Fixing Mental Healthcare in America

Fixing Mental Healthcare in America

An interview with Dr. Nicole Eberhart and Dr. Ryan McBain from the RAND Corporation. Curt and Katie kick of their special series related to the problems and potential solutions in the mental healthcare system. We interview Drs. Eberhart and McBain about the study they authored related to the structural concerns in the mental health system as it is currently built and their recommendations for solutions and best practices going forward.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Interview with Dr. Nicole Eberhart, Senior Behavioral Scientist, and Dr. Ryan McBain, Policy Researcher, The RAND Corporation

Nicole Eberhart, PhD is a Senior Behavioral Scientist at the RAND Corporation and a licensed clinical psychologist whose research and evaluation focuses on mental health. She has expertise in health program evaluation, prevention and early intervention, health services and systems, and innovative care models including those that integrate primary and behavioral health care. Dr. Eberhart been evaluating mental health programs and policies in California and nationally for over a decade.

Ryan K. McBain is a policy researcher at the RAND Corporation. He focuses on the design and evaluation of health policies and programs meant to reach vulnerable populations—including those coping with mental health conditions, HIV/AIDS, homelessness, and poverty. To achieve this, McBain has utilized a wide range of methodologies, including econometric approaches for quasi-experimental analysis, cost-effectiveness analysis, and decision analytic models, as well as key informant interviews and focus group discussions. Internationally, McBain has worked with the World Bank, World Health Organization, Harvard University and Partners In Health, where he has focused on evaluating mental health, HIV, and primary care service delivery systems, primarily in sub-Saharan Africa and Haiti. McBain holds a Ph.D. and M.P.H. in global health with concentrations in health economics and health policy analysis from Harvard University, as well as a B.A. in psychology from Gordon College and Oxford University in the United Kingdom.

In this episode we talk about:

  • Introducing our new series on Fixing Mental Healthcare in America
  • RAND corporation report on the mental health system
  • Structural issues in the current mental health system
  • Work force issues, lack of professionals, poor distribution across communities
  • Payment issues – Mental Health providers are not paid as well as other medical providers
  • The problem of fee for service, government insurance programs, and private pay
  • Culture problem – historical lack of value of mental health, stigma and de-prioritization of mental health
  • Lack of educational programs for mental health, lack of consistent, effective crisis response
  • The idea of increasing wages for entry level positions
  • Peer Support Specialists as another way to expand mental health workforce
  • The importance of lived experience and the professionalization of the peer support specialist profession (for example certification)
  • The idea of paying for value rather than paying for services
  • Focusing on prevention rather than costly emergency services
  • The need for legislators to make changes
  • The costs of not fixing the mental healthcare system
  • An evidence-based continuum of care
  • Taking a big picture approach (looking at the cost for services and the cost for society)
  • Pushing back against the cost question – looking at how we are improving lives and the hypocrisy of asking this of mental health care and not medical care
  • Using tools LOCUS (Level of Care Utilization System) to assess needs and enforce parity
  • Mental Health education in K-12 curriculums, standards for mental health education, and promising places to start
  • Mental Health First Aid – the problem one-time events and short-term effects
  • How telehealth can be an engine for change and the importance of increasing and maintaining the momentum – looking at increases in access to both general and specialist mental health care
  • Mental health crisis response as an avenue that has a lot of political will behind it (BLM, social justice, and policing that can be replaced by mental health providers)
  • Mental health access needed to respond to the new hotline: 988
  • Arizona’s Crisis Now program and the impact they’ve seen from replacing police response to these incidents
  • Compartmentalization of different departments, budgets, etc. and the turf wars that can ensue
  • Being able to go to programs that are really doing good work and improving lives and using these as examples for what we should be doing as a whole country
  • The importance of advocacy at all levels
  • Coordination at a higher level to improve the integration of and care coordination for mental health care
  • Using the data from RAND to support advocacy
  • The comprehensive nature of the RAND report
  • The call to action for listeners to share their stories and experiences in the mental health system
  • The hope for an impact and on-going conversations that make a difference

Our Generous Sponsors:

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Resources mentioned:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

RAND Report: How to Transform the US Mental Health System

Dr. Ryan McBain’s Publications

Dr. Nicole K Eberhart’s Publications

SAMHSA

Pubmed.gov

University of Michigan: Behavioral Workforce Research Center

Email them:

mentalhealth@rand.org

Twitter:

@RandCorporation

@NicoleKEberhart

Relevant Episodes:

A Living Wage for Prelicensees

Biden and Trump on Mental Health

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Who we are:

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also Past President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano http://www.crystalmangano.com/

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