Possibly the biggest barrier to people getting the support and care they need for loneliness and all mental health and wellness conditions is the stigma surrounding these conditions. We are too often afraid to ask for help, and afraid to talk about the issues facing us, our families and friends. We need to do more to address the stigma surrounding loneliness, mental health and substance use disorders. We need to make it okay to talk about these things just as we talk about cancer or heart disease.
I had the pleasure of interviewing Dr. Doug Nemecek, Chief Medical Officer, Cigna Behavioral Health
Dr. Doug Nemecek is the Chief Medical Officer for behavioral health at Cigna. Dr. Nemecek also leads Cigna’s national Coverage Policy team, responsible for developing policies and tools that are used to interpret standard medical, behavioral, and pharmacy benefit plan provisions. Additionally, he helps to coordinate Cigna’s national medical cost trend analysis and initiatives to address major medical cost drivers for our clients.
Prior to joining Cigna, Dr. Nemecek served as Executive Medical Director for Allina Behavioral Health Services in Minneapolis, overseeing five outpatient clinics and four inpatient mental health units with over 80 mental health providers. He also has 10 years of clinical experience with an inpatient and outpatient psychiatric practice in Minneapolis.
Dr. Nemecek received his M.D. and completed his psychiatric residency at Washington University in St. Louis in 1993. He is recognized as a Distinguished Fellow with the American Psychiatric Association, is board certified by the America Board of Quality Assurance and Utilization Review Physicians and holds an M.B.A. from the University of St. Thomas in Minneapolis. Dr. Nemecek is currently the Chair-elect for the Board of the Association for Behavioral Health and Wellness. He also serves on the Scientific Board for Shatterproof, a national non-profit organization dedicated to ending the devastation that addiction causes families.
Thank you so much for doing this with us! Our readers would love to “get to know you” a bit better. Can you share your “backstory” with us? What was it that led you to your eventual career choice?
Iwas a 3rd-year medical student when I fell in love with psychiatry. I recognized the incredibly positive impact that mental health and substance use care had on individuals and their families, and I knew that I wanted to help provide psychiatric care to people in need. After 10 years with a successful psychiatric practice, I saw that I could have an even bigger impact by improving mental health and substance use care for people across the United States, and I joined Cigna, where our mission is to improve the health, well-being, and peace of mind for those we serve. And we do that by valuing the “whole person,” treating mental and emotional health is just as important as physical health.
Can you share the most interesting story that happened to you since you started your career?
Since joining Cigna, I’ve had the privilege to engage in discussions about mental health and substance use disorder care with people from all across the United States, including employers large and small, health care providers, and policymakers at the local, state and national level. This has allowed me to see and learn about the various issues and ideas about mental health and substance use disorders, and to find partnerships to drive change and improve people’s lives.
Can you share a story about the most humorous mistake you made when you were first starting? Can you tell us what lesson or takeaway you learned from that?
I look back to the start of my career at Cigna, and the first job I initially applied for was the role of Chief Medical Officer for behavioral health. I applied even though I had no experience in managed care or insurance at the time. I figured I could learn about managed care on the job. I did not get that job, but did build relationships and was then offered my entry role as a Medical Director with Cigna. I’ve learned so much about health care at Cigna that if I went back to my practice management role again, I know that I’d be so much better at that job now.
Are you working on any exciting new projects now? How do you think that will help people?
At Cigna, we are focused on making high-quality mental health and substance use disorder care more accessible and affordable for our customers. This includes identifying centers of excellence to help customers pinpoint the best place to receive care, developing innovative value-based reimbursement models for care, and rapidly expanding the availability of telehealth and virtual care options to make care more convenient and accessible. All of this will help our customers attain optimal outcomes and allow them to be healthier and more productive at home, at work, and in their communities.
Can you share with our readers a bit why you are an authority about the topic of the Loneliness Epidemic?
Cigna is deeply committed to addressing societal issues that impact not only our customers and employees but the general public. In 2018, we released our first Loneliness Index, which found 54% of Americans classify as lonely. As part of our efforts to combat the rise of loneliness and improve mental wellness across America, we released the results of our second survey on loneliness in America in January 2020. We found that three in five Americans (61%) now report feeling lonely. This is a 7-percentage point increase from our 2018 survey. Additionally, we concluded that loneliness and the workplace have a clear connection.
With more than 170 million customer relationships globally, as well as a deep understanding of the mental health crisis impacting a quarter of American adults, we believe we have an opportunity, a unique perspective and a moral obligation to use our scale, resources and solutions to help people improve their lives. Whether we’re engaging with our customers, our employees, veterans or the general population, we address people’s mental and physical health and the connection between them, a whole-person approach that supports mind and body for the greatest benefit. The data and insights we’ve gained through this research will help us innovate new health and well-being solutions that can improve people’s lives.
Ok, thank you for that. Let’s now jump to the main focus of our interview. According to this story in Forbes, loneliness is becoming an increasing health threat not just in the US , but across the world. Can you articulate for our readers 3 reasons why being lonely and isolated can harm one’s health?
Feelings of loneliness can affect your mental and physical health? For example, chronic loneliness can drive up cortisol levels in the body. Cortisol is a hormone that your body creates when under stress. Over time, higher cortisol levels can lead to inflammation, excess weight gain, insulin resistance, problems concentrating, and more.
If left unchecked, chronic loneliness symptoms can put you at greater risk for more serious medical and emotional problems, including:
- Sleep disorders
- Type 2 diabetes
- Heart disease
- High blood pressure
- Substance use
We also know that chronic loneliness has the same mortality risk as smoking 15 cigarettes per day. Loneliness ls literally killing us.
On a broader societal level, in which way is loneliness harming our communities and society?
Loneliness is an epidemic exacerbating a mental health crisis across America that contributes to societal ills including drug use, overdose, gun violence, and suicide. Our study also shows the significant impact that loneliness is having on our businesses and workplaces. We saw that people who are lonely say that they are less productive on the job. They also miss twice as many days of work due to illness, and 5 times as many days of work due to stress. People who are lonely are twice as likely to think about quitting their job in the next 12 months. All of this impacts the workplace and adds significant costs to the business. At Cigna, we believe if we can reduce loneliness, we may be able to make a significant positive difference in the lives of millions of people, at home and at work.
The irony of having a loneliness epidemic is glaring. We are living in a time where more people are connected to each other than ever before in history. Our technology has the power to connect billions of people in one network, in a way that was never possible. Yet despite this, so many people are lonely. Why is this? Can you share 3 of the main reasons why we are facing a loneliness epidemic today? Please give a personal story or an example for each.
Our study revealed that America’s loneliness epidemic is getting worse and it is an issue felt broadly across all demographics of Americans. Of note, our survey found that Generation Z feels lonelier than older generations, with 80% of Gen Z saying they feel lonely. We also learned that people who identify as heavy social media users say they are lonelier than those who are not heavy users. When we lack balance in our lives, in our daily activities and do too much or too little of any given thing (e.g., sleep, work, time with family), it exacerbates loneliness. And this need for balance extends to our use of social media. If we use technology and social media in a way that allows us to make more in-person, meaningful connections with others, that is helpful. But just having a thousand friends or followers on social media doesn’t really help us feel connected to others.
Technology also allows us to work from home, from airplanes, and from hotels. It allows us to have just about anything we need to be delivered to us at home, so we don’t have to leave home. While this flexibility can be helpful with managing all of our daily needs, it also can lead us to a life of isolation and severe loneliness.
Ok. it is not enough to talk about problems without offering possible solutions. In your experience, what are the 5 things each of us can do to help solve the Loneliness Epidemic? Please give a personal story or an example for each.
While the solution to loneliness is unique to each individual, we do know that there are steps each of us can take to begin to address loneliness, including:
- Learn to recognize loneliness in ourselves and others.
- Reach out to your families, friends, and colleagues when you suspect they are lonely. People are not likely to reach out to you if they feel lonely, but they are just waiting for you to ask and offer support.
- Be open to others reaching out to you. Accept offers to connect, meet and have a conversation.
- Get to know your coworkers better. Don’t simply walk past everyone at work as you walk to your desk. Stop and say ‘hello.’ Share a cup of coffee with someone. And don’t eat lunch alone.
- Take advantage of your employer’s health and wellness offerings.
- Find the work-life balance that’s right for you. And work on balance for all areas of your life, including sleep, exercise, etc.
- Use technology to stay connected but don’t forget that face to face communication is important too. In the end, it is the face to face, meaningful interactions that help us build connections and eliminate loneliness.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
- Possibly the biggest barrier to people getting the support and care they need for loneliness and all mental health and wellness conditions is the stigma surrounding these conditions. We are too often afraid to ask for help, and afraid to talk about the issues facing us, our families and friends. We need to do more to address the stigma surrounding loneliness, mental health, and substance use disorders. We need to make it okay to talk about these things just as we talk about cancer or heart disease. When we do this, we will open the door for everyone who is struggling today and help them to get the help and support they need.
We are blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂
- As loneliness and mental health concerns reach epidemic levels across the United States, we recognize that these are issues that impact people around the entire world. In that light, I’d love to connect with Prince Harry. He’s been vocal about his own emotional struggles and has raised awareness of mental health concerns around the globe. I’d want to talk about the opportunities we have to truly address stigma and take steps to improve mental wellness for everyone. None of us can do this alone, but together we can make an impact.
How can our readers follow you on social media?
Your readers can follow me on LinkedIn. Additionally, for the full survey report, as well as some additional documents on Cigna’s 2020 loneliness findings, visitCigna.com/CombattingLoneliness and follow Cigna on Twitter, LinkedIn and Facebook.