Research tells us time and again that mental health conditions such as depression have an impact on a person's everyday life, which may include physical health. Health care professionals should consider the entire spectrum of a member's health care needs, both mental and physical. By doing so, health care professionals can deliver a total member experience, one that embraces the interrelationship between mind and body.

Our goal is to help you and your health care professionals better understand the mind-body connection by providing a variety of easy-to-use products and tools. We use information and technology to tailor materials to your unique needs. We build and continually update innovative tools and programs to help you and your health care professionals achieve the best mental and physical health possible.

Here are just a few of the decision-support tools and dedicated programs we offer:

• The Reawakening Center
• Healthy Outlook Program®
• The Aetna Employee Assistance Program (EAP)
• Aetna's Successful Aging Program
• DocFind®
• Aetna Depression Management
• Depression Disease Management Program
• Medical Psychiatric Case Management

The Reawakening Center

Depression is estimated to be the leading cause of disability worldwide. While nearly 19 million Americans experience depression annually, it's a subject that's rarely discussed openly. Seeking help for depression usually carries with it a stigma, which could explain why only 23 percent of adults diagnosed with depression actually receive treatment.* That's why Aetna developed the Reawakening Center.

This online depression screening and information tool educates you about depression in a way that is creative, entertaining, supportive and nonthreatening. Use this tool to learn more about yourself, discover ways of dealing with your feelings and emotions, and understand when you may benefit from professional help. The Reawakening Center also assesses your readiness for taking action so you can be more successful in addressing your feelings of depression, should you be at risk.

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Healthy Outlook Program®

Because depression often accompanies chronic illness, Aetna includes depression screening and referrals as part of our Healthy Outlook Program. This program reaches out to members at risk of the following chronic health conditions:

• Asthma
• Chronic heart failure
• Coronary artery disease
• Diabetes
• Low back pain

Our coordinated program components include education, provider counseling, patient self-care and physician support, all of which help you better manage your condition. By identifying and treating your condition early, you can help to avoid complications and improve your quality of life.

Once you are identified and enrolled in the Healthy Outlook Program, you will receive quarterly mailings, a depression workbook, early intervention and, in some cases, individualized case management, with an emphasis on lifestyle changes.

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The Aetna Employee Assistance Program (EAP)

Aetna has long been a leader and innovator of health-related programs and services. Our Employee Assistance Program was designed to help you and your family balance the demands of work, life and personal issues.

The Aetna EAP includes many options, such as individual and family counseling, as well as referrals and resources for child care, elder care, and legal and financial concerns. We believe that this program can serve as a source of early intervention for many problems and issues. For an EAP to be most effective, you should access the program as soon as you recognize a problem, to help manage your work and life issues before they become unmanageable.

Our EAP assesses your needs and refers you to resources to serve you. Aetna's EAP professionals may be able to help solve a problem early and encourage the appropriate use of behavioral health and medical benefits. This helps you better manage your health and wellness, as well as your health-related costs.

Here are just some of the benefits of the Aetna EAP:

• A supportive environment — Aetna's EAP provides resources to those dealing with such diverse issues as marital distress, substance abuse or workplace conflict. In addition, the EAP can help you with general work/life concerns through optional services, such as elder care, child care, and legal and financial assistance.



• Easy access — You can access the Aetna EAP conveniently and confidentially, 24 hours a day, 7 days a week. Whether by phone or the Web, you are directed to resources quickly, which can help you efficiently manage issues.



• Personalized services — One phone call to the toll-free number puts you in touch with a trained professional who can assess your needs and refer you to an EAP professional or other resource.

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Aetna’s Successful Aging Program

Experience teaches us that the well informed make the wisest choices. We believe that accessing and understanding your benefits are important elements of the total mind-body approach to good health.

To complement our Employee Assistance Program (EAP), we offer a Successful Aging Program, continuing our commitment to help you achieve enhanced health, productivity and satisfaction as you deal with aging issues for yourself and family members. This program can help you to plan for your retirement and can provide support to you beyond your working years, all the while helping to control your health care costs. It also can help you to assist loved ones with elder care.

With an emphasis on successful aging, this program continues the many benefits offered in EAP and includes the following elements:

• A focus on excellence in service delivery by providing a single point of contact (called an advocate, coach or retiree assistant) to help you address issues such as:
  • Planning for your own retirement.
  • Finding elder care assistance for loved ones.
  • Helping you navigate the health care maze and resolve concerns.
• An empathetic approach in dealing with unique aging needs (such as grief counseling, Medicare support and geriatric case management).
• Efficiency and effectiveness.
• Delivery of accurate and relevant information that is easy to navigate via:
  • Easy telephonic access with personal service.
  • A custom-designed website with the needs of the older population in mind.

Empowering people to make sound decisions is part of our business philosophy.

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DocFind®

Aetna Behavioral Health provides members with access to a multi-disciplinary network of health care professionals that includes psychiatrists, psychologists, clinical social workers, clinical counselors and certified addiction counselors. The network also includes intensive outpatient and other alternative settings, where qualified programs are available.

To find out which health care professionals participate in the Aetna Behavioral Health network, visit DocFind, our online directory. Please be sure to select the plan type that you are interested in.

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Aetna Depression Management

Depression is a common illness that affects up to 10 percent of the population and can last weeks, months or even years if not treated properly. To help manage this condition, Aetna Depression Management provides a dedicated care planner to coordinate the efforts of primary care physicians and mental health specialists in identifying and treating depression. Once identified and enrolled in the program, you will receive educational materials and individualized care management, with an emphasis on appropriate treatment and adherence.

Identifying depression in the primary care setting is a quick and simple process. Primary care physicians will ask you two questions to determine if you have any possible signs of depression. Based on your response, the physician may choose to ask a series of additional questions called the Patient Health Questionnaire (PHQ-9). The PHQ-9 is an effective tool used to identify and assess depression and will provide the physician with the information needed to determine if treatment is necessary.

The treatment of depression varies from person to person. Aetna Depression Management provides:

• Tools to assist primary care physicians in the identification and treatment of depression
• Access to mental health specialists for consultation
• A dedicated care planner to assist in the coordination of care
• Educational support tools to help you manage depression

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Depression Disease Management Program

The Depression Disease Management Program is currently available for fully insured and self-insured HMO members who have both Aetna medical and behavioral health benefits. Starting in January 2005, the program will be available for self-insured PPO members when offered as part of their employer benefits in two situations: (1) when a member is covered by both Aetna’s medical and behavioral health benefits, or (2) when a member is covered only by Aetna behavioral health benefits.

The Depression Disease Management Program consists of the following components:

• A self-assessment — Identifying depression and other health disorders occurring at the same time.
• Educational information — Available on the website, by telephone using an interactive voice response system (in English and Spanish), and through mailings.
• Online services and decision-support tools — Related to depression and its treatment.
• Telephonic outreach — A team of case management clinicians who may contact you via telephone.
• A team approach — Includes pharmacy, primary care physicians and behavioral health professionals.

You may be recommended for Aetna's Depression Disease Management Program for the following reasons:

• You have been admitted for inpatient psychiatric diagnosis of major depression, dysthymia, depression not otherwise specified or bipolar depression.
• You receive outpatient treatment for one of the above diagnoses.
• Pharmacy data indicates that you are not using your antidepressants appropriately.
• Your primary care physician refers you to the program.

Aetna's Depression Disease Management Program will help you to access providers to get the treatment you need when you need it, and will help you to better understand your pharmacy benefits, allowing you to take antidepressant medications in a cost-efficient and effective manner.

In 2005, this program will expand to include alcohol disease management and anxiety disorders.

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Medical Psychiatric Case Management

To help providers address the needs of members who have both medical and behavioral health conditions, we have established the Medical Psychiatric Case Management program. Starting January 2005, this program will be available to self-insured PPO members when offered as part of their employer benefits in two situations: (1) when a member is covered by both Aetna’s medical and behavioral health benefits or (2) when a member is covered only by Aetna behavioral health benefits.

This program evaluates members with certain medical conditions to determine if they also have any behavioral health issues. Examples include an alcohol-dependent member with diabetes who is currently drinking; a member with multiple medical problems, including depression, who is overwhelmed and not able to comply with treatment; or a disabled member who is in psychological distress but cannot get to therapy.

Members who have behavioral heath issues and agree to a referral will be assigned a medical psychiatric case manager. Case managers work as your "team leader" in that they assess your needs, arrange for your treatment and help to coordinate any other services. This case management plan includes behavioral health services, as well as medical care.

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Aetna's tagline, We want you to know^SM, has special relevance in behavioral health care. We want to eliminate the stigma associated with mental health issues by helping you to understand the benefits of behavioral health services and by offering sensitive guidance when you call us.

We're here to help.

*Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Household Survey on Drug Abuse. 1994-97.