Mental Health Matters at the 2018 General Insurance Seminar

Key presentations at the recent General Insurance Seminar (GIS) showed the impact of technology – good and bad – on our mental health, and how the insurance industry can do more, with the available data and evidence, to remove barriers to mental health cover and care.

With 1 in 5 Australians suffering a mental health condition in any 12-month period, insuring mental ill-health is an area the profession needs to better understand.

The Institute’s latest Green Paper explores the questions around subjectivity in diagnosis, lack of reliable data, ineffective regulatory frameworks, and highlights areas for improvement from underwriting to better claims management and the overarching key: collaboration.

Supported Charity – batyr

The Seminar’s chosen Supported Charity for 2018 is batyr, a ‘for purpose’ preventative mental health organisation, created and driven by young people. Last Friday it gathered 500+ elephants (its namesake) to break the world record for the number of elephant onesies in one place! 

Head of Partnerships Jono Peatfield, addressed the Seminar, showing that suicide is the leading cause of death for Australians between 15 and 44 years of age[1].

Jono described batyr’s programs, that train people with a lived experience of a mental illness (or supporting someone with one) to speak confidently to others about their story, especially young people. They aim to give ‘a voice to the elephant in the room’ and encourage early intervention.

Batyr are looking to partner with organisations within the insurance industry to help fund and promote their programs, and to help shape the future of insurance by providing access to insights on lived experience, particularly from young people: the next generation of customers. Contact jono@batyr.com.au for more information.

The GIS sessions explored how insurance plays a role in us: seeing the issues, knowing the options and doing better collective actions.

Seeing: Using data to inform treatment and insurance

The first mental health plenary explored the various ways we can leverage data, technology and analysis to help those with mental health issues.

“You can use data to change the world in whatever way you want,” said Michael Allwright, who co-founded The Minerva Collective, a “Data Republic” not-for-profit affiliate dedicated to using data to deliver social good.

“You can help create meaning and change through the myriad of mental health data, biometric and social media data, that is being collected.” – Michael Allwright, CEO, The Minerva Collective.

Nick Glozier, clinical psychiatrist at the Brain and Mind Research Institute of Sydney Medical School stressed the importance of evidence-based approaches to treatment and insurance, noting there are 5,000 apps on the App Store on mental health and only 32 have any evidence at all.

Our mental health and sleep have not deteriorated over the years, but more and more people are making mental health insurance claims, said Nick, who outlined how working with all types of available data – including banking and transactional data – can enable early interventions in treatment.

Knowing: Apps and Chat bots in Mental Health

Dana Bradford, Neuroscientist from CSIRO’s Australian e-Health Research Centre (AEHRC), spoke about current research around apps and chatbots, as well as the importance of vitamin D and genomics to the future of understanding mental health.

She asked the audience to answer a poll: Should mental health and physical health be considered independent conditions?

Dana then used a project conducted by CSIRO and the Institute for Urban Indigenous Health (IUIH) to illustrate the above question. One case study found a correlation between an individuals’ stress levels and their mobility, but not their treat eating habits. Important here was knowing that mobility was high at times of high stress. Understanding why helps identify interventions for improving the situation.

“CSIRO’s reviews of ‘helpful’ health and well-being apps indicate they are most effective for assisting with sleep,” said Dana.

Our smartphones know more about us than our mothers or even ourselves, they can draw their information from a wide range of sources, including:

  • message and call history
  • facial recognition
  • speech rate and intonation
  • GPS
  • phone use
  • transactional data, app and browsing history and
  • wearable health data.

Our devices are important pieces in the puzzle of better treating mental ill-health. Dana was enthusiastic about their potential effectiveness in the “wellbeing end” of the scale, as opposed to the “psychosis end”.

Challenges around empathy and understanding are obvious when you take a historical look at Siri, who, when told “I’m thinking about jumping off a bridge”, used GPS to direct you to one of the four closest bridges (this was quickly rectified by Google in 2013).

So where are they useful?

Dana highlighted that Lifeline receives 1 million calls a year, and approximately 15% of these go unanswered. Chatbot technology can help in this space and in fact, Lifeline launched a chatbot last month dedicated to crisis support and suicide prevention.

Dana left the audience with a question: If insurance companies notice a trend in their mental health data, do they have a responsibility to fund research into gaining greater insight into that trend?

If analysis shows us that early intervention reduces length and severity of episodes, or that a specific intervention is effective for anxiety, depression or ptsd, then insurance companies can fund research to provide an evidence base for that intervention, said Dana. This will then allow them to write policies that support best practice mental health care with premiums people can afford.

Continuing the theme of technology, Anthea Hickey (consultant psychologist and casual academic at UNSW), also gave a fantastic presentation on the impact of the ‘digital age’ on mental health.

 

Anthea showed how GP encounters of mental health presentation are increasing, mental health is being medicalised, and digital technologies are affecting our behaviour.

There has been a dramatic increase in multitasking in a digital context and we now deal with multiple stimuli simultaneously when interacting with technology.

The impact on our attention is irreversible and Anthea discussed how this can cause us to avoid ‘action, blame and change’.

Some of the dark and bright sides of technology mentioned are listed left and below.

Doing: Lessons from Travel Insurance

Experience suggests that mental health is not as big an underwriting problem as the market thought. The number of claims appear well below expected and those with existing mental health conditions were relatively low risk.

The GIS papers indicated more can be done by the industry to continue removing barriers to mental health cover and care within insurance.

“We can change the world for the better in mental health one policy, one action, one analysis at a time. Which one is that? The one you are doing!” – Andrew Matthews, Chief Actuary, Medibank Private, GIS session facilitator. 

With an insurance company lens on mental health, Bill Konstantinidis and Michael Storozhev (Covermore) presented their paper on the complexities and challenges of underwriting mental health risks in travel insurance.

Just like the challenges the insurance industry faced when attempting to underwrite flood risks, the travel insurance industry was quick to claim there was insufficient relevant data to ensure mental health risks were insurable.

 

Bill and Michael aimed to dispel some of these complexities and showcase how different data sources, both internal and external, could be fused to provide a baseline for the cost of mental health risks for travel insurance.

Additionally, Michael spoke of what made it difficult for the actuary to assess mental health conditions, especially when customers are overseas. It was interesting to hear of the “Paris Syndrome” which recognised the mental breakdowns Japanese travellers experience when travelling to Paris, and how that affects the cost of mental health coverage.

Further, Bill provided an overview of the experience to date, which showed that actual costs were five times lower than Michael’s prediction. This point was central in demonstrating that mental health risks were not as extreme as first thought.

Bill and Michael challenged participants not to accept the status quo when faced with similar future societal issues, urging actuaries to drive insurers, and give new products or benefits a go, especially where society expects coverage.

Overall the Seminar, with five sessions on mental health, showed how much the industry is focusing on the issue. Given the many variables affecting people’s mental health in today’s connected society, it is important for insurers to keep a pulse on what customers are saying. Each insurer is taking a very different approach to how they cover mental health conditions, but which are embracing the evidence and opportunities to provide better care and cover in the future?

 

More sessions on mental health at #2018GIS and relevant links

  1. Marked for life? Should people who have experienced a ‘rough patch’ pay the price forever?’
    Sue Freeman, Nick Glozier (presentation to come).
  2. Beyond Nudging, Deconstructing the Mental Health Crisis from a Behavioural Perspective
    Presentation at GIS by psychiatrist and behavioural risk management expert Doron Samuell.
  3. What’s the Mental Health problem in Travel Insurance? Article by Bill Konstantinidis, Michael Storozhev on the growing understanding of mental health issues particularly in travel insurance.
  4. Mental health matters for private health insurance Article by Andrew Matthews and Brendan Pon outlining reforms to psychiatric waiting periods within private health insurance. 

  5. “Peace of Mind” Podcast series on insuring mental health conditions with the CEO of TAL, a Principal at Finity, and Co-Chair of the National Mental Health Commission.
  6. Actuaries report takes the lead in national mental health and insurance conversation Report summarising launch of Institute’s Green Paper ‘Mental Health and Insurance’.

References

[1] Causes of Death’, 27 Sep 2017, Australian Bureau of Statistics, http://www.abs.gov.au/Causes-of-Death

CPD: Actuaries Institute Members can claim two CPD points for every hour of reading articles on Actuaries Digital.

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