#59 - Former Universal Health Services Executive on The Behavioral Health Industry Evolution

By Stephen Hays

Martin Schappell spent 15 years as a leader at Universal Health Services (the largest inpatient psychiatric hospital operator in the United States) as a Senior Vice President in the Behavioral segment. He joins us to talk about the behavioral health care industry, how care has evolved over the last 30 years, and the impacts of our current climate on the mental health of the seniors in our population. In this episode we talked at length about why behavioral healthcare has changed so much, what is good about those changes as well as what is bad.  We also discussed where the opportunity is for entrepreneurs in this space.  Martin now serves as president and CEO of Shell Point Retirement Community where he has been for the last 4 years.  Shell Point is the second largest single site senior living community in the United States with 2,500 residents and 1,200 employees in Florida.  Martin’s behavioral health care industry experience and his firsthand knowledge from operating Shell Point give him unique insights into the mounting mental health differences   Links mentioned in the show: Universal Health Services, Shell Point Retirement Community   HERE ARE SOME OF THE THINGS WE TALKED ABOUT: Martin shares observations from his career which began as a licensed marriage counselor, and eventually led him to behavioral health care hospital management and into senior management at one of the largest providers in the country. Martin talks about how he believes he was really wired for “business” versus being a “clinician” but that his clinical training made him a great leader. He told me that learning about people, their motivation, understanding mental illness, etc. has influenced his leadership style. As Martin transitioned from the non-profit clinical world to Charter Behavioral Health, he transitioned into a business management role. Eventually, Charter failed, and sold hospitals to UHS in bankruptcy during 2000.  That led Martin to land at UHS where he served as a Senior Vice President in the Behavioral segment.  The delivery of behavioral health care has evolved greatly over the last 30 years. Delivery has become more efficient.  30 years ago, it was very common for people to be hospitalized for 3 months at a time for acute mental health problems.  Now it’s more common to be hospitalized for 3 days or less at a time.  The industry has prioritized efficiency over individualized care as the reimbursement model has shifted over the years and while here are positive consequences on system capacity, there are negative consequences on the quality of individualized care as well. We talked about the natural evolution that a person goes through during treatment and how this process takes time. It’s a very personal and individual process that is different for everyone.  So at some point, standardization is not in the best interest of the people this system is trying to help.  Everyone’s pace may be a bit different.  But to accelerate that beyond someone’s ability to gain insight is rushing the process. What drove this duration change?Some of this is because of the cost of treatment – we reduced length to reduce cost.  We are automating, and standardizing treatment when it is a very individual thing.  Therapy is by design, a very inefficient process so it is not going to be possible to standardize it for everyone. We talked about the Art versus the Science of recovery and treatment. We got into the balance between the two concepts and how getting that balance right leads to a highly individualized level of care which the modern-day system is leaning away from. Where is the greatest opportunity for entrepreneurs in the mental health startup landscape?  We talked at length about this. Martin was clear that his top priority is around testing and measurement. He explains that we need to find solutions that standardize the assessment, diagnosis, and validation of diagnosis in the early days of treatment.  Often times, due to a lack of accurate testing, we misdiagnose and then establish a treatment plan that does not work leading to years of bad experiences and an unhealthy human. We spent time talking about senior mental health care and how seniors are disproportionately being driven into self-isolation and loneliness during this time of COVID. There are consequences to that isolation and withdrawal.  Ove the next 6-12 months we will likely see an escalation of mental health issues in seniors as a result and we talked about what we can be doing about it since we know we can predict it. Connect with the Stigma Podcast in the following ways: Patreon Page,  Website, Twitter, Facebook, LinkedIn, Email Connect with host Stephen Hays here: Stephen Hays Personal Website, Twitter, LinkedIn, What If Ventures (Mental Health Venture Fund)    

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