Engage With Your Community: It’s important to stay connected with your community, but also recognize that if you’re giving too much of yourself, you can always re-focus on yourself when you need to.
As part of my series about “Mental Health Champions” helping to normalize the focus on mental wellness, I had the pleasure to interview Molly McShane Perlman, MD, MPH, CEDS National Medical Director, Monte Nido & Affiliates.
Molly McShane Perlman, MD, MPH, CEDS serves as National Medical Director of Monte Nido & Affiliates, overseeing medical and psychiatric components of eating disorder treatment at more than 30 facilities across the country. She is double board certified in Psychiatry and Addiction Medicine. Dr. Perlman has a long-standing passion for helping those in need and has made research strides in the eating disorder space. She is also Vice President of the Executive Board of the Eating Disorder Coalition (EDC), which is the national advocacy organization working to advance the recognition of eating disorders as a public health priority in the United States. Additionally, she is Secretary of the Board of the REDC, the Consortium Representing Eating Disorder Care, which represents over 85% of residential eating disorder treatment beds in the United States. In this role, she advances the field of eating disorders by contributing to development of treatment guidelines, outlining standards of care, and advocating on Capitol Hill for the need to expand access to treatment.
Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit. Can you tell us a bit how you grew up?
I was raised in a big family in Orlando, Florida, so my household was always very active and fun. I’m the oldest of four girls and we are all about six and a half years apart. I went to a large public school with more than 3000 students in my earlier years, then continued my higher education studies at Duke University in North Carolina. The combination of a high-quality education and a vibrant, connected community — due in no small part to their storied athletic teams — provided a wonderful experience for me, and I majored in biology with an intention eventually to go to medical school.
You are currently leading a social impact organization that is helping to promote mental wellness. Can you tell us a bit about what you or your organization are trying to address?
I am the National Medical Director of Monte Nido & Affiliates, overseeing eating disorder treatment at more than 30 residential and day treatment facilities across the country, and have been with the company since 2013. Monte Nido & Affiliates treats individuals of all genders and ages battling eating disorders, with a particular expertise in providing treatment in a residential, home-like setting. From our research and experience, we have found that most people battling eating disorders also have co-occurring mental illnesses, like depression, anxiety, PTSD, or substance abuse, that go can unidentified or under treated.
I became part of the Monte Nido & Affiliates program in 2013 when I joined our program, Oliver-Pyatt Centers, which is located in Miami, Florida. Monte Nido & Affiliates programs are currently in 12 states throughout the country. Our programs are very individualized and client-centric by design, which enables us to treat each person and their unique circumstances holistically. This model is critical in order to make it possible for each person to work toward full recovery from an eating disorder. We treat our clients in small groups so that each person is getting the direct care and attention they need: therapist, psychiatrist, nutritionist and other expert specialists, all trained to provide the best care needed to help them move forward.
Can you tell us the backstory about what inspired you to originally feel passionate about this cause?
Right after medical school, I moved to New York City where I worked in cancer research at New York University. This is where I got my first exposure to working with underserved populations, which showed me some of the health disparities that exist in this country. I saw firsthand that our healthcare system had many gaps in it, particularly for those struggling with mental illnesses. This experience prompted me to pursue my master’s in public health at the University of Miami, where I also trained and worked in HIV research at the Jackson Memorial Hospital, one of the largest health systems in the country. For decades I’ve seen these health disparities and people struggling with lack of access to care, and with mental illness in particular there’s a huge stigma that causes so much of it to go undetected, untreated, and oftentimes ignored. This passion for wanting to help those in need of access to mental health care led me to psychiatry. This allowed me to contribute my absolute best self while also championing those in need.
Many of us have ideas, dreams, and passions, but never manifest it. They don’t get up and just do it. But you did. Was there an “Aha Moment” that made you decide that you were actually going to step up and do it? What was that final trigger?
I initially studied internal medicine with a plan to become a primary care physician, so that I would be able to address the physical and mental well-being of my patients while providing preventative care. After a year of seeing patients every 15 minutes in a busy primary care clinic, however, I realized I could better address my patients’ problems in the psychiatry field. In one instance, I recall meeting with an elderly woman on 10 medications for diabetes, high blood pressure, and depression. In reviewing her labs, it was clear her diabetes was worsening, despite being on a good regimen of medications, including insulin, and receiving diabetic diet education. I reflexively started to write prescriptions for higher doses of insulin, but instead sat down to understand what was going on. She shared that she was deeply depressed and didn’t want to live. She had decided to stop her medications and planned to die from her diabetes. To be trusted by patients to help them through their darkest moments is a great privilege. That experience prompted my decision to switch from internal medicine to psychiatry indefinitely.
When I began to learn the statistics on eating disorders, I was shocked at how commonly diagnoses are missed, leaving individuals to suffer in silence — particularly for people of color and gender and sexual minorities. Eating disorders have the highest mortality rate of any mental illness, and statistics have shown that someone dies of an eating disorder in the United States every 52 minutes. Once I was aware of these statistics, there was no turning back. As a psychiatrist, I find it very rewarding to work with a team of compassionate specialists including therapists, dietitians, primary care physicians and family therapists, in order to best treat the individuals and families impacted by eating disorders.
Can you share the most interesting story that happened to you since you began leading your company or organization?
I have a couple of stories, but the most interesting one that comes to mind has to do with the research I’ve conducted in the eating disorder field. I lead Monte Nido and Affiliates’ Research team and am co-Principal Investigator of our IRB (Institutional Review Board) approved, multi-site Clinical Outcomes Study, which was recently published in the industry-leading International Journal of Eating Disorders. We learned that over half of our clients that come in for residential treatment for their eating disorders actually meet criteria for post-traumatic stress disorder. That’s not just having a traumatic experience — typically a sexual assault — but extends to developing really debilitating symptoms around that: fears of going out, nightmares, flashbacks, etc. Eating disorders feed right into all of those consequences. We are leading the field in understanding and treating the impact of trauma on eating disorders, and that’s something I’m really proud of. We’re able to utilize that data to train our therapists on how to treat traumas, and we’re making great strides. Patients are now coming out of treatment not just recovering from their eating disorders, but from their PTSD as well. So, it’s very exciting that our research is adding to the field’s knowledge base.
None of us can be successful without some help along the way. Did you have mentors or cheerleaders who helped you to succeed? Can you tell us a story about their influence?
I’ve been fortunate to have many great mentors throughout my journey. One person in particular that sticks out in my mind is Dr. Wendy Oliver-Pyatt, the physician who founded Oliver-Pyatt Centers (OPC) in Miami. OPC is where I first started working in the eating disorder space, and the company merged with Monte Nido & Affiliates shortly after I joined. Dr. Oliver-Pyatt is an outstanding psychiatrist who recovered from her own eating disorder and realized decades ago there weren’t enough quality treatment options for people who needed help. Adding “entrepreneur” to her many list of traits, Dr. Oliver-Pyatt opened, developed, and grew Oliver-Pyatt Centers for women.
I had the opportunity to meet her when she was in the process of removing herself from direct clinical care and looking for a psychiatrist to work with her. Eager to be a part of the team, I said to her, “You know, as soon as you’re ready to create that position, I would love to work with you.” She called me as soon as the position was open, and it was a perfect fit.
Dr. Oliver-Pyatt is an expert in the field and has been for decades, so she really trained me and educated me about the ins and outs of eating disorders. She taught me which medications work and don’t work and taught me how to use my best clinical judgement. All in all, she was a great mentor and gave me the stepping stones I needed early on in my career.
According to Mental Health America’s report, over 44 million Americans have a mental health condition. Yet there’s still a stigma about mental illness. Can you share a few reasons you think this is so?
Unfortunately, there certainly is a stigma around mental illness, but I do think we’re seeing improvement now that more people are starting to have the conversation about its impact. Now, we see everyday people, our friends and family, celebrities, and influencers speaking out about their personal struggles and experiences on social media or publicly. We’ve heard from very prominent people, like Michael Phelps, who has been vocal about his own struggle with depression and has become a great mental health advocate, especially for young men.
Removing the stigma around mental illness completely is the goal, to ensure those who need help are encouraged to receive it. I tell all of my patients that this is a brain disease, and just like any other disease. If you have high blood pressure, you need to go to the doctor and find out what you need to do — change your diet or take a special type of medication. The same logic applies to depression or having an eating disorder. If we finally are able to get more people educated to recognize the symptoms of a mental illness and get diagnosed and treated, I think we will see the stigma removed. But to do this successfully, we’ll also need to make treatment more accessible, affordable, and accepted by insurance companies.
In your experience, what should a) individuals b) society, and c) the government do to better support people suffering from mental illness?
On an individual level, we need to encourage families and loved ones to seek professional help if we see them suffering with a mental illness. Approximately 10 million people suffer from a mental illness that severely interferes with major life activities. Sadly, more than half of these mental illnesses go untreated. As a society, we should work towards reducing stigma and educating the public that mental illnesses are not a choice or someone’s fault. These are diseases that require professional treatment. Specific to eating disorders, it is important to promote body positivity, acceptance, and health at every size (HAES).
As for the government perspective, supporting organizations that promote awareness and access to care through legislative action, such as Eating Disorder Coalition, is important. More government funding and support should be allocated to scientific research of mental illnesses, resources for education, prevention and training, and improved access to care.
What are your 6 strategies you use to promote your own wellbeing and mental wellness? Can you please give a story or example for each?
Promoting your own wellbeing and mental wellness is just as important as the work we do with our patients:
- Stay Connected: During COVID-19, we’re seeing more and more isolation. It’s important to connect with loved ones and friends, even if it’s virtually.
- Getting a Full Night’s Rest: Basic self-care is important, and sleeping is important. I encourage people to go to bed at the same time and wake up at the same time every day.
- Incorporate Mindful Movements: Enjoy your body, for what it is. This can mean doing some yoga stretches or finding ways to move your body in a comfortable way so that you’re engaging in physical activity, but in moderation and not to the extreme.
- Listen to Your Body: That means listening to your body when you’re hungry, and then going ahead with nourishing yourself. This can also be something simple like having a knee pain while doing a physical exercise and making the decision to take a break. It’s great to feel your body, get to know your body, and be kind to your body.
- Engage With Your Community: It’s important to stay connected with your community, but also recognize that if you’re giving too much of yourself, you can always re-focus on yourself when you need to.
- Practice Deep Breathing: Deep breathing is a good strategy and one that I practice myself, while encouraging my patients to do the same. Sometimes five deep breaths in and out can be helpful. This may pause some of the anxiety we can get caught up in.
What are your favorite books, podcasts, or resources that inspire you to be a mental health champion?
One book that has inspired my treatment approach is “8 Keys to Recovery from an Eating Disorder,” by Monte Nido founder, Carolyn Costin, and Gwen Schubert Grabb.
If you could tell other people one thing about why they should consider making a positive impact on our environment or society, like you, what would you tell them?
I would say that working directly with patients with eating disorders is the most rewarding part of my job, and through this journey I’ve had to develop perseverance. The hard work that we put in to make a little change in the world is more than worth it. Eating disorders, like other mental illnesses, are medically disabling, and encouraging patients can be nothing short of lifesaving. I remind people that full recovery is possible, and that they deserve to free of their mental illness. Perseverance is paramount, and as we say at Monte Nido & Affiliates, you work through the hard stuff — not around it.
How can our readers follow you online?
Monte Nido & Affiliates Instagram: https://www.instagram.com/monte.nido/?hl=en
Monte Nido & Affiliates Twitter: https://twitter.com/TheMonteNido?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor