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When Clients Need More Than A Little Cheering Up

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The tabloids are full of articles about boomer clients who had it all, and more, and lost it all because of behavioral health problems such as depression or alcoholism.

What if boomer advisors borrowed an idea from group health insurers and started screening clients for signs of depression, anxiety or other conditions that could lead to loss of income, irrational decisions about finances or an endless stream of unproductive calls to the advisor’s office?

The behavioral health units at companies such as Aetna Inc., Hartford, and CIGNA Corp., Philadelphia, are starting to create opportunities to screen plan members who file big health claims or disability claims for behavioral health problems.

Aetna, for example, is starting to use a short questionnaire to assess the mental health of plan members who suffer from chronic illness. The company is giving the screening test to about 100,000 chronically ill health plan members each year, according to Dr. Hyong Un, national medical director at Aetna’s behavioral health unit.

The patients who have taken the test include tens of thousands of baby boomers. Aetna has found that about 19% of the chronically ill patients suffer from depression, compared with a depression rate of about 5% for the general population.

Many of the boomers with behavioral health problems suffer from mild depression, severe depression or alcoholism.

At least one study seems to indicate that, for the boomer generation, the peak period for depression may have shifted from the 30s to sometime between 45 to 64, Un says.

The boomer group is an interesting population group, because many boomers are just starting to notice the high blood pressure, diabetes and other lifestyle-related illnesses that eventually could lead to congestive heart failure and heart attacks, Un says. “People in that age group can still make a lifestyle change,” he adds.

But, if a boomer is depressed or suffering from untreated anxiety, the boomer is “probably not as likely to follow the recommended treatment regiment,” Un says.

For a group health insurer, detecting and treating behavioral health problems can have an immediate, noticeable effect on claims.

The Eden Prairie, Minn., behavioral health unit of CIGNA recently published results of a study indicating that aggressive management of treatment for severe depression cut overall medical costs by more than $3,000 per year for each patient included in the program.

When Aetna’s behavioral health unit conducted a similar study, it found that, even during the first year of operation, an aggressive program for treating patients facing a combination of chronic illness and behavioral health problems saved about $1,500 per patient per year.

For an employer, tackling behavioral health problems may improve attendance and productivity.

For the advisor working with a high-income boomer client, finding a subtle, tactful way to address behavioral health issues could be a good way to protect the client’s wealth and income.

Untreated depression and anxiety could play a role in some relatively affluent boomer clients’ difficulties with retirement planning and estate planning.

A recent survey by the life insurance arm of Hartford Financial Services Group Inc., Hartford, found, for example, that 24% of survey participants with $5 million or more in assets have not even written a will. Behavioral health problems may be keeping some of those millionaires from looking out for their own financial interests.

In North York, Ontario, Robert Sealey, an accountant, has made a name for himself by offering “mental accounting services, financial advice and coaching for clients who suffer from depression.” Sealey helps clients handle matters such as the financial records disorganization that can result from depression and the increased spending that can result from manic depression.

Ordinary financial advisors may not be able to give clients screening questionnaires, but, in many cases, Un says, detecting depression can be as simple as asking a patient, “Gee, are you depressed?”


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