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The Mental Health Crisis in America: Recognizing Problems, Working Toward Solutions

September 21, 2019 at 8:00 AM to September 22, 2019 at 12:30 PM

View the full lineup of experts speaking at the Austen Riggs Center Fall Conference.

 

Conference Director: Eric M. Plakun, MD

Annual Fall Conference at Tanglewood's New Linde Center for Music and Learning Celebrates the Austen Riggs Center's 100th Anniversary (1919-2019)

Decades of research on the brain and biology have dramatically increased our understanding of the complexity of mental disorders, but have not “moved the needle” in delivering better outcomes. Despite the focus on and funding for biomedical research, evidence is mounting that both nurture and nature play crucial roles in the causation and treatment of mental disorders.

At the same time, funding and insurance coverage for treatment is often limited to crisis stabilization rather than recovery’s goal, which is living a self-directed life. Access to care is limited by the large numbers of uninsured or underinsured individuals, assaults on the Affordable Care Act, incomplete implementation of the federal mental health parity law 10 years after its passage, and the many faces of stigma.

Our mental health system is broken, and the statistics are sobering: suicide rates have increased 30%, homeless individuals struggling with mental disorders are part of the urban streetscape, the opioid crisis is exploding, and emergency room boarding of patients who need psychiatric care is a growing problem,” states Medical Director/CEO and Conference Director Eric M. Plakun, MD. “We are convening this conference on behalf of Americans who are dealing with profound mental health issues, and to tackle critical concerns, both clinical issues and those related to access to care, which is often improperly limited to symptom relief or crisis stabilization rather than the treatment of important underlying problems.”

Dr. Plakun Gives an Overview of the Fall Conference

 

View the full lineup of experts speaking at the Austen Riggs Center Fall Conference.

Confirmed presenters, speakers, and panel participants include national and international experts in the fields of mental health care, treatment, research, advocacy, and the law (as of January 2019):

  Meiram Bendat, JD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America.     Francine Conway, PhD, will present at the Austen Riggs Center Centennial Conference - The Mental Health Crisis in America on September 21-22.     Anita Everett, MD, DFAPA, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.     Peter Fonagy, PhD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.

  Jeffrey Geller, MD, MPH, will present at the Austen Riggs Centennial Conference - The Mental Health Crisis in America on September 21-22.      Carol Gilligan, PhD, will present at the Austen Riggs Center Centennial Conference - The Mental Health Crisis in America on September 21-22.     Colleen White Holmes, MBA, President and CEO of 18 Degrees (formerly Berkshire Children and Families) will be a panelist at the 2019 Austen Riggs Fall Conference.     Tom Insel, MD, will present at the Austen Riggs Center's centennial conference on the Mental Health Crisis in America on September 21-22, 2019.         

  • Meiram Bendat, JD, PhD, Founder and President at Psych-Appeal, Psychotherapist, and Attorney
  • Francine Conway, PhD, Dean of the Graduate School of Applied and Professional Psychology (GSAPP) at Rutgers University-New Brunswick and Distinguished Professor at Adelphi University’s Derner Institute of Advanced Psychological Studies
  • Anita Everett, MD, DFAPA, Director of the Center for Mental Health Services at the Substance Abuse and Mental Health Services Administration (SAMHSA)
  • Peter Fonagy, PhD, OBE, FMedSci, FAcSS, FBA, Head of the Division of Psychology and Language Sciences at University College London (UCL) and Chief Executive of the Anna Freud National Centre for Children and Families (London)
  • Jeffrey Geller, MD, MPH, Professor of Psychiatry and Director of Public Sector Psychiatry at the University of Massachusetts Medical School, and President-Elect of the American Psychiatric Association (APA)
  • Carol Gilligan, PhD, American feminist, ethicist, and psychologist; Professor at New York University; Visiting Professor at the University of Cambridge; author of In A Different Voice (1982)
  • Colleen Holmes, MBA, President and CEO of 18 Degrees (formerly Berkshire Children and Families)
  • Tom Insel, MD, Co-founder and President of Mindstrong Health and former Director of the National Institute of Mental Health (NIMH)

Ted Kennedy Jr., Esq., will be speaking at the Austen Riggs Center's Fall Conference on September 21-22, 2019.   Harold Kudler, MD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.   Saul Levin, MD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.   M. Christine Macbeth, ACSW, LICSW, will be presenting at the Austen Riggs Center's Fall Conference on September 21-22, 2019.   Nancy McWilliams, PhD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.       
David Mintz, MD, is the Director of Psychiatric Training and Associate Director of Training at the Austen Riggs Center.   Margaret Parish, PhD, is the Director of Patient Care at the Austen Riggs Center in Stockbridge, MA.   Eric M. Plakun, MD is the Medical Director/CEO at the Austen Riggs Center.   Caroline E. Reynold, JD, will present at the Austen Riggs Center's centennial conference on The Mental Health Crisis in America on September 21-22, 2019.   Jane G. Tillman, PhD

  • Ted Kennedy, Jr., Esq., Health Care Lawyer at Epstein Becker Green and Board Chair of the American Association of People with Disabilities (AAPD)
  • Harold Kudler, MD, Psychoanalyst, Adjunct Associate Professor in the Department of Psychiatry and Behavioral Sciences at Duke University, and former Chief Consultant for MentalHealth Services at the US Veterans Health Administration (VHA)
  • Saul Levin, MD, MPA, FRCP-E, Chief Executive Officer and Medical Director of the American Psychiatric Association (APA) and Clinical Professor at the George Washington University School of Medicine and Health Sciences
  • M. Christine Macbeth, ACSW, LICSW, President and Chief Executive Officer at the Brien Center for Mental Health and Substance Abuse Services
  • Nancy McWilliams, PhD, ABPP, Psychologist, Psychoanalyst, Author, and Visiting Professor at Rutgers University Graduate School of Applied and Professional Psychology
  • David Mintz, MD, Director of Psychiatric Training and Associate Director of Training at the Austen Riggs Center and American Psychiatric Association (APA) Psychotherapy Caucus Leader
  • Margaret Parish, PhD, Director of Patient Care at the Austen Riggs Center and former President of the Board of the Center for the Study of Groups and Social Systems, Boston’s A. K. Rice affiliate
  • Eric M. Plakun, MD, DLFAPA, FACPsych, Medical Director/CEO at the Austen Riggs Center and American Psychiatric Association (APA) Board of Trustees member representing New England and Eastern Canada
  • Caroline E. Reynolds, Esq., Partner at Zuckerman Spaeder, LLP, and Plaintiff Counsel for Wit v. United Behavioral Health
  • Jane G. Tillman, PhD, Director of the Erikson Institute for Education and Research at the Austen Riggs Center and Assistant Clinical Professor at the Yale Child Study Center

Examining Crucial Issues Including

• Complex Psychiatric Problems:
“Moving the Needle” to Achieve Better Patient Outcomes

• Suicide on the Increase:
Assessing Causes, Contributors, and Collateral Damage

• Treatment Goals:
Crisis Stabilization or Recovery?

• Mental Health Parity Law:
Implementation Through Top-Down and Bottom-Up Change

• Hope Through Engagement:
Innovative Solutions to Clinical Challenges

SATURDAY, SEPTEMBER 21, 2019

8:00-8:30 a.m.            BREAKFAST AND REGISTRATION   Studio E Lobby & Cindy’s Café

8:30 a.m.-12:00 p.m.   MORNING SESSION > THE CRISIS AND THE STRUGGLE FOR SOLUTIONS   Studio E

The morning sessions explore the scope and scale of current crisis in mental health care with a focus on limitations of treatment models and obstacles to access to care for those with complex psychiatric problems – and establish a framework for solution-based discussions. 

8:30 a.m.          Welcome, introductions, and conference overview – Lisa A. Raskin, PhD, John William Ward Professor of Psychology (Neuroscience), Amherst College and Chair of the Board of Trustees, Austen Riggs Center; and Eric M. Plakun, MD

9:05 a.m.          21st Century Challenges – Anita Everett, MD, offers a broad perspective on problems in provision of mental health services in the clinical domain, but also in terms of access to care. 

9:30 a.m.          Four R's That Protect Against Suicide: Relationships, Resilience, Reasons for Living, and Restriction of Lethal Means – Jane Tillman, PhD, speaks on the problem of suicidenoting the dramatic increase in the suicide rate and reporting on what we are learning about causes, contributors and collateral damage. 

9:45 a.m.          Keynote Presentation: Beyond Magical Thinking – Tom Insel, MD, describes what he calls the flaw of “magical thinking” of our field: imagining that there is a single pill, single app, or single intervention that will be “a silver bullet” for mental illness.

10:30 a.m.        BREAK

10:45 a.m.        Panel Discussion #1, followed by plenary discussion

Panel features morning speakers as well as two new panelists (who will give initial commentary), all of whom are individuals with expertise on the scope and scale of current crises in clinical models and access to care. 

Moderator:      Ming Jack Po, MD, PhD (Product Manager, Google AI Healthcare; member, Austen Riggs Center Board of Trustees)

Panelists:        Eric M. Plakun, MD; Anita Everett, MD; Jane Tillman, PhD; Tom Insel, MD;
                         Saul Levin, MD; and Colleen Holmes 

12:00 p.m.       LUNCH BREAK   Cindy’s Café

1:00-5:00 p.m. AFTERNOON SESSION > INNOVATIVE SOLUTIONS TO THE CLINICAL PROBLEM: THERE IS HOPE THROUGH ENGAGEMENT  Studio E

The afternoon session moves from the specific to the general, as we discuss specific clinical approaches to the crisis in mental health care, followed by a broader social perspective on the nature of the problem and what is needed in a solution. We will explore Riggs and other psychodynamic models as innovative, potentially scalable biopsychosocial solutions to clinical challenges, then take a broad view on the “crisis in connection” we face as a society, and how this crisis contributes to the problems we are exploring.

1:00 p.m.         Introduction – Kim Leary, PhD (Associate Professor of Psychology, Harvard Medical School and Associate Professor of Department of Health Policy and Management at the Harvard Chan School of Public Health; former Robert Wood Johnson Fellow in the Obama White House; member, Austen Riggs Center Board of Trustees)

1:10 p.m.         Are the Foundations of Riggs Treatment Scalable? – Margaret Parish, PhD, discusses aspects of the Riggs biopsychosocial treatment model as offering potential contributions to the solution. 

1:25 p.m.         Can We Improve Outcomes in Treatment Resistance Through Medical Psychotherapy? – David Mintz, MD, discusses a way of working with medications that attends to the meaning of medications—a scalable clinical approach he has described as “psychodynamic psychopharmacology.” 

1:40 p.m.          Standing for Reality: What Really Matters in Psychotherapy – Nancy McWilliams, PhD, ABPP, addresses current conceptualizations of mental health and psychotherapy, emphasizing both clinical wisdom and scientific knowledge that should guide effective treatment, whether long- or short-term.

2:05 p.m.         The ADHD Compassion Project: Dispelling The Illusion of Children With ADHD as The "Bad Other" – Francine Conway, PhD, speaks about her work addressing troubled students in inner city schools who are seen as having attention deficit problems, using a scalable psychodynamic approach to treatment. 

2:30 p.m.          BREAK

2:45 p.m.         Keynote Presentation: Responding to The Crisis of Connection: Remembering Erik Erikson – Carol Gilligan, PhD, raises issues addressed in the recent book she co-edited, The Crisis of Connection, noting a societal shift in the relationship between the “me” and the “we” in our culture. Dr. Gilligan will also link her comments to Erikson, who was one of her mentors.

3:30 p.m.          Panel Discussion #2, followed by plenary discussion

Panel features afternoon speakers as well as two new panelists (who will give initial commentary), all of whom are individuals with expertise on the scope and scale of current crises in clinical models and access to care. 

Moderator:      Kim Leary, PhD

Panelists:        Margaret Parish, PhD; David Mintz, MD; Nancy McWililams, PhD; Francine Conway, PhD; Carol Gilligan, PhD; Harold Kudler, MD; and M. Christine Macbeth, ACSW, LICSW

5:00 p.m.         END OF CONFERENCE DAY 1

6:30 p.m.          AUSTEN RIGGS CENTENNIAL CELEBRATION (Note: there is a separate fee to attend this event) Cindy’s Café, Studio E Lobby and Studio E Performance Space SOLD OUT

This evening event includes a cocktail reception; the presentation of two “Four Freedoms of Mental Health” awards to Senator Chris Murphy (D-CT), and Carol Gilligan, PhD; and a performance by psychiatrist and pianist Richard Kogan. 

SUNDAY, SEPTEMBER 22

8:00-8:30 a.m.             BREAKFAST AND REGISTRATION   Studio E Lobby & Cindy’s Café

8:30 a.m.-12:30 p.m.     MORNING SESSION > SOLUTIONS TO THE CRISIS IN ACCESS TO CARE:
TOP-DOWN AND BOTTOM-UP   
Studio E  

The morning session explores approaches to achieving parity through top-down [legislative] and bottom-up [class action lawsuits] solutions. Insurance entity stances undermine access to adequate care when they limit the goal of treatment to crisis stabilization achieved in short-term interventions. This is in contrast with clinicians’ generally accepted overarching goal of treatment, which is achievement of “recovery”–helping patients work toward living self-directed lives, while coming to grips with strengths and limitations. 

8:30 a.m.          Opening remarks and introductions – Eric M. Plakun, MD

8:55 a.m.          The Importance of Mental Health Parity – Saul Levin, MD, offers brief remarks about the importance of Senator Chris Murphy’s (D-CT) Mental Health Parity Compliance Act of 2019, co authored by Senators Murphy and Bill Cassidy (R-LA), and APA efforts to advance full implementation of parity. Dr. Levin’s remarks will be followed by video remarks from Senator Chris Murphy (D-CT).

9:05 a.m.          Lessons From The Legal Trenches – Caroline E. Reynolds, Esq., explains the theory of the case, in which UBH (Optum), the nation’s largest behavioral health claims administrator, was found liable for breaching its fiduciary duties to its insureds by developing and using medical necessity criteria that were pervasively more restrictive than generally accepted standards of care.

9:30 a.m.          Improving Access to Care: New Frontiers in Parity and Civil Rights – Ted Kennedy, Jr. Esq., speaks about top-down and bottom-up solutions around access to care relevant to his legislative work and his work as a lawyer for people with disabilities. 

9:50 a.m.          Keynote Presentation: The Consequences of Losing Epistemic Trust: A Perspective From The UK on Mental Disorders That Persist and Resist Treatment – Peter Fonagy, PhD, OBE, FMedSci, FAcSS, FBA, speaks about the interface of the intrapsychic and social context of patients with persistent disorders—aka complex psychiatric patients. He will address the social biology of persistent mental health problems, focusing on what he considers as the core pathology in terms of learning or adaptation in these individuals rooted in a pervasive absence of trust. 

10:30-10:45     BREAK

10:45-11:45     Panel Discussion #3 – Access to Care

Panel features morning speakers as well as two new panelists (who will give initial commentary), all of whom are individuals with expertise on the scope and scale of current crises in clinical models and access to care. 

Moderator:      Eric Plakun, MD

Panelists:         Saul Levin, MD; Caroline E. Reynolds, Esq.; Ted Kennedy, Jr. Esq.; Peter Fonagy, PhD; 
                          Meiram Bendat, JD, PhD; and Jeffrey Geller, MD, MPH 

11:45 a.m.        Closing Panel – Conference Synthesis & Plenary Discussion

Moderator:      Eric Plakun, MD

Panelists:          Conference speakers will be invited back on stage to participate in a final closing panel discussion, with audience discussion. The goal will be to review and tie together the main issues, themes and learning that emerged from the previous sessions.  

12:25 p.m.       Closing Remarks, future directions, acknowledgments, and thanks

12:30 p.m.       End of Conference Day 2

 

Learning Objectives

  • To describe limitations of mental health treatment models and obstacles to access to care for those with complex psychiatric problems
  • To identify psychosocial elements that may contribute to improved clinical outcomes
  • To describe progress in top-down legislative and bottom-up judicial and cultural remedies addressing access to care problems

Continuing Education

The Austen Riggs Center designates this live activity for a maximum of 10.75 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Austen Riggs Center is accredited by the Massachusetts Medical Society to provide continuing medical education for physicians.

The Austen Riggs Center also designates this live activity for 10.75 continuing education credit(s) (CE) for psychology and social work.

The Austen Riggs Center is approved by the American Psychological Association to sponsor continuing education for psychologists. The Austen Riggs Center maintains responsibility for the program and its content. For additional information about this program, please call the Erikson Institute Education Coordinator, at 413.931.5230.

The Austen Riggs Center, #1344, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual conferences, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual conference may be accepted for continuing education credit. Austen Riggs Center maintains responsibility for this conference. ASWB Approval Period: 02/02/2017-02/02/2020. Social workers completing this conference receive 10.75 continuing education credits.

For a listing of jurisdictions that accept ACE, please visit: www.aswb.org/ace/ace-jurisdiction-map/.

The Austen Riggs Center follows all state and federal laws and regulations, including the Americans with Disabilities Act of 1990 (ADA). In accordance with the ADA, the Austen Riggs Center is committed to accessibility. If you need accommodations for your course, please contact info@austenriggs.net.

For additional details, please visit: www.austenriggs.org/accreditation-educational-activities.

Award for Excellence in Psychotherapy

Training and research are core elements of the Austen Riggs Center and are offered through its Erikson Institute for Education and Research. This Austen Riggs Award for Excellence in Psychotherapy recognizes and supports the development of psychiatric residents who have demonstrated interest and ability in psychodynamic psychotherapy and/or psychodynamic psychiatry or have shown promise as researchers in biopsychosocial approaches to psychiatric practice, including psychotherapy. Nominations are due by June 15, 2019, and applications are due by July 15, 2019. Nominations for 2019 are now closed.

Media Partners

Thank you to the Berkshire Eagle for being a media partner for the 2019 Fall Conference - The Mental Health Crisis in America. Thank you to WAMC, media partner for the 2019 Fall Conference - The Mental Health Crisis in America.

Conference and continuing education information - Kathleen Young, Erikson Institute Education Coordinator 413.931.5230
Underwriting and sponsorship opportunities - Lisa Lewis, Development Officer 413.931.5333
Media passes are available upon request - John Zollinger, Director of Communications 413.931.5816

Location

Linde Center for Music and Learning
3A W Hawthorne Rd, Lenox, MA 01240

 

REGISTRATION IS NOW CLOSED FOR THIS EVENT

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