more patients make progress and feel better—and in a shorter amount of time.

CB: What are some other major advancements in Kaiser Permanente’s mental health care?

Balan: In addition to the acceleration of telehealth and digital self-care, we can also report investments in key areas, including hiring more than 500 mental health clinicians in California in the last 5 years, committing $11 million toward technology, and $700 million in expanding and enhancing mental health care facilities. This is reported by Kaiser Permanente’s internal data.

We’re continuing to expand our rapid intake and assessment center to expedite care for our members. And we’re working in our communities to reduce stigma, address homelessness, and reduce the barriers that prevent people from seeking the mental health support they need.

Kaiser Permanente is at the forefront of mental health and wellness, fueling the global conversation and engaging with diverse partners to make  mental health and wellness a reality for all. We’re fostering open and honest conversations with people of all ages, including with our Find Your Words campaign, which is designed to make it easier for people to support themselves and others, and our innovative Presence of Mind initiative, which focuses on helping youth and young adults prioritize their well-being in collaboration with the esports and gaming community. These are just a few examples of how we’re cultivating health for our members and making a positive difference in homes, workplaces, and communities.

To learn more about Kaiser Permanente’s mental health care and how it’s supporting employers during the pandemic, visit


Yener Balan, M.D., DFAPA, is the VP of Behavioral Health and Specialty Services for Kaiser Permanente Northern California. He focuses on behavioral health, autism spectrum disorders, and transgender care services. Dr. Balan received his medical degree from Albany Medical College and completed his residency at the Albert Einstein College of Medicine. He’s also been recognized as a distinguished fellow of the American Psychiatric Association.