Jill Schwartz-Chevlin, MD, MBA, FACP
Chief Medical Officer, Vynca
Over the past two decades practicing palliative care, I’ve cared for patients navigating some of the most complex periods of their lives. Many struggle not only with pain, fatigue, or shortness of breath, but also with anxiety, depression, and uncertainty about what lies ahead.
These behavioral health challenges are real clinical concerns. In serious illness, they can further complicate the management of chronic conditions, contributing to increased emergency care, hospitalizations, and reduced quality of life.
For patients living with serious illness, behavioral health challenges can significantly affect health outcomes. Anxiety, depression, fear, and other mental health concerns can make chronic medical conditions harder to manage, contribute to worsening symptoms, and increase the likelihood of hospitalization and further decline. Acute symptoms such as pain, fatigue, and shortness of breath may be related to chronic medical conditions, but they can also be exacerbated by emotional distress. At the same time, social changes such as reduced autonomy, increased need for assistance with activities of daily living, and loss of independence can deepen anxiety, fear, and a reduced sense of purpose.
Caregiver burden can also play a major role. Increased tension between patients and caregivers, or increased stress in the home, can lead to urgent care needs, emergency department visits, and hospitalizations. These dynamics directly affect a patient’s quality of life and their ability to remain at home, where many patients want to be.
For many patients, the challenges extend beyond the clinical. Housing instability, food insecurity, limited transportation, and social isolation can all compound the stress of illness. These are not peripheral concerns. They shape how patients feel, how they function, and whether they can engage with their care at all.
Healthcare often treats medical, behavioral, social, and spiritual issues as separate problems requiring different specialists. But as palliative care providers, we understand how each of these areas affects a person’s ability to live more fully and freely.
Creating an environment where the care team works in sync to improve care, address what matters most, and ensure patients feel heard and understood is at the core of what we do at Vynca.
Consider a patient who lives alone with advanced heart failure and requires oxygen. He has repeated hospitalizations for shortness of breath, struggles to manage his medications, and has limited transportation, which contributes to missed provider appointments.
Now imagine a team committed to identifying those gaps and helping him and his family anticipate his needs. That team creates a system to improve medication adherence, gives providers and family members visibility into missed doses, invites family into home visits to educate them on what may happen next, helps them understand how to reduce exacerbations, and makes clear who to call at the first sign of new symptoms. With a 24/7 team of clinicians available to respond, we can change outcomes, improve quality of life, and reduce caregiver burden.
Integrating clinical, behavioral, social, and spiritual care into a coordinated model means meeting patients where they are, often in their homes, and responding to changes before they escalate into crises. It means recognizing that social needs, behavioral health needs, and spiritual needs are foundational to providing holistic care for patients with complex chronic medical conditions.
Mental Health Awareness Month is an important reminder that emotional well-being deserves attention, especially for patients living with serious illness.
When care teams are designed to see the whole picture, patients and families have a better chance to feel supported physically, emotionally, socially, and spiritually.