How Are We Going to Solve the Behavioral Health Crisis
Episode 538

Lisa Henderson, Co-Founder & COO at Synchronous Health

How Are We Going to Solve the Behavioral Health Crisis

In this podcast, Lisa Henderson, co-founder and Chief Operating Officer at Synchronous Health, discusses how Synchronous’ combines technology and human clinicians to provide 24/7 mental health support. She shares her thoughts on digital health, improvements she has observed in patient’s lives, responses from mental health providers, and more. Find more details of how Synchronous Health helps in this interview!

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How Are We Going to Solve the Behavioral Health Crisis

Episode 538

About Lisa

Lisa Henderson is the Co-Founder and COO at Synchronous Health. She’s a health innovator, counseling industry leader, and a book and podcast fanatic. She’s also an adjunct professor at Vanderbilt University, Peabody College of Education and Human Development, Nashville.

Lisa is the Chair-Elect of the American Counseling Association Southern Region, a President Emeritus at the Tennessee Counseling Association. She received her Bachelor’s degree in Psychology and a Masters of Science in Public Health from Middle Tennessee State University and her Mental Health Counseling degree from Walden University.

 

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Welcome back to the Outcomes Rocket. Saul Marquez is here and today I had the privilege of hosting Lisa Henderson. She is the co-founder and chief operating officer at Synchronoss Health. Her previous experience includes experience as an adjunct faculty at the Vanderbilt Peabody College, chair of the southern region at the American Counseling Association, and also a past president for the Tennessee Counseling Association, among other leadership roles. Her focus has always been on health and also mental health of communities and individuals. And with her work at synchronous health, the impact that they’re making at a broader scale in times of great need is just extraordinary. And so I’m excited to dive into the conversation with Lisa in the work that she and her team are up to. But before that, Lisa, I want to welcome you to the podcast. Thank you so much for having me. Absolutely. It’s a true pleasure. So, you know, before we dive into what you guys do at Synchronoss Health, I want to understand better what inspires your work in health care.

Sure. So I started my career when I was planning my career and I was an undergrad and then went straight into grad school after that. I actually got a master’s in health, education and promotion. And so it was really focused on helping people live healthier lives. And part of that research experience in that master’s program was to be a health coach with police officers. Wow. It was really fun. We had some great sessions where, you know, I would have to kind of barter with them. So if I wanted a person who was leading the SWAT team, his stress levels were incredibly high. He wasn’t sleeping well. And so I wanted him to do yoga.

Well, in order for him to agree to do yoga, I had to meet him at the shooting range and learn how to shoot a pistol.

So, you know, being able to kind of meet people where they are and help them learn new skills was really fun.

But at the same time, it was so clear to me that those officers were living with so much more than just obesity and trouble sleeping. They were living with anxiety and depression and worry and guilt and all the things that humans experience. And it was just kind of sitting there and in my training as a health coach, really didn’t give me the tools to address those things. So I went back to school and got a master’s in counseling so that I could get into those deeper sorts of issues with folks. And it’s been just so rewarding ever since to be able to kind of take both sides of health.

What are you doing on the behavioral side in terms of lifestyle choices? And are you adherent to your treatment plans and taking your medication and things like that? But also why? You know what? What is the underlying factor of depression or anxiety or family conflict or, you know, other things going on that lead to the decisions that affect your health?

Mm hmm. Yeah. So cool. So you got this. This Masters in in public health education. And you said and this doesn’t really do it. I want to dig deeper. Help these people more. They’re stressed. There’s there’s a lot here. And you went to go get your your master’s in mental health. And it unlocked a lot of things. And, you know, it looks and sounds like you did the right thing, Lisa. I mean, now you’re you’re you’re part of this. This really neat company addressing a lot of these issues at scale. Tell me about how it happened. And folks, Lisa and I were having some fun connecting before the podcast. I shared my story with there about how I had a couple offers, people wanting to buy outcomes. Rocket before it was it was a it was a business, you know, profitable business and the pressures that I got at home for saying no to those offers. Lisa, I want to hear your story. We are saving it here for for us to to share it with the listeners, to tell me how synchronous help happened and and what exactly you guys are doing to add value to the health care ecosystem. Sure.

So it’s similar to your experience.

So one of my co-founders, there are three of us co-founders of Synchronoss Health, Katie Lau, Guy Barnard and myself, Katie and I are both mental health clinicians. Report together for about 10 years. And several years ago, we started a treatment center. And the first sort of level of programming that we provided was an intensive outpatient. So we had people with us. In our services, in our program for nine hours a week, and we would have them for one to four months. And even folks who had been with us for nine hours a week would still come in and say, I forgot or I was too stressed or I was too triggered to use the skills that we’re learning while we’re here and then have them show up when I meet them in real life. And so we were thinking, OK, you know, if they don’t meet clinical criteria for a higher level of care, we’re not seeing the improvement that we want to see. We could keep doing more of everything we were doing was evidence based and supported by research. So it’s not like, you know, what we were doing was in any way deficient. It just wasn’t hitting them at the right time and place when they really needed it. So we created an app. And, you know, we’re two mental health clinicians. No experience and technology. Go out and find a reputable, trustworthy technology partner to build this app with us. That lets a lot of fun. And as we started doing, you know, the initial sort of fada testing of that, we started getting people asking a lot of questions and wanting to know more and wanting to know how much we spent and wanting to know how much we would sell it for and all sorts of things.

So there is more here than we realize.

And it was sort of around that time that Katie and I were introduced to guy who on the opposite end of the spectrum had been doing population health for chronic care management and was running into some things related to mental and behavioral health. And so he was interested in what we were doing and we were interested in his technology and, you know, starving populations at scale. And so that’s how we all came together and created synchronous health.

Wow, that’s pretty cool. You know, and it’s amazing, right? I mean, if you work to solve the problems that exist, the problems that are in front of you. I mean, you you started with getting that mental health counseling masters Right. you. What you had wasn’t enough. So you went to get more. You got to this sweet spot. Evidence based stuff wasn’t working. You said, you know what? You and your partner said, let’s do something else to do more. And it hit the mark. And then someone offers to buy it, just like you have to solve problems, people. And then. And what Lisa and her team did is they said, all right, look, there might not be any quick gain here. But what I do know is I’m going to solve a problem and it’s going to work out. And ultimately, if you add value, you’re going to get rewarded. And so, Lisa, tell me a little bit more about how you guys have built this this system and this technology to to serve the health care ecosystem.

Sure. So, you know, one of the things I love about doing mental health work is that, you know, somebody comes in and they start talking about what’s going on in their lives. And, you know, the the art and the science of mental health care, it is being able to take all of that information that they’re giving you that a lot of it seems irrelevant or disconnected from the course of care. That being able to find patterns and being able to see, you know, in this case, you respond really well to, you know, retraining, training, your thoughts in this case. Actually, that doesn’t work very well. This is where we need to do something that’s more behavioral. And so being able to kind of put all of that together, we call it just using seemingly inconsequential data to create a whole person care plan. And as we are doing that, we started looking at and says, you know, a guy and his technology sort of lends come in that when it comes to pattern recognition, artificial intelligence is better at that than people were. Artificial intelligence really falls short, though, is context. And so, you know, a guy can can actually see faster than I can when somebody, you know, is likely to relapse. But that likeliness to relapse might actually indicate, no, they’re gearing up to change jobs.

They’re not actually gearing up to go out and relapse. And so, you know, it’s the context that is critical. If if you reach out to someone because their patterns have changed in a way that indicate they might relapse, but really they’re just about to change jobs or go on vacation or move, you know, all of these big life events that are happening in the data might look like a relapse. But if you treat it like one, you’re going to lose that person there. You’ve lost all credibility. And so we’re where we come in is we kind of put those two things together. We’re. We have the data that sort of gives us that picture of really quickly and effectively looking at what are the patterns and how are they changing. But then we’ve got the clinicians who look at it and say, oh, yeah, well, that’s because, you know, they’re they’re about to change jobs or they’re about to move. That’s not actually a risk of relapse. But just in case. Let me give some extra support so that as they’re in this really stressful time, they have everything they need at the moment, that they need it so that they’re not then risking relapse as highly as they would without that support.

Yeah, that makes a lot of sense. Just being able to fine tune those those observations, those patterns offer some context to it. And so and so tell me a little bit about how you guys are doing this. Maybe some applications and some stories where you’ve found this. This works well and how it works well.

So our approach is that we want to be able to support any person with any condition in any setting as long as they are stable for the community. So if if you are actively feeling suicidal, you know that that requires a higher level of care than what we’re able to do. If you are being released from a course of care where you had been suicidal and now you’re stable, then you know that that’s great for us. So whether it’s eating disorders, depression, substance use disorders, you know, all different kinds of conditions that people live with. We are able to support somebody as long as they’re kind of in that, you know, moderate to severe. Once you get into acute. Well, we’ll bring others involved. But as far as the the folks that we support, we combine technology and human clinicians to be able to provide this sort of 24/7 wraparound care that promotes the active use of skills all the time. So typically what happens is you go to counselling and counselling is really effective. You go to counselling. You’re in there for an hour. If you’re lucky, it’s an hour. A week, you might be forty five minutes a week. Might be every other week. You know, it sort of depends on on what your treatment plan calls for. That hour that you spend with your counsellor is typically the best hour of the week. It’s the place where you’re safe and you can really think through and understand and decide how you want to respond to things rather than reacting to them. You can explore different ways of thinking about things and reacting to things and responding to things.

So we wanted to sort of take that feeling of safety and that ability to have somebody prompt for. What if you did this instead? How would that change things? We needed that to be available outside of the counseling session. So that’s where we created Carla. And Carla’s a bot that is primarily today delivered through an app, but can also be in smart devices and, you know, home devices and things like that in email, in slack, where wherever the person is interacting with technology, Kalila can be there, too. So when you’re one of my favorite examples of this is we’ve got a person who we’re supporting with depression. And we know that when he gets home from work, he is most likely to just walk in the door, say something curt to his wife, avoid his children and turn on the TV and wait until he falls asleep and then get up the next day and go to work. And that’s kind of how his life is right now. And this is a pre-K over example. So sure. Sure. It’s actually a little bit harder because all he does is go upstairs. But as we’ve started to work with him, we realized that, you know, his depression is really it looks and feels like tamped down rage where he’s afraid that if he lets any of it out, it’s going to explode and he’s going to say really mean things to his kids and he’s going to damage his relationship with his wife and that kind of thing.

So what we were able to do with him is that on days where his heart rate is averaging Right. around ninety six or so, he’s pretty likely to not want to talk to anybody when he gets home and have a pretty tough night for his family. And so what we decided was that five. Thirty Carl is going to check with the average of his heart rate was for the day she’s finished. Then soon as he gets home because she’s G.P.S. away or so, as soon as he gets home, she’s going to send a message that says, go put your tennis shoes on. I’ve got your favorite playlist ready for you. Go for a run. And so he goes in, puts his tennis shoes on, comes out. And then as he’s going for a run, Kahless playing the music that he sort of, you know, helps him kind of process all of that rage feeling. So he’s getting the physiological release of the run. He’s getting the time to kind of let all of that out. And then by the time he gets home, he’s feeling much better and has more patience and can engage better with his family. There’s less conflict. And he’s actually then able to sleep better and then able to be more productive at work the next day. That’s cool. So the impacts are, you know, he feels better, his family feels better, his employer gets more out of hand. And then over time, his total cost of care goes down as well.

Yeah, that’s pretty neat. And so how are you guys pulling the, you know, the heart beats per minute and all that stuff? Is it wearables? What are you using to pull that?

So anything that is connected, Carla is able to see. So some of this is in beta right now. So that when you know that example that I gave, you know, we’re still really testing and refining some of that. But in that example, that particular participant wears a smartwatch that’s connected to his smartphone. Carl is able to kind of see that information and pull that data. And then also being able to leverage things like G.P.S. location and time. And so that’s kind of what pulls all of that together. And then over time. So right now, what we’re what we look at is when we’re there’s some pretty good research out there about, you know, music beats per minute as it relates to the outcomes that you want for heart rate, heart rate and emotions thereafter. So we’re actually able to do a lot of that testing within the product. So part of that will include both for the Ronstadt’s. How are you feeling? And then after the Ronstadt’s, how are you feeling? And so we can really test that. Here’s what the data and the research say. But how did this feel for you?

Because when it comes to implementation, there’s such a wide chasm between what was found in the lab versus what is actually really going to happen in real life.

Yeah, that’s neat. And, you know, more and more, especially now that, you know, coalbed came and I mean, it’s here, we’re still dealing with it. We’ve begun to realize the benefits of digital health more. You know, you mentioned Kalila enables that continuous care. And those touch points that would otherwise only be forty five minutes to an hour like those prompt manner. And I think I’ll tell you, I recently got an Apple Watch. I held I held back. Lisa, Mike. And then eventually I’m like. Just get it. And I love the little kind of vibration. And it reminds you to breathe. And I love that, like, just, you know, those touch points, if those touch points are clinical and and evidence based. If you could do that to your patient and to your employees in a way that helps them and makes them more productive and happier. Why not? And it’s something that’s what you guys are doing.

Right. And we started really thinking about what is it that I, I, as a clinician, wish I could do for people when I’m not with them and then been sort of looking at the other side of that. What is it that my participants say that they wish that they could get from me when I’m not with them and they’re not with me? And I think that’s where. So we we have the lens. Of course, you know, the employers and the insurance companies and the health systems, they want to reduce the cost of care and improve health outcomes. They want to be able to be more profitable in the services that they deliver. And behavioral health has a huge impact on the margins in terms of whether people are going to get better or not from whatever procedure or service they’re being given. What we also see is that those motivations don’t matter at all to the participants. And if the participants aren’t getting. Their problem solved then. You’re not going to see any utilization of a service that would otherwise be really useful. So we sort of take this comprehensive view of, you know, what is it that the customer sort of the eco system wants for this person? What is it that this person wants for themselves? And then, you know, what is this sort of clinical view in terms of what’s appropriate and useful and getting the drive towards the outcomes that everybody’s aligned around?

Mm hmm. Yeah. Now, that’s that’s awesome. I think it’s I think it’s such a great approach. And as you guys have embarked on this journey with this, there’s this technology, this app and also the clinical context, what would you say has been one of the biggest setbacks or lessons that you’ve learned that’s made you better?

Two things I think that actually may be related to one another. In the beginning, we we always knew that it was going to be really important to have this combination of human and digital in order to have good care. And over time, the ratio of that will probably change in the beginning. What we started doing was introducing Kalila before they had a session with their human specialist. And what we would find is people would be really confused. They would not really understand what this was, know what it’s for. Even though we had information, we had explainer videos, we add things that they had to actually click, that they had read it. And all those sorts of things. But still, it was kind of like, I don’t really get it. And so people wouldn’t use it. Now, what we’ve seen is by introducing the human first, it’s not ideal from a data collection perspective because we wanted some baseline data for our humans to start with. But people are so much more likely to engage with the technology when they have a human say. Think of Kaala as my assistant and your assistant. And she’s the messenger between us.

So you’re going to you know, I’m going to tell Carla what to ask and what to say and when to ask and say it. And so when you get a message from Carla, think of it as a message from me. But it’s just being delivered at a time when it’s useful to you. And I may or may not be available. And that’s when people are like, okay, then I get it, I’ll use it. And then more precisely, Carla matches the language and the approach and the precision from their experiences with their clinician to when they get those messages, the better they receive it. So to drill down on that just a tiny bit further, you know, we’ve got some sort of out of the box digital programming that is, you know, effective and good and useful and has as far as digital products go. Good engagement and utilization and outcomes. But it doesn’t hold a candle to what people respond to. And the improvements that we see when it’s something that their specialist wrote for them and told Carla to deliver it according to these triggers. That’s the real magic.

That is that is pretty cool. That is pretty cool. And it you know, it works together. You know, there’s I don’t know. I feel like the fear for A.I. and, you know, how it’s being used to kind of feel like it’s going away. You know, overall, it works together. What do you see the responses from, you know, mental health providers as it relates to coralline? How works? Do they feel like they’re going to get replaced or are they relieved and happy that working alongside them? What are your thoughts there?

Yeah, it’s really interesting because it kind of runs the gamut. So I would say, you know, the data point that comes to mind first is we have a waiting list of hundreds of counselors who want to join our team.

So in addition to all that we have hired, we’ve got lots more who want to work with us because they look at this technology.

These are folks who, you know, they’re they’ve been in practice for a few years. They recognize the limitations of I really only know what my participant tells me. And I really only can help them if they remember to use the skills outside of session. And so here’s this bridge that goes both ways. And so they’re really excited about that. And, you know, we we’ve had several referrals from clinicians who work for us referring their friends. Who want to work for us, too. So there’s really good evidence to say, you know, once clinicians understand how this works and that it is really supportive technology to their work, not replacement, that really helps. When I talk to folks who are brand new into the field, so like my students who who, you know, this is maybe they’re in their second or third year of their master’s program. Some of them are in their internships and they’re doing some client work. Some of them haven’t gotten there yet. When I, you know, on the first day, give them kind of my background, my bio, my experience, at least one of them says, so you’re replacing this now.

Gala’s no good without you. You know, Carla is dependent on the work that you do in order to be useful when you’re not they’re not available. And you trust me, I’ve been on call 24/7. It is no way to live. You don’t give good care that way.

It’s not what you want, Carla, to be there for those moment. And so then, you know, they kind of start to understand that it is, you know, enhancements, not replacement. Totally. Just one more, you know, sort of cohort of clinicians who have been around for a pretty long time. They’ve been hearing about this in tech. It’s going to take over. I mean, all the way back to Elysa in the 80s when people were talking to Elysa just because they wanted to. That the idea of being replaced by a robot is is not necessarily new. And so there’s some skepticism of, you know, OK, we’ve we’ve heard this before and it’s yet to be to be real.

Mm hmm. Yeah. Now, this is good. This is good stuff. And, you know, I’m glad that you’re seeing that response overall because the reality is these these technologies help us. You know, overall, it help us do better with delivering care and receiving care and increasing effectiveness overall. What are you most excited about today, Liz?

Goodness, there are so many things that I’m excited about. I think, first and foremost, I’m just so grateful that we started Synchronoss Health about four years ago and that gave us time. We started really delivering services. Those first two and a half, three years really were building out the platform and the product and the programs and processes and all that sort of stuff. And so, you know, we’ve had a year and a half or so of delivering services and to have had that experience before and Right. as coded happened and really forced, you know, digital services. And think about all of the time that I spent helping colleagues of mine and other companies and people who are organizations and schools that are affiliated in some way, being able to help them transition everything to online and digital was just it is so rewarding, you know, that the timing worked out so that when all of this happened, we could say, hey, we know how to do this, let us help you.

And I’m just I will forever be grateful for that. And then also looking at going forward, you know, this has sort of forced people to face the fears of digital health and look at the realities of this is what it’s really good at and this is what it’s not. And so let’s be strategic and thoughtful. Let’s not throw all the spaghetti at the wall. Let’s really focus on the problems that technology and digital health can solve. And then let’s make room in the in-person care system for people who really still require that level of care.

Yeah. Now, that’s that’s awesome. I certainly agree. I mean, there’s there’s there’s the opportunity to continue on. And what you’ve done already is is tremendous. And whether Cauvin or not Right., I mean, the opportunity is tremendous and it just happens to be that it’s been accelerated by what’s going on. So I think it’s awesome that you guys are doing what you’re doing, folks. You know, if you’re curious about learning more synchronous health can be found at Cinq, that health, that’s a supply and see that health. And also, you know, go to our our website for the fall show notes and transcript. Our contracted that health type N Sync health. You’ll find them there. This has been a great chat. Lisa, I’d love if you could just leave us with a closing thought and the best place for the listeners could reach out to you or your team to learn more. Sure.

So I think, you know, thanks again for for having me on. I always love talking about just how we can make health more accessible for everybody. You know, health is a state of being. And I think we all have the ability to get there. And I’m just thrilled to have mental health and behavioral health be recognized as that integral role that it plays in all of that. So, you know, as as you’re thinking about health and the future of health, putting behavioral health Right. at the heart of it, it’s gotta be in there in order to achieve every other goal that you have for somebodies health and well-being. I think also, you know, in order to get in touch, I’m on LinkedIn, of course, but also we’ve got some forms that are available on the Web site, but also feel free to reach out directly. My email address is just first name. Last name. I think that helps. So Lisa Henderson at Think That Health awesome.

Lisa. Well, hey, I really appreciate the the insights you’ve shared today. And folks, take this up on I’m connecting. You know, now’s not a good time to start looking at programs that can help you and help your your organization improve mental health and overall health. So, Lisa, really appreciate you spending time with us today. Thank you.

Absolutely. My pleasure. Thank you.

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Things You’ll Learn

  • The hour you spend with your counselor is the best hour of the week.
  • Technology helps deliver and receive care and increase the effectiveness in the overall health process.
  • Be strategic and thoughtful in using technology.
  • Focus on the problems technology and digital health can solve.

Reference
https://sync.health/