Five Question Fridays With Dr. Lloyd Sederer
Welcome to the latest installment of our ‘Five Question Fridays’ interview series. This interview series aims to discuss everything from technology to policy with some of the most respected thought leaders, executives, and advocates in the industry. Our last guest was Glenda Wrenn, Director of Behavioral Health for the Kennedy-Satcher Center for Mental Health Equity, who talked about the current state of mental health and the need for Health and Human Services organizations to invest in compliance.
This week, we’d like to welcome Dr. Lloyd Sederer. Lloyd currently sits as the Chief Medical Officer at the New York State Office of Mental Health, the largest state mental health system in the country. From publishing numerous books to speaking at conferences in front of thousands of attendees, Lloyd has done an exceptional job at spreading the word of mental health treatment and awareness, earning countless awards in the process.
Check out our ‘Five Question Fridays’ interview with Lloyd Sederer below:
Lloyd, you currently sit as the Chief Medical Director at the New York State Office of Mental Health, the largest state mental health system in the nation. Can you shed some light on your current responsibilities and some interesting projects you’ve been working on lately?
My “elevator talk/description” of my job, admittedly too simplified but also simply put, is that I am to uncover what mental health services are not providing - that we know can work for patients and families - and then make that happen. And do that in both the large public mental health system my agency operates, as well as the over 2,000 mental health programs my agency licenses and oversees in the state of New York. I love this job because it is about identifying proven treatments and services and seeing to it that New York State provides them.
My agency operates (we run) a large public mental health system of 22 psychiatric hospitals with 3,700 adult, child and forensic inpatient beds; 90 outpatient mental health clinics serving 25,000 people every year; and we care for 10,500 patients in the NYS prisons with active mental illness. I see our service system as a type of innovation laboratory, where we can do more of what we know works, learn how to implement better care, then generalize what we learn to the non-governmental, not-for-profit mental health providers, using our licensing and standard setting authority. Do it, show that and how it can be done, then spread it, so to speak.
We are working very hard to build the community based mental health system that never happened in the 1960s, after JFK’s Community Mental Health Act, which was to take the place of institutions (state hospitals) that were being closed. The outpatient system we have today is woefully under-resourced and inadequate to serve the existing needs of patients, families and communities. The inadequacies in community services leave us dependent on hospital (inpatient) services, which are necessary from time to time, but do not adequately serve people with chronic illnesses who need ongoing, comprehensive community care – and rehabilitation. We are slowly adding more community services but still have a long way to go.
Your most recent book, Improving Mental Health: Four Secrets in Plain Sight, draws upon over four decades of diverse clinical practice and mental health research, and public health experience in attempt to bridge the gap between science and practice. What inspired you to write this book and how does it differ from other mental health books on the market?
I had read the even shorter book by my friend and colleague (Siddhartha Mukherjee, MD, winner of the Pulitzer Prize for The Emperor of All Maladies) called the Laws of Medicine. It was a memoir about his early career and three rather counter-intuitive “laws” he learned as a cancer doctor in training. I then happened to go on a 7 day, 8 hours/day, hike with lots of time to reflect. I asked myself, what might be the equivalent “laws” for my specialty, psychiatry and mental health? I saw four that were more principles than laws, which made a lot of common sense yet were hardly applied. I called these “Four Secrets” to better mental health hiding in plain sight.
The book is mercifully short, 108 pages including photos. I wrote it to help clinicians improve the lives of their patients—and patients to improve their own lives—by identifying these secrets and taking action in ways that can work, immediately. It is a book filled with stories, clinical reports, science and cultural examples.
After reading the book, Dr. Mukherjee wrote: “Sederer's thoughtful and provocative book could not be timelier. It arises out of a seemingly confusing moment in mental health and poses an immense creative challenge: to draw out the rules, or laws, that govern the psyche as it adapts to an ever-changing world. His laws or secrets often counterintuitive, yet full of clinical utility illuminate his profound understanding of patients and their particular predicaments. There’s a powerful thread of wisdom that runs through Sederer's writing like a bright red line, reminding us that by identifying the driving tenets of clinical care, we refresh and deepen our engagement with it in the future. I read this book in a single setting, and felt so much wiser at the end.”
Back in April, you attended the National Council for Behavioral Health’s NatCon17 Conference. What was your experience like at the conference and what were some of your biggest takeaways?
The NatCon annual conferences are terrific. Thousands of mission oriented people, clinicians, consumers, families and policy makers, gather and learn from one another. It is a high-energy event.
I was able to contribute there in two ways: First, I did a TED-like talk on my Four Secrets book, a 17-minute summary of what I wrote and hope to convey. You can find this presentation on YouTube. Second, with my dear friend and colleague (and filmmaker) Randi Silverman, we hosted screenings and discussions of seven (7!) documentary films focused on mental health, addictions, trauma and family – including Randi’s brilliant film “No Letting Go” about her family and their journey with an adolescent son with bipolar disorder.
Our 2017 State of Workforce Management survey, which received responses primarily from nonprofit mental health executives, revealed that 97% of CEOs expect to invest in digital tools and strategies within the next 12 months. In your opinion, what impact has technology and software had on the mental health clinics that you work with?
The workforce shortage for mental health professionals is not only vast, it cannot be overcome by ‘manufacturing’ more psychiatrists and mental health and substance use clinicians. We must make technology our friend to improve access to needed and effective services.
Two very promising methods underway are TeleHealth and personal, digital monitoring and guidance tools.
TeleHealth is not new. Medical care done over video has been around for some time, but the technology, cost and privacy issues – not to mention unfamiliarity by clinicians – had kept it very limited. Now, iPads and Smartphones can be in patients’ and clinicians’ hands that are simple to use, HIPAA secure, and inexpensive. They also provide highly sought after convenience for patients, many of whom cannot find the time for travel and office appointments and seek a good alternative. I am involved with a start-up called “Hello Session” that has solutions to all these challenges.
Another start-up, now under contract with the British National Health Service (NHS), is PredictiCare. PredictiCare’s first project is with people with Substance Use Disorder (SUD), where real-time analysis of patient data from Smartphones provides alerts about client functioning that can be immediately used for intervention early on to help prevent addiction relapse. I am a medical advisor to this company.
Throughout your impressive career, you have published multiple books for professional and lay audiences on mental health, contributed hundreds of articles to medical journals, and your work has been featured in the New York Times, The Wall Street Journal, and The Washington Post. What continues to drive your passion for mental health and what’s next in store for Lloyd Sederer?
Flattery will get you far, especially with the likes of me! I began regularly writing for the general public about 9 years ago, and became medical editor for mental health for The HuffPost 7 years ago. I have written 5 books for an educated lay audience and about weekly medical and policy articles as well as film, theatre, TV and book reviews. Email me if you want to be on my mailing list (he shamelessly says)!
Writing has always been a form of oxygen for me. I eschew professional writing when I can because of the reach and advocacy that the lay audience provides. I write evenings and weekends, and the more I do it my skills in this craft develop. For 12 sequential semesters, I have taught medical writing for the lay public at the Columbia Department of Psychiatry.
I have just completed my 12th book that will come out in the Spring of 2018 from Scribner (Simon & Schuster). It is titled “THE ADDICTION SOLUTION: Fixing America’s Drug Crisis.” I believe we can do so much more than we are doing today to prevent and treat addictions to psychoactive drugs, legal and illegal. I look forward to spreading that message when the book comes out!
We’d like to thank Lloyd for his participation and incredible insight. Make sure to follow Lloyd and the New York State Office of Mental Health on Twitter for more updates. If you’re interested in participating in our interview series, send an email to email@example.com. This DATIS blog may not be shared or repurposed without permission.