How prepared are health systems to make these types of treatments standard?
That’s such a big question. I believe what’s changed in the last six months to a year — and it’s led to this commission — is the will of the health systems to do it. And that’s in direct relation to the will of the field, the families, the patients. What it will take, I believe, is grassroots work. Demonstrating it in action — which is what we’re proposing to do as part of the commission. So, there’ll be thought leaders like us, and other partner thought leaders, who demonstrate it in action, and then that leads to discussion around the bigger policy health care issues that surround it … reimbursement, payers, all of that. And we see if this can happen, if we can create that inflection point.
You’ve addressed the issue of stigma openly; do you sense that has softened?
Yes, and that’s a big part of creating the momentum to do something like this. A lot of my positivity about that is coming from young people, who are speaking openly about it. Athletes and other people in the public limelight, people who at one point maybe wouldn’t have spoken about it, are now speaking about it. You also see the explosion of health tech companies focusing on mental health, and that’s a big shift. I think the circuit part of circuit-based precision mental health is now seen as very important — and something people are genuinely excited about. There are more young people wanting to enter the field, which for many years was not the case. Now they see new, exciting progress in mental health care.
Your team has been testing these concepts clinically. What has inspired you about the results?
I’ve found that families, and patients, really respond to data that explains what is getting disrupted in their brain. They understand why we’re choosing a particular treatment. Having a scan helps us understand which options are likely to be effective. If we can match a particular person’s circuit type to a treatment, we can double the chance of their getting better. And that means you could get it right the first time, instead of playing whack-a-mole with meds, trying one and not really knowing if it will work when the patient is already in a state of deep distress.
But most of this work remains at the research level, so what you’re embarking upon is a mission to integrate it into clinical action, right?
The research side has made serious accelerations, so I think there’s been an implicit assumption that if you can get a good model, and a good predictor, it will somehow naturally make its way into practice. That has been the good-faith feeling among researchers. This is our effort to take these important developments and get them deployed clinically, to think through how to make that work, so that we don’t go any longer without putting them to good use.
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