Posts Tagged Leadership
Robert A. Mines, Ph.D., Chairman and Chief Psychology Officer
Thank you John Oliver and your staff for a significant public service on your show this week! Your commentary and excellent coverage of a major problem in substance use disorder and alcohol treatment will have an impact far beyond what the insurance and professional communities have been able to do.
MINES has patients who have gone out of network, received poor care, the payors have received outrageous bills, the patients are stuck with bills that can only result in medical bankruptcy and as you noted, people die in these disreputable facilities. A major component that you pointed out is patient brokering. When people Google substance abuse/use treatment, the top 20-30 are facilities, mostly in Florida and California, or are patient brokers. Reputable facilities in the person’s community do not even make the list. Then the facilities sometimes even pay the airfare to fly the patient to their facility and if the patient does not meet medical necessity for that level of care, the facility turns them out on the street to find their own way back to the state/community they live in.
You mentioned addictionologists as a resource for finding reputable care. In addition, Employee Assistance Programs as well as managed behavioral health services (insurance) are knowledgeable and informed about substance use and alcohol treatment. They know which facilities and programs are in network with the insurance and which ones do a good job.
Evidence-based treatment supports the use of a continuum of care from outpatient, intensive outpatient, partial hospitalization, residential and detox (medical and social detox). There are medications that also contribute to sobriety and health.
These are chronic illnesses/conditions that require the patients to cope with all their lives. Learning relapse prevention and adherence skills are essential.
If you decide to delve into this national problem further in a future episode, I would be happy to consult with you and your team.
The following clip may be not suitable for some work environments:
This is a link to a pdf of an article published by the Self Insurance Institute of America on predatory treatment facilities and managed behavioral healthcare strategies for helping the patients and the payors. http://www.minesandassociates.com/documents/Predatory_Facility_Article.pdf
Psychology of Performance #62: Veteran’s Mental Health, Memorial Day and President Trump’s Stigmatization During Mental Health Month*
*This blog has nothing to do with party affiliation, it is about leadership, modeling, and stigma and its consequences.
President Trump has made stigmatizing comments related to mental health during Mental Health Awareness month (May 2017). This is unacceptable leadership behavior on many levels. As the Commander-In-Chief of our armed forces, he has now sent a message to our active duty personnel and veterans that it is ok to call people “nut jobs” and other derogatory names related to mental illness, psychological stress, and behavioral problems. The irresponsible nature of this during Mental Health Awareness Month, and right before Memorial Day when we honor those who have served our country, now sends a message to our active duty personnel and veterans that they should not seek help or they will suffer social or job-related consequences.
Why is this a problem?
You may be wondering why am I making an issue of this? The US Department of Veterans Affairs has the following quick facts (not fake news, just the facts).
- In 2011, more than 1.3 million Veterans received specialized mental health treatment from VA for mental health related issues.
- The Rand Center for Military Health Policy Research, Invisible Wounds of War, 2008 noted that of the 1.7 million veterans who served in Iraq and Afghanistan, 300,000 (20%) suffer from post-traumatic stress disorder or major depression.
- The American Psychological Association has identified the critical need for mental health professionals trained to treat post-traumatic stress disorder and traumatic brain injury. Please review this commentary. http://www.apa.org/about/gr/issues/military/critical-need.aspx
The commentary goes on to note:
- suicide rates are increasing for returning service members;
- unemployment rates for veterans outpaces the civilian rate;
- brain injuries are linked to PTSD;
- female veterans are particularly likely to suffer from mental health issues related to “military sexual trauma” (20%);
- many in need (about 60-70%) do not seek help;
- stigma associated with mental illness in military communities; and
- long term consequences of unaddressed mental health needs.
Leadership and Stigma
It is well established in the psychological literature that social learning through the modeling by others has an impact on subsequent learning and behavior. When President Trump engages in direct insults to people while using derogatory mental health terms, his subordinates, employees, constituency, and his military receive the message that he is modelling that implies that having a mental illness (caused by serving our country) or stress (caused by serving our country) means you are less of a person, not competent to work, is something to be ashamed of, and should be kept a secret. Furthermore, it gives others permission to act in a similar manner further pushing those who are concerned about seeking help away and reinforces the stigma in the military and in society. Finally, his comments about grabbing women’s genitalia that came to public awareness while he was a presidential candidate further erode female military personnel’s safety in their own units when twenty percent (20%) have already experienced “military sexual trauma”.
Psychology of Performance
Employees’ performance can be negatively impacted by “bullying behavior”, or demeaning comments about their illnesses. It is exacerbated when leadership models this behavior because then it becomes acceptable with no organizational accountability. The consequences are lowered productivity, increased absenteeism, presenteeism, and increased medical costs. The cost of untreated mental illness to employers, families, and society is significant. President Trump’s behavior as a leader in this area is concerning and needs to stop.
This Memorial Day, I ask you to remember those who served and honor those who are still alive by letting them know the pain and suffering they experienced can be healed if they have such symptoms. They deserve our support, compassion, and gratitude. There are many resources available to them, encourage them to use them. Finally, stand up to those such as our President and Commander-In-Chief who model unskilful and unwholesome behavior.
Have a day filled with loving kindness and compassion!
Robert A. Mines, Ph.D., Chairman and Psychologist
One of the theories that has impacted my consulting most profoundly over the last several years comes from the work of the Arbinger Institute. The two books from this group have helped guide me to a vision of the absolute practical and financial benefits of collaboration in the workplace. The books are: “The Anatomy of Peace – Resolving the Heart of Conflict,” and “Leadership and Self Deception – Getting out of the Box.” This work offers a relatively unique perspective of how and why collaboration can break down in our relationships. In both of these books it is suggested that when we engage in any act of self betrayal, i.e., acting in any way against our own sense of what is the right thing to do in any given situation, we naturally begin creating a path of self-deception. We begin fooling ourselves in a way that impedes objectivity and truth. An act of self-betrayal may be anything from not going out of our way to help someone who may be in need of our help, to not honestly confronting someone or a situation when appropriate, to not acknowledging the truth of a situation. According to Arbinger, when we engage in an act of self betrayal we automatically begin justifying our action. We begin to amplify our own virtues and extend blame to others. We end up in what Arbinger describes as a “box.” The box is a lens through which we objectify others in order to justify ourselves. This is the concept of self deception; we are seeing others through a distorted lens due to our need to justify our own actions. We are not truly seeing them objectively, but amplify their faults and our virtues. We know we are in a box when we objectify others.
I believe most of us end up in this situation at times. Beyond the Arbinger concept I believe we may end up “in the box” for other reasons than self betrayal, such as disappointments or negative experiences with others. Regardless of the cause, I agree that we are “in the box” when we objectify others. This happens in traffic all the time. Think about it – have you ever called someone you don’t even know a name because you were frustrated by their driving (or just by the darn traffic jam)? Do we objectify our leaders or our subordinates in the workplace when they don’t live up to our expectations? The “us/them” that occurs in many workplaces is a process of objectification and justification.
A further concept from Arbinger is that when we are in a “box,” we enter into collusion with others in which we invite the very behaviors we least want from them. If instead of supporting my co-worker, I regularly correct them, they may begin to resist me. I may in fact, know more than they do and have valuable things to teach them. However, instead of focusing on their success – helping things go right for them, I focus on correcting what they do “wrong.” I may begin to see them as inferior or disinterested. When I do this, I invite greater resistance. The more they resist, the less they learn and the more I have to correct and the more I see them as a problem. This is a circle of collusion in which we are both inviting the very behaviors from one another we least want. This is the opposite of collaboration. Collusion is working around our perceived deficits of others. Collaboration is bringing out the best in one another in partnership.
The Arbinger theory encourages us to take responsibility for our own box, to get out of our box, focus on helping things go right vs. focusing on correcting others, and to stay out of the box by practicing and acting according to what we know is right.
Once in a training program in which I was describing the Arbinger theory, one of the participants asked me this: “Is it possible for a group to be in a box with an individual or another group?” WOW! What a concept – think about different departments in a workplace that could potentially get into boxes with one another – Sales and Operations, Accounting and Business Development, R&D and I.T. Is there ever generalized objectification and justification between these groups? Do they ever collude in inviting the very behaviors they don’t want from the other? Then we think about even bigger realities like religion and politics…
In my next blog I will examine the Arbinger model applied to groups and politics.
Patrick Hiester MA, LPC
Vice President of BizPsych
References: “Leadership and Self Deception: Getting out of the Box,” “The Anatomy of Peace: Resolving the Heart of Conflict.” The Arbinger Institute. Berrett-Koehler Publishers Inc.