Latest / Becker's Healthcare Behavioral Health / Holly DuBois, MD, Chief Medical Officer at Connections Health Solutions

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Holly DuBois, MD, Chief Medical Officer at Connections Health Solutions · Becker's Healthcare Behavioral Health

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  - Welcome to the Becker's Behavioral Health Podcast. I'm
• 1:02
  - Ella Reuter, your host.
• 1:04
  - Today, I'm joined by doctor Holly Debois,
• 1:08
  - chief medical officer at Connections Health Solutions.
• 1:12
  - Today, we'll be discussing the future of psychiatry
• 1:14
  - and how advances in science, technology, and research
• 1:17
  - are reshaping the way behavioral health leaders think
• 1:19
  - about diagnosis,
• 1:21
  - treatment, and long term recovery.
• 1:24
  - Doctor Debois, thank you so much for being
• 1:26
  - here today.
• 1:27
  - Yeah. Of course. Pleasure to be here. Thanks,
• 1:29
  - Ella.
• 1:30
  - Could you start off by telling us more
• 1:32
  - about Connections Health Solutions and your role at
• 1:34
  - the organization?
• 1:36
  - Yep. Absolutely. So at Connections, we're the largest
• 1:39
  - provider of crisis services and behavioral health in
• 1:41
  - the country.
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  - I serve as chief medical officer helping to,
• 1:46
  - design, shape, and,
• 1:48
  - deliver our clinical product. I help,
• 1:52
  - lead
• 1:53
  - our medical director team,
• 1:55
  - in local leadership
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  - of their, sites that are now across the
• 1:59
  - country
• 2:00
  - and,
• 2:01
  - certainly working alongside
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  - the other members of our executive team to
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  - be providing medical,
• 2:06
  - support and guidance to our model as it
• 2:08
  - grows and changes.
• 2:11
  - Wonderful. And thank you so much for that
• 2:13
  - brief introduction.
• 2:15
  - I know we've talked about psychiatry
• 2:17
  - moving towards treating symptoms to better understanding the
• 2:20
  - biology behind mental illness.
• 2:22
  - Can you talk to us more about what
• 2:24
  - that shift looks like?
• 2:26
  - Yeah. Absolutely. You know, when I was thinking
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  - about us getting together, Ella, I think it's
• 2:30
  - really interesting if we start
• 2:32
  - separating choice and behavior
• 2:35
  - and,
• 2:36
  - illness and disease. And I think,
• 2:38
  - probably a popular corollary for that right now
• 2:41
  - are the GLPs.
• 2:42
  - And I think where, you know, there used
• 2:44
  - to be sort of a colloquial,
• 2:46
  - of course, understanding of obesity,
• 2:48
  - and all of the factors that could contribute
• 2:51
  - to somebody,
• 2:53
  - being overweight,
• 2:54
  - and
• 2:55
  - maybe an unwillingness or or,
• 2:59
  - lack of full understanding of of how that
• 3:02
  - condition or disease impacts choice and behavior. And
• 3:05
  - now when we see real disease modulating drugs
• 3:08
  - like GLP ones and the impact that they
• 3:10
  - have on someone's well-being,
• 3:12
  - you know, mental health should really be no
• 3:14
  - different.
• 3:15
  - And that's really what we see across psychiatry.
• 3:18
  - And then, you know, in a crisis
• 3:20
  - center, we see somebody really in their most
• 3:23
  - exposed sort of derailed state of,
• 3:26
  - mental health often, and there are a number
• 3:29
  - of factors. We can't just treat the symptoms
• 3:31
  - that brought somebody there. We need to understand
• 3:33
  - the disease,
• 3:35
  - meet the individual where they are, and hopefully
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  - have,
• 3:38
  - the right treatment at the right time. And
• 3:40
  - the sooner, the better, of course, to prevent
• 3:43
  - that crisis from, escalating.
• 3:51
  - And can you talk more about why it's
• 3:53
  - such an important movement for behavioral health care?
• 3:56
  - I think specifically for crisis care in terms
• 3:58
  - of,
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  - you know,
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  - the trickle down of patients that won't have
• 4:03
  - to come into crisis care if they're able
• 4:06
  - to get care more upstream,
• 4:08
  - and kind of how
• 4:10
  - that can affect the system as well.
• 4:14
  - Yeah. Yeah. Absolutely. And I there's something I
• 4:17
  - often
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  - say is we're orienting folks to our organization
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  - or,
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  - onto the medical team that who may not
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  - have worked in that setting before that a
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  - behavioral health crisis evolves exponentially, not linearly. So
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  - what was a five at minute zero can
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  - be a 50,
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  - at minute two.
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  - So these things aren't linear, and the sooner
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  - and the more targeted and,
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  - specific
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  - our interventions are for that individual, the better.
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  - It's really important that we understand that because
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  - right now, you know, there there are a
• 4:50
  - lot of vulnerable people in our world and
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  - in our country,
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  - folks who are impacted their mental and physical
• 4:56
  - health, their financial stability.
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  - Scarcity is a real thing.
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  - You know, there are a lot of sort
• 5:01
  - of meta problems that I think people are
• 5:04
  - confronting, and those with a,
• 5:07
  - mental health condition can certainly be more vulnerable
• 5:10
  - and more prone to the impacts of those.
• 5:12
  - And so if we can identify,
• 5:15
  - support, treat,
• 5:17
  - stabilize, and then, you know, really,
• 5:21
  - transition folks, back to their community as quickly,
• 5:25
  - and effectively as possible, it's important.
• 5:30
  - And how do you really see
• 5:32
  - precision psychiatry changing the way that clinicians diagnose
• 5:35
  - and treat patients?
• 5:37
  - Yeah. This is so exciting. And, you know,
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  - this is a role, certainly, even when I
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  - was in training, you know, many, many years
• 5:44
  - ago, was was just sort of at its,
• 5:46
  - nazence, and I really credit so many
• 5:49
  - amazing intellectual and thought leaders in the field,
• 5:52
  - whether it's targeted TMS,
• 5:55
  - ketamine treatment,
• 5:56
  - things that are going to already really have
• 5:59
  - revolutionized
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  - the possibility to treat somebody
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  - from crisis to cure. And that's really what,
• 6:06
  - you know, of course, we're passionate about doing
• 6:08
  - at Connections,
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  - and being able to offer someone actual meaningful
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  - cure
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  - to these persistent,
• 6:15
  - mental illnesses that, you know, heretofore were,
• 6:19
  - really considered sort of a chronic condition to
• 6:21
  - manage. If we can start thinking about cure,
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  - if we can start thinking about
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  - really precise treatments that also minimize side effects,
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  - it's so important.
• 6:30
  - You know, by and large psychiatry, we don't
• 6:32
  - have the sort of monitoring, testing, diagnostics that
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  - other fields of medicine do. And as those
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  - evolve and we can hand people
• 6:41
  - and communities really tangible evidence of this is
• 6:43
  - what this mental illness looks like,
• 6:46
  - is just so important for broader acceptance and,
• 6:51
  - really access to the right care.
• 6:54
  - Really making sure that people are accessing the
• 6:57
  - right level of care at the right time
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  - is, I think, a through line in behavioral
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  - health care
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  - in general. So
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  - Absolutely. And, you know, the other thing that,
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  - you know, I love about
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  - our organization and what we offer, that's really
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  - unique,
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  - compared to most in psychiatry and mental health
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  - care is, you know, we are open, for
• 7:18
  - folks twenty four seven. And a lot of
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  - times,
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  - you know, you don't know necessarily is are
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  - we reaching a crisis point with my loved
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  - one with this serious illness or not, but
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  - it could be.
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  - And, you know, getting on the phone isn't
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  - gonna work at two in the morning, but
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  - sometimes somebody needs an evaluation at that time.
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  - And so I really
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  - because
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  - there's still so many unknowns,
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  - and we don't want patients and families to
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  - be lingering or wondering.
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  - 100%.
• 7:48
  - And
• 7:49
  - going more towards technology and research, we know
• 7:52
  - that those are rapidly advancing.
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  - What role do you see behavioral health organizations
• 7:58
  - playing in bringing those in innovations into everyday
• 8:01
  - care? Yeah. Absolutely. So, you know,
• 8:05
  - sixteen,
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  - seventeen years ago, I think, when I started,
• 8:09
  - practicing telepsychiatry.
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  - This was, something radical and new. Of course,
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  - now it's table stakes. It's every day before
• 8:15
  - COVID, certainly after COVID.
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  - That's just one element of technology. And at
• 8:20
  - the time,
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  - really, the
• 8:24
  - the, tremendous door that it opened was access.
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  - Well, let's, you know, move to 2026.
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  - Access shouldn't be the problem that it is.
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  - It continues to be. And, of course, you
• 8:34
  - know, telehealth is one means to solve that
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  - end.
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  - But furthermore, I think,
• 8:40
  - you know, if we can be smart,
• 8:43
  - help clinicians make better decisions in real time,
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  - whether those are technological
• 8:48
  - solutions
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  - or,
• 8:52
  - you know, those sorry. Those really should be
• 8:54
  - technological solutions to give clinicians time back to
• 8:57
  - spend with their patients,
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  - whether it's patients having the tools that they're
• 9:01
  - ready to do some
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  - decision making, education, etcetera,
• 9:05
  - via technology. You know, I'm certainly
• 9:08
  - all for it. I think
• 9:10
  - more importantly,
• 9:11
  - sort of zooming out from there, the way
• 9:14
  - I see this is to finally equalize behavioral
• 9:17
  - and medical health care. I think it's you
• 9:19
  - know, behavioral has existed over here
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  - on the sideline and not gotten the same
• 9:24
  - funding, attention,
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  - sort of level of
• 9:30
  - demand and importance.
• 9:31
  - And it it certainly I think if we
• 9:33
  - as a behavioral health organization
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  - can harness technology in new and creative ways
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  - and really demonstrate that we can be innovative,
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  - we can save costs, we can improve access
• 9:43
  - and maintain or improve quality,
• 9:45
  - you know, I think everyone will finally start
• 9:47
  - paying attention.
• 9:50
  - Mhmm. And where do you still kinda see
• 9:52
  - those gaps in technology and research within the
• 9:55
  - field and industry,
• 9:57
  - more specifically?
• 9:59
  - Yeah. I still think there's a real misunderstanding.
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  - You know, I've I've
• 10:02
  - even
• 10:03
  - we've,
• 10:04
  - even encountered, you know, people in communities who
• 10:07
  - wondered, would do your patients have smartphones? Do
• 10:09
  - your patients have access
• 10:11
  - to computers? Well, of course. There's just still
• 10:13
  - so much bias.
• 10:15
  - And so I really you know, I see
• 10:17
  - that as probably the number one barrier.
• 10:20
  - I think there's, you know, there's so many
• 10:22
  - great and cool solutions out there. I read
• 10:24
  - about them every day, new apps
• 10:27
  - for, monitoring substance use, for example.
• 10:30
  - You know, there's there's just the the field
• 10:32
  - is pretty wide open. And I think as
• 10:35
  - long as we pay attention to quality and
• 10:37
  - safety,
• 10:39
  - and ensure that those folks who are most
• 10:40
  - vulnerable are getting the right tools,
• 10:42
  - I think we'll see a lot of exciting
• 10:44
  - change in the near future.
• 10:47
  - Is there anything you wanna mention for Connections
• 10:49
  - Health Solutions and specific around
• 10:52
  - technology use and advancement there?
• 10:56
  - Sure.
• 10:57
  - You know, at Connections,
• 10:59
  - you know, we've operated
• 11:00
  - very complex twenty four seven brick and mortar
• 11:03
  - facilities for now,
• 11:06
  - you know, for
• 11:09
  - for many years.
• 11:10
  - And so watching our organization evolve and evolve
• 11:13
  - quickly,
• 11:15
  - certainly with use of AI both in our
• 11:18
  - in our day to day work and exploring
• 11:20
  - those solutions that make sense, that give clinicians
• 11:23
  - time back, not to ever replace clinicians, but
• 11:25
  - to give them time back
• 11:27
  - with their patients has been really extraordinary. We've
• 11:29
  - created a real hybrid work environment where we've
• 11:32
  - been able to access,
• 11:34
  - you know, the right provider at the right
• 11:36
  - time by,
• 11:38
  - using,
• 11:39
  - telehealth
• 11:40
  - in our brick and mortar facilities really effectively
• 11:42
  - and seamlessly. That's been a big win and
• 11:44
  - and been able to bring our model to
• 11:46
  - communities that wouldn't have been able to afford
• 11:48
  - it otherwise.
• 11:50
  - I think that, you know, we
• 11:53
  - will continue to see opportunities to,
• 11:56
  - be that safety net for folks once they
• 11:58
  - leave our facilities,
• 12:00
  - and looking at what sort of monitoring and
• 12:02
  - digital solutions we may have there,
• 12:04
  - because we have that rare opportunity to to
• 12:06
  - treat somebody
• 12:07
  - in crisis, and we're their trusted provider at
• 12:10
  - that time. We we really wanna ensure that
• 12:12
  - we're,
• 12:13
  - keeping them safe in their community then for
• 12:15
  - years to come after.
• 12:20
  - And lastly, I'm really curious.
• 12:23
  - When you think about the next five to
• 12:24
  - ten years, what do you hope psychiatry
• 12:27
  - looks like?
• 12:30
  - Oh, gosh.
• 12:32
  - I hope psychiatry brings
• 12:34
  - finally, some clarity of understanding,
• 12:37
  - to what it is to live with, to
• 12:40
  - treat,
• 12:41
  - and to cure a mental illness because I
• 12:43
  - think there is,
• 12:45
  - just still I've used this word before already
• 12:47
  - today, but so much bias around,
• 12:50
  - you know, really the impact
• 12:52
  - that a serious and persistent, in particular, mental
• 12:55
  - illness can have and that,
• 12:57
  - this isn't this is a public health concern.
• 12:59
  - This isn't a,
• 13:01
  - the concern of the very, very few who
• 13:03
  - have access to any care
• 13:05
  - or the very many who have access to
• 13:08
  - very little.
• 13:09
  - So, I'm really hoping that with a lot
• 13:11
  - of these advancements, with greater understanding, with,
• 13:16
  - you know, we talked about precision psychiatry or
• 13:18
  - at least diagnostics
• 13:19
  - that make things,
• 13:21
  - tangible and objective,
• 13:23
  - that we can finally sort of bring psychiatry
• 13:25
  - and mental health care right alongside its physical
• 13:28
  - health,
• 13:29
  - cousins.
• 13:31
  - And do you have anything that's giving you
• 13:33
  - the most optimism right now about where the
• 13:35
  - field is headed?
• 13:38
  - Well, really just seeing the tremendous,
• 13:40
  - appetite and support
• 13:42
  - for,
• 13:43
  - crisis services across the country has been really,
• 13:47
  - phenomenal. You know, we've
• 13:48
  - seen firsthand the ability to enter a community
• 13:51
  - and within months,
• 13:54
  - lower the rate of suicide. Within months, lower
• 13:56
  - the number of opioid related deaths.
• 13:59
  - This really phenomenal,
• 14:01
  - impact that that, you know, immediate access to
• 14:04
  - the right care can have. And I think
• 14:06
  - it's now that folks understand,
• 14:09
  - the need, it's it's it's really exciting.
• 14:14
  - And I feel like too having that access
• 14:16
  - and, like you mentioned, twenty four hour access
• 14:18
  - to crisis services, especially in a brick and
• 14:21
  - mortar, is also helping break down,
• 14:23
  - like you mentioned, the bias and the stigma,
• 14:26
  - and people are able to really connect with
• 14:28
  - those services and also stay within their community
• 14:31
  - as well, which I think is super important.
• 14:33
  - And I think that even breaks a barrier
• 14:36
  - for
• 14:36
  - psychiatry as a whole in terms of just
• 14:39
  - being able to connect with mental health providers,
• 14:43
  - and seeing that you can have effective care,
• 14:46
  - and,
• 14:47
  - they can be helped in these settings and
• 14:49
  - things like that. So I think that's really
• 14:51
  - interesting to point out as well.
• 14:54
  - Yeah. Absolutely. Absolutely.
• 14:56
  - But I just wanna thank you so much
• 14:58
  - for joining us today. I really appreciate it.
• 15:01
  - It was a pleasure, Ella. Thanks for having
• 15:03
  - me. Yes. And thank you so much to
• 15:05
  - our listeners for tuning in to the Becker's
• 15:07
  - Behavioral Health Podcast.
• 15:08
  - For more conversations with behavioral health leaders across
• 15:11
  - the country, you can find us wherever you
• 15:13
  - get your podcasts.
• 15:14
  - Thank you so much.