I'm not against awareness campaigns. They matter. They reduce stigma. They get people talking.

But setting up "days" does nothing for patients in between those days.

I know this because I lived it. In 2005, I broke my neck. The healthcare system that followed felt designed to isolate me.

No doctor seemed able to help me. Nobody offered options beyond opiates. Nobody asked why I was having the pain I was having.

More importantly, nobody asked what was happening to me mentally.

I needed someone to listen. I needed someone to ask about my mental state, not just my physical symptoms.

That question never came.

The System Design Creates The Blind Spot

Here's what I learned: specialists do what they're trained to do. They focus on their specialty.

They're not trained to treat depression, insomnia, or mood disorders. So they don't ask about them.

This creates predictable gaps. We discuss mental health if you've been diagnosed with a mental health condition. We forget about the burnout and depression that comes with being a cancer patient. Or a COPD patient. Or a diabetes patient.

Research shows that 25% of cancer survivors have persistent mental health conditions. These conditions make the physical illness harder to overcome.

The isolation compounds everything.

Care Navigation Already Works

The solution exists. It's proven. It's called care navigation.

Care navigators and nurses can be the point person who connects physical treatment to mental health support. They need training on local services and insurance networks. They need authority to be part of the care team.

The data is clear. Patient navigation programs reduce emergency department visits by 32% to 52%. They get patients to the right specialist or primary care provider.

The cost savings exceed implementation costs.

So why isn't this happening everywhere?

Follow The Reimbursement

Behavioral change in healthcare follows one thing: billing codes.

Providers and office staff won't think holistically about patients unless they can bill for the time it takes. It's not about awareness. It's about economics.

The good news? Policy is shifting. Medicare established reimbursement for patient navigation services starting January 1, 2024.

The rule covers individuals with serious conditions expected to last at least three months. Cancer, COPD, heart failure, severe mental illness, and substance use disorder. We must expand the conditions covered and, more importantly, who can bill for these navigation codes.

This is the infrastructure change that awareness campaigns can't provide.

We don't just need mental health support in emergencies. We need it integrated across all disease states. We need it available every day, not just on designated awareness days.

We need care navigation as a covered benefit by insurance. This way, offices and providers get paid for helping patients find the next right clinician based on their symptoms.

Mental health or otherwise.

The system will produce what it's designed to produce. Right now, it's designed to create gaps.

We have the evidence. We have the policy framework starting to emerge. We need to expand it before more patients experience the isolation I did.

Because awareness without infrastructure is just noise.