Mental Horizons Podcast

Episode 13 is with Dr. Matthew Stanford, CEO of the Hope and Healing Center & Institute in Houston, TX and adjunct professor of psychiatry at Baylor College of Medicine and Houston Methodist Hospital Institute for Academic Medicine.

Dr. Stanford’s research on the interplay between psychology and issues of faith has been featured in The New York Times, USA Today, Christianity Today, and U.S. News & World Report.

Dr. Stanford earned his doctoral degree in behavioral neuroscience at Baylor University and completed a postdoctoral fellowship at the University of Texas Medical Branch at Galveston. Professionally he has worked with a variety of clients with mental illness, including those with aggression, personality disorders, post-traumatic stress disorder, substance dependence, bipolar disorder, and schizophrenia.

As director of the Hope and Healing Center and Institute, he conducts training seminars and serves individuals living with mental illness and their families. He is the author of three books:

1) Grace for the Afflicted: A Clinical and Biblical Perspective on Mental Illness, Revised and Expanded

2) The Biology of Sin: Grace, Hope, and Healing for Those Who Feel Trapped

3) Grace for the Children: Finding Hope in the Midst of Child and Adolescent Mental Illness.

Three main talking points:

1) Dr. Stanford talks to Virgil about how people often turn to their clergy for support around their mental health issues. In this light, congregations have the potential to act as a healing community for these individuals. But some clergy can “over spiritualize” mental illness and this is where training and awareness raising efforts for congregations can help to steer people towards the proper supports.

2) Dr. Stanford and Virgil then discuss a critical aspect of this issue: that clergy do not make a lot of referrals to mental health professionals. Dr. Stanford believes that with the proper training, clergy and leadership in congregations can help to spot, support, and refer parishoners at the right time to the right people, leveraging the trusting relationship they already have and helping get people the help they need.

3) And lastly, Dr. Stanford outlines some excellent resources for anyone who wants to learn more: a CBT-based curriculum and training he has developed that prepares people who are part of faith communities to act as mental health coaches, other training resources offered by the Hope and Healing Center and Institute, and an annual mental health conference they host.

Episode 12 is with Attorney Debra Rahmin Silberstein, Partner at Burns & Levinson LLP in Boston. Attorney Silberstein specializes in trusts and estates, tax-related matters and elder law planning. Debra has extensive experience working with families where mental health planning is a priority and uses creative techniques to assist clients in reaching their goals. Debra is a graduate of Syracuse University where she earned a B.A. in Economics and obtained her J.D. from Hofstra University School of Law in 1984. Debra then obtained a Ph.D. in Social Policy from the Heller School at Brandeis University in August 2009.

Debra has over twenty-five years of legal experience and is an active member of the Massachusetts Bar Association and was the 2018 recipient of the Powley Elder Law Award. Today she is going to be talking with us about legal remedies for families coping with long term mental health issues. She is going to speak about alternatives to guardianship as well as other topics. This is part 2 of two podcasts focused on legal remedies in mental health. If you want to learn more about legal remedies that can be used during crises, please listen to Part 1 with Lisa Cukier.

Debra will be telling us more about how to integrate into long term mental health planning the use of a durable power of attorney’s, health care proxies, psychiatric advanced directives and discretionary trusts with incentives.

Three main talking points:

1. A brief overview of what guardianship is and who the people are who seek this legal intervention. We will also discuss some of the challenges and limitations of guardianship.

2. What alternatives to guardianship exist and in most instances are preferable? Alternatives such as DPOA’s (or durable powers of attorney), healthcare proxies and incentivized trusts. We will also discuss the importance of using a team approach when accessing any of these legal remedies.

3. PAD’s or psychiatric advanced directives. What they are, why everyone with a mental health issue needs one, and how they are written.

Virgil and Debra also talk more about the DPAs and HCPs. These are critical tools, and aside from steps we one take to minimize “revocation” in a crisis, families should know who should serve in these roles, how to use of teams (or committees), family members and social workers etc.

Episode 11 is with Lisa Cukier, Partner at Burns & Levinson in Boston where Lisa is also a member of the firm’s Executive Committee. This show is part one of a 2-part podcast series. In part 1, Lisa will talk to us about legal remedies in mental health crises and in part two, Debra Rahmin Silberstein, also a partner at Burns & Levinson, will talk about legal remedies in long term mental health planning.

Lisa Cukier splits her practice between high conflict divorces and high profile trusts and estate litigation and is on the show today because she is well-known for her ability to handle the toughest of cases and is particularly skilled at handling sensitive matters where mental health is concerned.

Lisa’s practice also includes handling complex child custody, parentage issues, blended family issues, adoption, and guardianship and conservatorship. She received her J.D. from Suffolk University Law School and her B.A. from Northeastern University and was a 2018 Women Worth Watching award recipient. The Women Worth Watching organization identifies, promotes and supports women in leadership and Lisa was nominated by her peers as an executive who embodies exceptional purpose and drive and represents diversity within her sphere of influence. Before going to law school and becoming an attorney, Lisa worked as a social worker.

Lisa is here today to talk to us about legal remedies that can help to mitigate mental health crises.

We have three main talking points for our conversations today:

Our topic today is focused on legal remedies that are available to mitigate mental health crises. Lisa will start us off with a few stories or scenarios that describe the kinds of situations and individuals we will be focusing on.

Secondly, Lisa will dive into the legal remedies or tools available to clients who are in the midst of a mental health crisis. We will discuss in simple terms when these remedies can be brought into the conversation and how.

And lastly, Lisa will talk with us about how these legal remedies look in action: who is on the team and how do these roll out in real-time, in real life?

In episode 10 of our Mental Horizons Podcast, Dr. Chris Palmer introduces us to the growing field of nutritional psychiatry.

​Dr. Palmer is a graduate of Washington University School of Medicine and completed his internship and psychiatry residency at McLean Hospital, Massachusetts General Hospital, and Harvard Medical School. He is currently the director of the Department of Postgraduate and Continuing Education at McLean and is an assistant professor of psychiatry at Harvard Medical School. 

Dr. Palmer has a private practice near Boston where he focuses on, “the interface of mental health and metabolic disorders”. His website is a great resource for anyone interested in this topic.

Dr. Palmer is also a researcher and is the author and co-author of numerous published studies. This summer, he published an article in the Journal of Clinical Psychiatry titled, “Diets and Disorders: Can Foods or Fasting Be Considered Psychopharmacological Therapies?” and his work with the ketogenic diet with people who have psychotic disorders was recently featured on NPR in a segment titled, “Prescription: More Broccoli, Fewer Carbs. How Some Doctors Are Looking To Food To Treat Illness”.

Dr. Palmer is pioneering the use of the ketogenic diet as a medical intervention for mood and psychotic disorders. He delves into his work on this topic at the end of our conversation, after giving an overview of what nutritional psychiatry actually is.

The show follows 3 main talking points:

Dr. Palmer orients listeners to the field of nutritional psychiatry. How have psychiatry and nutrition already been overlapping? And what is nutritional psychiatry? 

Dr. Palmer drills down specifically into the area of “serious mental illness” and how research and practices in nutritional psychiatry can be brought into treatment plan discussions for people with mental health issues such as bipolar disorder and schizophrenia.

Dr. Palmer’s discusses two case studies and his won research and the most promising areas of nutritional psychiatry that he believes deserve more attention.

Ross is trained as a sociologist, psychotherapist, and social worker and specializes in the integration of psychology and sociology. These two disciplines are typically rigidly separated in academia and as such, psychiatric problems are usually understood -- and treated -- only as psychological phenomena. In contrast, Ross views psychiatric disorders through a unique psychosocial lens.

For over 20 years, he has been helping individuals suffering psychiatric symptoms to find the psychological and social means for remaining outside of institutional settings. He is the CEO and founder of Ellenhorn, the first fully-operating intensive hospital diversion and wrap-around program in Massachusetts. Ross also created and led one of the first Programs for Assertive Community Treatment (PACT) teams in the Commonwealth.

Dr. Ellenhorn is a published author and his 2007 book, Parasuicidality and Paradox: Breaking Through the Medical Model, addresses psychiatric hospital recidivism and techniques for diverting hospital use. He is a graduate of the UCLA School of Social Welfare and is the first person to receive a joint Ph.D. from the Florence Heller School for Social Welfare Policy and Management and the Department of Sociology at Brandeis University. His new book, published by Harper Collins, and titled “How We Change (and the Ten Reasons Why We Don’t), will come out and May, and addresses many of the issues we’ll discuss today.

Three main talking points:

1. Ross speaks about his personal experience of becoming aware of the power of psychological labels and stigma in his own life and how that stigma led to him feeling like he had less control over his own future.

2. Virgil speaks with Ross about how, as a young social worker in mental healthcare, he began to notice that clients, families and colleagues were having conversations about the importance of recovering hope. Ross will tell us about his observations that led him to believe that the recovery of hope is essential to the overall process of recovering from psychiatric symptoms.

3. Virgil and Ross discuss how fear of hope is a concept that exists within and outside of the mental health field and is something that is likely relevant to most of us at some point in our lives. We will ask Ross about his research and the consequent methods he has found to help clients and families overcome their fear of hope.

A conversation with Dr. Eric Plakun. Dr. Plakun, the medical director and CEO of Austen Riggs Center in Stockbridge, Massachusetts. Austen Riggs just celebrated its 100th year! Austen Riggs is a therapeutic community, open psychiatric hospital, and center for education and research, promoting resilience and self-direction in adults with complex psychiatric problems.

Dr. Plakun graduated from Hofstra University and received an MD from the Columbia College of Physicians & Surgeons and completed his psychiatry residency at Dartmouth and a Fellowship in Psychoanalytic Studies at Austen Riggs.

Dr. Plakun is a board-certified psychiatrist, psychoanalyst, researcher, and forensic psychiatrist. He is the editor and author of close to fifty articles and book chapters on the diagnosis, treatment, longitudinal course, and outcome of patients with borderline personality disorder and treatment-resistant disorders.

He is a Distinguished Life Fellow of the American Psychiatric Association and on their Board of Directors as well. He is the founding leader of the APA’s Psychotherapy Caucus. In 2003, Eric was selected by the Massachusetts Psychiatric Society as their “Outstanding Psychiatrist in Clinical Psychiatry.” Most recently he has also offered compelling testimony in a major class-action suit that may finally begin forcing medical insurance companies to expand their coverage of mental health treatments.

During this hour-long conversation, Virgil speaks with Eric about how he came to this work and will hear his thoughts on effective mental health treatment, the role of environmentally impacted genes on one’s mental health, and where he sees the field of mental health treatment headed.

Three main talking points:

Point one: Effective treatment must be more than just crisis management and stabilization. A quick fix is not enough to help people truly recover from mental illness. We will review changes in the science, law and social policy with a focus on striving to achieve parity for health care for those suffering from mental illness.

Point two: Environmentally impacted genetics and integrative mental health care. We are moving more toward bio/psycho/social psychiatry which addresses the impact on our genes of environmental factors, especially adverse childhood experiences. Psychotherapy in particular addresses the sense of loss that someone may experience from trauma and other negative social determinants.

Point three: Organizational leadership. Austen Riggs is 100 and moving more strongly than ever into a role of leadership, such as is found in an upcoming conference with an array of first-class mental health thought leaders. Austen Riggs is leading the way in calling for broad, not reductionist, mental health care as well as in calling for broader economic access by pushing to achieve parity.

Lisanne Finston is the Executive Director of Gould Farm, the oldest therapeutic farm community in the U.S., founded in 1913. Prior to this, she spent 20 years serving as Executive Director of an innovative anti-hunger organization serving people with mental health and addiction challenges in New Jersey.

Virgil speaks with Lisanne about how she came to this work and how her studies in divinity and social work have shaped her leadership. Virgil and Lisanne will also discuss what Gould Farm is and where Lisanne sees the mental health field headed.

Virgil speaks with Dr. Elyn Saks, J.D., Ph.D. Among many things, Dr. Saks is a scholar, a mental health lawyer, an author, a Macarthur Fellow, a professor, and a life-long advocate for improving mental health care.

She is a graduate of Oxford University, where she studied philosophy, she is also a graduate of Yale University where she earned her Juris-doctorate degree and is currently completing a Ph. D. in psychoanalysis.

In 2002, Dr. Saks published the book, Refusing Care: Forced Treatment and the Rights of the Mentally Ill, in which she wrote,

“It has been said that how a society treats its least well-off members speaks volumes about its humanity. If so, our treatment of the mentally ill suggests that American society is inhumane: swinging between over-intervention and utter neglect, we sometimes force extreme treatments on those who do not want them, and at other times discharge mentally ill patients who do want treatment without providing adequate resources for their care in the community.”

In 2007, Dr. Saks published her acclaimed memoir, The Center Cannot Hold: My Journey Through Madness, which chronicles her own personal experience of schizophrenia that began in her teen years.

In 2012, Dr. Saks gave the TED talk, “A tale of mental illness - from the inside” which now has nearly 4-million views. Dr. Saks' contributions to the betterment of our mental health system are countless and it is a great honor to have her on our show today. It is going to be a fascinating talk!

In this episode, Virgil had the pleasure of speaking with Dr. Steve Sharfstein about the history of the moral treatment movement. Dr. Sharfstein is the former longtime CEO and President of the Sheppard Pratt Health Systems and former president of the American Psychiatric Association.

Virgil asked Dr. Sharfstein questions such as, “What was the moral treatment movement, in what ways did it succeed, why did it fail, and how does it still impact the treatment field today?”

An hour-long conversation with Dominic A. Sisti, Ph.D., Director of The Scattergood Program for Applied Ethics of Behavioral Health Care and Assistant Professor in the Department of Medical Ethics & Health Policy at the Perelman School of Medicine at the University of Pennsylvania.

Virgil and Dr. Sisti discuss conceptual parity: the realization that there is no health without mental health, how the field of psychiatry has been alienated from the rest of the medical field to everyone's detriment, and how the integration of mental health with overall health will improve outcomes for adults with mental illness.