Put more money into mental health research! Mental health research gets the fewest dollars, and yet is one of the most common illnesses that decreases an individual’s functioning and quality of life. Advances in mental health medicine can only be achieved with research dollars.
The COVID-19 Pandemic taught all of us many things. One of the sectors that the pandemic put a spotlight on was the healthcare industry. The pandemic showed the resilience of the US healthcare system, but it also pointed out some important areas in need of improvement.
In our interview series called “In Light Of The Pandemic, Here Are The 5 Things We Need To Do To Improve The US Healthcare System”, we are interviewing doctors, hospital administrators, nursing home administrators, and healthcare leaders who can share lessons they learned from the pandemic about how we need to improve the US Healthcare System.
As a part of this series, I had the pleasure to interview Dr. Gail Saltz.
Dr. Gail Saltz is best known for her work as a relationship, family, emotional wellbeing, and mental health contributor in the media where she is a go-to expert for commentary on the mental health aspects of current/breaking issues and news. She is a bestselling author of numerous books, serves as a Medial Expert for the Physicians for Human Rights, and is host of the podcast “How Can I Help?” from iHeartRadio. Dr. Saltz is an Associate Professor of Psychiatry at the NY Presbyterian Hospital Weill-Cornell School of medicine, a psychoanalyst with the New York Psychoanalytic Institute and has a private practice in Manhattan.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a bit about your backstory and a bit about what brought you to this specific career path?
When I started my medical career, I originally planned to be an internist. I did a residency in internal medicine, but along the way I found that the once-a-week rounds run by a psychiatrist were the highlight of my week. It was fascinating to understand psychiatrically what might be impacting our patient’s health and mental health. The mysteries of the mind and the impact of the brain’s health on all aspects of health were what lit my fire, so I switched to psychiatry training. As a young psychiatrist, I found that one of the biggest impediments to getting patients to treatment and keeping them in treatment was stigma. So, I embarked on a public education mission via television, radio, books to break down the stigma of mental health care. We have come a long way since those first days, but we still have more to do.
Can you share the most interesting story that happened to you since you began your career?
A while back, I decided to host a series of lectures about historically brilliant and iconic people. When I was researching subjects for the series, I discovered all of these genius icons from vastly different fields either had a mental illness or a learning disability. I found this so fascinating and it moved me to work on my latest book “The Power of Different: The Link Between Disorder and Genius.”
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
When I first started doing television interviews, I let the people that worked in television tell me how to wear my hair. They said it had to be straight, because no one wore their hair curly. Now, I have very curly hair, and it really started to interfere with my life. I was stressed thinking I always needed to take the time to straighten my hair since an interview could happen at the drop of a hat. Ironically, I really don’t even like how my hair looks straight. One day, I simply could not get my hair straight in time before going on air, and I realized the world didn’t end. That finally allowed me to say — no more! This lesson taught me that I am better off just being myself and I don’t have to say yes to everything requested when it’s not reasonable.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
One of them is “just stay in the boat” which comes from white-water rafting. Before a rafting adventure, the guide prepares you by saying you will do a lot of high-level rapids, take some risks, have excitement, test your still, but you need a few techniques to just stay in the boat and not fall out.
At various junctures in life when I’m thinking about taking risks or having adventures, whether in my career or in relationships, I always feel confident to dive in as long as I have a few coping skills to metaphorically “stay in the boat.” It also holds special meaning because my husband and three daughters will often say this to each other as we laugh about our adventures.
Are you working on any exciting new projects now? How do you think that will help people?
I have a fairly new podcast with iHeartMedia and Seneca Women called “How Can I Help?” where I take mental health questions from listeners and answer them. Since so many people are struggling and there isn’t enough access to care, this is my way of reaching the masses with mental health information.
How would you define an “excellent healthcare provider”?
The words I would use to describe an excellent healthcare provider are:
- good listener
- well-trained and highly knowledgeable
- continues learning
- able to admit mistakes
Ok, thank you for that. Let’s now jump to the main focus of our interview. The COVID-19 pandemic has put intense pressure on the American healthcare system. Some healthcare systems were at a complete loss as to how to handle this crisis. Can you share with our readers a few examples of where we’ve seen the U.S. healthcare system struggle? How do you think we can correct these specific issues moving forward?
The United States has a dearth of psychiatrists and especially child psychiatrists. Mental health care in this country is treated like a stepchild of health, which is a tragic error. Mental health care gets fewer dollars for practitioners, and fewer dollars for research, which leads to slower understanding of better treatment options. As a result, mental health remains behind other forms of health care. There are simply not enough practitioners to treat all of the people in need at this time, especially in some parts of the country.
Insurance companies claim parity, but if you look at numbers that is not the case. Most people have terrible coverage for mental health care. This needs to change. More dollars need to go to neuroscience and psychiatric research. More people need to be drawn to the field knowing they can financially support themselves. We need more support for facilities that provide psychiatric care and addition. We need the United States to prioritize mental health.
Of course the story was not entirely negative. Healthcare professionals were true heroes on the front lines of the crisis. The COVID vaccines are saving millions of lives. Can you share a few ways that our healthcare system really did well? If you can, please share a story or example.
Necessity is the mother of invention! During the lock downs almost all of my colleagues turned to telemedicine to see patients, which is something we never did before. We quickly found out it works really well for psychiatry and psychotherapy! This allowed us to see more people, including those who would not otherwise come in. I know many of us feel confident we can continue doing for the betterment of all.
Here is the primary question of our discussion. As a healthcare leader can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Decrease stigma of health care providers getting mental health care!! Most health care providers are discouraged from getting care themselves. Either they are not given the time or they are shamed. It’s not good for the field, and it’s not good for patients. Systems need to encourage self-care and mental health care.
- Physicians, not administrators need to make the rules. Many hospital systems are built around making money, and as a result they rarely have physicians informing those making the vital decisions about how the system actually works. Physicians know what they can handle and what is better for patient care. Administrators who are mostly concerned with the financial bottom line may overtax systems in such a way that it is not best for patient care.
- Elevate the science. These past few years science and medical expertise has taken a hit in public perception. This decreases patients’ willingness to see doctors when they should and to follow public health initiatives. This harms everyone.
- Change financial systems. When insurance pays little and medical students go into debt for their field, we are working in the wrong direction to encourage new talent.
- Put more money into mental health research! Mental health research gets the fewest dollars, and yet is one of the most common illnesses that decreases an individual’s functioning and quality of life. Advances in mental health medicine can only be achieved with research dollars.
Let’s zoom in on this a bit deeper. How do you think we can address the problem of physician shortages?
In my field, it’s a huge problem. Psychiatrists are amongst the lowest paid of any medical specialty. As long as this remains the case, it will be hard to change. Insurance pays very little and many don’t take insurance. Additionally, most people cannot afford out of pocket treatment.
When you have medical students graduating with huge debt, without hope of recouping their financial losses, they can’t afford to be a psychiatrist…much less a child psychiatrist which takes even longer training. Everyone wants mental illness to be treated, but systems so far have made that very difficult.
How do you think we can address the issue of physician diversity?
I think it has to be extremely deliberate and everyone has to make the effort to support POC at the earliest stages of their careers. This can be done through mentorship, direct access to funding, support, and putting more POC into leadership roles (especially female POC since there is a serious shortage). The real fall off occurs the higher up you go in leadership. Without younger people seeing leaders who look like them, you are not creating true diversity and encouraging diverse people to pursue their careers to the fullest.
How do you think we can address the issue of physician burnout? What concrete steps would have to be done to actually manifest all of the changes you mentioned? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
Physician burnout is real, and has been for a long time. The pandemic has only made this problem worse. Burnout can only be solved by limiting workload, hours worked, and the overall stress of the work. Doctors are often expected to be “on” all the time, available all the time, to be selfless and take on any stress with a smile. However, just like everyone else, doctors need time to sleep, eat, exercise, live healthy lives, and be able to get mental health care if they need it.
This means corporations have to have enough physicians so one doctor isn’t responsible for an absurd number of patients. This means not requiring bureaucratic amounts of documenting in unrealistic time frames. This means allowing enough time to see each patient that is reasonable. And it means allowing doctors time off to recharge, like any other human.
When patients and communities express verbal appreciation for their health care, it means the world. Most people go into medicine because they care deeply about helping patients, not because we want to trick them. However, praise can’t replace the basic need for a better balance between work and life. When our patients understand this, they are better supporting their doctors.
Lasty, leaders need to publicly support doctors. When political leaders perpetuate anti-public health messaging, and accuse doctors of lying about a diagnosis or treatment to make money, they are demoralizing the field and exacerbating burnout.
If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?
I would love to see a movement to bring mental healthcare to everyone by further decreasing the stigmas surrounding it. This could be done by increasing accessibility and affordability for care and increasing research around these illnesses. Mental illnesses affect close to half of the US population, and by sheer numbers, this is the biggest health problem we are facing today. In fact, depression is the leading source of disability in this country. While all of our organs do matter, I would love a movement that changed people’s perceptions to look at the brain first because without brain health, what have you got?
Part of getting to this point includes better education around mental illness. More people need to understand that therapy and medication can change a brain for the better. There are newer treatments on the horizon that deserve research money (TMS, ketamine, etc.). And finally,
more people need to know that real expertise is required in treating mental illness. Not all “therapists” are trained to do the specific type of therapy an individual may need for their illness and that expertise matters.
How can our readers further follow your work online?
They can visit my website https://drgailsaltz.com/, or follow me on social media.
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.