Vice President of Behavioral Health & Emergency Services at Yale New Haven Hospital

Let me first make a disclaimer. I am not a trained expert in any field of psychiatry, psychological medicine, sociology, or any other field that specializes in understanding the human condition as it relates to our emotional hardiness. While I have deep experience in a variety of aspects of health care, my more intimate exposure to mental health has been the result of my role as the Vice President for Behavioral Health & Emergency Services for the last 7 years, as well as a family member managing through life with other family members who have experienced concurrent mental health and substance use disorders in recent years. I also count my 4+ decades of experience as a manager and leader in acute care facilities as having provided me with certain reasonable perspectives on behavior and mental health in general.

The media is replete with daily stories of the fragility that is growing in the capacity of our population to tolerate any level of physical discomfort or emotional stress. One might use the common statement that we live in a society where “everyone gets a trophy.” It also seems that the pendulum is slowly swinging back into balance with respect to that perspective. However, I believe that if we really want to have a significant impact on mental health in general, we need to take an intentional, standardized, and consistent approach, with an understanding that we are in it for the long game.

As many of the readers are aware, CBT and DBT are proven therapies that have demonstrated their effectiveness for a variety of disorders in a broad range of ages. While one focuses on patterns of thinking and behavior (CBT), the other focuses on your interactions with yourself and the world around you (DBT). It seems to me that these are all skills that would allow any individual to maintain a better degree of emotional stability and resilience, not to mention better decision-making and a potential host of other positive benefits.

The other program that has fascinated me, is the Alcoholics Anonymous (AA) twelve step program. Having attended a number of AA meetings, I was initially, and continue to be fascinated at the level of self-introspection and self-discovery that many of these individuals demonstrate. 

In attending one of my first meetings, I was constantly contrasting that with what I experience so often in the workplace and other life settings. In those settings it is more often a litany of blame, excuses, and victimhood. Religious overtones aside, I must imagine that taking an intentional approach to this type of self-assessment would be a good thing for all of us to do on a regular basis.

So, my approach to better mental health for all? Create a curriculum based on CBT/DBT and the 12-step program, which begins in kindergarten and continues through the end of every undergraduate program. Educate and teach children as they grow up, how to effectively cope with what the realities of life will bring into their lives. All schools, across America, no exceptions. I would like to believe that over time, there will be improvement that would touch our society at so many levels it would be extraordinary, not to mention the reduction in costs related to mental health issues that span from mild depression to more extreme forms of mental illness.

It is obvious that the current approach is not working. Efforts are variable in terms of success, billions of dollars spent every year related to mental health, and the problem is only getting worse. While we continue to make incredible strides in the treatment of more severe mental health issues with interventions such as intranasal ketamine, deep brain stimulation, and collaborations with the neurosciences, we are missing the opportunity to create a significantly larger volume of emotionally stable and resilient human beings through a more initiative-taking approach. What do we have to lose?