Support to and Let's Seriously Think of Solution to: Employee Strikes Highlight America's Mental Health Crisis

Support to and Let's Seriously Think of Solution to: Employee Strikes Highlight America's Mental Health Crisis

In California mental health workers of Kaiser Permanente, major health insurance and health care provider, strikes for not enough employees for quality care.

I'm sure this sounds familiar for many mental health practitioners employed by a cooperation. Lack of staffing seemed to be an issue in where I used to work, in the substance abuse treatment center.

The issue is the following:

• The affordable care act has increased the number of patients into the mental health field.
• In response to such demands there should be an increase in number of service providers.
• However, actually there is a decrease in number of service provider.

As a result, service cannot be provided to the patients, and as a result there are people who committed suicide and possibly homicide.

This currently is named the "Mental Health Crisis" as adequate care is not available in relation to the demands. As a type of crisis, this issue it is a maturation crisis (crisis built over time) where the number of mental health problem is increasing in the nation and when it comes to a certain point it will have a tipping point "crisis."

Let me analyze the situation to see where the cause is and the possible solution to this problem.

1) Is it affordable care act or other reasons too?

Increase in number of mental health issues has been discussed a lot around 2013, now the focus seems to be on increase in mental health issue in Children.  Either way, the discussion of "increased mental health issue" has been around.

The affordable care act just made it easy for individuals who originally did not have insurance to come see a professional for there challenges to see the professionals, or they thought they can see the professionals.  These individuals were always around suffering from mental health issues and we as a nation did not do anything about it.

So it is not necessary the affordable care act but the underlining issue of increase in mental health must be taken care of.

2) Should there be an increase in number of service providers?

It is a simple way of resolving the issue, yet from a business perspective this cannot easily be accepted as "people" are one of the most costly expense to a business. So if they do, another problem will naturally happen, decrease in the already reduced salary of mental health professionals.

Then what should the business and employees do?

LEVERAGE! the time and human interaction.

The number of clients/patients seen in an hour must increase. Of course, that is the reason why psychiatric medications became popular (you need to see the patients one a month or so).  However, we know the kick back of that problem, actual problem not resolved, increase in substance abuse, etc. etc.  Moreover, there seems to be a decrease in number of psychiatrist in this nation anyways (according to the news).

Quick question when do you think mental health practitioner makes money?

When they give the service to the clients?

YEEEE (incorrect)

When we complete the paperwork for the INSURANCE COMPANY.

We just can't prove YOU (patient) that we did a great job, we need to prove the insurance company.  And do they pay? HAHAHA, you tell me.

1) So cutting down on the paper work time will be essential by implementing efficient system or...

When I used to practice, I wanted to provide as much service as possible in the working hour for my client.  Ended up doing multiple after hour works, up to 5 hours, doing paper work.  Yes, I did provide great service, but burning out was the correct word. And majority of the paper work did not benefit any bit to my client.

There are multiple services, computer programs to make the writing paperwork more efficient as possible, does the company implement such system? and have they trained the employees in it?

By the way the reason why we like private pay client is that they pay upfront (not after like the insurance company) and no unnecessary paper works.

2) Cutting down treatment time by having ways for the clients/patient to know, like, and trust the practitioner before hands.

There has been a lot to be said about treatment time reduction.  Strategies such as "brief therapy" discusses a lot about it. Legendary therapist/doctor like Dr. Milton Erickson will be able to resolve a problem in one session.  Yes, there is extraordinary skills that Dr. Erickson had but what it really boils down to is TRUST.

If the clients trust us then the treatment goes exponentially fast.

But in order to gain trust, they need to like us, and before that know us.

The key of Dr. Erickson was in his later years, people heard about him, friend referred him, or seen on some paper and came.  Clients already knew about him, likely to like him, and possibly trusted him before the treatment started.

This cuts down on how fast we can finish the treatment.

Think about this.  You opened a door, and there is a total stranger.  How long would it take for you to TRUST that person?  Even if you knew they are professionals, it's not like fixing your car, it's about your life and you need to collaborate in order to make the necessary change (not like a surgery where you are knocked out and the surgeon just operates).

Social psychology would say at least three interaction to have a concrete perspective about another person.  Okay... that is three sessions already!

Thus, interesting enough therapists' public relation effort will reduce the treatment time.  Why do you think I write blogs?

Thus solutions are:

1) Have an introductory video of the therapist on a website or places clients can see.
2) Have podcast for the company and have your therapist as a guest.
3) Each therapist should have a blog, twitter, or some sort of way to send out messages to the world.

And of course, the therapist must keep training, improving their skills, knowledge, experience, and on themselves.

3) Decreasing service provider. The cause of it.

Is there decrease in service provider? Ahh, yes and no.  Yes, seems to have less psychiatrist, less people coming into our field, and no there is a lot of licensed psychologist, and alternative individuals such as healers and coaches.

General: Low pay for what we do. Salaries are originally based on the need to obtain the skills, knowledge, ability, and effort to maintain attitude and awareness of the required job.  Now a days it is based on the end result we provide and who we provide to (difference between treating depression of a millionaire and depression of a homeless).  The nature of the targeted population tends to be the lower income population.  Yes, there is rich people who have mental illness that needs treatment but that's not many compared to the poor.  Usually these rich people come to get treatment when they become broke.  It is difficult to maintain wealth with mental health issues, thus natural targeted population does not bring money to this industry.

If you treat many or provide value to many, it can compensate for the low income low paying population.  However, the nature of the service tends to be one-on-one or at max one-on-twelve (group therapy) and limits the income.

Rare cases are substance abuse because it requires some level of cash flow in order to sustain the habit. Many times, the family members are wealthy "enough" to pay for the treatment.

Moreover, the level of mental stress and psychological contamination risk (getting mentally ill yourself) are high.


Psychiatrist: pay is high but risk is higher.  1/3 of all sued cases for medical doctors are apparently against psychiatrists. Federal funding also was shifted from specialties to primary physician, resulting in natural drop in numbers.

Psychologist: pay is high but likelihood of being hired is slim.  All the knowledge, experience, skills, and abilities seemed to be undermined and seen equal to a master level therapist.  Plus you only need one to manage many below.  You can find many psychologist who will provide treatment and I am sure they will provide values to you but many are like me and take private payment, or only specific insurance.

Coaches and Healers: Their pay and expense to gain the certification or skills matches for these individuals. Plus many times they deal with higher functioning individuals which means higher economic status, higher pay.

Conclusion:

Strike itself, I will support it because it shines a light on the crisis we are facing now which will become worse if it is left untouched.
1) We must reduce the number of clients to begin with by providing prevention to the community, and hopefully the insurance company pays for such prevention seminars/training.
2) Always have better efficient way to reduce the unnecessary time wasted on paper work.
3) Find and implement ways to increase visibility of the therapist so they are known, liked and trusted before the session to reduce number of sessions (overall therapist will be able to see more people in a year).

Lastly, the strike also has to do with not only the lack of therapist in Kaiser but also has to do with team development, where the business and employee do not have the same mission.  Simply, they are not working as a team. If the mission was the same then people will work overtime, and be creative.  The inability to create a company were mission comes first, then the team, and individuals last are the cause of the problem, which probably my mentor, a rich dad adviser, Blair Singer would say.

see: https://news.vice.com/article/employee-strikes-highlight-americas-mental-health-crisis

My thought to: Opinion Journal: What Caused the Financial Crisis?

My thought to: Opinion Journal: 

What Caused the Financial Crisis?

In this short 5 minutes video an expert brings on the topic of what caused financial crisis. The response was primarily to the government having loans with low down payment.

If you categorize financial crisis based on "crisis theory" it will be categorized under maturational crisis, which means a crisis that developed in the normal increase of stress, and it is predictable.

Maturational Crisis is caused by a role change or inability to change the role.

So who's role did not change in response to what?

Just like Robert Kiyosaki says, August 15, 1971 is probably the date we need to go back to the reason for our role change.

This is the date, president Nixon took money off the gold standard and money became debt based "currency." (see more on http://www.historycommons.org/context.jsp?item=financial_crisis_1).

This means the role of "money" changed and we as people needed to adapt to this new rule and change our role.  It is like a baseball changing to a tennis ball, or a kitchen knife changing to a paper cutter. Although it seemed similar, it was a drastic change.

As a result people continued to work and use money as if it was "money", something that would not change in its value.  However, inflation shows that the value has been changing, which for those who did not adapt to the new rule, relied on "dept" to survive.

Dept in this scenario is stress. Increase in dept of individuals, families, communities, counties, states, and the country has led to a point of crisis to release the stress somehow.  And this is financial crisis.

Interestingly, as I mentioned above maturational crisis are predictable.  And indeed, the U.S.' financial crisis is also some what predictable.  Just like every dept based country has gone bankrupt the results are determined.  You don't need a genius to imagine what happens when you keep on borrowing money which does not create any income/asset.

So, Taka! When is it going to happen?

Good question.  If you have any literacy on reading charts for stock, then those investors and traders have been aware of what is going on. (see: http://www.forbes.com/sites/chriswright/ 2015/01/13/sell-sell-why-the-sp-500-will-halve-in-2016/)

Although, it is out of topic, let me do a quick analysis of the candle stick chart pattern for S&P 500.  The resistance (the highest value attained) is 2088.50 on December 29, 2014. Next is 2062.00, on January 8, 2015 (based on investing.com).  Okay, if there is an upward trend usually chronologically we should be seeing a higher number than 12/29/2014.  Now the next point is 1984.25 on January 5, 2015.  If we ever penetrate lower than this number we need to be aware for the big down fall.

Make sure you change your "role" of your retirement fund and investment (i.e., change to sell from hold). That is at least what we can do for prevention of financial crisis.  

If the market goes above 2088.50 then we have little more time to breath.

So, what is my opinion as a psychologist about the cause?  It is lack of prefrontal cortex use among the mass, meaning the lack of flexibility to shift thinking patterns and decision making knowing that the rule have changed.  Or lack of awareness to the fact the rule has changed (which is also a prefrontal cortex weakness).

Strategies will be to set alerts on Yahoo! Finance if you do have an Yahoo account or have Google alerts to send you information about S&P 500. Also, news related to such economical crisis is a good alert to have as it is predictable.

Oh, for those who want to take advantage of it, when stock market begins moving down, buy the stock in about 2 years when "usually" it is at the lowest possible.  Thus, saving money for investment from now may not be a bad idea.  That is how John Templeton became a millionaire after the Word War I (see: http://www. templeton.org/sir-john-templeton/life-story).

Can you turn this crisis to an opportunity?

See video at: http://www.wsj.com/video/opinion-journal-what-caused-the-financial-crisis/4395C507-D179-436F-B286-6C66A1B9524C.html

Saving My Aunt who had a Stroke and Meningitis through Coma and Brain Recovery

In end of last month (December 2014), my maternal aunt had a meningitis and a stroke.

She went into a coma, where my family was told that she had 50/50 chance to survive. I personally did not know what I can do, especially when I was in the U.S. and my aunt was in Japan.

So, just as a good psychologist will do, I researched about coma, stroke, meningitis to add to what I already know and give the information to my family. Especially, to my grandmother who was extremely worried.

Interestingly, I found a case study where they helped a person to be awake from coma using hypnosis and continued using hypnosis for recovery in 1987 (see: http://www.tandfonline.com/doi/abs/ 10.1080/00029157.1987.10402705).

To give a hypnosis, I recorded a hypnotic session of 8 minutes (which can be repeated) hoping that the Ericksonian hypnosis will have an affect on my Aunt's recovery.

And interestingly enough, she opened her eyes in two days from coma, right after listening to my recording where I state the suggestion of "open your eyes!"

I am sure she was receiving the correct treatment for her medical condition, and it is still interesting where such thing happens.

I created more recordings to support her brain recovery through hypnosis and also did couple of neuropsychological test to see her progress and have statistical expectation on her recovery.

Interestingly enough medical treatments in Japan do not do such things.

Neuropsychological assessment, treatment planning, and hypnotic treatment are some thing I believe Japanese treatment can do more of.

Response to the article: Bad Therapy: Something Is Rotten in the Psychology Profession

My study of psychology or as a therapist has always been competence first.  Crisis management and intervention were part of my criteria as a competent psychologist.  I always looked for ways to be better, greater, humane, and helping psychologist.

Mean while there are people who go opposite direction like...

Torturing people?

Yes, there are psychologist who go against the supposedly ethics code that we abide by.
Yeah... not like have good intension but making mistake. With bad intention use the power of psychology. Like the opposite direction of a competent psychologist. 

Awareness and Attitude are important as a competent any professional. We must be aware of our power and work towards the greater good with compassion, a great attitude.

I don't agree with all ethics code, because you get a sense that it was created from fear rather than passion or caution. (i.e., fear of being sued, hurting others, being hurt, etc.)

However, I agree with the basic principles which are:

Principle A: Beneficence and Nonmaleficence
Principle B: Fidelity and Responsibility

Principle C: Integrity

Principle D: Justice

Principle E: Respect for People's Rights and Dignity

So torturing obviously goes against basically everything?
Yes, yes, if you are in military you are made to swear that you are soldier or officer first then a psychologist, and based on research you don't get any accurate information from torturing an individual. "Think about it, would you say the correct thing to a person who torture you or say whatever in order to get off the hook?"

Either way, we might not get good information from torturing but we definetly know how to psychologically provide pain, just reverse the process of therapy and positive psychology.

For what reason? To satisfy our sadistic nature? That is just sick, and that person is in need of serious therapy...

For same reason confession no longer hold the same power of evidence in legal cases no days.

Read full article at: http://www.huffingtonpost.com/deborah-kory/something-is-rotten-in-the-psychology-profession_b_6348962.html

Or Original: http://www.psychotherapy.net/blog/title/bad-therapy-let-s-talk-about-torture...wait-what

Comment on: Obama Is Pals With Sony Executive He Said Never Called

The position where Sony Pictures are in for the movie "The Interview," is a great opportunity for us to see how crisis management is going to be applied and how good of a manager they have. 

Sony Pictures is getting cyber hacked and receiving threats of violence.  Apparently from the North Korea. Interesting way to put your company into crisis. Start a fight with a country.

Okay, it is a great way to manage crisis when you make sure you have a relationship with someone with power like "the president." (read the article).  However, in this case I don't known what will help. "I wish they have spoken to me." So president Obama says.  And what would you say? "Don't DO IT!"  Why did not anyone think this was a bad idea? (it may be a fun idea).

Does Sony Pictures have a higher purpose in producing this movie?

Because there is a difference between making fun of some historical individual who passed away and involving people who is still alive that is in great power.  Especially, when they are seen equivalent to "God" in their country.

On the other hand if it does get publish it is a great insult to North Korea and if it does go public in North Korea it can significantly shave off the power of dictatorship because they are no longer "untouchable."  Saying or doing the taboo is powerful. Romanian Revolution started with anonymous crowd booing, so if this is the right timing the movie can work as a "boo" too.

Either way it is an interesting psychological "war" an individual company began with another country.

For the article see: http://www.bloomberg.com/politics/articles/2014-12-23/obama-is-pals-with-sony-executive-he-said-never-called

How Mission Leads: What an Ordinary Staff at Papa Johns can teach us about Marketing, Sales, and Service.

How Mission Leads: 

What an Ordinary Staff at Papa Johns can teach us about Marketing, Sales, and Service.

So look at the picture, it’s that Philly Cheese Steak Large Pizza from Papa Johns and the 10pcs Chicken bites.  Okay, okay, it’s not the most healthiest thing on this universe but hey! Some lightning stroke me.

To defend my part I used to have an account with Papa Johns, and every other delivery stuff on planet and I do not have it anymore, thank you very much.

But the point is!

How much do you think that cost?

$30 with tip?

$25?

$20?

NONE!  ZERO! $0!

Okay just that for some who knows me will say, okay TAKA is doing that negotiation stuff again and showing off.

NO! NOT this time!

AND! There was a great teaching moment through this event that shows the importance of mission, values, translating it to group, and employees being the best marketer and salesperson to your brand.

This is what happened.  Lightning strikes, and I decided to order some pizza, for no reason.  I was planning to make some food for myself.  Moreover, I don’t like to eat pizza in the first place that much (yes that’s bull).  And I look for some things, but I guess Bellevue, WA is like the “nice” area, that they don’t do delivery pizza as much and I ended up with those usual choices (i.e., Pizza Hut, Dominos, Papa Johns, Little Caesars, etc.).  Well, I chose Papa Johns, I ordered the pizza online.

One problem!  I clicked on pick-up not delivery. Delivery was what I wanted!

So, I call to negotiate to change to delivery, as usual.  And the staff, Mr. Blake says sure!

10-20 minutes later.

Mr. Blake calls, and apologize that the store cannot deliver to my address because it is too far.

That makes sense that I was not able to send it as delivery in the first place.

I actually went back and checked.  You get a small red text at the top telling you “We're sorry. Papa John's does not offer delivery service for the address you entered. We do, however, have stores that offer carryout service.” Ahh.

Now so whose fault is it?  You know what, it is my error in the first place, well if you want to be an ineffective human being then you can say “It’s Papa John’s fault of having the text being so small!” or “It’s Blake’s fault who said okay we can deliver when they couldn’t!”

Stop being a BMW (B!tch, Whining, and Moaning  person) please!

Well the teaching comes here.  Blake, the ordinary staff, apologizes and makes the pizza (order) free, if I go pick it up!   

WOW!

In my mind I was planning for some negotiation of minor thing like a discount but not for FREE!

I jumped into my car and drove.

It was raining and plus there was some event and it took me a while to get to Bellevue downtown.

I was little suspicious but Blake as he claimed gave me the whole order for FREE.

Story does not end here. Because you are dealing with Dr. Taka Endo!

I asked:

Me: “Who is the decision maker for giving this pizza for free?”

Blake: “I am.”

Me: “Did you decided to give this free or is this part of the training?”

Blake: “I decided… well it is kind of part of training.  When events like this happen and there is some screw ups, I decide based on what will keep things ‘Fun’ because pizza should be a fun food.”

Me: “That’s awesome, I am surprised and you are amazing.”

Blake: “No, I’m not a good person, I just do some things.”

Me: “Well even there is training, not everyone can act based on great values.”

We shook hands and I got his name and he thanked me.

Debriefing:

What happened: There was a mess up where primary reason why for the problem was me and Blake gave me the pizza for free.

Why: Because he acted to resolve the problem based on his values/companies values.

What did we learn: Its when problems happen, that the integrity and strength of a company is challenged, and how much you have taught and trained the employee shows up.  Moreover, for an about $22-25 Papa Johns is getting great PR and Marketing from me writing this.  It cost them $22-25.  I have written this on blog, facebook, tweeter, and possibly use the story in my book.

Papa Johns mission is to create raving fans through “(a) authentic, superior-quality products, (b) legendary customer service and (c) exceptional community service.” And one of their core values are P.A.P.A (people are priority always).

The ordinary staff working in this company acted based on this mission and core values which aligned with his value/belief of “pizza is a fun food.”

My mentor/teacher, author of bestselling book on sales and teamwork, Blair Singer mentioned that these “code of honor,” a set rules each person follows, are essential to the company (any unit like family), and with it each employee will sell the product naturally.  For sure Blake has sold the product or the brand of Papa John’s really well to me.

And just like quality management guru, W. Edward Duming said, "statistically, quality is always cheaper [for the company]." Keep great quality product, service, and staff, with right marketing the company will explode in its value.

I don’t know this event generalizes to all Papa John’s but, one thing I can say is that ordinary guy is money for the company, and they should keep him.  Whoever trained him should get credit too. And if you are interested it is the Papa John’s by the Bellevue Square.

http://www.papajohns.com/about/pj_mission.shtm

I came home and writing this article, I ate the pizza, unfortunately the time elapsed too long and it is cold but makes my heart warm, and definitely was a FUN experience.

Awesome Experience trumps all benefits of what you are selling.

_________________________________________________________________________________

Oh, yes I am writing a book right now about targeted brain training, systematic self-help book that assesses and creates specific easy habits that people can continue subconsciously to succeed (like CBT homeworks we give in therapy but easier and more customized to the client) by effectively stimulating the brain to control brain chemicals, and strengthen neuron-connection/create new dendrites.  And by theory we can increase cells too.  

I will be asking friends to do some survey so if you see it please do it! And Help me out!

The book will be forwarded by Raymond Aaron, New York Times Bestselling Author of one of the dummies series, two of chicken soup series, and a book relating to business after he completed one of the toughest race on earth the “Polar Race” coming in 4^th place at age 62.  I have a publisher, and book architect (editor and program designer). So, it is really happening and really excited.

How to choose a good therapist /counselor/ psychologist/ mental health practitioner -Myth about Therapist-

Myth About Therapist

"How do I find a therapist like you?"

I actually got this question couple of times in my life as a practitioner and as ego stroking as it is (thank you for those who believes that I am outstanding), I really did not know the answer.

The actual question is:

"How do I find a good therapist?"

I wanted to know this too.  Because I wanted to be an outstanding therapist.

Thus, good amount of time, my graduate school research was about competence of the therapist.

Let me share you what I found.

Beginning with some myth about "Good Therapist"

*Following information is based on Dr. Scott D Miller's research (refer: http://www.scottdmiller.com/).

MYTH 1) A Therapist with a Higher Degree is Better.

I think many doctorate degree therapist will hate me for saying this, yet the research shows there is not much of a difference between those who are at doctor level, master level, and bachelor level.

This is because the first step of therapy requires real human interaction and communication.  Ability to build good human relationship does not reflect on the degree the person has.  The difficulty of mental health therapist to an medical doctors is that we need to not only get written consent to treatment but we need emotional and psychological consent from our clients/patients.  We need our clients to know us, like us, and trust us at a high level.

SO: Choose a person you can fully trust, 98% of building that relationship is the therapist's responsibility.

MYTH 2) A Therapist with More Experience is Better.

More Experience = Better Right?  WRONG!!!  More Practice = Better.  Think about it, we cannot correct our self when we are giving the actual therapy.  Imagine practicing basketball or piano, when you make a mistake you go back and practice until you be "perfect."  When do you think therapist does that?  "After graduate school when friends and your mentor bust your, you know what (if then), I don't know."

Another point:  Which do you think is better?  A Newly Graduated Therapist OR A Therapist Who Have YEARS of Experience?

Correct answer is, "A NEWLY GRADUATED THERAPIST" because they know the most CUTTING EDGE TECHNOLOGY and TECHNIQUES.

Of course, if you can confirm that the experienced therapist has been humble and has been keeping updating his/her knowledge and skills then they're better.  Good luck finding such people (like seriously).

MYTH 3) A Therapist who has Experienced What I am Going Through Before is Better.

Like Recovering Addict treating Substance/ Other Addicts, Like Ex-Depressed Person Treating Depressed, Parent treating parent, like Domestic Violence victim treating another DV victim.

WHO SAID THEY OVERCAME THEIR PROBLEM? OR APPLY WHAT THEY KNOW TO THEIR LIFE?

Have you ever seen a sales person not wearing, having, riding, etc. their own product?
SAME DEAL.

It is important to find a therapist that HAS WHAT YOU WANT.

What do I mean?  I mean if you want to be HAPPY then the therapist should look that they are HAPPY regardless of their experience.

The ability to care for you does not necessary come from that they also experienced the same thing.  More worst is when that person had that problem and resolved it effortlessly and does not know how but believe its easy to resolve.

They will have an attitude like "Why can't you just let it go?" "Why can't you resolve it, its so easy?"
It may be true but if they don't really know how, then I will bet you that you will be annoyed.

MYTH 4) A Good Therapist will Make Me Feel Good INSTANTANEOUSLY

Yeah... what you think a quick fix end up like?  Like Duct Tape on a toilet pipe, yes it does its job for now but is that your true goal? To have the same problem over and over and over and over again?

A Good Therapist will be upfront with you, that treatment will take time to truly be effective.  Specifically, in shortest 4, average 8, at maximum 26 sessions.  After 26 sessions there is some effect but other then maintenance or prevention of the problem it has not much of an effect.

Well, either way as effect size goes (how effective the treatment is to the symptoms), we do a better job then over the counter headache medicine or tooth pastes.  Long term for mild to moderate symptoms better and cheaper than medications.

MYTH 5) A Therapist Who Use a Particular Method is Better than Another

 According to the American Psychological Association official report, IF the therapy/treatment is STRUCTURED there is not much difference among "style" (methods).  Just choose what you like.  By the way if you're not sure about the styles, I'm not going to say "google it" rather I would suggest to check if the therapist can explain you the clear plan.  They "should" have one, if not, you know what to do. (However, give them at least 3 session to conceptualize and create the plan, by then your job is to give as much information to the therapist and check if you get the "bond" with them).