Resolving Challenges in Behavioral Health

About this Episode

Welcome to today’s episode of The Communication Solution podcast with Casey Jackson, John Gilbert and Danielle Cantin. We love talking about Motivational Interviewing, and about improving outcomes for individuals, organizations, and the communities that they serve. In this episode, we embark on a thought-provoking discussion on the scalability of mental health services and the application of motivational interviewing (MI) within systemic frameworks. Addressing the complexities of navigating the mental health system, the conversation delves into the limitations and potentials of MI, the impact of organizational culture and leadership, and the critical role of empathy and consistency in effecting meaningful change. Through an exploration of the challenges faced by both providers and recipients of mental health services, the podcast offers insights into the intricacies of enhancing care delivery on a macro scale.

In this podcast, we discuss:

• Complexities of the Mental Health System: The episode opens with a candid examination of the prevailing frustrations and criticisms surrounding the mental health system, setting the stage for a deeper exploration of its systemic issues.
• The Scalability of Motivational Interviewing: John Gilbert introduces the topic of scaling MI practices within the mental health sector, questioning how these techniques can be effectively expanded to meet broader systemic needs while addressing individual autonomy and well-being.
• Compliance vs. Behavior Change: Casey Jackson articulates the difference between compliance-based models and behavior change models, underscoring the limitations of traditional approaches in facilitating long-term mental health improvements.
• Challenges of Scaling MI: The conversation navigates the practical and philosophical hurdles in broadening the application of MI, including the need for political will, financial investment, and a cultural shift towards preventive care.
• Impact of Organizational Culture and Leadership: The discussion emphasizes the crucial influence of leadership and organizational culture in the successful implementation and scaling of MI practices, highlighting the necessity for consistent vision and communication.
• Empathy in Systemic Change: The hosts reflect on the importance of empathy at all levels of the mental health system—from individual care to executive decision-making—pointing out how a genuine understanding of diverse perspectives can drive more effective and compassionate solutions.
• The Role of Measurement and Feedback: The episode touches on the significance of measuring MI fidelity and providing feedback as key strategies in ensuring the quality and effectiveness of scaled interventions.
• Success Stories and Challenges: Casey shares examples of successful MI implementation in various settings, including the challenges faced and the remarkable outcomes achieved through dedicated efforts and strategic planning.
• Vision for Future Scalability: The dialogue explores the potential for a future where mental health services are more efficiently scaled, advocating for a concerted effort among stakeholders to adopt evidence-based, person-centered approaches like MI

You don’t want to miss this one! Make sure to rate us or share this podcast. It would mean so much to us!

This has been part one of a two-part podcast. We hope you’ll join us for the second portion. You don’t want to miss this one! Make sure to rate us or share this podcast. It would mean so much to us! Thank you for listening to the communication solution. This podcast is all about you. If you have questions, thoughts, topic suggestions, or ideas, please send them our way at casey@ifioc.com. For more resources, feel free to check out ifioc.com.

Transcribe

 Hello and welcome to the communication solution podcast with Casey Jackson and John Gilbert. I’m your host, Danielle Cantin. Here at the Institute for Individual and Organizational Change, otherwise known as IFIOC, we love to talk about communication, we love to talk about solutions, and we love to talk about providing measurable results for individuals, organizations, and the communities they serve. Welcome to the communication solution that will change your world. 

Hey everyone. It’s Danielle Cantin here with the communication solution podcast. I’m your facilitator here with your hosts, Casey Jackson and John Gilbert. Hey guys. Hello.  I’d like to turn this episode over to John. You have a great idea for what we can talk about today.

And instead of me trying to reiterate it, I’m just going to toss it to you. Okay. Well, thank you. Yeah. I think it’s a work in progress here, but I know that Casey and I definitely can riff off this and, and this is more Casey’s wheelhouse, but a lot of this relates to a recent podcast we did where we went into the lived experience of helping people that,  are unhoused or dealing with that or mental health issues.

And how that is as someone that’s helping them and what that experience is like and how am I fits with that. So for those that are interested in that, you can go deeper into that dive. I’m really curious about the other kind of side of this where people have all seemingly I I’m less aware of this. I know Danielle.

You shared some things as well, that there’s a lot of opinions and a lot of,  frustration and a lot of ideas about the mental health system and how it’s completely broken or how we need to do this or that. And Casey, I’m thinking of starting there with you because you had shared before this, even some extreme views that I haven’t even heard around this and just starting to think, well, when we look at this macro view of scaling.

Mental health services and behavioral health services, and in my role in that, how does that all come together from your perspective? And where are the limits of M I, where someone’s autonomy leads to hurting other people and antisocial behaviors, or that’s creating self harm and more,  constant visits to the E.

R. that are. Creating lots of costs. So I’m curious to kind of look at this in that way and approach it. We can kind of take it whatever direction you’re, you’re feeling most well, the, I’ll start with the easiest thing to start with, which is, you know, in, you know, almost every state, the basic lies, if somebody’s going to do harm to themselves or others, then.

You take a more specific approach if they’re going to hurt themselves or hurt other people. So that’s one of the indicators that makes it easier to think about where there’s a higher probability that people tend to lean towards compliance. I think it’s such an, it’s just an incredibly complex topic, and I’m going to try to untangle aspects of it when I think when you’re talking about the larger behavioral health system, the mental health substance use.

It is replicated from a Western medical model, which is very much about where are the fees, how are we spending the dollars, where’s the profit margin, how much money is being spent on this, which is very, you know, this John from O’Keefe and Healthcare.  Yes, there’s an element of it that really does have to do with patient care.

 But if you ask patients these days and if you ask providers these days in the health care field, no one feels particularly good about where health care is providers or or the patients. And so you’re gonna hear that same level of frustration in behavioral health as well to the hardest thing with.

Behavioral health. And again, these are just always need to preface this, but this is just my bias from, you know, 35 plus years in the field is that since we’re replicating a health care system and behavioral health, health care has not had particularly good outcomes when it comes to behavior change.

They don’t have particularly good outcomes historically when you look at anything that requires behavior change around health, like diabetes, heart disease,   obesity, things that require behavior change, healthcare has not done a good job with their outcomes are not particularly good. Because they tend to use a hierarchical perspective.

They tend to use a compliance, kind of finger shaking, guilt approach historically, there’s been, you know, significant changes in health care, but that still is the basic cultural context. And so that’s the basic cultural context in. Behavioral health is, you know, I know when I was raised in the addiction world, the addiction field, it was extremely condescending, extremely paternalistic, finger shaking, guilt ridden.

 I remember one of the sayings from, you know, somebody that was in recovery that I worked with and I used to do groups with him and he was,  kind of our, the veteran counselor in our, in our  addiction agency, and I remember him telling people frequently, if you don’t think you’re an addict or an alcoholic, don’t let the doorknob hate you or the good Lord split you,  get out on the streets and figure it out for yourself.

And when you’re ready to come back and talk to me, then I’ll talk to you. And which just has zero correlation with behavior change, but it really does feed a righteous perspective. The whole. Evolution of motivation and behavior change based approaches, I think, has been profound on the field. They’re not the standard.

They’re not the norm, but they’ve been profound because we’re using behavior change based interventions with behavior change versus medical interventions with behavior change, which don’t particularly work well. So instead of the expert Asking you a bucket load of questions, assessing all the things that are wrong w