Memorial Hermann taps Charlie Health to fill gaps in critical mental health services

Houston-based Memorial Hermann Health System is partnering with Charlie Health to expand access to outpatient mental health treatment for teens and young adults.

In Texas, the state that ranks last in terms of mental health treatment access, nearly three-quarters of young people with depression are not getting the help they need.

"We have a national mental health crisis of all ages, but specifically with the adolescent population, and that really rose after COVID," Victoria Regan, M.D., vice president, women’s and children’s service line at Memorial Hermann, said in an exclusive interview about the collaboration with Charlie Health.

"One significant challenge our high-acuity patients experience is waitlists for outpatient treatment programs due to increased demand and limited resources," she said. "Addressing the mental health crisis requires proactive efforts to eliminate barriers to care for those who require an additional level of mental health support, which is exactly what Memorial Hermann is doing with Charlie Health."

Memorial Hermann serves patients in Houston and southeast Texas and operates 17 hospitals and numerous ambulatory sites.

Charlie Health, which launched in 2020, offers virtual high-acuity mental health care for teens and young adults. The startup aims to make virtual intensive outpatient treatment accessible to young people and their families, and the program combines supported groups, individual therapy and family therapy into evidence-based, comprehensive and personalized treatment plans.

Charlie Health's services are growing as there has been a significant surge in adolescents and teens seeking mental health services, resulting in a notable strain on existing resources, according to reports. Suicide rates among youth aged 10 to 19 jumped 40% from 2001 to 2019, while emergency room visits for self-harm rose by 88%, Centers for Disease Control and Prevention data show. 

Charlie Health's evidence-based virtual IOP is specifically designed to bridge the care gaps faced by high-acuity mental health patients. The company offers a level of care in between traditional once-weekly therapy and inpatient treatment, according to Carter Barnhart, CEO and co-founder at Charlie Health.

The company pairs every patient with a personalized therapist who is trained to address their specific needs. Patients also are placed into curated groups with peers coming from similar backgrounds and life experiences, executives said.

Adolescents and teens are showing up to hospital emergency rooms complaining of severe headaches and stomach pains but mental health issues such as anxiety and depression tend to be behind the scenes, according to Regan.

"They don't want to go to school, and another common symptom is the parents say their child's energy level has really decreased. For a lot of these kids, their anxiety and depression has escalated because it's been masked for a while," Regan noted.

The medical system struggles to keep up with the crisis, experts say, with limited options for inpatient and outpatient treatment.

The ED often serves as a revolving door, with over 25% of young people returning for mental health crisis treatment six months after their previous visit due to a lack of follow-up care resources, according to one study.

"What we're seeing as a health system, you tend to start seeing these patients show up in the emergency room with physical complaints, when it really it's more emotional. So oftentimes, these children would get admitted only to find out that it wasn't truly a traditional medical problem, and it was more related to the mental health problem. We could hold them and have our child psychiatrist see them while they're in the hospital, but you want to make sure to get them out of the hospital and to the right treatment program and get them back to their normal lives and families can feel more secure," Regan said.

"Partnering with Charlie Health excited us because they offer newer technology, evidence-based care in a virtual setting and data that supports their treatment program," she added. "They also provide a full continuum for the child, so not only are they providing an intensive treatment that many children need, but making sure that they have that warm handoff to the next level of care, so the child continues to succeed and not relapse with their symptoms."

Memorial Hermann is working with Charlie Health to extend the mental health care their providers can offer to high-acuity patients who may benefit from outpatient treatment programs. Patients who choose to enroll in one of Charlie Health’s virtual programs will receive a tailored outpatient treatment plan that incorporates a variety of mental health services.

"Charlie Health is filling in this continuum of care gap so that we can ensure that every single patient has access to high-quality, high-acuity care. That's the differentiator: that we're able to offer that care coordination for Memorial Hermann's high-acuity patients that are showing up in the ER that otherwise they wouldn't have solutions for," Barnhart said. "When we look at the stats, we know that readmission rates and the costs of care are exponentially higher when patients leave inpatient or ER and have no transitional care. It creates that revolving door."

She added that it's critical for health systems to partner with other organizations to address mental health gaps. "I don't know if it's necessarily with virtual providers. I think it's more with providers that emphasize the continuum of care and know their partner and know that we can't all do everything. It would be impossible for all of us to do everything in the behavioral health space," Barnhart said.

Charlie Health is now available in 30 states. 

"Teaming up with Memorial Hermann was a strategic decision for Charlie Health as we expand our evidence-based treatment in the state of Texas," Barnhart said.

She cited the health system's reputation for innovation as a key factor in the decision to ink a collaboration to expand virtual mental health services in southeast Texas.

Charlie Health's services, in partnership with health systems like Memorial Hermann, can help "unclog" emergency departments, she noted.

"Our emergency departments right now are overrun by people who are showing up or mental health issues, and Memorial Hermann is just one of the many, many places that is seeing this," Barnhart said. "We wanted to partner specifically with Memorial Hermann because they have such an extensive network and really robust community ties. What we've seen over the last three years of already working with them without a formal partnership is the relationship that they have in the community and their desire and similar mission to us and their vision of really ending the youth mental health crisis. It requires many people to come together and to partner to really build that world without suicide, which is core to Charlie Health and what we're doing here." 

She added, "We want other hospitals and healthcare systems to know that they can partner with providers like Charlie Health to create a continuum of care in every single community."

Regan said Charlie Health's services help provide timely access to care when mental health providers often have long waitlists, while also offering the convenience of virtual care. These services are covered through most major commercial insurance and Medicaid plans in Texas, according to the organizations.

"I think with mental health, it truly takes a village," Regan noted. "You've got to have that right partnership between the healthcare system but also, more importantly, between the provider for mental health and the patient."

Charlie Health works with major commercial and Medicaid insurance plans, and being in-network with health plans has been a key focus for the startup, Barnhart said.

"The reason we've been able to secure those in-network contracts is because of our outcomes. We publish our outcomes regularly. We share those outcomes with payers, and we really create win-win scenarios. We create this opportunity for enhanced care coordination with places like Memorial Hermann, so there can be that warm handoff from the ER. We built a referral pathway specifically for Memorial Hermann so that patients can get into our care within 24 hours or 72 hours, depending on how urgent the need is. And then we can successfully treat them and then transition them to the next level of care," she said.

While improving access to care through virtual services is important, Barnhart also stressed the importance of providing high-quality, effective care.
The company cites peer-reviewed research that found Charlie Health's mental health services drive positive outcomes, with 94% of patients avoiding further admissions to the emergency department for mental health reasons in the three months following treatment. Additionally, 89% of clients reported improvements in self-harm, 95% reported improvements in symptoms related to depression, 92% reported improvements in symptoms associated with anxiety and 74% reported a reduction in suicidal ideation.