The stigma associated with mental health issues and substance abuse continue to plague the delivery system. Patients often don't explain the complexity of their symptoms and care is far too fragmented. For Dr. Stephen Odom, addressing the underlying causes of substance abuse and mental health is at the core of the mission at New Vista Behavioral Health. A 30-year veteran of the industry, Odom left the hospital world in 2012 to launch Simple Recovery. The goal: create a community-based treatment program that worked with patients in their environment, not a sterile medical complex. Fast-forward a few years and Odom is now CEO and chief clinical officer of New Vista, which has four niche programs in Southern California. Odom recently spoke with Modern Healthcare Managing Editor Matthew Weinstock. The following is an edited transcript.
MH: Tell me a little bit about how you ended up moving to this setting. You were in the hospital world for quite a while.
Odom: I'm an old hospital guy, mostly behavioral health and substance abuse in not-for-profit hospital settings, pretty big systems. I really enjoyed that and got involved in lots of hospital things across departments and across the organization, but specifically in behavioral health and substance abuse.
You get a lot of people who really don't like being in hospitals. So trying to keep people comfortable in a hospital, in that antiseptic sterile way, even if you try to make it pretty, didn't ever really work. The other piece that happened there was you come up with this fantastic discharge plan of what they're supposed to do when they leave. You put it in their hands, try to make the connections, and then when they leave, oftentimes, they wouldn't follow through, and so they would ultimately relapse.
So I had the idea that if I could create treatment that was out in the community that had more of a residential feel and kept people connected to the care, they would get exposed to those triggers and stressors in the world, and they could talk it through with us and stay sober.
MH: What have you learned over the years about not just improving in-the-community treatment, but also about building relationships with those higher levels of care and being able to become that discharge plan?
Odom: Healthcare needs to be relational, not transactional. It seems old school in a lot of ways because people tend to be driven through the episode of care by their health plan, but even within that, knowing who you're working with makes all the difference.
The other thing to remember is as much as people are doing destination treatment for behavioral health, by and large healthcare is local. If you take care of your community in your own backyard, that's probably the best way to provide excellent care, so we've really focused on that.
We're in-network, so we make strong connections with independent practice associations, with ERs with other psych and chemical dependency facilities, so that when it's appropriate, we're the people that you think of.
MH: So you haven't had challenges with referral entities?
Odom: Not for the referrals. The challenge in-network is a managed-care challenge. They're pushing hard to have shorter lengths of stay.
One of the real frustrations is when we have a care manager on the insurer's side say, “Well, we don't need to pay for the treatment anymore because they can just go to AA and AA's free.” We love AA, but we believe AA is an adjunct, and it's an after-care type activity that sustains recovery, but when it sounds like the managed-care company's turning it into treatment, that's problematic.
MH: How much of that challenge is related to misperceptions that we continue to see across—even the healthcare industry—of behavioral health issues?
Odom: That's exactly right. What this speaks to is the idea that once you remove the substances, they should return to normal. This is a group of people who have been using substances as a coping mechanism to the point where it's turned on them, and it creates all the problems in their life. It doesn't solve anything. When you take the alcohol and drugs away, there's all the problems, and there's a lack of coping skills, and there may be other psychological factors or relationship issues.
Just to put it back in their court. When they say, “They should just go to AA,” if you read through that big book that AA has, one of the primary tenets is drinking is but a symptom of our problems. We should be able to do the treatment that we need to do using modern psychological interventions, whether it's cognitive behavioral therapy, or dialectical behavior therapy, group therapy, all the things that we use help get to the uncovering stage of why they're in such pain that they're medicating beyond the fact that once you have an addiction, it's hard to let go of it because of the habit.
MH: With New Vista you've now created a much larger organization.
Odom: My goal for Simple was basically to create this discharge plan treatment methodology, scale it up to where we could treat 50 people between our inpatient and outpatient, and then take that pod of treatment, and replicate it in another geography that made sense.
I got a call from a recruiter saying there was a group that's looking for a CEO.
Their idea was, “We really like addiction and behavioral health treatment. We're investor folks, but we are mission-driven, and we believe that there's a severe lack of quality mental health and substance abuse treatment, and we'd like you to help us build that out.”
I wanted to build a company that could serve different niches in the market really well and be the very best at those niches. The first thing that I was able to put together or acquire was our Avalon property in Malibu, and it's a unicorn because it's an absolutely amazingly beautiful place. It provides incredible mental health and substance abuse services. It's really hard to get a mental health license like that in the state of California, and it had one, and so it's very high end.
It treats serious mental disorders, bipolar, schizophrenia, other thought disorders, and then it also treats substance abuse, but those are all what we call dual-diagnosis or co-occurring, so everybody also has a mental health disorder. It's a pretty limited group of people who go there. We tend to work with a lot of folks who are from wealthy families and in the sports and entertainment industries; the proximity to Hollywood helps a lot.
The next thing, I've always enjoyed working with other healthcare professionals. If you knew how bad things were for them, it would scare you a little bit sometimes, and I feel like we can do really good treatment in that niche, so we put some things together to start our Center for Professional Recovery, which treats addicted physicians, attorneys, pilots, other doctoral level healthcare people.
There's not that many programs that are focused on those groups of people, and it's interesting that they seem to do better when they're in groups or treatment together than when they're with what we call civilians. They don't talk about the fact that they passed out in the OR shooting fentanyl and they're an anesthesiologist, because that's just too glaring for the world to know about.
Every now and then, we get a nurse into treatment, and our clinicians are really excited about having a nurse, but sometimes, the nurse isn't so excited about being in treatment with a bunch of doctors.We also started to build out a program that is very first responder-oriented. There's lots of special, unique facets of who they are, and how they resist treatment and why. They need to be in cohorts of their peers in order to really gain a benefit.
MH: You've talked about Simple Recovery and the idea of being the discharge plan. What that means functionally.
Odom: One of our jobs in treatment is to put together a master treatment plan which looks at all the assets and deficits that a person has, and basically, all the wellness categories you want to think about—emotional, vocational, physical, nutritional, relational, sexual, avocational.
We put specific things within those areas that are problematic, whether it's depression, or alcoholism, or family dysfunction related to substance abuse, and then we have to make a determination: Is this something we're going to treat? Are we going to refer it, or are we going to defer it?
We pick up those pieces that have been either referred or deferred.
We take a look at things like where are they vocationally? Are they happy in their job? Are they out on a medical leave? Are they out on workers' comp? Is this the right career for them? And then we help them work through that.
By walking with people—scaffolding is a term I like to use—we help people get back into college, we help people interview for jobs, we help them put resumes together. We're actually one of the only programs I know of in the whole country that has a licensed occupational therapist.
MH: What kind of growth plans do you see for New Vista over the next few years?
Odom: As far as our niche programs are concerned, if there was opportunity in the right geography, I would put another physicians' program somewhere. A lot of the focus is going to be on what Simple Recovery does, which is building that capacity and being able to leverage helping more lives, so back to that whole value share proposition could happen. I think we need to have a certain census in those types of facilities so that we can do it.
I'd be happy to expand outside California.
