Healing A Broken Mental Health System: Dr Joel Frank Of Duality Psychological Services On 5 Things That Can Be Done To Fix Our Broken Mental Health System
An Interview With Stephanie Greer
Revamp the Training and Financial Compensation Practices of Training Programs: One significant change that could occur to help improve the mental health care system would be to revamp the compensation rates for students and trainees during their clinical experiences while completing their educations.
The current state of the mental health system is a conversation that echoes in the halls of policy-making, the corners of social advocacy, and within the private struggles of individuals and families. As we continue to witness an unprecedented need for robust mental health support, the shortcomings of the existing system become more glaring. It is within this backdrop that we seek the insight of those who are at the forefront of behavioral health. In this interview series, we are talking to behavioral health leaders, policymakers, mental health practitioners, advocates, and reformers to share their perspectives on healing our broken mental health system. As a part of this interview series, we had the pleasure of interviewing Dr. Joel Frank.
Dr. Joel Frank is a licensed clinical psychologist and owner of Duality Psychological Services from Los Angeles, California, with over a decade of experience in the mental health and neuropsychological fields. Throughout his professional career, Dr. Frank has worked across many clinical and research settings, helping individuals better understand their current circumstances and psychological state. He has found profound success in and draws enjoyment from working with people to regain balance and power in their lives, both cognitively and psychologically.
Thank you so much for joining us in this interview series. Before we start, our readers would love to “get to know you” a bit better. Can you tell us a bit about your background and your childhood backstory?
I grew up in suburban Chicago, Illinois, in an amazingly diverse neighborhood with individuals from all walks of life. From an early age, I have been fascinated with people and their stories. During my younger years, I remember being very curious about how people developed into those I interacted with, who came from all walks of life. What led them to have particular perspectives, beliefs, and behaviors? How they became the person they were at that very moment. As I got older, I began tailoring my education and experiences in psychology and mental health, specifically with individuals seeking asylum in the United States. Once the time came to start my graduate education officially, I leaped into the mental health field and never looked back. Throughout my education, training, and career, I have worked in settings such as inpatient facilities with individuals involved with the legal system and those who were actively suicidal or homicidal, university hospitals conducting neuropsychological evaluations, insurance-based outpatient facilities with marginalized individuals, schools, and outpatient practices that operated out of network from insurance companies. Based on these experiences, I formed my practice, Duality Psychological Services, in a manner that I believe allows the most latitude for helping people reach and sustain their goals.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
One of my favorite life lesson quotes is, “Be like water making its way through cracks” by Bruce Lee. For me, this quote is a salient reminder of life’s unpredictability and to be aware of circumstances I can and cannot control. In other words, to be like water flowing through cracks, the quote suggests being powerful like water and utilizing flexibility when navigating situations.
Let’s now shift to the main part of our discussion. It is often said that “the mental health system in America is broken”. What does that statement mean to you? From your perspective what is “broken” today?
From my perspective, the phrase “the mental health system in America is broken” is a bit too generalized as it is true and false in certain ways. While there needs to be large-scale change to the mental health system in America, certain aspects of how it operates are beneficial for clinicians and patients. Some of the primary broken aspects of the American mental health system are the compensation practices for individuals training to become therapists and psychologists, how the determination of needs and reimbursement are managed by insurance, the overall cultural belief about “fixing” mental health issues, the stigmatized view of participating in mental health treatment, and the viewing of mental health services as lesser essential than other medical services.
What about any bright spots? Do you think there are any elements that we get right in today’s world that we wouldn’t want to reverse unintentionally?
I think one of the brightest current spots relating to the American mental health system is that working on mental and psychological well-being is becoming more accepted. While participating in mental health treatment is still not seen as an essential practice by many individuals, much more of society today is beginning to embrace the idea that working on one’s mental health is just as important for one’s longevity as focusing on other aspects of one’s health. I hope that this trajectory continues and, one day, people view incorporating mental health treatments into their overall health practices is as embraced as normal as visiting a primary care physician or going to a physical therapist.
In your opinion, what are the 5 most impactful things that could help heal the broken mental health system? These could be on any level including training, workforce, policy, culture, equity etc.
1 . Insurance Reform Regarding Client Care: One highly impactful change that could be made to improve the mental health care system is to address how insurance companies approve and dispense coverage for mental health services. In many insurance policies, there are different rates for different psychological services. Furthermore, specific mental health ailments are not covered by insurance, regardless of necessity. One salient example of how a client’s insurance coverage impacted their treatment was with an individual with obsessive-compulsive disorder that I worked with years ago. This particular individual’s insurance provider only afforded them eight total sessions for a very complex case of obsessive-compulsive disorder. His condition was well entrenched and had been routinely reinforced for years, causing significant strain on his family, work, and financial lives. After the fourth treatment session, due to the complexity, he and I had only then finished covering the groundwork of how his obsessive-compulsive disorder became so severe. By the end of the eighth session, we had begun challenging his delusions and were practicing new coping strategies. While I’m confident that he could have experienced sustainable change with additional sessions, due to the limited number of sessions, I am unsure if the work we did together was reinforced enough to be maintained.
2 . Remove the Word “Fix” from the Societal Impression of What Mental Health Clinicians Do: An excellent way to help improve the mental healthcare system is to alter this societal impression that mental health workers “fix” mental health conditions. Mental health ailments, such as anxiety, depression, and so forth, have likely been around for years for individuals. They have developed well-entrenched thoughts, behaviors, and lifestyle patterns because these conditions have existed for many years. Instead of fixing them, a more appropriate thought process around mental health conditions is to learn to manage the symptoms associated with them. Thinking about mental health work from a symptom management perspective acknowledges the long-standing nature of mental health conditions. For more individuals, the symptoms related to their mental health condition will never entirely go away; they will only lessen in frequency or to a tolerable level. So, learning how to manage symptoms associated with mental health conditions effectively is a more appropriate ideology than trying to “fix” mental health conditions that will likely be with the individual for the rest of their lives to some degree.
3 . Increase Funding for the Development of New, Budget-Friendly, Accessible Programs and Services: One of the primary issues with the mental healthcare system is the discrepancy between the amount of funding for mental health services and the amount of need for mental health services. Some programs offer affordable mental healthcare options. Even with those, there still is an abundance of need for mental health services across the United States. Additionally, for many individuals who wish to start getting mental health treatment, the cost of participating in that treatment is a significant barrier. Therefore, to help close the gap between the amount of offered affordable mental health services and the volume of need for mental health services in the United States, more funding is crucial.
4 . Revamp the Training and Financial Compensation Practices of Training Programs: One significant change that could occur to help improve the mental health care system would be to revamp the compensation rates for students and trainees during their clinical experiences while completing their educations. For example, it is not uncommon for many students to work for free in the equivalent of part-time jobs while going to school full-time to complete their degree under the auspice that the unpaid job is part of the educational curriculum. The reality of this dynamic is that because the students are working part-time jobs for free on top of going to school full-time, they need to either rely on student loans and accrue large amounts of debt, seek financial support from their social support systems, or obtain additional paid jobs on top of the unpaid part-time job and full-time education curriculum. Many students and trainees will be burned out when they become licensed and finish their degrees. So, even as early career professionals, while they try their best to assist the people they treat, their burnout can interfere with their ability to provide patient care. For some, they may even want to leave the mental health industry entirely.
5 . Treat Mental Health Work as Important as Other Medical Disciplines: Presently, participating in mental health treatment is seen as a luxury experience or non-essential compared to engaging with other medical disciplines. The struggle with trying to elevate mental health services to be on par with other medical services is that the immediate benefit of participating in mental health treatment is less apparent compared to taking medication or having surgery. The reality, though, is that by participating in mental health treatments, a person can reduce biological ailments such as high blood pressure, cardiovascular issues, the presence of chronic pain, the treatment of headaches, and a host of other physical ailments. These biological benefits are in addition to the quality of life assistance participating in mental health treatments can have. One barrier to making societal change so that the discussion of participating in mental health treatments is as acceptable as discussing seeing other forms of medical professionals is to decrease the stigma or taboo nature of talking with friends, family, and other social supports about how they are doing psychologically. Reducing the stigma surrounding having a mental health ailment and openness around discussing the topics will help elevate the importance of engaging in mental health treatment closer to the significance of participating in other medical treatments.
If all of the items on your list were magically implemented tomorrow what change might we see in the world? What are the signs (big and small) that would show us that the system is being healed?
There would be a few markers that the mental health care system is healing. First, there would be more affordable and accessible mental health care options for individuals. Second, people would feel more comfortable talking about their mental health, which would likely lead to more societal acceptance of engaging in treatment. Third, the financial stress load of students and trainees would be less because they would be compensated at a rate appropriate for their work, leading to less long-term burnout.
What is a project you or others are working on today that gives you hope? How can our readers learn more about this work?
In California, there is usually some legislature or bill aimed at either improving funding for or expanding services to mental health treatment. Seeing the possible policy changes and expanses surrounding mental health care in California gives me hope that Statewide and National mental health care system reform is foreseeable. So, I would encourage individuals wanting to muster hope about the trajectory of the mental healthcare industry to look into California’s proposed changes and improvements.
How do you see technology shaping the future of mental health care and its accessibility?
I believe technology will play a significant part in helping expand the accessibility and affordability of mental health care for many individuals. While currently in its infancy, some services offer alternative methods of seeking treatment, such as texting-based therapies and telehealth options. My belief is that as technology advances, so will the accessibility options.
In your view, how do social factors like poverty, education, and culture affect mental health care and its effectiveness?
While there are issues relating to culture and education that can make views regarding mental health treatment more complicated, the most significant impacting factor toward participation in mental health treatments is financial. One of the most salient current barriers to participating in mental health treatment is justifying the cost of the treatment in addition to other daily expenses. Furthermore, enrollment in mental health services can be costly because of the coverage and reimbursement rates for particular insurance plans. So, out of all the possible barriers to interacting with the mental health care system, poverty is the largest.
In light of the growing mental health crisis among young people, what innovative approaches or interventions have proven most successful for children and adolescents?
Providing mental health treatment for children and adolescents is different than offering therapy to adults. Regarding innovative approaches or interventions for treating younger populations, I have found tapping into various aspects of geek culture and the geek therapy realm beneficial. For example, with some younger clients I’ve worked with, I have used comic books to discuss themes such as power dynamics, grief and loss, and trauma. Other practitioners might use video games during sessions. To best stimulate participation and dialogue from some younger individuals, it is beneficial to tap more into projective tools and non-personalized items that still discuss themes relevant to their lives.
We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch, and why? He or she might just see this if we tag them. 🙂
Mel Brooks is one particular individual I’ve always idolized since childhood. As a young Jewish kid growing up in the south suburbs of Chicago, Mel Brooks was a formative individual for me both culturally and developmentally regarding my perspectives on my life and the world around me. His use of comedy, satire, and social commentary helped expand my worldview and showed me how a person can use humor to cope. Because of his work and the works of similar individuals, I took classes at the Second City in Chicago to improve my improvisational prowess and learn how to have fun even amid serious circumstances. Because of my appreciation for Mr. Brooks, similar artists, and time at the Second City, I routinely use humor and improv exercises during the group and individual therapy sessions I conduct to stimulate conversation and imagination.
How can our readers further follow your work online?
For individuals wanting to follow me online, look me up on X @DualityPsych or Instagram @DualityPsychServices. Individuals can also stay up-to-date regarding all Duality and my happenings by joining our practice newsletter by contacting us at www.DualityPsychServices.com.
Thank you for your time and thoughtful answers. I know many people will gain so much from hearing this.
About The Interviewer: Stephanie Greer, PhD is the Co-founder and CEO of Akin Mental Health — a company dedicated to guiding families on their journey supporting a loved one with mental health challenges like bipolar disorder, schizophrenia and severe depression. Stephanie is passionate about this topic from her own personal experience growing up with a mother who struggled with bipolar 1 disorder and found a path forward to overcome the obstacles and live well. Stephanie’s professional experience includes a doctorate in neuroscience as well as design research roles at Hopelab and Apple. Stephanie brings this personal passion together with her world-class science and technology background to support families across the US in their personal journeys supporting loved ones with mental illness. To learn more about Akin Mental Health and join our community, visit us at akinmh.com.
Healing A Broken Mental Health System: Dr Joel Frank Of Duality Psychological Services On 5 Things… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.