Latest / Brain Stories / Episode 13 - Brain Stories Connections: A Radical New Model for Mental Health Care

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Episode 13 - Brain Stories Connections: A Radical New Model for Mental Health Care · Brain Stories

• 0:00
  SPEAKER_01: Welcome to the Rip It Up episode of Brain Stories.
• 0:03
  SPEAKER_01: It's number 13.
• 0:04
  SPEAKER_01: We're going to share what we learned in the first 12.
• 0:07
  SPEAKER_01: And what we're going to do differently is we blaze the path forward.
• 0:10
  SPEAKER_01: This is a moment that invites reflection.
• 0:17
  SPEAKER_01: I started telling stories about mental illness because first and foremost, they were jaw-dropping stories.
• 0:22
  SPEAKER_01: Tales that exploded with that thing called cognitive dissonance.
• 0:27
  SPEAKER_01: One of the first stories I heard was Piles, which eventually became episode 12.
• 0:32
  SPEAKER_01: She was educating people about mental illness from her room, while her brother on the other side of the wall in his room was living with one.
• 0:40
  SPEAKER_01: Another was Adrian's, who told me he began helping to care for his dad by getting him medicine when he was a two-year-old.
• 0:46
  SPEAKER_01: And as an adult, he knew no one else in the world who had been raised by a parent living with schizophrenia.
• 0:53
  SPEAKER_01: That became episode two.
• 0:55
  SPEAKER_01: And by the way, not long ago, his parents celebrated their 50th wedding anniversary.
• 1:00
  SPEAKER_01: What I ultimately found about these stories of mystifying illness was that they were deeply moving.
• 1:05
  SPEAKER_01: Full of heartbreak, but also joy, love, hope.
• 1:09
  SPEAKER_01: And an expanse of triumph that demands 45 different definitions of the word resilience.
• 1:19
  SPEAKER_01: I heard a lot of stories, and many of them, most of them, in fact, I was asked not to tell.
• 1:25
  SPEAKER_01: Not usually because of shame.
• 1:27
  SPEAKER_01: It was because being open about mental illness so often wrecks your life.
• 1:31
  SPEAKER_01: I will never forget when Ronald Brownstein, the brilliant conductor whose story starts in episode six, told me about revealing to his manager that he had bipolar disorder.
• 1:41
  SPEAKER_01: His manager, a man who could make or break a career, never spoke to Ronald again.
• 1:47
  SPEAKER_01: Ronald spent most of the rest of his life hiding the fact that he lived with bipolar disorder until it nearly killed him.
• 1:54
  SPEAKER_01: And he invented an orchestra for people who live with mental illness and those who supported them, with his partner, Caroline Witten.
• 2:00
  SPEAKER_01: And by the way, their musical organization now spans three states and multiple ensembles.
• 2:11
  SPEAKER_01: True confession.
• 2:13
  SPEAKER_01: I started this process knowing little about mental illness, and about some of them, basically nothing.
• 2:19
  SPEAKER_01: I will never forget three hours in a Westwood cafe with a therapist Lila Gallusian.
• 2:24
  SPEAKER_01: She gave me a priceless download on borderline personality disorder for the cost of a cup of coffee.
• 2:30
  SPEAKER_01: I've been educated and helped by so many along the way, I can never adequately thank them.
• 2:35
  SPEAKER_01: All of that gave me the tools to pursue the stories with a working knowledge.
• 2:39
  SPEAKER_01: And that was really important.
• 2:42
  SPEAKER_01: But intelligence turns out not to have been the most important thing.
• 2:46
  SPEAKER_01: Heart was.
• 2:47
  SPEAKER_01: Heart was also the most transformative.
• 2:50
  SPEAKER_01: It wasn't that long into brain stories before I realized I'm no longer objective.
• 2:56
  SPEAKER_01: Living with a mental illness makes life hard, but our response to mental illness is so often awful.
• 3:02
  SPEAKER_01: Imagine get a diagnosis of diabetes or cancer, and you're put in jail.
• 3:07
  SPEAKER_01: Or left to figure out your own treatment on the streets, homeless.
• 3:11
  SPEAKER_01: What's crazy is not the illness.
• 3:13
  SPEAKER_01: It's how we as a culture react.
• 3:16
  SPEAKER_01: And so much of the time, that is an abject failure.
• 3:20
  SPEAKER_01: One that consistently prioritizes short-term profit over long-term health.
• 3:24
  SPEAKER_01: We are all paying for bad mental health care.
• 3:31
  SPEAKER_01: But there was an upside of not knowing very much at the start.
• 3:35
  SPEAKER_01: It meant that I was in a great position to learn.
• 3:38
  SPEAKER_01: I'd like to share a few of those lessons.
• 3:40
  SPEAKER_01: One, mental health is health.
• 3:44
  SPEAKER_01: The distinction we make between mental health and physical health is completely made up.
• 3:49
  SPEAKER_01: Two, mental health is something we spend too little time and money on.
• 3:54
  SPEAKER_01: Many of us go to a gym three or four times a week for muscle strength or cardio.
• 3:58
  SPEAKER_01: We should have gyms for mental health.
• 4:00
  SPEAKER_01: If we had the equivalent of tight abs or bulging deltoids for mental health, we'd all probably be in better shape.
• 4:06
  SPEAKER_01: But seriously, if we dedicated time to building our mental health, the thing we call physical health would vastly improve.
• 4:12
  SPEAKER_01: Even though, as said, there is no difference between the two.
• 4:16
  SPEAKER_01: As for mental illness, that's something we all experience.
• 4:20
  SPEAKER_01: Just like what we call physical illness, which, am I wearing this out, is a distinction we made up.
• 4:27
  SPEAKER_01: Most of us get mental illness in average ways, like grief or anxiety.
• 4:32
  SPEAKER_01: Some of us get it in above average ways, like serious depression, and a few of us in extraordinary ways.
• 4:40
  SPEAKER_01: Which takes us to number three.
• 4:43
  SPEAKER_01: Serious mental illness is indeed serious, but it's almost always manageable.
• 4:48
  SPEAKER_01: All we have to do is spend the time.
• 4:51
  SPEAKER_01: The second most interesting thing I learned about serious mental illness is that we know how to manage it.
• 4:57
  SPEAKER_01: We just don't do it, or hardly ever.
• 5:00
  SPEAKER_01: Four, most of the things we fear about mental illness are the wrong things.
• 5:06
  SPEAKER_01: Probably at the top of that list is violence.
• 5:09
  SPEAKER_01: How we typically respond to that fear is to isolate people with serious mental illness, which is one of the most frightening things to do to absolutely anyone.
• 5:18
  SPEAKER_01: But here's the most important thing I've learned.
• 5:21
  SPEAKER_01: When it comes to mental illness, we can do so much better.
• 5:26
  SPEAKER_01: And that is what pointed me to the new direction for brain stories.
• 5:30
  SPEAKER_01: So episode 13 is the final episode of season one, but it's also the first episode of that new direction.
• 5:38
  SPEAKER_01: We will be producing another round of beautifully told stories that we'll officially call season two.
• 5:43
  SPEAKER_01: But that's going to take some time and fundraising.
• 5:46
  SPEAKER_01: So for the next phase, we'll be shining a light on things we're doing better or should do better.
• 5:51
  SPEAKER_01: You can expect interviews, carefully selected episodes from other podcasts, or anything that offers eye-opening and eye-popping views about mental health.
• 6:01
  SPEAKER_01: As our story editor Karen Gibbons said to me at one point early on in Brain Stories, there are no rules.
• 6:08
  SPEAKER_01: So be ready for anything.
• 6:13
  SPEAKER_01: We're going to jump into the next phase in a minute.
• 6:15
  SPEAKER_01: But first I have to say how grateful I am to all those who lent their talents to making season one.
• 6:21
  SPEAKER_01: Incredibly accomplished people with hard-won experience and perspectives gave of themselves unstintingly.
• 6:27
  SPEAKER_01: They were paid as best we could, but I guarantee you the motivation was way more than cash money.
• 6:33
  SPEAKER_01: Speaking of money, I am so grateful for our financial supporters.
• 6:37
  SPEAKER_01: They were generous based on pure faith before a single show had been released.
• 6:42
  SPEAKER_01: It could never have happened without their help.
• 6:45
  SPEAKER_01: And for those who entrusted us with their stories, I have nothing but love and respect.
• 6:52
  SPEAKER_01: Finally, a special thanks to my family, whose support means the world to me.
• 6:58
  SPEAKER_01: Check that.
• 6:59
  SPEAKER_01: It means the universe.
• 7:02
  SPEAKER_01: Now let's step into the future.
• 7:04
  SPEAKER_01: Brain Stories Phase 2, Good Ideas About Mental Health.
• 7:09
  SPEAKER_01: I first met Dr.
• 7:10
  SPEAKER_01: Stephen Siegel at a mental illness conference, and truth to tell, I missed his entire presentation.
• 7:16
  SPEAKER_01: All I saw was him responding to questions from people who approached him afterwards.
• 7:21
  SPEAKER_01: But there's a lot you can tell from how someone takes questions.
• 7:27
  SPEAKER_01: Dr.
• 7:28
  SPEAKER_01: Siegel runs a department at a big school, the University of Southern California.
• 7:32
  SPEAKER_01: He treats patients, he teaches, he trains, he mentors, he manages, and he researches.
• 7:38
  SPEAKER_01: He also oversaw the overhaul of student mental health services, which handles more than 10,000 people.
• 7:44
  SPEAKER_01: He had every reason to scoot right out of that conference and get back to a very demanding job.
• 7:49
  SPEAKER_01: Yet he stayed for every person with a question.
• 7:52
  SPEAKER_01: Never rushing, never showing impatience, addressing each query with dignity and care.
• 7:58
  SPEAKER_01: That alone was something I almost never see.
• 8:00
  SPEAKER_01: What's more, he spoke frankly about mental illness and schizophrenia in particular.
• 8:05
  SPEAKER_01: He didn't hesitate to call out the weaknesses and failures of a healthcare system that hasn't come up with a significantly new medication for mental illness in decades.
• 8:14
  SPEAKER_01: In other words, he was my kind of guy.
• 8:18
  SPEAKER_01: What didn't come out in that 15 minutes was that he was also a visionary in leading the creation of one of the nation's largest academic student mental health systems.
• 8:27
  SPEAKER_01: USC now has a model that looks revolutionary, one that has been transformed from a system that was reactive and limited to proactive and comprehensive.
• 8:38
  SPEAKER_01: It's a program that is working not just for every student at USC, but could and probably should be scaled up for an entire nation.
• 8:46
  SPEAKER_01: Dr.
• 8:46
  SPEAKER_01: Siegel is currently the vice president of behavioral health for USC.
• 8:51
  SPEAKER_01: Here's our conversation.
• 8:53
  SPEAKER_01: Welcome to Brain Stories.
• 8:55
  SPEAKER_01: What were your early influences and what sort of led you towards psychiatry?
• 9:02
  SPEAKER_00: When I went off to college, I started off thinking I would be a political science major and probably go into law.
• 9:09
  SPEAKER_00: I went to Colgate University, and Colgate had one of the very first neuroscience programs in the country.
• 9:16
  SPEAKER_00: And it was just this overwhelmingly interesting information that I started learning, and I pivoted, became a neuroscience major, and I basically said, Well, I'm I don't want to be a doctor, but it sounds like knowing a lot about medicine will make me a better scientist.
• 9:35
  SPEAKER_00: And I have to say, I didn't love most parts of being a doctor, but when I got into psychiatry, I had, again, good luck.
• 9:44
  SPEAKER_00: I was placed on a schizophrenia unit and I was just smitten.
• 9:48
  SPEAKER_00: Once I interacted with people with schizophrenia, there was really no turning back.
• 9:53
  SPEAKER_00: Schizophrenia in particular, I mean, what was it about schizophrenia?
• 9:57
  SPEAKER_00: When you you see someone with schizophrenia, and I mean they're in so much distress.
• 10:03
  SPEAKER_00: And at one level, it's just amazing.
• 10:08
  SPEAKER_00: Amazing that that someone could have so many problems, and yet if they just take medicine for a couple of months, it just melts away.
• 10:18
  SPEAKER_00: For many people.
• 10:19
  SPEAKER_00: I know not for everyone, but if you take medicines, they get better.
• 10:24
  SPEAKER_00: This is a big, big deal.
• 10:26
  SPEAKER_00: We can actually treat this.
• 10:28
  SPEAKER_00: And schizophrenia is one of the few things in all of medicine that is not your fault.
• 10:34
  SPEAKER_00: You didn't participate in this, you know, by and large, there's some risk factors, but by and large, you didn't do this.
• 10:41
  SPEAKER_00: But when I look at things like a lot of orthopedic issues, a lot of cardiac issues, a lot of pulmonary issues, you know, you can kind of look and go, well, you know, you did that.
• 10:53
  SPEAKER_00: You know, you are the constellation of your choices.
• 10:56
  SPEAKER_00: So, you know, eat a lot, don't exercise, smoke cigarettes, whatever you.
• 11:02
  SPEAKER_00: People with schizophrenia, it's just not their fault.
• 11:05
  SPEAKER_00: And if I do my job, I can actually change their life.
• 11:09
  SPEAKER_00: And that that's what was appealing to me.
• 11:12
  SPEAKER_01: There's an awful lot we don't know about mental illness.
• 11:15
  SPEAKER_01: Of all those facets and alleyways of mental illness that we don't have a clear grasp on, what what part are you most curious about?
• 11:23
  SPEAKER_00: But I think many of us would like to be able to go from reactive treatment to prevention, but even more importantly, from reacting and and toning down symptoms to cure.
• 11:37
  SPEAKER_00: Again, I keep coming back to schizophrenia.
• 11:40
  SPEAKER_00: Cure doesn't feel like it's in our grasp at this time, and that's a little bit demoralizing.
• 11:48
  SPEAKER_00: You know, treatment really, really well in our grasp, I think.
• 11:52
  SPEAKER_00: But I would love to be alive long enough to see us move into prevention and cure.
• 12:00
  SPEAKER_01: What do you think that's gonna take?
• 12:02
  SPEAKER_00: So part of this is the physics of understanding what's happening that causes someone to have the kind of brain changes that lead to schizophrenia.
• 12:14
  SPEAKER_00: That's just gonna be an iterative advancing in science that you know hopefully we'll get to the point where we understand what is actually the difference between a brain circuit and a group of cells in someone who has the disease versus doesn't.
• 12:28
  SPEAKER_00: But then there's all the other things that get in our way: changes in funding, changes in cultural mores, not getting people the resources they need.
• 12:41
  SPEAKER_00: Those things are the most frustrating because we could put the kind of resources into mental health prevention that that went into AIDS, that go into cancer.
• 12:53
  SPEAKER_00: The leaps and bounds that have been made in those fields reflect the resources and the emphasis that have gone in there.
• 13:04
  SPEAKER_01: I want to turn to the what the what you've done here at University of Southern California, USC.
• 13:10
  SPEAKER_01: You created one of the nation's largest student mental health systems.
• 13:14
  SPEAKER_01: Tell me about the evolution of that.
• 13:16
  SPEAKER_01: What was it when you first started?
• 13:18
  SPEAKER_01: What has it become?
• 13:19
  SPEAKER_00: So when I first got here in 2016, USC had a counseling center, uh, very, very, very typical of a college this size of most colleges.
• 13:28
  SPEAKER_00: So there's a counseling center and there's a student health center, and they are not part of the Department of Psychiatry or the Department of Internal Medicine, they are not part of the health system.
• 13:37
  SPEAKER_00: They're these independent groups.
• 13:39
  SPEAKER_00: But we brought Counseling Center into the Department of Psychiatry, which meant it was inside the School of Medicine, inside the health system, and it added a whole layer of quality control and standardization of practices.
• 13:51
  SPEAKER_00: And we probably brought about 15 or 16 people in, and over the course of the next eight years, grew that to over a hundred.
• 14:01
  SPEAKER_00: So we now have about a hundred faculty members who can only treat USC students.
• 14:08
  SPEAKER_00: We have 20 trainees in therapy who train in that environment.
• 14:12
  SPEAKER_00: Along the way, we realized that student health, which now was inside, you know, this part inside Department of Psychiatry, still was limited, even with at the time, say 60 faculty members there.
• 14:27
  SPEAKER_00: Students would be able to come in, get an appointment relatively quickly, but they'd get like maybe three to five sessions and have to use their health insurance to go out for really long-term care, you know, years.
• 14:39
  SPEAKER_00: And so we convinced the university that we should build a commercial practice on campus.
• 14:45
  SPEAKER_00: And so we got an entire floor of a building right in the middle of main campus and built out a beautiful new facility.
• 14:53
  SPEAKER_00: So now when people go to student health, they literally, after their intake and their first three to five sessions, they don't have to go out into the diaspora looking somewhere in LA for someone who takes their insurance, but rather they can just simply go from the third floor to the fifth floor of that same building.
• 15:12
  SPEAKER_00: And so the vast majority of students at USC who need long-term mental health care can get it from us.
• 15:17
  SPEAKER_00: We've now built this system at USC that can take care of, you know, 10,000 students a year with everything from an initial assessment to being engaged in long-term therapy and/or psychiatric care.
• 15:31
  SPEAKER_00: And then about five years ago, we decided that we were going to find this one unifying thing, and we decided it was gonna be to build this simply the best student mental health program in the world.
• 15:42
  SPEAKER_00: Then it sounded really arrogant and maybe grandiose, but you know, we got hundreds of people to work together.
• 15:50
  SPEAKER_00: We formed research groups, we formed clinical pathway groups, we we formed groups that would go out and learn what the issues in the community were, and then put together a program that's now called My Mental Health.
• 16:03
  SPEAKER_00: It's completely philanthropically funded.
• 16:05
  SPEAKER_00: We have a huge team of programmers, clinicians, and administrators that run it.
• 16:10
  SPEAKER_00: And so every student at USC gets an individual invitation signed by me and the president that says, you know, dear Bob, please click on the link below.
• 16:22
  SPEAKER_00: It will bring you to a brief survey that will take 10 minutes, at the end of which you will be linked to the appropriate mental health services for your needs.
• 16:31
  SPEAKER_00: The second they hit done, so it will instantly write them an email and say, you know, thank you for taking the My Mental Health Assessment.
• 16:39
  SPEAKER_00: Based on your answers, you should.
• 16:42
  SPEAKER_00: And there's five risk categories.
• 16:45
  SPEAKER_00: The bottom two are no symptoms at all or very mild.
• 16:49
  SPEAKER_00: That group will get one saying, Thank you for filling it out.
• 16:52
  SPEAKER_00: Here's a whole list of resources to stay well.
• 16:55
  SPEAKER_00: And these can be drop-in groups, online resources, things like that.
• 16:58
  SPEAKER_00: But it'll say, and if anything changes, reach out to us.
• 17:01
  SPEAKER_00: That is a full two-thirds of the population.
• 17:04
  SPEAKER_00: And we've now done this for four full years.
• 17:07
  SPEAKER_00: That has been, and again, we have 50,000 students.
• 17:10
  SPEAKER_00: The first year we did 10,000, then 20, then 30, essentially, then 40,000 students.
• 17:14
  SPEAKER_00: And so there's groups that have had it once, twice, three times, and four times.
• 17:18
  SPEAKER_00: And out of that huge group, two-thirds of the population are in that no or low.
• 17:24
  SPEAKER_00: But 25% of the population meet criteria for a major mental illness.
• 17:28
  SPEAKER_00: This is, you know, major depression, severe anxiety, maybe mild psychosis.
• 17:32
  SPEAKER_00: And that's 25% based on this assessment.
• 17:35
  SPEAKER_00: It's not like they came in for care, it's just going out to the whole community.
• 17:38
  SPEAKER_00: And those people will say, you should see a mental health professional.
• 17:41
  SPEAKER_00: Click this link, call this number, you should get care.
• 17:46
  SPEAKER_00: But if they don't do it, they'll get a reminder or two, but we will not insist.
• 17:51
  SPEAKER_00: And so the remaining 9% fall into two categories, high and acute.
• 17:56
  SPEAKER_00: To be in high, you have to have really severe mental illness.
• 17:59
  SPEAKER_00: This is someone who's depressed, they're not getting out of bed, they're not going to class based on their answers.
• 18:03
  SPEAKER_00: They may be having their first break psychosis, and about 1% of our population come in in the middle of their first break psychosis.
• 18:10
  SPEAKER_00: But they had to answer no to all three of the following questions.
• 18:15
  SPEAKER_00: You know, do you want to kill yourself?
• 18:17
  SPEAKER_00: Do you intend to kill yourself tonight?
• 18:19
  SPEAKER_00: And have you taken action already?
• 18:21
  SPEAKER_00: They have to say no to all of those.
• 18:24
  SPEAKER_00: If they say no to all of those, they have 72 hours to get in touch with us, or we will send our mental health rapid response team out to find them and insist that they meet with someone.
• 18:36
  SPEAKER_00: Again, this is someone who's not in imminent danger, but they have severe mental illness.
• 18:42
  SPEAKER_00: The last 3% have said yes to one of those questions.
• 18:45
  SPEAKER_00: This will wake somebody up.
• 18:47
  SPEAKER_00: If it's two in the morning on Sunday, we have a counselor on call in our crisis team, and they'll start calling.
• 18:53
  SPEAKER_00: They'll text, they'll call, they'll use the apps, and they'll say, You have 48 hours to be in front of us, or we will, you know, come find you.
• 19:01
  SPEAKER_00: And we've met with every single one of those people.
• 19:03
  SPEAKER_00: Often those people will end up in hospital tonight.
• 19:07
  SPEAKER_00: Hundreds of students over the last four years have been out there suffering, thinking about dying, and they get this survey randomly in the mail, and it's their lifeline, and they end up engaging and getting care.
• 19:23
  SPEAKER_00: And something like, you know, two-thirds of respondents who come into care through this mechanism say they had no intention of seeking care or finding us, but it was receiving this outreach that brought them the ability to find care in community.
• 19:41
  SPEAKER_00: So that's really what I see as the crowning achievement of our department.
• 19:45
  SPEAKER_00: Maybe the most important advance in mental health at USC ever, and I think maybe one of the most important advances in college mental health in the country.
• 19:55
  SPEAKER_01: That is so extraordinary.
• 19:56
  SPEAKER_01: And I just hearing that going like, this needs to scale up to 330 million people.
• 20:03
  SPEAKER_00: And we'd love to bring this to high schools, we'd like to bring it to other colleges.
• 20:06
  SPEAKER_00: We started a small pilot project to just bring it to a reservation in northern Montana that we had a connection to.
• 20:13
  SPEAKER_00: But all of these projects will take support.
• 20:18
  SPEAKER_00: None of what I've described to you is covered under the auspices of insurance.
• 20:23
  SPEAKER_00: And none of what I've described to you in terms of this massive expansion and outreach program can be covered as part of the you know growing, crushing debt that comes with tuition.
• 20:36
  SPEAKER_00: We have really generous donors who've made this possible by giving us the resources to build and sustain these kinds of outreach programs.
• 20:48
  SPEAKER_01: Let me just ask you this from the bottom of your heart, what do you so long to see happen in the field of mental illness before you reach the point where you're passing the mantle on to the next generation?
• 20:59
  SPEAKER_00: You know, I focused on the science before, but it's probably not the biggest issue.
• 21:03
  SPEAKER_00: It's really the place mental health has in society and medicine.
• 21:07
  SPEAKER_00: So the part that I find most frustrating is the disparity between mental health access and everything else.
• 21:15
  SPEAKER_00: In medicine, there's such gross inequity in access to mental health, and it's it's ways that people are not aware of until they need it.
• 21:28
  SPEAKER_00: Even other doctors are not aware.
• 21:31
  SPEAKER_00: So I'll give a concrete example.
• 21:33
  SPEAKER_00: Whoever you are out there, you are overwhelmingly likely to have a mental health carve-out.
• 21:40
  SPEAKER_00: And the way that this works is your insurance company doesn't actually pay for medical coverage and mental health coverage the same way.
• 21:49
  SPEAKER_00: Their insurance pays for cardiac care or cancer care or urology care here at USC, but there's a very high likelihood that their insurance Unbeknownst to them says, uh, for mental health, you gotta go see this other group.
• 22:06
  SPEAKER_00: And that means that when they're in the hospital and we have to go do an emergency or an urgent mental health uh evaluation because something happened, we don't get paid.
• 22:16
  SPEAKER_00: Because they're here, we have to help, but their insurance company will literally say the fact that they needed mental health care while you were doing open heart surgery in that same visit will pay for the surgery, we won't pay for the mental health care.
• 22:29
  SPEAKER_00: It's really abysmal.
• 22:31
  SPEAKER_00: But because of that, compensation is low, and when people ask me, would I be a psychiatrist again?
• 22:37
  SPEAKER_00: I s I sometimes say no.
• 22:40
  SPEAKER_00: And they ask why, and I say, the world doesn't deserve us.
• 22:44
  SPEAKER_00: We work as hard or harder than anyone else, and a psychiatrist makes a third to a quarter of what other types of physicians make, and then get from a psychiatrist to a psychologist, they make half what we do.
• 22:58
  SPEAKER_00: So I think the biggest advance in mental health is stop treating us like we have second-class diseases, we're second-class clinicians, we deserve second-class compensation and resources because it's not just the pay for the physicians and the psychologists.
• 23:21
  SPEAKER_00: You know, surgery department may get$50 million a year in mission support because of the margin they bring in.
• 23:28
  SPEAKER_00: Psychiatry gets a closet.
• 23:31
  SPEAKER_00: So I think USC has been very forward-thinking about supporting us, and I feel really supported here, but at the end of the day, you know, a cardiac surgery brings in so many more resources than you know, an equally sick, equally disabled patient with a mental condition that you know all the resources go to surgery or cancer.
• 24:00
  SPEAKER_00: They don't go to mental health, and as a result, access is bad, and everything else around it is kind of second class.
• 24:10
  SPEAKER_01: It's a failure of the culture.
• 24:13
  SPEAKER_00: It really is.
• 24:14
  SPEAKER_00: And you know, the biggest barrier to this is the other, the other docs, right?
• 24:18
  SPEAKER_00: And I know that my colleagues in other fields are gonna say, don't take my money to get yours, but fair enough, let's just come up with a an a fair way to split the pie.
• 24:26
  SPEAKER_00: And right now we have a way that screws over everyone with mental illness and everyone who's trying to help them.
• 24:32
  SPEAKER_01: Thank you so much.
• 24:34
  SPEAKER_00: Thank you for letting me have this chance and for having interest in this field.
• 24:43
  SPEAKER_01: We can do so much better when it comes to mental health.
• 24:47
  SPEAKER_01: But you're already part of making that happen by the simple act of listening.
• 24:51
  SPEAKER_01: So thank you.
• 24:52
  SPEAKER_01: We appreciate that.
• 24:53
  SPEAKER_01: Also, by spending time on this, you're probably improving your own mental health.
• 24:56
  SPEAKER_01: So good job in dedicating some time to you.
• 24:59
  SPEAKER_01: Finally, at the end of this, I'll be adding a minute of something that really helps my mental health just for its sheer beauty.
• 25:06
  SPEAKER_01: So keep listening.
• 25:07
  SPEAKER_01: With season one finishing, we're going to take a well-earned break for a few weeks, and we'll begin releasing new episodes in June.
• 25:14
  SPEAKER_01: Just follow us, and you don't ever have to worry about missing a thing.
• 25:18
  SPEAKER_01: And while we're on break, catch up on any episodes you haven't heard.
• 25:22
  SPEAKER_01: If you like this episode, shout it out.
• 25:24
  SPEAKER_01: Tell friends, family, colleagues, or anyone looking for a great rec.
• 25:28
  SPEAKER_01: Post brain stories on your Insta or Facebook.
• 25:31
  SPEAKER_01: Do a TikTok dance about us.
• 25:33
  SPEAKER_01: The best way that someone can find out about brain stories is from you, and you might just be helping their mental health.
• 25:40
  SPEAKER_01: Want to share a story you have about student mental health services?
• 25:43
  SPEAKER_01: We'd love to hear it.
• 25:44
  SPEAKER_01: And might even share a part of it in a future episode, with your permission, of course.
• 25:49
  SPEAKER_01: Email that or anything else you'd like to say to Brainstories Productions at gmail.com.
• 25:59
  SPEAKER_01: Thanks to the team that made this story possible.
• 26:02
  SPEAKER_01: Our episode producer and editor was Kate Ruscosa.
• 26:06
  SPEAKER_01: Original music for this show comes from Paul Schwartzel.
• 26:09
  SPEAKER_01: The show is executive produced by Frank Cosa and Janet Yang.
• 26:13
  SPEAKER_01: And as always, thank you to our advisors and all our supporters.
• 26:21
  SPEAKER_01: The show is a copyright of Brain Stories Productions and the Samuel Bay Corporation.
• 26:26
  SPEAKER_01: The use of this episode or its content in any way or form for artificial intelligence, its development or training, is copyright infringement and expressly prohibited without prior written agreement.
• 26:36
  SPEAKER_01: And now I want to share something that always picks me up when I hear it.
• 26:40
  SPEAKER_01: No surprise that it's called The Flying Theme.
• 26:43
  SPEAKER_01: It's a piece written by Paul Swartzel, who composes music for Brainstories and wrote this just to show how wonderful a music cue can be all by itself.
• 26:53
  SPEAKER_01: It's on my mental health playlist.
• 26:55
  SPEAKER_01: I recommend it for yours.
• 26:56
  SPEAKER_01: And if you really like it, shoot me an email, and I'll see if Paul can make it available as a download.