Head Inside Mental Health
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #Head-Inside Mental Health featuring conversations about mental health and substance use treatment with experts from across the country sharing their thoughts and insights on the world of behavioral health care.
Head Inside Mental Health
Breaking Down Healthcare Silos with Dr. John Santopietro
Dr. John Santopietro never planned to become a leader in mental healthcare transformation, but after witnessing systemic failures firsthand, he couldn't stay on the sidelines.
From his unique beginnings working in a family fish market where he observed countless personality types, through his Quaker education emphasizing introspection – Dr. Santopietro's path to psychiatry reveals how personal experiences shape professional passions. Today, as Senior Vice President at Hartford HealthCare and Physician-in-Chief of their Behavioral Health Network overseeing 3,000 employees, he's implementing bold solutions to fix a fractured system.
The conversation delves into a troubling shift in psychiatric care – from an earlier model focused 80% on understanding patients to today's approach emphasizing 80% management of symptoms. Dr. Santopietro shares how integrating mental health into primary care dramatically improves both psychiatric and medical outcomes, with diabetic patients seeing A1C levels drop a full point when receiving comprehensive care. His team-based approach, embedding psychologists across medical specialties from orthopedics to cancer treatment, demonstrates how breaking down silos between providers elevates patient care.
Join us for a conversation that offers both practical wisdom for clinicians and hope for patients navigating a complex system, reminding us that at its heart, healing comes from human connection.
Hello folks, thanks for joining us again on Head Inside Mental Health, featuring conversations about mental health and substance use treatment, with experts across the country sharing their thoughts and insights on the world of behavioral health care. Broadcasting on WPBM 1037, the voice of Asheville Independent Commercial Free Radio. I'm Todd Weatherly, your host, therapeutic consultant and behavioral health expert. Joining us today is our distinguished guest and friend of mine, dr John Santopietro. Dr Santopietro is the Senior Vice President at Hartford HealthCare and Physician-in-Chief at their Behavioral Health Network there in Hartford, connecticut. Assistant Clinical Professor of Psychiatry at the Yale School of Medicine, assistant Professor of Psychiatry at the University of Connecticut School of Medicine and Assistant Professor at the Frank H Netter MD School of Medicine, quinnipiac University.
Speaker 1:John got his BA at Yale, but he went on to get his MD from Northwestern Medical School in Chicago. He did his internship and residency at Cambridge Hospital with that little school up there in Mass. What's the name of it? Harvard? Yeah, that's the one. The little school up there in Mass, what's the name of it? Harvard? Yeah, that's the one. He also did a fellowship with Austin Riggs Center, a residential therapeutic community up in Stockbridge, mass, probably the place where he and Virgil crossed paths at one point.
Speaker 1:Dr Santo Pietro is a 2001 diplomat with the American Board of Psychiatry and Neurology and he retains his certification and license in multiple states there in the Northeast but keeps it up in North Carolina as well, having been former chief clinical officer and chair of Department of Psychiatry at the Carolinas Healthcare System in Charlotte. But we will hold that against him. John has many such leadership appointments across the Northeast, including former president and medical director at Silver Hill Hospital. Over there with our friends in New Canaan Just had Dr Murata on the show. Dr Santo Pietro is a distinguished fellow with the American Psychiatric Association, member of the Connecticut Psychiatric Society and the American Medical Association foreign board. Member at the American Association of Community Psychiatrists, also member of the group for the advancement of psychiatry and the American Association of Psychiatric Administrators. Doc, welcome to the show.
Speaker 2:Wow, that was way too long. You know, I'm like who is that guy?
Speaker 1:Who's this guy we're talking about? Well, you know, the thing that I like to say is he's also just like a nice guy and I like hanging out with him.
Speaker 2:Well, it's kind of like imagine like those, if you know you're about to like uh, you know they say your life flashes before your eyes when you're like get in a car accident or something like that's what I'm like. Who?
Speaker 1:is that guy, and?
Speaker 2:and actually the I just recently um, since that bio, uh, my uh, apa American Association status has moved to Distinguished Life Fellow, which means that I'm old, which means that you're old.
Speaker 2:No, that's the only. The qualification is. You've been in it for 30 years, oh wow. Well, anyway, I don't think of myself that old. So I am. You know, it's a total honor here, todd, to be, you know, able to have a conversation with you. It's a total honor here, todd, to be able to have a conversation with you for a variety of reasons. Most importantly, I think we get up every day and have a that many of us kind of get bitten by a bug that really changes our life. So I thought maybe I don't know if it's okay just saying a little bit about how I ended up getting into the.
Speaker 1:Well, that's a story I haven't heard. I'd love to hear story like where you know what, where did the bug bite you? You know? I guess is the question well and it's.
Speaker 2:I don't know if I would have been able to ask that, like you know, 20 years ago. But looking back, um, here's how I, here's how I think of it. So I grew up in rhode island, which is a very small state, obviously, and I'm all italian. If people that have been in rhode island might know, there are a lot of italian people in in rhode island. So I uh, nobody's not italian in in my family until me. My wife is actually all irish and, um, I uh, and it was a very tight family, and when I say it was a close family, three of the brothers one, two, two, three married. Three sisters One, two, three sisters no kidding, from across the street.
Speaker 1:Right. And so, Because that's how it was in the old country you know, essentially that's how it was.
Speaker 2:That's how it was and what they did was they had a fish market and that was the family business that they started.
Speaker 2:And so I grew up working in a fish market, since I was like a little kid and so I was always around a lot of people and people were always talking and kind of in each other's business and we'd have big gatherings and holidays and stuff. So I was interested in how and you meet a lot of interesting people working in a fish market. If you want a lot of different personality types to observe, it's a great way. And so then my mother, my parents, were both teachers. They were the first generation to go to college and they believed in education, and so my mother taught at a private school so we could go for free back in the day, and that was a Quaker school, and I don't know if people know much about Quakers, but they're very inward looking. So and I went to this school, the one school from kindergarten through high school, so 13 years in one school, and there we would have silent meeting once a month, even when you're just a little kid, like in kindergarten.
Speaker 1:I'm a big fan of Parker Palmer, who's you know kind of takes the Quaker method and uses it as a you know this introspective way of doing development work. It's cool stuff, but I'm very familiar with the Quaker method. Yeah, neat stuff.
Speaker 2:I'm going to have to check that out. Like meaning in the work, like in our work.
Speaker 1:Yeah, with educators and with, you know, care providers. You can imagine that he aligns to folks that are in care and teaching professions. Courage to teach, courage to heal. You know Parker Palmer's neat stuff, but the method that he uses is the Quaker method and I think it's really cool. It's neat that you grew up that way, yeah.
Speaker 2:Yeah, and literally. So you know these silent meetings for an hour and however many that added up to my whole education, and you're in a room with you know, I don't know 50 people, maybe sometimes 100, more than that 100 people, and nobody's in charge of the meeting. Anybody can speak, so it's a very intense sort of it's sort of like group therapy. So you know, I was sort of primed to do something in mental health. And then I, when I was in college, I took a course on Sigmund Freud, you know, in when I was a sophomore, and that was it. I was just blown away and I'm like, wow, there's an unconscious and you can help people by talking to them. And and then I went to medical school and all that stuff, always thinking I'd be a psychiatrist or do something in mental health, and finished all that training that you described in 2000. And my first job job.
Speaker 1:I left the dates out because I didn't want to date you too bad.
Speaker 2:You know it's like I can't believe what's going anyway. Um, yeah, I mean, we have three boys and the two one's about to graduate from college and one's a freshman in college and one's in high school. So, um, so am I, and I was just just planning on being a clinician, which I just is in quotations, because that is, to this day, my favorite thing to do. It's what brings me the most, in a sense, joy and satisfaction.
Speaker 2:But what happened was my first job was in an inner city hospital just outside of Boston, in Dorchester, and I basically couldn't believe how broken the system was and I couldn't unsee that. And so I was the way I described it is. I was just afflicted with. I couldn't stay out of the fight to make things better, meaning getting involved in leadership, and so I'm kind of a reluctant leader in a sense, like it was not my first thing that I wanted to do, but every day that I feel like I can make a difference as a leader and help move things incrementally forward.
Speaker 2:And so that's been it for 25 years now, and I've been in, I really worked in like 12 systems and um, which is a whole other story, but at the end of the day, uh, community mental health state hospital, inner city hospital, community hospital, silver Hill. You mentioned um, north Carolina, maine, massachusetts, connecticut. So I have a pretty good sense of the system and what's out there. And right now, the role that I'm in, which I've been in for over six years, which is a total record for me, is this leading behavioral health at Hartford HealthCare, which is a not-for-profit health system in Connecticut, we have 47,000 employees in the whole organization, 3,000 in behavioral health, which is really unusual to and to have that many in a big system, in a in a big healthcare system.
Speaker 1:And a nonprofit system that maintains its nonprofit and it hasn't been bought by some other system, which has happened to our system as well. You know, here here in Asheville. But, um, I mean, I think that some of the other things that you're doing some pretty innovative stuff around community mental health. You've got a new recovery center that just opened, the Ridge Recovery Center. You've, you know, got your got your iron. You know, irons in a lot of fires, or or a lot of irons in the fire, some of which have come out and are serving the community in ways that are really incredible.
Speaker 1:I was responding to something. I was somebody asked a series of questions and I was responding I think it was on LinkedIn or somewhere but I said you know the thing that we need to do. People talk about a broken system. I'm like I'm not sure when it was functional, but we do have these pockets. I don't know what state of functionality we came from, where we would say that it was broken, but we do have these pockets. There are these places and I would say that you and your role and the work that you're doing is one of them where there is exceptional work being done, where there's real solid community work and solid treatment that's happening in a format that is welcoming and makes people feel a part of something and causes them to stay invested and engaged, and causes them to stay invested and engaged in the country little spots here and there, and I think we just need to find those models and do more of them in places where we can plant them.
Speaker 1:In your mind, you've always had this you wanted to be a clinician and you went and got an education and everything. It sounds to me like the bug bit you when you got inside of the system and saw how broken it was and decided to make some changes. That's where the bug bit you, and then you can't let it go. So in your mind, what work have you done that you think that we need more of, and or what do you see for the future in terms of bringing our mental health and behavioral health care system back into a place where we feel like it serves the people that are in greatest need?
Speaker 2:Yeah, that's really a fantastic question, honestly, and we could probably spend a week talking about it.
Speaker 1:It's been a long time. Give me the highlights you know.
Speaker 2:Well, my mind goes in two directions on that. You know, one is sort of the the rocket science side and one is the not rocket science side. So I'll start start with the non who get how important it is to connect with other human beings in this work. I mean, I can't overstate that, at the end of the day, as of today, there is no blood test, there is no head scan, there is nothing that says this person has bipolar disorder or this person has PTSD, in terms of an actual physical, you know lab value, right, which is amazing, right. If you have pneumonia, you know we get a sputum sample. We find out what bacteria it is. We can tell within. You know a couple percent.
Speaker 1:We can see your white blood cell count, we know that you're, et cetera et cetera, right, genes, you know, cancer, all this stuff.
Speaker 2:So at the end of the day, what we do is imprecise. You know it doesn't have precision, but it doesn't mean we're not good at it. We can be really good at it. And you know you know this as well as I do that there's a difference between when it's being done really well and when it's not being done so well. And I think about that in terms of, like, clinical soul. You can sort of tell that there's sort of clinical soul in an organization and in individuals.
Speaker 2:I would say, actually the irony and I've been doing this for a long time, I probably, you know, I mean I have 3,000 people here.
Speaker 2:I don't know how many people across the years I've had on my teams, but it's thousands, right, I can't think of almost any of them that didn't start out as like caring, you know, loving you, loving bright people that want to make a difference and help other people.
Speaker 2:So where it goes wrong is usually in the system, like they start that way but it's within a system that starts for whatever and again, the system doesn't intend to do this, but for whatever reason there's too much emphasis on throughput and productivity or all this paperwork or caseload. Now the other side of it is we do have access issues. So I'm definitely a fan and I do see as many patients still as I actually can because I love it. But on the other side of it is this is is again all in a non-rocket science bucket, and the other way I would describe this is basically there's two things we do when people come into our services. We either are trying to understand them or we're trying to manage stuff right right, right right manage stuff is you come in with a symptom, we give, give you medicine.
Speaker 2:You come in, you know, and I work. We have 337 inpatient beds. You know, you, you're, you have an aggressive behavior and you get a shot of medication and maybe put in restraints. That's management, right Understanding is, like why are you here today? Like, why are you asking for help? What's going on? Who? Every single person is totally unique. Why are you back here today? Why are you back here today? What's going on? You know?
Speaker 2:And when I trained, which was ages ago, mid to late 90s right, I would say it was like 80 understanding, 20 management, which is, which is astonishing because it's reversed now, you know it's people are coming out of training and it's 80% management. And it just takes psychiatrists how many psychiatrists are just like given a pill? Right, like 80% management, 20% understanding. So when, when you're asking like if I could wave a magic wand, you know, and and fix something, that's that's thing is that we would shift the emphasis back to understanding, being human with each other. Engagement, like you're an engagement, you know, savant, like you know, and what you do in the world and your work is in the top echelon of engagement and not everyone can reach that, but we can certainly do a lot better than we're doing. Then there is the rocket science stuff.
Speaker 1:Yeah.
Speaker 2:Which is like how do you? You know, because what I'm trying to do in my leadership career is work within a system to bring the best care to the most people. The best care side is hard to balance with the most people side, right. So when I was at silver hill, you mentioned which is a fantastic, high, high um you know highly expert staff, um, and they provide excellent treatment to about 500 people a year 600 a year.
Speaker 1:High cost, you know high cost for many, you know, for many of the programs they do but um, but they do a great career, live in a world where you know insurance doesn't pay for this stuff the way it should.
Speaker 2:I hope. I hope in the next life we'll wake up.
Speaker 2:Yeah, the opposite where it gets paid for because it should, where it's our brain and all that uh stuff. Where I work now, we do um 500 000 outpatient visits a year. We do a hundred thousand inpatient days a year. We serve 30 40 000 people a year, so, um. So there's the access issue. This is more rocket science stuff. So what do we really have to do in the coming years so that we can treat, you know, of all the people that have mental illness? You know, I mean Substance use issues are both right and substance use. We're missing even more. So we have to start thinking about innovation. We have to start thinking, and a lot of people are doing this. I don't think anyone's totally hit it out of the park yet, but you know there's virtual care in general. There's like app based stuff. There's, you know, ai people are even thinking about, which is controversial and I'm not sure how that's going to fit into things.
Speaker 2:I think we've got to be careful with it, but yeah, yeah, yeah and I mean you as the engagement expert. Be interesting what you think about whether AI would ever substitute for connecting, you know, with a human or connecting, you know, with a human.
Speaker 1:I I think it can make you know there's a part of the thing that you run into and I I mean I haven't worked with lots of clinicians and you know been in startup and and managing programs paperwork and documentation is just everybody's, you know, bugaboo chasing after people who need to document so you can get insurance. Billing or coding or any of those other kinds of things are not always very good at that aspect of the care. Make their job easier so they can really focus their attention on what you and I are talking about, which is the connection piece, because you know the there's a there's a piece of research out there that's fairly old but it's still relevant, that you know. Uh, it doesn't matter. The methodology that you use largely is not as impactful across methodologies as the therapeutic connection, as the therapeutic alliance that the care provider has with the person that they're serving. If the therapeutic alliance is strong, chances are good you're going to get pretty good outcomes with your care, regardless of the method that you use.
Speaker 1:Now you know we've got some pretty sophisticated methodologies and clinical work out there, including some technology that's helping us with the brain and all those other pieces, right, but I still think that it takes a person to connect with a person. They need to feel like they're not alone, and you can't just screen your way through to better mental health. It can be a tool and it can be used. You know daily meditation, you know you've got somebody who's immediately available to you on a platform virtual platform that can respond to a text message or do a quick video meeting with you. Those are cool things, but I think that and I'd like to get your idea about this between insurance companies not paying for it and the stigma that exists both around mental health and addictions issues, you've got you've got people don't seek care, right, you've got a lot of people who don't seek care.
Speaker 1:And then then you, if you stack on top of that this, the complement of there's a lot of care out there that is insufficient to the task. You know people are getting. They're walking into a hospital. It's a revolving door. They're not getting the care they need because there's no management on the other side. There's no place for them to go. So you end up with these very complicated conditions as a result of poor care done repeatedly Yep, as a result of poor care done repeatedly. So you end up with this much greater need and I wonder if it's a matter of getting to everybody early enough before we get into this sticky wicket of complicated didn't seek care for years and years and years, and now is the psychiatric condition they have to go to the hospital for Like. Ideally they would have started managing this mental health much earlier. How do we get? How do we get to that Like? What's the path there?
Speaker 2:Yeah, that's a great question. That goes on my rocket science list and I don't mean to say it's really hard, but more just a systems issue. For sure, systems issues better way to say it. So there are a variety of ways to do that. Obviously, you know, working with kids and and getting working on, you know, psychological resilience, right. Like we always talk about the bad side of things, like when you're you have a mental illness, we talk about mental illness. We don't talk about mental health a lot like really, and there's some good programs out there where they're working with kids even in college, like giving courses for credit that you can take on how to be psychologically resilient.
Speaker 2:But at scale, I would say probably in my mind, one of the most impactful things is to get mental health into primary care, because everybody almost has a primary care provider and they are overwhelmed, they're working super hard, they don't have a lot of time with patients, they need a lot of support, and I've been involved in my career, including where I am now we have very robust integration into primary care. I did this when I was down in North Carolina as well, and one of the nice things about behavioral health into primary care, connecting them is. You can be virtual right. So you can have, because you know a person comes in and see their primary care doc, you can screen them. Even if you don't screen them, you know the behavioral health team can get a report of all of the patients that are on psychiatric medications, for instance, and then they can reach out. Hey, here's your behavioral team, you know just how's it going. And that doesn't have to be in person, it can be over video, it could be on the phone, it can be through the chart and lots of studies show this and this is consistent with when I've done it in systems.
Speaker 2:When you integrate behavioral health into primary care, your well, first of all, your mental health outcomes are better. So generally your depression scores fall and your anxiety scores fall, but also your medical conditions get better. You're in one, that's right. I'm going to walk hand in hand. Your A1Cs came down a full point for the diabetic population. So it's good that you're onto that, because we're just seeing people downstream when they're falling out of the river down there. We should really look at them when they fall into the river. You know, way back, way back.
Speaker 1:And you've got maybe a couple years on me not a ton of years, but a couple of years on me. I I can. I can say I can remember and I've seen the shift and I don't remember exactly when it was. I would say it's probably in the 2000s. When you walk into the dock and they give you the sheet, it's like where you're having problems. What's your thing today? Fill out this tick list of the conditions that you might have a history of or suffering from or you're concerned about, and the category that got added were psychiatric symptoms, depression, anxiety, are you having disturbed thoughts or you know sleep, etc. Etc. Etc. There's a section that is that is there now, that was not there very early on at the primary care physician's office where you might list something where you're experiencing depressive symptoms or you're experiencing whatever it is that's in the psychiatric realm, and then they have to ask about it. Now they're still gun shy on treating you or you're getting referred out often because it's not their wheelhouse. That's fair.
Speaker 1:I think that the other piece and I'd like to hear the ways in which you're doing this now, because I know that you are is when we go into concierge, when people go into concierge level care, especially with individuals who might be suffering from co-occurring medical conditions, co-occurring substance use in addition to mental health, et cetera. You've got a team that's talking to one another. Yeah, uh, and I think that the the one of the things that the rest of the world experiences as a deficit is none of their providers talk to one another. Yeah, they're all, you know, they're all expertly. You know, my favorite is, uh, expertly hitting, uh, or hitting expert tennis shots from separate courts. Oh, interesting, yeah, yeah, and it's, you know, they're, they're, they're hitting into a, they're not. They don't have anybody to play off of. Yeah, and you're getting these siloed kinds of treatment results yeah out of serving the greater public.
Speaker 1:and I wonder what the systems you know, how are you trying, how are you seeing and how are you managing integrating the medical with the psychiatric, with et cetera? Like, how is that happening for you there at Harvard?
Speaker 2:Yeah. So a number of things. One is just very concretely we're very lucky. We got about 60, 70 psychologists in our system, which is really unusual. You may know just the trends in the field for no good reason. When I trained there were a lot of psychologists in big systems, even on inpatient units, and then over the subsequent 10, 20, 30 years it changed. But we have a psychology department, we have training program on health psychology. So we have about 30, you know, maybe even 40 psychologists that are embedded in medical practices. This is different than the integration into primary care. This is specialty practices. So this is, you know, liver transplant service.
Speaker 2:This is movement disorders, this is cancer, this is actually even orthopedics. We have, like a psychologist that works in orthopedics. So there's a growing and there's a growing understanding that the mind, you know, plays a role in Huge role.
Speaker 2:Huge role Weight loss, surgery, stuff like that. But at a more basic level, todd, this is the stuff that still, I want to say, bothers me a little bit. You know, like I, cause I do the work and it is so fun, I would never want to do the work in isolation. It's no fun, like it's much more fun to pick up the phone, which I do every time, and, and you know, get a release and talk with a therapist and talk with the primary care doc and bring, by the way, the family in to the next. I've gotten a couple of those calls Right. Well, I mean, and this to me, this is when I and it's my own failing that I haven't moved the needle further on this, maybe even nationally, because it seems so obvious to me how can you do the work unless you're getting all that data right? Because right now we don't have an MRI machine, but we are the MRI machine, so the more data you have, the more accurately you can figure out what's going on with someone. But it's just fun.
Speaker 2:It's challenging to put things together. I mean people come into us because they haven't been able to put things together and it's just fun. It's challenging to put things together. I mean people come into us because they haven't been able to put things together and it's complicated or else they wouldn't come in. So what we also do, here at least, is we emphasize it is a team sport Like. Team-based care is a term you'll hear getting thrown around, but it is for real and again, lots of studies show that team-based care is better, is better care. So we do. We do a lot of that as as well yeah, man, that's just a.
Speaker 1:I think that simple. You know, team-based care. It's simple. I mean, I think it leads to things that are profound in terms of quality of care. Yeah, but it's also something. The thing that carries people the most, whether it's professionals or you're on the ground workers or you're direct care, I mean the thing that carries people the most are these kinds of simple things. It's like I'm part of a team or you know communities, the solution, or there are these principles that kind of carry a person and I, yeah, I'm not, you know, like you. I have the, I have the heart that wants to make it the national issue and solve the problem. Yeah, I, I, I. I have not yet accomplished that. I'm not going to saddle you with failure and I'm not giving it up just yet either. So we're going to keep working Right, we're not giving up.
Speaker 2:Well, I mean cause it just seems so obvious. You know, sometimes I think of us, I I love. One of the reasons I went into the field is I love hanging out with clinicians. They're so. You learn from every one of them. You know everyone does things a little bit differently. They have different methods or tricks. You know, in a sense and how to engage with people, and one of the things that is really impactful is case conferences, which is something I always bring in wherever I am. They used to be around 30 years ago, not so much anymore.
Speaker 2:All this productivity stuff and also bringing the patient into that right, and it's always impactful to the patient First of all. See all these caring, smart people that care about them, that are putting their heads together to try to figure out what's going on with them, and then you learn stuff you know from each other. One of the other things I'm doing is we have two times this year once at a big conference that we had on patient experience and then one recently we had a summit for our interns. We have like a social work interns and there's a particular patient of mine I've been working with for two years who struggles with a lot of really tough stuff and she's extraordinarily bright and articulate and, um, and really wants to give back. She's always like when she gets hospitalized, you know we, you know you can bring residents and interns in and she'll talk with them about, um, what's going on with her, and, and so I've had a conversation with her in in the, at the big conference right, with all kinds of administrators and everything that has never seen a psychiatric interview, um, and then we were invited to go to this intern, uh, so, and so what it does? First of all, it normalizes talking with patients, and when I say patients, I mean a human being who's in the patient role.
Speaker 1:A shocking concept really.
Speaker 2:Well, it's just someone in the patient role. In that sense I'm in the doctor role, but that could switch. I mean, we're all patients at some point, so it normalizes it. It's also like I think of us and I don't know if this makes any sense to you, but, like you know, I, when I look at so, the way the work that our people do, including you I'm like these are like star athletes. It's imagine we were like a professional, we were playing like professional baseball, right, like that's how good people are at this, and yet we rarely get to see each other do it.
Speaker 2:You know, inspired by it to learn things, to actually even critique each other too at times, like yeah, I don't know, like, like should, I might want to consider this or do it this way, or I've done it this, yeah exactly which is just I mean the value in that.
Speaker 1:I mean to me just the opportunity, even with the show. That's part of what the show is about. Actually. It's like getting with people like you and just you know, let's take 30 or 40 minutes and just hear this person's wisdom of decades worth of care and I don't think people understand the value of it and the fact that you know, in many ways, somebody like you with as many credentials as you have and all the things hanging on the wall and everything else. I think one thing that people might not know at first glance is that you're also, like this, really nice person that's fun to hang out with well, I mean it's not, you know, that's my opinion yeah, I mean to mean to me part of that is, you know, it's not rocket science.
Speaker 2:I grew up working in a fish market. This is not and partly I say that for people to know that you can learn this stuff Like I still literally use lines from when I was in training and I saw I used to observe the way that people would. We'd had a lot of that back in the day. You would observe how people interview and I still literally use lines today. I have a couple of them come to mind that are really good. One is especially with somebody that is kind of depressed. It's what keeps you going.
Speaker 1:Yeah, like very simple.
Speaker 2:You know it's a very simple and there's usually only a few categories of things. You know or you don't get an answer. You know it's a very simple and there's usually only a few categories of things you know, or you don't get an answer you know, or another one is do you have anyone out there? You can lean on Right, literally like. I heard that 30 years ago and I've used it every.
Speaker 1:Every year You've got techniques like motivational interviewing and all these things. I'm like like, hey, you know, a lot of this is socratic method, you know what I mean. Like it's socratic method that's been distilled and and and refined and everything else, but asking somebody a good question that causes them to focus on what are the resources you have? Like, how are you keeping yourself well, right, right, they haven't. They have an you know as opposed to you know. Are you feeling terrible? Have you had any suicidal thoughts? I mean, those can be important questions and I'm not discounting them. Right, having a person focus on the ways in which they're maintaining a well-being Right Is a shift. I think many of our you know, provider networks need to make a little bit.
Speaker 2:Yeah, and I think our folks don't get nearly enough credit for what they do. They they, you know and to make it perverse like they get a lot of attention when something goes wrong.
Speaker 1:Right, yeah, oh yeah.
Speaker 2:Yeah, but no one gets how incredible, like it's, a little bit of what we do is sort of like a trade. It's like becoming a really good plumber, Like you know. I think you said you have to apprentice, you know and watch people and get better and make some mistakes too. You know, like that's how you know, you, you learn. But I want to get back to stigma, because you did use that word and I don't want to. I know we don't have too much time left and I want to. I think that's critical. I mean that would be the other thing if I could wave.
Speaker 2:Wave a magic wand is, um, there, there is so much stigma still. I mean the good news is the younger generations, I think, are doing better. But it is embedded in a lot of what we do. It's embedded in our systems and, um, you know, to give a shout out to the system I'm in and all my places have been good. I mean, they've had great luck in finding good places to work.
Speaker 2:But as big systems go again, this is, you know, it's a 47,000 person, $7 billion not-for-profit system, which these days is not huge. Seven billion dollar not-for-profit system, which these days is not huge. Um and uh, behavioral health is big here, but it's not as big as the rest of what we do, right, we have acute care hospitals and orthopedics and surgery and primary care and emergency rooms, right, um, but one of the reasons I'm still here after six more than six is that there is less stigma here around mental health than I've ever seen in any other system, and I think that's a function of the culture, you know, of an organization and the culture of our organization. They've been working on it for 15 years officially. You know they really work hard on it. We have leadership behaviors including be curious, not judgmental.
Speaker 2:That's literally a leadership behavior. And so you had mentioned this program that we started and I do want to, you know, let people know about it, not only because it's a great program. It's called the Ridge Recovery Center. It's in Northeastern uh, connecticut.
Speaker 1:Opened last year, is that?
Speaker 2:right. Exactly a year ago. In fact, we had just had a event one year event and two of the two of the former patients that came were were. One of them was the first patient.
Speaker 1:Oh wow.
Speaker 2:The other one was like the fifth patient or something, and they told their stories of recovery, you know, and and what so? Um, what's extraordinary about this program which shouldn't be extraordinary but it is is that, um, and you know the field well, so there's a lot of small private you. You know residential rehab, so it's like 60 beds and we've got some are withdrawal management or used to call them detox, some are residential rehab and then a few of them are extended stay. You can, it's like a sober living kind of thing. So most of the, a lot of the people that do that do them in small private organizations which you know, to make a living, to make it work, to sustain a place, it has to be out of pocket. This is not that way. This is insurance-based and it's part of a large health system and the fact that a health system during the pandemic you know how bad that was for health systems, I mean you know, hundreds of millions of dollars lost, billions really across the country.
Speaker 2:During that period our system invested in starting this program, which is, you know, again like. It's sort of a heartwarming feeling to me, because they treat behavioral health as as any other thing, as orthopedics, as surgery, as cancer. But on the other side you're like why should you? Why should that be so unusual? Like why yeah?
Speaker 1:exactly.
Speaker 2:Right, and especially because every one of us has in our family, somewhere, our friends, people who struggle with this stuff.
Speaker 1:If you stand with a person on either side of you, one of them struggling with one of you struggling with a condition.
Speaker 2:That's right. But anyway, I know we're kind of winding down, but I don't know.
Speaker 1:Well, you know, I think you and I could wind up several times to be my guest, which is exactly why I was. I was really grateful that you wanted to come on the show and hang out with me today. This has been Dr John Santo Pietro with Hartford healthcare there up in Connecticut.
Speaker 2:Thank you, you're very welcome.
Speaker 1:It's so glad to have you on the show. This has been Headed Side Mental Health. We'll see you all next time. Bye-bye.