Gut check: Finding new pathways to better mental health 

Alarming growth in rates of anxiety and depression have employers searching for new ways to support workforce mental health. Here’s a strategy to consider: Addressing the increasingly clear connection between mental health and gut health. As it turns out, the gastrointestinal system, responsible for the digestion of food, absorption of nutrients and maintenance of our immune system, also influences the nervous system – with important consequences for mental health.

It’s interesting to note that while the topic of gut health is not new, as we enter year three of the COVID-19 pandemic it has become one of the top-searched health topics on Google – in particular, leaky gut syndrome, fermented food, and gut health protocols. Multiple studies have demonstrated that the gut microbiome (the community of microorganisms present in the gastrointestinal tract) influences stress reaction and anxiety-related symptoms. Mental health stressors may also lead to digestive disorders. The constant two-way communication occurring between the gut and the brain is referred to as the gut-brain axis.

These findings may explain why a higher-than-average percentage of people with Irritable bowel syndrome (IBS) and functional bowel problems develop depression and anxiety. In addition, research has shown that even short-term stress can affect the microbiome. Clearly, the pandemic has included periods of significant stress for many people – while at the same time, eating habits have been greatly disrupted (think of the explosion in the use of food delivery services). Over two years of prolonged stress, many people have found themselves in a cycle of stress and unhealthy eating behaviors that put them at risk.

Opportunities to address gut health and mental health in tandem

The latest evidence suggests that interventions focused on the gut-brain axis can have a positive effect on mood, motivation, and higher cognitive functions, and underscores the importance of addressing GI concerns as part of a comprehensive approach to supporting mental health and emotional wellbeing.

Employers can start by educating the entire health plan population on the gut-brain connection. The basic message is that we benefit both physically and mentally from eating a largely plant-based diet, adding healthy bacteria-rich or fermented foods, exercising, using mindfulness practices, and maybe even getting support from a mental health coach or a licensed clinician. Beyond this type of broad communication, you could also use your claims data to zoom in on individuals with anxiety and depression-related medical and pharmaceutical claims and offer tangible solutions through an integrated health and wellbeing strategy that includes a component targeted to addressing gut health. For example, individuals with severe gastrointestinal disease such as Crohn’s disease or IBS mostly likely suffer from anxiety and/or depression. A GI vendor such as Vivante Health or Oshi Health provide timely access to clinicians and include stress management and mental health support which may prevent digestive flare-ups.

If you’re interested in exploring new pathways to better workforce mental health, consider these steps:

• Communicate an understanding that mental health struggles are normal and improving one’s diet can assist in improving mental health. This most emphatically does not mean encouraging a targeted group of individuals to follow a hyper-restrictive diet, which may actually result in short-term emotional stress rather than long-term improvement in mental health.
• Review your carrier and vendor capabilities to ensure that offerings include risk stratification to identify plan members with early indicators for either mental health conditions or GI distress.
• Ensure offerings treat the whole person. The best outcomes will follow from helping individuals improve self-care for chronic disease -- including GI conditions -- while addressing their emotional well-being.
• The brain and the gastrointestinal system are intimately connected and have a direct effect on each other. A health strategy that considers the whole person could be a way to both mitigate chronic GI issues in your population and improve workforce mental well-being.