NOEL KING, HOST:
Imagine you walk into the pharmacy and you see this - aspirin in Aisle 2, shampoo in Aisle 3, and therapy in Aisle 4. CVS is trying it. It's piloting a program in dozens of stores to offer counseling in the hope of reducing overall health care costs. And here I must mention that CVS owns the health care company Aetna, which is one of NPR's sponsors. NPR's Yuki Noguchi has the story.
YUKI NOGUCHI, BYLINE: Clients spill their guts to Philadelphia barbershop owner Angela Miller (ph).
ANGELA MILLER: You hear everything. I've heard so many stories. It was just like, I'm not a counselor (laughter). But they feel comfortable talking to you because you know their family. You know who they're married to. You know what they're struggling about.
NOGUCHI: It's been an intense year for clients and for Miller herself.
MILLER: People have lost work. They lost their jobs. My business had to shut down for about four months, and I wasn't really financially prepared for that. And my family, last year in March, we all caught COVID. I almost died from it.
NOGUCHI: The stress got to Miller, who has raised five kids on her own. And the isolation, she says, stirred up decades-old childhood trauma. She reached out to a therapist's office. A month later, they called back to say the next appointment would take another month.
MILLER: And I said, you need to change your practice because for somebody reaching out, they could be suicidal. This could be a breaking point. And you're telling somebody that's depressed, severely depressed, to wait another four weeks?
NOGUCHI: Then she noticed her local CVS advertising mental health services. She called and reached a counselor right away.
MILLER: I got, you can come in today. I said, today? And she said, yeah.
NOGUCHI: That gap is part of why CVS launched this pilot. It plans to expand into 34 stores this year, targeting diverse communities like this bustling area just north of Philadelphia. Rachel Garfield, co-directs the Kaiser Family Foundation program on Medicaid. She says therapy remains too expensive for many people, but insurers recognize there's huge unmet patient need.
RACHEL GARFIELD: It is kind of approaching a crisis situation. And I think that that is leading a lot of people, including some payers, to stand up and take notice.
NOGUCHI: Payers like CVS, which purchased insurance giant Aetna three years ago. To lower costs for patients, CVS negotiates with other insurers. It's a bet that could pay off for CVS, too. Jeff Cook is a vice president at the chain. He says internal data show if you treat mental health before it escalates into a crisis, it reduces other medical costs.
JEFF COOK: You're not going to be able to reduce emergency visits if you can't address some of the other problems around mental health. You've got to be able to address both sides. And as an industry, we haven't done a very good job of being able to tie those two together.
NOGUCHI: CVS isn't alone in offering therapy in a store. Walmart has opened 20 in-store health centers offering counseling along with primary and diagnostic care. Back at the CVS in Philadelphia, therapist Eve Townsend (ph) walks out of her office inside the urgent care clinic. She says she hopes offering counseling in stores will reach more people. Every other therapist she knows is already swamped with patients.
EVE TOWNSEND: That's a huge issue, the fact that people are saying, I'm crying out for help; I need this particular service. I don't want to go in inpatient; I don't want to go to the emergency room - and not having anywhere to go.
NOGUCHI: Patients can sit in an upholstered chair in her office or talk over video. The room is next to a nurse practitioner and adjacent to the pharmacy. Townsend says this proximity to everything works.
TOWNSEND: To be able to say, I can refer you within this clinic with a nurse practitioner, or you can get your medication here at the same place where you're receiving your mental health services, it's like a one-stop shop.
NOGUCHI: Nurse practitioner Felicia Anyanwu (ph) agrees. She works 10 feet away from Townsend and often refers patients to her.
FELICIA ANYANWU: At times, shingles manifests as result of stress. People might have hives as a result of stress.
NOGUCHI: She says rooting out the real cause makes it less likely these people end up in costly emergency care.
ANYANWU: If it's something that could be treated at this level, that has, in fact, decreased the cost for the insurance carrier as well as the patient.
NOGUCHI: These days, barber Angela Miller touts how therapy is brightening her outlook.
MILLER: I will share that, hey, I'm in counseling now, and I've been feeling better about this situation.
NOGUCHI: So far, she says, she's referred five friends to the therapist at CVS.
Yuki Noguchi, NPR News, Philadelphia. Transcript provided by NPR, Copyright NPR.
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