A psychiatrist leader of the year

Over the past year, I've blogged here about many well-known societal leaders and what leaders in behavioral healthcare can learn from them. These include the Biblical Joseph, Nelson Mandela, Tutu, Aung San Suu Kyi ("The Lady"), Brandon Marshall, and Pope Francis. More formally, each year this publication, Behavioral Healthcare, selects five Behavioral Healthcare Champions who "reflect the special brand of dedication, courage, inspiration, and excellence that makes the leaders of behavioral health organizations unique."

Aren't recognizing all of these leaders enough, even if none of them are psychiatrists? Why focus on a psychiatrist, given that leadership by psychiatrist of behavioral healthcare systems has diminished over recent decades? And what validity does a selection by a committee of one - me - have?

The simple answer to these questions is that I'm a psychiatrist and think that the broad-based training of psychiatrists still offers unique leadership potential. Moreover, an excellent candidate for a promising system has emerged this past year. My own bias is supported and supplemented by national coverage for his work in two very different states, Connecticut and North Carolina.

That psychiatrist is John Santopietro, M.D. The year of his most notable leadership started on that most tragic day of December 14, 2012. That was the day of the massacre of 26 people, including 20 young children, at Sandy Hook Elementary School in Newtown, Connecticut. At that time, Dr. Santopietro was President of the Connecticut Psychiatric Society. As such, he had the responsibility to lead the disaster response of psychiatrists. Working 60 hours straight in coordinating 150 volunteer psychiatrists, they provided "therapy by walking around," as Dr. Santopietro called it. He, himself, did not go to the site, wisely recognizing where he was needed most and, moreover, that his subjectivity would be compromised since he had three young boys of his own, aged 11, 7, and 4. For this work, the Connecticut Psychiatric Society honored him with its Service Award, even after he had moved away.

One day short of the one year anniversary of this tragedy, and we know how psychologically important first year anniversaries can be, that crisis was recalled by the Charlotte, Carolina Observer. Why Charlotte, Carolina? Dr. Satopietro was recruited to be the first Chief Clinical Officer for Behavioral Health at Carolinas Healthcare System. In so doing, he was moving from a state doing relatively well in public mental healthcare to one well behind and deteriorating. North Carolina was spending 20% less on public mental health now than the relatively low amount a decade ago. Although some might say this is a positive, North Carolina has the lowest state inpatient bed ration in the country. Yet, the Carolina Healthcare System, which is a private, not-for-profit system and the second largest non-profit care system in the USA, decided to pick up the slack. This decision included building a new psychiatric hospital, even though it is expected to lose money. The story of this expansion and its potential for being a national model for integrated health and mental healthcare is told in the video, as well as in the article "Sweet Tea and Mental Health Transformation."

What important characteristics of a psychiatric leader is Dr. Santopietro exhibiting? No question that he has a track record of accomplishment, both in a crisis and everyday clinical work. He is knowledgeable about the complexity of mental healthcare. He seeks out mentors and, in fact, a mentor recommended him for this job. He asks for help when he doesn't know the answers, including from Rosalynn Carter when he got to North Carolina. He knows how to bridge cultures, including the importance of drinking sweet tea in the South. He knows himself. And he knows that sometimes two heads are better than one, as he values his co-leader administrator.

Perhaps most importantly for reducing stigma, he has found that metaphors, as in "sweet tea," are a good way to educate the public. He describes the Newtown shooting as a "psychological nuclear bomb" and the on-site psychiatrists as "human radiation absorbers." He knows the behavioral healthcare system needs to be "engineered," and that the mass shootings by someone with untreated mental illness is like a bridge collapsing. He describes the dyad leadership model as like a pair of binoculars, having "two viewpoints fixed in a unique way which makes depth perception and clarity easier."

In designating this particular psychiatrist, note that it as "A" psychiatrist leader, not "The" psychiatrist leader. There may be many others out there of equal or more importance. If you know of any of them, let us know who and why. 

Wishing you and our patients all a happy and (mentally) healthy New Year!