Health Care Leader Perspective: Pulling the Patient Back Together

(This article was written by Ted Townsend, president and CEO of UnityPoint Health – Cedar Rapids.)

The shocking deaths of fashion designer Kate Spade and celebrity chef Anthony Bourdain last month seemed somehow intertwined, timed so close together as to reinforce the hidden message behind whatever drove them to their suicide. I had never heard of Kate Spade, but my wife had. Anthony was a kind of oddball idol for me. The idea of traveling the world, sampling foods and educating the masses about cultural cuisines has any number of adherents. What he added to the travels was a sardonic insight into the cultural personas that created that food. It was different. It gave him a gravitas that others lacked. It also gave him an ability to speak not just about what sustained their bodies but in large part their souls as well. I found his show and his life captivating, something like “Wow, if only I could do that, what a great life!”

And then he ends it all, at sixty-one years of age, alone in a hotel room, in a foreign land. Somewhere along the way he and the people closest to him had lost touch with a critical part of him. The same must have been true for Kate. As with so many of us, the physical presence, its health and wellbeing, are typically readily apparent. The inner self, the psyche, for good or ill is often separated, less tangible, much more difficult to find and navigate for both ourselves and those around us. That is true for each of us. It turns out to be true for celebrities too.

And it was that idea that these lost connections can affect anyone, even people living what looks like a perfect life of professional and personal goals, that made me think those in health care trying to put these two sides of each patient back together are onto something. For too long health care has divided the patient in two. If there was a medical problem you saw one set of providers. If you had a mental health issue you were quickly triaged out to an entirely different set of providers and rarely did the two connect. In fact they often didn’t even understand each other and where there is misunderstanding there are missed needs and opportunities. These need not be great factors, but even for the most talented of medical physicians, the thought of finding and treating a behavioral health problem seemed out of place if not daunting, even beyond their competence. It led to a separation, sending this otherwise single person down two disparate but parallel roads.

Today we’re trying to put those back together. While too late for those who’ve chosen to end their life, it is abundantly clear there are thousands if not millions of others who can benefit from hitting the reset button on health care delivery. It’s one of the reasons we felt fortunate to bring our regional UnityPoint Health resources together with AbbeHealth. They not only stretch our resources into new communities, they give us a chance to extend our service beyond the decades of acute inpatient services and the opportunity to re-integrate behavioral health into our existing clinics, to re-connect behavioral health and medical care at all points along our delivery system compass. And we are not alone. Virtually every UnityPoint Health region is working to build this same kind of partnership with local behavioral health specialists, to find ways to partner, integrate care, to pull the patient back into a person.

Which gets us to a “teachable moment”. I could write more about us, about UnityPoint Health, or Abbe or other health care providers striving to improve. Instead I will repeat some things for all of us to “integrate” into our lives. For yourself and those around you, keep an eye out. If someone you know shows a sudden change of personality, even sometimes for the better with an improvement in mood or appearing calmer and happier, take notice. I they start to act or behave recklessly, pay attention. If they increase their use of alcohol or drugs, start speaking about wanting to die, or even simply expressing feelings of hopelessness or feeling trapped, don’t just listen, offer to help. Help them reach out. There are excellent resources in our community at all hours of the day or night. Make a call to a crisis center or if needed a suicide prevention hotline.

I don’t know if it is true in all communities, but at least at AbbeHealth we know that many of our patients have been suicidal or have suicidal thoughts at one time or another. We know that we’ve debriefed on three local suicides in just the past few weeks. In our emergency department, we know that the highest frequency of patients presenting with a mental health concern is with 15 year olds. Working with our behavioral health colleagues versus in disconnected parallel offers us a chance to bring two sides of the same coin back together to do a better job of keeping people healthy, improving care, reducing costs, and with any luck reducing the senseless loss of lives unfulfilled.