Teaching Students to Lead Mental Health in a Medical Health System

December 18, 2017

Faculty Viewpoint

The secret to improving mental health care is to stop talking about “them” and begin talking about “us.” That’s the philosophy that brought Dr. Paul Block to William James College.

Block has joined the College to be part of a faculty team that is developing curriculum that will teach behavioral health professionals how to work and create change within a health care system designed for physical rather than mental health. Block says that in many large health care organizations, behavioral health programs and policy decisions are made by non-behavioral health professionals, despite the contributions psychologists can offer. He knows whereof he speaks. He has served the Governor of Rhode Island on numerous health policy committees, ran community service organizations and divisions and served as an expert for members of Federal and state legislatures.

We asked Block to elaborate on how mental health providers can lead reform.

Q: What can mental health providers do to balance the care equation?

A: My William James College role is to teach professionals how to orient administrators of health organizations to the unique demands of mental health care in order to get a more rational share of budget dollars, resources and attention. We need to educate administrators that simply recognizing mental health issues isn’t enough. We need to create a system of care where mental health care is delivered like physical care—from a provider with whom all patients have a long-standing relationship and who has an in-depth understanding of their psychological health. That is the approach that will ultimately improve care and reduce costs.

Q: You say that medical professionals can be skeptical about the practice of behavioral health. Why is that?

A: I believe there are several factors:

1) The mental health profession has not historically managed and documented the quality of care we offer. As a result, the average administrator or policy maker doesn’t have the data necessary to determine what improves the quality of care and fund expansions of it.

2) The stigma of mental health works against us. Those outside the profession too often believe behavioral health is only about treating severe mental illness and substance abuse. Of course it includes that. However, that impression overshadows the other troubling reality—over half of the people with diagnosed mental health conditions receive no treatment, and, of those who do, over half of them receive care at their primary care physician’s office. Only one in seven of them receives care that matches best practices.

Q: How will you teach students to address these inequities?

A: Behavioral health professionals and administrators need to learn how to articulate their needs, goals and impact as well as medical care providers. Many administrators are running systems that are losing

money. Mental health providers need to know how to create compelling arguments that structure the case for mental health care, promoting evidence-based care that is efficient, enabling us to share risks and savings. We have to be skilled in building relationships with decision makers, advocates, senior department directors and other internal influencers so that behavioral health can function effectively within a medical health system. Even better, we have to become members of the leadership teams that make these decisions. I will be training students to have the necessary skills.

When it comes to funding, mental health has always been the poor cousin. It is up to us to change that from the inside. I believe we can train future behavioral health professionals to make the case with their medical colleagues that mental health care is a practice with well documented standards, high quality best practices, evidence-based treatments and effective interventions for all.  

Paul Block, PhD—A change agent for the mental health paradigm

Dr. Paul Block joined the Doctoral Clinical Psychology department at William James College this year as an Associate Professor. He is working on the clinical faculty team that is building curriculum to train future healthcare administrators. Block holds a PhD in clinical psychology and has a distinguished career of clinical and administrative executive positions and academic appointments.

Politics first brought Block to psychology. “Growing up in Washington, DC, I watched politicians espouse beliefs despite evidence to the contrary and then behave in exactly contrary ways. I wanted to understand how people could act that way,” he says.

Block’s accomplishments include the founding and management of centers for behavioral health, substance abuse, integrated health and community services, including treatment for families, children, women, veterans and the homeless. He has published numerous peer- reviewed articles, spoken at nearly 50 national and regional conferences and served as an expert witness before congressional committees. He was also an Assistant Professor and core faculty at the Graduate School of Professional Psychology at the University of Denver.

Block’s goal at William James is to “Interest students in issues of behavioral health policy and leadership and help prepare all of them enough, and many of them as leaders, to play significant roles in helping develop and manage the highest possible quality services for the behavioral health needs of the general population.”

His ultimate personal goal? “Someday I’ll be sipping coffee at a lake in the mountains,” he says “watching my students lead more effective and affordable healthcare.”