YCSC State of the Department: Looking Ahead to 2025

Transcript

• 00:00Welcome, everyone.
• 00:02I'm so glad that you
• 00:03can join.
• 00:05And to our colleagues on
• 00:06Zoom, thank you so much.
• 00:08I hope you can hear
• 00:09okay and apologize for a
• 00:10bit of the technical difficulties
• 00:12in the very beginning.
• 00:13So welcome back from our
• 00:15winter break.
• 00:17Hang on. The slides are
• 00:18not moving. Where did Kyle
• 00:20and the group go?
• 00:23Damn.
• 00:24Okay. We'll do it this
• 00:25way. So welcome back from
• 00:27the winter break.
• 00:28I'm really so glad that
• 00:29you're here. I hope you
• 00:30had actually a very restful
• 00:32restorative time.
• 00:34This is always a really
• 00:35lovely time to welcome everyone
• 00:37back. We have a we
• 00:38have a peculiar
• 00:39rhythm to our beginnings of
• 00:41the year.
• 00:42We actually have two years.
• 00:45We have the beginning of
• 00:46our academic year, in September
• 00:49where I welcome everyone new.
• 00:51We pause, we reflect, we
• 00:52talk about what's ahead, and
• 00:54then we have the beginning
• 00:55of the calendar year and
• 00:57the new year, and that's
• 00:59where we're at.
• 01:01It is a peculiar rhythm,
• 01:03but I'm very I think
• 01:04it makes some sense, to
• 01:05actually look ahead in the
• 01:07newness of the year to
• 01:08what's ahead as well.
• 01:11The other thing though that
• 01:12I've often brought forward when
• 01:14we've had these sessions
• 01:16is to talk with you
• 01:17about the winter solstice.
• 01:19And I think even last
• 01:21year we brought up the
• 01:21winter solstice which was on
• 01:23December twenty first
• 01:25and I do hope you're
• 01:25actually noticing that there is
• 01:27twenty five minutes now more
• 01:28light since December twenty first
• 01:31as of today.
• 01:32And as of the middle
• 01:33of January you will start
• 01:34gaining two minutes a day
• 01:35and as of the middle
• 01:36of February you'll start gaining
• 01:37three minutes a day. And
• 01:39so the winter solstice is
• 01:41actually really important.
• 01:42It is light bringing into
• 01:44dark or light darkness into
• 01:46light, light coming forward.
• 01:49The other part though about
• 01:50the winter solstice that's often
• 01:52very much celebrated
• 01:54is
• 01:56is that it actually is
• 01:57a time of rejuvenation.
• 01:59And in many cultures, actually,
• 02:01it's been to a time
• 02:01of restoration, renewed life,
• 02:04warmth coming, spring coming.
• 02:07And it's actually on this
• 02:09point
• 02:10that that I want to
• 02:11pause a bit more today
• 02:14because in putting together this
• 02:15talk for today,
• 02:17I have found more of
• 02:18a dilemma
• 02:19because I often actually, I
• 02:21know remind us
• 02:24that
• 02:25twenty twenty four
• 02:27and indeed the beginning, the
• 02:28very literal beginning of New
• 02:30Year's Day was a challenging
• 02:32time.
• 02:34And I always want to
• 02:36remind us of that as
• 02:37we celebrate our opportunities, as
• 02:40we think about all that's
• 02:41ahead
• 02:42and all that's good.
• 02:43I also want to think
• 02:45with us about all that's
• 02:46happening around us. It's a
• 02:47kind of realistic
• 02:49optimism.
• 02:51But the dilemma that I've
• 02:52experienced today or in putting
• 02:54this talk together for today
• 02:57is how with so much
• 02:58going on,
• 03:00so much uncertainty
• 03:03that deeply impacts children,
• 03:05that deeply impacts families,
• 03:08that deeply impacts many of
• 03:09the missions that we serve
• 03:10and indeed our central mission
• 03:13being to help children, to
• 03:15help children flourish, to protect
• 03:17children.
• 03:18How do we also at
• 03:19the same time
• 03:21celebrate
• 03:22all that we're doing here?
• 03:24How do we actually keep
• 03:26a realistic optimism
• 03:28while at the same time
• 03:29really honoring that mission for
• 03:31all children?
• 03:33And so that's what I
• 03:34want to do today is
• 03:36to actually be a little
• 03:37bit, a tiny bit different
• 03:39in our state of the
• 03:40department, if you will, or
• 03:41as Charlton reminded me the
• 03:43state of the union.
• 03:45And what I'd like to
• 03:46do is to bookend,
• 03:49really to talk about department
• 03:51snapshots,
• 03:52our faculty, our finances development,
• 03:54talk about our strategic goals.
• 03:56And remember, we have this
• 03:57peculiar rhythm,
• 03:59so this will be highlights
• 04:00since September.
• 04:03But I also want to
• 04:03come back at the end
• 04:05and I want to reflect
• 04:06on centering children
• 04:08and to bring into that
• 04:10several news stories that came
• 04:12out over the holidays,
• 04:14over our holiday break,
• 04:16to, to bring home that
• 04:18theme.
• 04:19So it'll be a bookend.
• 04:22But
• 04:23to turn then to our
• 04:24department faculty,
• 04:26finances, etcetera,
• 04:27we could actually stop right
• 04:29now on this slide.
• 04:31We are an extraordinarily
• 04:32diverse department. We are productive
• 04:35as Henry James said, we
• 04:36are a blooming buzzing place.
• 04:39He used that to refer
• 04:40to babies, but we're actually
• 04:41a blooming buzzing department.
• 04:44We're a caring department, and
• 04:45we could just stop right
• 04:46there.
• 04:48But I wanna give you
• 04:49a few more details
• 04:51about that, but feel good
• 04:52about the fact that we
• 04:54actually are a very creative
• 04:56department.
• 04:57See if this does actually
• 04:58work. Don't do it this
• 04:59way.
• 05:00Let me change the slides
• 05:02this way.
• 05:04So just to start, we
• 05:05actually are growing.
• 05:06I show you this slide
• 05:08regularly, but we are now
• 05:09a hundred and ninety faculty.
• 05:11We're nearly two hundred faculty.
• 05:13We need to actually stop
• 05:14saying that we're five hundred,
• 05:16we're almost five
• 05:17fifty people.
• 05:20And what importantly
• 05:21is to look at our
• 05:22gender and racial distributions.
• 05:25We are nearly
• 05:27two thirds women across the
• 05:29department
• 05:30and we are nearly a
• 05:31third
• 05:33of underrepresented
• 05:34minorities across,
• 05:36that's on average across.
• 05:38That doesn't mean that we
• 05:39don't have work to do,
• 05:40we still have work to
• 05:41do but we need to
• 05:42really celebrate,
• 05:44that our department is becoming
• 05:46increasingly diverse.
• 05:48And I mean that not
• 05:49just in our racial diversity,
• 05:51but also in our diversity
• 05:52of viewpoints, diversity of experience,
• 05:55and we need to continue
• 05:56to welcome and bring that
• 05:57in to the department.
• 05:59But it is amazing that
• 06:01we are five forty five
• 06:02people as of this point.
• 06:05Just to take a closer
• 06:06look at our faculty
• 06:08from assistant to full professor,
• 06:10you can see that progression.
• 06:12We still have work to
• 06:13do to make that be
• 06:14a little bit more balanced
• 06:16and more even across.
• 06:18In our research tracks, we
• 06:19have, as you can see
• 06:21there, and still we need
• 06:22to continue to try to
• 06:23work to make that more
• 06:24balanced across.
• 06:26And then in our social
• 06:28work track,
• 06:29I still continue to have
• 06:30the mission of actually trying
• 06:32to have a progression
• 06:34for our social work faculty.
• 06:36But this gives you a
• 06:37sense of the distribution
• 06:38of faculty.
• 06:41Here is our total operating
• 06:44finances and I'm very much
• 06:45glad to go over any
• 06:46of this.
• 06:47Our revenue is now fifty
• 06:49seven point eight million. So
• 06:50we're coming close to sixty
• 06:53million and our expenditures are
• 06:54fifty nine point eight. So
• 06:56the gap between our revenue
• 06:58and our expenditures is closing,
• 07:00which is great.
• 07:01And I'll explain that a
• 07:02little bit more.
• 07:05And our grant revenue were
• 07:06up, five point seven million
• 07:08from last fiscal year, which
• 07:10is also great news.
• 07:13Our annual billings and patient
• 07:14care, as you can see,
• 07:15eleven point six and our
• 07:17annual collections, five point seven.
• 07:19The reason I have those
• 07:20two red arrows to continue
• 07:22is to continue to remind
• 07:23you to advocate always for
• 07:25the reimbursement
• 07:27for mental health services for
• 07:28children.
• 07:30They just don't get reimbursed
• 07:31at the what they what
• 07:32we bill is what they
• 07:34are what is appropriate,
• 07:36what the reimbursement is is
• 07:38what commercial payers pay.
• 07:40So that's the gap.
• 07:42But let me go to
• 07:43why we've closed that gap
• 07:45in the revenue
• 07:47and to remind you that
• 07:48funds flow that we've now
• 07:49been talking about
• 07:51for two years, how funds
• 07:52are allocated from the health
• 07:54system to the school of
• 07:55medicine to support clinical care.
• 07:58The boxes that we're most
• 07:59concerned about are these,
• 08:02that is that we are
• 08:03now paid for the work
• 08:05we do for the patients
• 08:07we see.
• 08:08We also get funding for
• 08:10clinical directorships and the clinical
• 08:12overhead is covered
• 08:13and the salient points are
• 08:15these,
• 08:16that the funds are now
• 08:18provided exactly for patients seen,
• 08:20that's great news. It should
• 08:22be. Right? That does make
• 08:24logical sense. It should be
• 08:26paid for what you do.
• 08:28The fixed cost such as
• 08:29paying for our space and
• 08:30the assessments on our clinical
• 08:32revenue are now transferred centrally,
• 08:34so are not on our
• 08:35books.
• 08:36And so our unfunded clinical
• 08:38gap has shifted from six
• 08:40point six million to now
• 08:41just around two million.
• 08:43That's the gap you saw
• 08:44between
• 08:45revenue and cost.
• 08:48So that's great news
• 08:50because there's a lot of
• 08:51things we can do to
• 08:53close that gap even further.
• 08:55That is really great news.
• 08:58And it is all because
• 08:59of the increasing partnership between
• 09:01the health system and the
• 09:03school.
• 09:06Now the other thing that
• 09:07has changed just to emphasize
• 09:09that
• 09:10what has changed under funds
• 09:11flow is nothing about working
• 09:13with patients that's changed.
• 09:15People actually should be free
• 09:17to do exactly what they
• 09:18always have done working with
• 09:20patients.
• 09:21What has changed is just
• 09:22from a central level that
• 09:24the cost that we bore,
• 09:26the assessments, the space, etcetera,
• 09:28is all transferred. That's no
• 09:30longer on us.
• 09:32Now I don't wanna get
• 09:33too much in the weeds
• 09:34about that, but I just
• 09:35want you to know that
• 09:36that's really important,
• 09:38not just from a financial
• 09:39point of view, but it's
• 09:40important because it signifies the
• 09:42partnership
• 09:43that's happening
• 09:44around between the health system,
• 09:46the school, and the emphasis
• 09:48on behavioral health.
• 09:50And I'll keep coming back
• 09:51to that.
• 09:54This
• 09:55is another slide that I
• 09:56often have showed you, but
• 09:58I've updated that it's our
• 09:59revenue of fifty seven point
• 10:01eight million,
• 10:02but as our grants have
• 10:04increased, they are becoming a
• 10:05greater portion of our revenue.
• 10:08In the past, we depended
• 10:10on nearly a quarter for
• 10:12gifts and endowments.
• 10:14And that's now now to
• 10:15about twenty percent that we
• 10:17depend on gifts and endowments.
• 10:19Twenty percent is not insignificant.
• 10:22And so let me just
• 10:23tell you, show you a
• 10:24little bit about that.
• 10:27We had a very, very
• 10:28successful
• 10:29meeting of the associates this
• 10:31November, our first in person
• 10:33meeting in several years.
• 10:35Actually, great to be in
• 10:37person.
• 10:38And had several wonderful panels.
• 10:41The theme suggested by our
• 10:42associates was the impact of
• 10:44the digital world on children's
• 10:45health
• 10:47and we were very fortunate
• 10:49to have Andrew Solomon,
• 10:52a writer
• 10:53who is now writing about
• 10:55teen suicide in the relationship
• 10:57to social media,
• 10:59impressed a number of our
• 11:00associates
• 11:01and starting to yield gifts
• 11:03that I will talk about
• 11:04a little bit later.
• 11:05But this is a theme
• 11:06that has become quite strong
• 11:08for us,
• 11:10which then reminds me to
• 11:12tell you just a little
• 11:12bit about why we fundraise.
• 11:16There's when you think about
• 11:18gifts and endowments,
• 11:19you can have two kinds
• 11:20of of
• 11:22donor activity.
• 11:23One is to put in
• 11:24a fund that lasts forever.
• 11:26The other is to give
• 11:27us money to use now,
• 11:29that's the type.
• 11:30It can come to the
• 11:31faculty. It can come to
• 11:32the department.
• 11:33It can be restricted that
• 11:35is you can use it
• 11:36for only this or it
• 11:37can be unrestricted.
• 11:40And what I wanna show
• 11:41you is the distribution
• 11:43of our restricted, unrestricted department
• 11:45faculty funds
• 11:47and I'll show you that
• 11:48on the next slide.
• 11:51And this compares fiscal years
• 11:53and so you should look
• 11:55at fiscal year twenty four,
• 11:57the last column.
• 11:59Let me see if this
• 12:00pointer works.
• 12:02You should look the pointer
• 12:03doesn't work. So look at
• 12:04fiscal year twenty four, and
• 12:06the top column or the
• 12:07top line rather
• 12:09are the funds that are
• 12:10for the department's broad use,
• 12:13but in parenthesis
• 12:15are the amount of those
• 12:16funds that are restricted.
• 12:19So for the department
• 12:20broadly used,
• 12:22ninety eight percent of the
• 12:23funds that we have, that
• 12:25half million that we have
• 12:26are restricted,
• 12:28meaning they can only be
• 12:29for a specific purpose.
• 12:32Under the faculty control is
• 12:33as you see that number
• 12:35but about a third of
• 12:36those are restricted, two thirds
• 12:39are unrestricted,
• 12:40can be used for anything.
• 12:42So unrestricted gifts to the
• 12:44faculty or the department give
• 12:46us the most flexibility,
• 12:48that's why we fundraise.
• 12:50We fundraise for that twenty
• 12:51percent
• 12:53and that's why we actually
• 12:54fundraise to try and get
• 12:56broader, broad flexibility.
• 12:59But I wanted you to
• 13:00have a sense of what's
• 13:02available to the department
• 13:03broadly
• 13:04and what's available to the
• 13:06faculty.
• 13:07And I'm glad to answer
• 13:08any questions about that.
• 13:13And I often put Krista
• 13:14at the end, which is
• 13:15never fair to Krista.
• 13:17I want to put Krista
• 13:18in the beginning because communications
• 13:20are definitely what hold us
• 13:22together.
• 13:23Communications are what we do
• 13:25and pretty soon we will
• 13:26not be able to list
• 13:27on one slide all the
• 13:29things that Krista is doing
• 13:30and trying to communicate.
• 13:33She wanted me to be
• 13:34sure to remind everyone that
• 13:36the clinical website is under
• 13:37reconstruction and updating. I'm sure
• 13:39there'll be celebration about that,
• 13:41but that that she's working
• 13:43very hard on that and
• 13:44deeply always available for any
• 13:47kind of input
• 13:48about how best to communicate,
• 13:50I would actually what I
• 13:52would really hope
• 13:54is that we are communicating
• 13:56so well that we don't
• 13:57need a State of the
• 13:58Union
• 13:59because you already know it
• 14:00all. We can just get
• 14:01together and we can discuss
• 14:03and we can talk.
• 14:07So I wanna turn now
• 14:08to our strategy and highlights
• 14:10since September.
• 14:12And some of the things
• 14:13that I'm gonna point out
• 14:14are things that I also
• 14:15pointed out in September because
• 14:17I wanna make the link
• 14:18between.
• 14:20And I also am always
• 14:22extraordinarily aware
• 14:23that there's so much going
• 14:24on in this department
• 14:27that I will inevitably,
• 14:29miss something, not highlight something
• 14:32that is not a good
• 14:34thing but it is a
• 14:35good thing that there's so
• 14:36much going on that it's
• 14:37impossible to cover it all.
• 14:40And I'm gonna try to
• 14:41be just highlights since September.
• 14:45So first, just a reminder
• 14:47of why do we need
• 14:48to think strategically?
• 14:50Why is being strategic incredibly
• 14:53important?
• 14:54Being strategic means to imagine
• 14:56where a field is going.
• 15:00Where do we want to
• 15:01be
• 15:02to anticipate the trends, to
• 15:04take the big big picture
• 15:05view and imagine who do
• 15:07we want to be and
• 15:09how do we get there?
• 15:11You have to have both
• 15:13tactical and strategic thinking.
• 15:15Tactical allows you to take
• 15:17your big picture vision and
• 15:19put it into place,
• 15:21but you must be able
• 15:22to imagine where the field
• 15:24is going.
• 15:26And I showed you in
• 15:27September,
• 15:28based on a number of
• 15:29discussions from so many of
• 15:31you in faculty meetings and
• 15:33and all the discussions that
• 15:34we have,
• 15:35these are some of the
• 15:36predictions of where we're going
• 15:38and then you'll start to
• 15:39hear those echo in various
• 15:41of the things that are
• 15:42happening.
• 15:43There's growing use of digital
• 15:45platforms for care,
• 15:47that was part of the
• 15:48theme of the associates.
• 15:50There's a growing reliance on
• 15:52artificial intelligence
• 15:53to optimize care, not just
• 15:55outside there in radiology, for
• 15:57example, where it's been for
• 15:59several years, but especially in
• 16:01our field.
• 16:03You're starting to see multidisciplinary
• 16:05networks come together,
• 16:07to provide care
• 16:09out not just in academic
• 16:11centers, but to provide care
• 16:13virtually.
• 16:14But those groups
• 16:16now need us to teach
• 16:18them.
• 16:19There's the need for enhanced
• 16:20professional development in those groups
• 16:22that are forming
• 16:24to provide the care.
• 16:26There's a much, much, much,
• 16:28and this is a good
• 16:28thing, a much stronger push
• 16:30for evidence based and behavioral
• 16:32health. We are we're further
• 16:34behind a number of our
• 16:35colleagues in other fields.
• 16:38How do we what are
• 16:39the metrics that we have
• 16:40to show that our treatments
• 16:42are effective
• 16:44and how can we disseminate
• 16:45those metrics to other other
• 16:47groups?
• 16:49Definitely increasing awareness of inequities
• 16:52and children and adolescents access
• 16:54to care
• 16:56and as you'll hear as
• 16:58we keep going here there's
• 17:00an increasing awareness that we
• 17:01need to be talking about
• 17:03child health,
• 17:04not child mental, physical health,
• 17:07but child health,
• 17:09and that that serves many
• 17:10advantages, but it especially serves
• 17:12an advantage for families,
• 17:14but it is a growing
• 17:16theme.
• 17:18So with that in mind,
• 17:20here are some of the
• 17:21broad strategic, these are broadly
• 17:23stated vision for our department
• 17:25missions.
• 17:26In research, we want to
• 17:27continue really to support the
• 17:29development of clinician scientists,
• 17:32to foster collaboration
• 17:33around child health,
• 17:36and some strategic faculty recruitments
• 17:38in these areas where we
• 17:40do see change happening,
• 17:42such
• 17:43as informatics,
• 17:44social
• 17:45media, even climate change is
• 17:47an increasingly
• 17:48important area for children's mental
• 17:50health,
• 17:51trauma.
• 17:53Education,
• 17:54we want to do
• 17:56we want to be the
• 17:57voice of professional development for
• 17:59the child mental health community.
• 18:02We want to continue to
• 18:03have an impact on growing
• 18:05a pipeline of mental health
• 18:06clinicians who are really prepared
• 18:08to deliver the most up
• 18:10to date care.
• 18:12And we need to enhance
• 18:13our pre med and medical
• 18:14student experience in our field.
• 18:16We've been very successful at
• 18:17that, but we need to
• 18:18continue to do that.
• 18:20Clinical
• 18:22innovation and models for how
• 18:23do we sustain behavioral health
• 18:25services and when I show
• 18:26you what's happening in behavioral
• 18:28health services you will you
• 18:29will intuitively get why we
• 18:31need to think about how
• 18:32do we sustain it.
• 18:35We need to become or
• 18:36continue to become
• 18:38the provider for the network,
• 18:39the Children's Hospital Network, which
• 18:41includes not just this hospital
• 18:43across the street
• 18:45but includes Bridgeport, Lawrence and
• 18:47Memorial,
• 18:48the hospitals that are a
• 18:49part of the Yale New
• 18:50Haven network
• 18:52and we need to think
• 18:53about how we not think
• 18:54about, act on how we
• 18:56continue to improve access to
• 18:57care through digital technology.
• 19:00And then for culture climate,
• 19:02we want to be experienced
• 19:04as the inclusive
• 19:05department
• 19:06that has respect for all.
• 19:09We center, we honor diversity,
• 19:11we center social justice.
• 19:13That is our broad goal.
• 19:15And Tara and her team
• 19:17have made considerable progress in
• 19:18that way and we'll talk
• 19:19more about that.
• 19:22I keep forgetting that it's
• 19:23not working.
• 19:24So to our research and
• 19:26scholarship mission that Tom, as
• 19:28vice chair of research, brings
• 19:29forward,
• 19:30you've seen this particular metric
• 19:32and not or schematic
• 19:34showing our various research areas,
• 19:37I want to actually say
• 19:38that we've had a tremendously
• 19:39productive year with grants and
• 19:41contracts and
• 19:42considerably congratulations
• 19:44to everyone.
• 19:46Excuse me.
• 19:48We've had nearly twenty eight
• 19:49million, annual
• 19:51across forty two awards.
• 19:53These are just a few
• 19:54of the people. This is
• 19:56not all of them,
• 19:57but a few of the
• 19:58people who have gotten grants
• 19:59over them this particular year,
• 20:01new grants.
• 20:02So it's been remarkably productive.
• 20:04And remember when I showed
• 20:05you that snapshot,
• 20:07our grant revenue was up
• 20:08near five point seven million.
• 20:10That just reflects everybody's scientific
• 20:13creativity
• 20:14and enormous work to do
• 20:16this,
• 20:17so congratulations,
• 20:18it's great.
• 20:20But grants are only part
• 20:21of the story.
• 20:23We've had two sixty six
• 20:24publications over twenty twenty three
• 20:26to twenty twenty four from
• 20:27the Child Study Center faculty,
• 20:30That's remarkable.
• 20:32And these are just
• 20:33a snapshot
• 20:34of those,
• 20:36but that really is remarkable.
• 20:38And when you look at
• 20:39the journals that they're published
• 20:40in, they're incredibly diverse,
• 20:43diverse impact, diverse themes. It's
• 20:46just just just beautiful to
• 20:47see.
• 20:48So
• 20:49this is a scholarship coming
• 20:51out that we we have
• 20:52an impact. We have an
• 20:53impact on the child mental
• 20:55health field.
• 20:57We're also coming from the
• 20:59associates.
• 21:00An associate just before the
• 21:02holiday break
• 21:03made a gift of one
• 21:04hundred thousand dollars
• 21:06with the idea of setting
• 21:07up a pilot grant program
• 21:09and the impact of social
• 21:10media on child mental health.
• 21:13So please stay tuned for
• 21:14for the, if you will,
• 21:16local RFP
• 21:18for that pilot grant program.
• 21:20And this particular person,
• 21:23is interested in how we
• 21:24take that and can we
• 21:25grow a bigger program
• 21:27in social media and
• 21:29impact on child mental
• 21:31health. Certainly a pressing theme
• 21:33pressing theme by the surgeon
• 21:35general's report, pressing theme from
• 21:37all the kinds of publications
• 21:39coming out, and something that
• 21:42quite frankly that we are
• 21:43a little bit behind on
• 21:44where other places have already
• 21:46started to move forward on
• 21:48this topic.
• 21:49So it's something that we
• 21:50can bring our best clinical
• 21:52science to.
• 21:54So please stay tuned.
• 21:57And then as I showed
• 21:58you, those are the research
• 21:59goals, but here are some
• 22:01of the very concrete activities
• 22:03that Tom and his team
• 22:04are bringing forward
• 22:05to achieve those research goals,
• 22:08To continue to develop a
• 22:09research resource library so someone
• 22:12who's writing a grant can
• 22:13go look at that library
• 22:14and get some models.
• 22:17To develop a unified research
• 22:19recruitment approach. Tom, thanks so
• 22:21much for your work on
• 22:22that because that's just gonna
• 22:23be a game changer
• 22:25for our clinical research.
• 22:28Research to practice, how do
• 22:29we actually take all that
• 22:31we're doing
• 22:32in those two hundred and
• 22:33sixty six publications?
• 22:35How do we actually take
• 22:36that and translate it more
• 22:38quickly
• 22:39into practice?
• 22:40Not only getting patients to
• 22:42participate, but actually impacting the
• 22:44treatment that we provide
• 22:46and then to facilitate, for
• 22:48example, shared data management
• 22:50and statistical support. These are
• 22:52just a handful of the
• 22:53things
• 22:53that Tom and his team
• 22:55are bringing together
• 22:56to actually facilitate those goals.
• 23:01Turning to education,
• 23:03with our newly appointed Julie
• 23:05Wolf appointed as vice chair
• 23:07professional development,
• 23:09her task is both external
• 23:11facing and internal.
• 23:12So externally facing reaching mental
• 23:15health professionals,
• 23:16pediatricians,
• 23:17educators,
• 23:19internal facing
• 23:20to develop professional development for
• 23:22all of us.
• 23:23How do we continue to
• 23:25learn?
• 23:26Professional,
• 23:27our professional training programs,
• 23:29child psychiatrists, psychologists, social workers,
• 23:32pediatricians
• 23:33And then also our work
• 23:34with medical students and pre
• 23:36professionals.
• 23:37Those are our internal,
• 23:39professional development
• 23:41and we then have our
• 23:42external.
• 23:43But let me show you
• 23:44some of the things that
• 23:45are happening in each of
• 23:46those areas.
• 23:48I mentioned in September, but
• 23:50this has now been verified
• 23:51by January,
• 23:52that we are actually an
• 23:54official
• 23:55training site for the REACH
• 23:57training program for pediatricians
• 23:59in child mental health.
• 24:01We have a shared faculty
• 24:02between the department of pediatrics
• 24:04and here
• 24:05and we're now training community
• 24:07pediatricians in basic child mental
• 24:09health.
• 24:10Our goal beyond that now
• 24:12is we'll follow what the
• 24:13reach people want us to
• 24:14follow for one hundred and
• 24:16one but now we can
• 24:17create our level two zero
• 24:18one.
• 24:19So pediatricians that, for example,
• 24:21Kasha want to learn more
• 24:23about autism and infants in
• 24:25with autism, we can have
• 24:26a two zero one for
• 24:28that.
• 24:28So we can use the
• 24:29REACH platform then to
• 24:32develop a much broader portfolio
• 24:34of training for pediatricians.
• 24:37Another part, there's so many
• 24:39of our other faculty that
• 24:40are doing a lot of
• 24:41community development
• 24:42examples. So,
• 24:45Ellie
• 24:45has TED talk around his
• 24:47space treatment
• 24:48and a book around that.
• 24:50Kasia
• 24:51recently had a very lovely
• 24:53program,
• 24:54highlighting movement disorders, tics movement
• 24:57and the relation in autism,
• 24:58really lovely
• 25:00bringing in people of a
• 25:01state of the art.
• 25:02Our colleagues in the Center
• 25:04for Emotional Intelligence,
• 25:05RULER regularly out there professional
• 25:07development for educators.
• 25:09We have our grief sensitive
• 25:11project,
• 25:12again, healthcare professionals around grief
• 25:15with families.
• 25:17Chris Cipriano just
• 25:19had the first, her first
• 25:20collaboratory
• 25:22continuing education event in this
• 25:24past spring. So we have
• 25:26a lot of professional development
• 25:28going on in this department
• 25:30that is externally facing.
• 25:32How do we bring it
• 25:33together under a unified signature
• 25:36so that people go online
• 25:38and say, yep, I want
• 25:39to, I'm interested in those
• 25:41five things.
• 25:42That's Julie's task.
• 25:45We also have a lot
• 25:46of professional development happening here
• 25:49for us
• 25:50and I've showed you some
• 25:51of this in September.
• 25:53Darren is leading a lot
• 25:54of it around leadership.
• 25:56These are two lectures to
• 25:58look forward to. Cheryl Bellamy
• 26:00will come in February
• 26:01talking about leadership.
• 26:03Catherine Sandler coming from London,
• 26:06also in June talking about
• 26:08her work and leadership and
• 26:10mental health.
• 26:12Darren's blog continues. She's doing
• 26:15peer coaching and pediatrics.
• 26:17We actually now have a
• 26:18puppetry workshop.
• 26:20I'm so excited about this.
• 26:22I'm just gonna be a
• 26:23fly on the wall, but
• 26:25a puppetry workshop for clinicians,
• 26:27how do you use puppetry
• 26:28and working with kids that
• 26:30will be in the spring.
• 26:31These are just again some
• 26:32of the examples of internal
• 26:34professional development.
• 26:37We, thanks to Veronica's
• 26:39great work, have reestablished
• 26:41the developmental pediatrics fellowship now
• 26:44in collaboration between pediatrics and
• 26:46here. So we have now
• 26:48a formal that has happened
• 26:49since September.
• 26:51And I showed you this
• 26:53in September, but just to
• 26:54note Andres' work with the
• 26:56medical students and how much
• 26:57we have medical student engagement
• 26:59in the Child Study Center
• 27:01as again a part of
• 27:02our internal
• 27:03professional development
• 27:05and then our eight week
• 27:07summer internship
• 27:08that happens in collaboration now
• 27:09with the Department of Pediatrics
• 27:11and Developmental Science
• 27:13where we have anywhere between
• 27:15twenty twenty one students joining
• 27:18us from all over.
• 27:21But I want to actually
• 27:22give you a sense of
• 27:23another professional development goal and
• 27:26this might be a bit
• 27:26of an aspiration.
• 27:29Well, it is an aspiration.
• 27:31We do a lot that
• 27:32we where we're where we
• 27:34are implicitly talking about prevention.
• 27:37We're implicitly
• 27:39talking about how do we
• 27:40help children
• 27:41not enter the mental health
• 27:43system.
• 27:45How do we help them
• 27:46thrive and not need our
• 27:48services?
• 27:49We'd be delighted actually if
• 27:50we were not so busy
• 27:52in that way.
• 27:54So my aspiration is this,
• 27:57for us to be the
• 27:58national
• 27:59international
• 28:00recognized go to source of
• 28:02information
• 28:04about child and adolescent
• 28:06behavioral health.
• 28:08And the metaphor that I
• 28:09would like to use is
• 28:10that when you have
• 28:12when your knee hurts in
• 28:14an unusual way, what do
• 28:15you do? You go online
• 28:17and look at the Mayo
• 28:18Clinic letter,
• 28:20most trusted source out there
• 28:22for looking at medical issues.
• 28:24Even if you're a physician,
• 28:25you actually go and read
• 28:26the Mayo Clinic letter.
• 28:28I want us to be
• 28:29the Mayo Clinic letter
• 28:31for child behavioral health.
• 28:34That's what I want us
• 28:35to be, aspirationally.
• 28:37That's why to look at
• 28:38professional development for the community.
• 28:41I want us to be
• 28:42the source that people know
• 28:43they can come to for
• 28:45reliable information
• 28:47about child and adolescent mental
• 28:48health.
• 28:50So hold that in mind
• 28:52because I hope next January
• 28:54to come back and show
• 28:55you
• 28:56Sly with many
• 28:58the many things that we've
• 28:59posted and that we've been
• 29:01doing around that.
• 29:03And Krista is is taking
• 29:05a deep breath right now.
• 29:09So the goals for our
• 29:10clinical mission.
• 29:13First off, we've had a
• 29:14remarkable,
• 29:15I hope you came or
• 29:16we at least saw pictures.
• 29:18In September, we had an
• 29:19incredible open house
• 29:21where we blended both research
• 29:23and clinical. We had research
• 29:25projects, we had Kartik talking
• 29:27about his studies.
• 29:28We had our clinical intervention,
• 29:30our community programs, everyone.
• 29:32Three fifty George was was
• 29:33buzzing.
• 29:34It was so crowded.
• 29:36We had members from the
• 29:37health system come, our new
• 29:39senior VP of the health
• 29:40system came, I'll introduce you
• 29:42to her in a moment,
• 29:43but it was great
• 29:45and we will do it
• 29:46again. And we learned a
• 29:47lot from that time but
• 29:49stay tuned, it was really
• 29:51a remarkable experience.
• 29:54Also this year was the
• 29:55first year that US News
• 29:57and World Report
• 29:59included child and adolescent behavioral
• 30:01health in its ratings.
• 30:03For years, they've rated pediatric
• 30:05programs but have not included
• 30:07behavioral health. It's been that
• 30:08kind
• 30:10of crazy other.
• 30:12This year, they included it.
• 30:14And so in this year
• 30:15and they didn't include ordinal
• 30:17rankings that is first, second,
• 30:18third, or fourth,
• 30:20but just included. So we
• 30:21were actually right.
• 30:23I'm delighted to say,
• 30:25among the best child and
• 30:26adolescent mental health programs.
• 30:29And we will continue to
• 30:31push for,
• 30:32the things that will move
• 30:34us up the rankings. There's
• 30:35a debate as to whether
• 30:36they will include ordinal rankings
• 30:38next year or not, but
• 30:40it's good. Now I know
• 30:41that many people have mixed
• 30:43feelings, including me,
• 30:45about
• 30:46US News and World Report.
• 30:48I am not chasing the
• 30:50rankings.
• 30:51We're not chasing the rankings.
• 30:53On the other hand,
• 30:55remember the aspiration.
• 30:57If we want to be
• 30:59the voice,
• 31:00if we want to be
• 31:01where people come to for
• 31:03the most up to date
• 31:04scientifically
• 31:05informed information,
• 31:07it helps.
• 31:08It helps
• 31:09to be recognized
• 31:11by US News and World
• 31:12Report, and it is especially
• 31:14good for our health system
• 31:15colleagues.
• 31:16It's really good for our
• 31:17collaboration with them.
• 31:19So it's good news.
• 31:22I know I've showed you
• 31:23this systems diagram so much
• 31:25that you're probably saying, oh,
• 31:26god, she's going to show
• 31:27the systems diagram again.
• 31:29We are a part of
• 31:30a large system that is
• 31:31to remind you, we have
• 31:32a health system, we have
• 31:33a medical school, we have
• 31:35a university, and we're a
• 31:36part of it. But I
• 31:37wanted to introduce you to
• 31:39our new colleague in the
• 31:40health system Beth Hines
• 31:42who comes to us as
• 31:43the senior vice president of
• 31:45the Children's Hospital.
• 31:47Beth comes from Minnesota.
• 31:50I hope you notice
• 31:52that she has an MSW,
• 31:54that she is deeply committed
• 31:57to children's behavioral health.
• 31:59She did come to be
• 32:00overall child health and women's
• 32:02services, but she is deeply
• 32:03a partner
• 32:04in children's behavioral health.
• 32:07And so much so that
• 32:08the first document she has
• 32:10produced
• 32:11as a kind of strategic
• 32:12vision for the Children's Hospital
• 32:14includes behavioral health all the
• 32:16way through it.
• 32:18So we have the behavioral
• 32:19health up here, urgent crisis
• 32:21center,
• 32:21philanthropy focused on behavioral health.
• 32:24And instead of calling us
• 32:26out as a separate service,
• 32:30Beth agrees that behavioral health
• 32:32should be integrated across all
• 32:35other child pediatric services,
• 32:38that we should be embedded
• 32:40in every child pediatric service.
• 32:44That's right.
• 32:45So we have a very
• 32:46very very strong advocate
• 32:48now in the children's hospital
• 32:50who recognizes
• 32:52the centrality
• 32:53of mental health or physical
• 32:55health.
• 32:57We also think a lot
• 32:59about a continuum of care
• 33:01and this is not a
• 33:02surprise I think to any
• 33:03of you but that we
• 33:05do operate in a continuum
• 33:06of care
• 33:07beginning with our consultation with
• 33:09pediatricians,
• 33:10access mental health,
• 33:12we've embedded mental health services
• 33:14and primary care. We are
• 33:15the providers.
• 33:17We have inpatient services, emergency
• 33:19services, pediatric psychology,
• 33:22consult and inpatient pediatrics,
• 33:25our day hospital in home
• 33:26services, outpatient services.
• 33:30The point of this
• 33:32is not to list an
• 33:34array of services,
• 33:36but to imagine how families
• 33:38traverse
• 33:39that continuum
• 33:41and to imagine where are
• 33:43the gaps in that continuum?
• 33:44How do we help families
• 33:45move along that continuum
• 33:47and to get people to
• 33:48think in terms of a
• 33:50continuum
• 33:51rather than a single point
• 33:52of care?
• 33:54A really important example of
• 33:56that
• 33:57is when there was so
• 33:58much news
• 33:59about
• 34:00hospitals,
• 34:01emergency rooms being overflowed with
• 34:04children waiting for behavioral health
• 34:05beds,
• 34:07the solution proposed
• 34:09was
• 34:10more beds.
• 34:13That's not the solution.
• 34:15If you think in that
• 34:16continuum,
• 34:18you should be thinking, well,
• 34:19how did so many children
• 34:20get to the emergency room?
• 34:23Can we
• 34:24impact that?
• 34:25Where do they go afterwards?
• 34:28Can we impact that? You
• 34:30should be thinking about flow
• 34:31across.
• 34:32So we're starting to get
• 34:34this idea out.
• 34:36We are now and I
• 34:37would say that right those
• 34:39first ones are definitely
• 34:40opportunities
• 34:41for the prevention part
• 34:44but we are also the
• 34:46now behavioral health consultants for
• 34:48Vizient.
• 34:49Vizient being one of the
• 34:51the,
• 34:53how to put it, one
• 34:54of the folks that provide
• 34:56metrics for health systems
• 34:58and there's a particular child
• 35:00behavioral health component of that
• 35:01and we are the consultants
• 35:03or one of the consultants
• 35:04for them now and have
• 35:06gotten them to be thinking
• 35:07about this and the children's
• 35:08hospital
• 35:09is thinking about a continuum
• 35:11of care idea.
• 35:13We need to continue that
• 35:14as well.
• 35:16The Westport office, which we
• 35:18have talked about for how
• 35:19many years
• 35:20has now actually officially opened
• 35:22and is seeing patients and
• 35:23getting referrals and more referrals
• 35:25are welcome.
• 35:26And our faculty are there
• 35:28and we're just delighted that
• 35:30it's going. And
• 35:31Michelle I know that you
• 35:32put a huge amount of
• 35:33effort into pushing it over
• 35:34the finish line so thank
• 35:36you for that.
• 35:38And
• 35:39we the pediatric psychology program
• 35:41continues to grow and thrive.
• 35:43We have pediatric psychologists embedded
• 35:46in the psych in the
• 35:47clinics you see. We've recruited
• 35:49these four individuals in twenty
• 35:51twenty four. But I just
• 35:52want to show you something
• 35:53that's quite impressive in terms
• 35:55of their volume.
• 35:57We started in twenty twenty
• 36:00embedding pediatric psychologists
• 36:03into,
• 36:05pediatric subspecialty
• 36:06centers.
• 36:08What you can see is
• 36:09that there's been a steady
• 36:10growth since twenty twenty
• 36:13in the number of families
• 36:14that they've seen.
• 36:16They've had a total of
• 36:17over six thousand five hundred
• 36:19completed visits or encounters,
• 36:22but it's the arrival rate
• 36:23that I want you to
• 36:24notice.
• 36:26And here's the point,
• 36:28a pediatric subspecialist
• 36:30and say pulmonology
• 36:32says to a family with
• 36:33a child with asthma, I
• 36:34think your child is very
• 36:35anxious and you need to
• 36:36see the psychologist.
• 36:40Here's an appointment to the
• 36:41child study center outpatient services.
• 36:46That's a gap.
• 36:48Families don't always make it.
• 36:50Their arrival rate to that
• 36:52appointment is actually often quite
• 36:54low for a whole host
• 36:55of reasons.
• 36:57Seventy four percent arrival rate,
• 36:59completion rate is very is
• 37:01very good.
• 37:03And what that says is
• 37:04that if you embed people
• 37:07in pediatric
• 37:08services
• 37:09where and you you do
• 37:11two things. You make it
• 37:12easier for them to access
• 37:14care and you also destigmatize
• 37:16mental health care. You talk
• 37:18about child
• 37:20health. So this is great
• 37:21and we're continuing to grow
• 37:23this and our health system
• 37:24colleagues are really excited about
• 37:26it.
• 37:28The urgent crisis center, which
• 37:30will be a pediatric emergency
• 37:32room devoted to behavioral health
• 37:34will get children out of
• 37:36the regular emergency room, out
• 37:37of the chaos of that,
• 37:39is now on track and
• 37:41will open mid-twenty twenty five.
• 37:44This will be a game
• 37:45changer in terms of care
• 37:47delivery.
• 37:48We can begin care in
• 37:49the emergency room. It will
• 37:51be devoted again to children's
• 37:53behavioral health
• 37:54and we're just really
• 37:57excited again to be partnering
• 37:58with the health system.
• 38:00They're renovating space specifically for
• 38:02it. I think it's actually
• 38:03rather
• 38:04delightfully ironic
• 38:06that they're renovating the doctor's
• 38:08lounge
• 38:09for the pediatric behavioral health
• 38:11phase. I think that's actually
• 38:13really cool.
• 38:16Okay.
• 38:18We also have the challenge
• 38:19of continuing need though to
• 38:21get a bit more serious
• 38:23And that is there's a
• 38:24continued high volume in the
• 38:25emergency
• 38:26department,
• 38:27nearly a twenty percent increase
• 38:29in behavioral health primary care
• 38:32visits.
• 38:33As you all know, there's
• 38:34continued rate high rates of
• 38:37eating disorders, anxiety,
• 38:39suicidality.
• 38:40Kids are sicker.
• 38:42There's more kids with mental
• 38:44health needs, and they are
• 38:45just sicker.
• 38:46They need more help.
• 38:48We continue to have a
• 38:50little over sixty thousand scheduled
• 38:51appointments, and we're serving roughly
• 38:53three thousand unique youths and
• 38:55families.
• 38:57But I wanna show you
• 38:58this,
• 39:02and this is a bit
• 39:02of a challenge. This is
• 39:04not just a local challenge.
• 39:05This is a national challenge.
• 39:07The blue line is our
• 39:08referral volume
• 39:10that's been going pretty steadily
• 39:12up,
• 39:13and the darker line are
• 39:15the number of clinicians or
• 39:16the clinical FTE that we
• 39:18have.
• 39:19So as you can see,
• 39:21our referral volume is exceeding
• 39:24now our capacity
• 39:26of people
• 39:27to do that.
• 39:29We are actively actively I
• 39:31have a meeting actually this
• 39:32afternoon. We are actually
• 39:33actively working with the health
• 39:35system to increase that clinical
• 39:37FTE.
• 39:38That's one solution.
• 39:42But the other question is
• 39:43why is this happening?
• 39:45Why are there so many
• 39:46kids? And this is actually
• 39:47a national trend.
• 39:50So if you look at
• 39:51projections forward, it's projected that
• 39:54over the next,
• 39:55as you can see out
• 39:56to two thousand and thirty
• 39:57four,
• 39:58there'll be a twenty two
• 39:59percent growth in outpatient visits
• 40:02for child mental health.
• 40:04This is a projection.
• 40:06So that
• 40:07that line will continue.
• 40:11The other projection
• 40:13is the green line is,
• 40:15children in
• 40:17in inpatient settings.
• 40:19And the projection there is
• 40:21not that the volume of
• 40:22children will increase,
• 40:24but their length of stay
• 40:26will increase.
• 40:28Don't know how to manage
• 40:29that under until length of
• 40:30stay will increase
• 40:31reflecting an increase in severity,
• 40:35a need for greater services.
• 40:37So we are facing
• 40:39we are facing a challenge.
• 40:41We are already in the
• 40:42midst of a challenge
• 40:44that there are more children
• 40:45than we can serve. We
• 40:47have a long waiting list.
• 40:48We'll continue to add people.
• 40:51But the question is or
• 40:52a question
• 40:54is
• 40:56meaning it do we are
• 40:57we asking the right questions?
• 40:59Are there other questions that
• 41:00we should be asking?
• 41:02We're We're embedding in pediatric
• 41:04specialty services, embedding in pediatric
• 41:06primary care, we're expanding telehealth,
• 41:09we're doing prevention work and
• 41:11training pediatricians,
• 41:13we're forming networks of child
• 41:15adolescent mental health providers.
• 41:18We're also trying to address
• 41:20the pipeline issue,
• 41:21the shortage of providers and
• 41:23address the payment models but
• 41:24what else should we be
• 41:26doing
• 41:27because there are a lot
• 41:28of kids
• 41:30And then, of course, as
• 41:31an academic institution, we also
• 41:33wanna ask the question of
• 41:34why are there so many?
• 41:36What is happening?
• 41:37What is happening in our
• 41:39society
• 41:40that there's so much need?
• 41:42And I'll come back to
• 41:43that in just a second.
• 41:47But I present that to
• 41:48you
• 41:49as
• 41:50both challenge and opportunity.
• 41:53We provide excellent care. We
• 41:56provide
• 41:56care that's state of the
• 41:58art.
• 41:59How do we train other
• 42:00people to provide that care?
• 42:02How do we disseminate what
• 42:03we do?
• 42:04How do we become a
• 42:05part?
• 42:06How do we not be
• 42:07overwhelmed by this tsunami but
• 42:09become a part of its
• 42:10solution
• 42:11in our capacity for innovative
• 42:13thinking?
• 42:16So for climate and culture,
• 42:19to remind you of the
• 42:20goal, which is a
• 42:21beautifully aspirational goal,
• 42:24and to remind you too
• 42:26of the graphic that I've
• 42:27often showed that cultures
• 42:29is what we aspire to
• 42:30but climate is how we
• 42:31behave
• 42:32and does our climate, how
• 42:33we behave reflect the culture
• 42:35we aspire
• 42:37to? Tara and her team
• 42:38have been doing actually enormously
• 42:41great work,
• 42:42and I'm not gonna go
• 42:43over everything.
• 42:45But just to say in
• 42:46the Biola Bernard Fund, there
• 42:48we have the fellowship,
• 42:50the fellows from our three
• 42:52training programs.
• 42:54Tara perhaps is developmental pediatrics
• 42:56gets going, we'll add a
• 42:57four.
• 42:59But we have the fellows.
• 43:00We've had two wonderful talks
• 43:02in December and there's another
• 43:04one coming up in March
• 43:05and the Biola Bernard Award
• 43:07to faculty for projects that
• 43:10impact health equity.
• 43:12But what I really want
• 43:13to focus on in this
• 43:15particular
• 43:16section
• 43:17is the work that
• 43:19Tara with Yasmin Davis has
• 43:20been doing around building and
• 43:22defining our values.
• 43:25And that we've had several
• 43:26meetings. I really encourage you
• 43:28to join. There's one tomorrow,
• 43:29Thursday
• 43:30around
• 43:31defining the values of the
• 43:33community that we want to
• 43:35have.
• 43:36The kind of community that
• 43:38we want people to
• 43:39live in,
• 43:41work
• 43:42in, feel like they want
• 43:43to come to.
• 43:45And some of the values
• 43:46that have come out so
• 43:47far,
• 43:50of how we want our
• 43:51community to be experienced
• 43:53are these.
• 43:55The top
• 43:57five are respect, equity, trust,
• 44:00human dignity,
• 44:01integrity.
• 44:03I think we could agree
• 44:04that that's the kind of
• 44:05community we want.
• 44:08That's where we want people
• 44:09to feel attracted to and
• 44:11be a part of.
• 44:13So we have another session
• 44:14to try and really solidify
• 44:16that,
• 44:17get that out,
• 44:19and then, like, how do
• 44:20we put that into action?
• 44:23How do we really make
• 44:24this the community
• 44:26that
• 44:27not only we want, but
• 44:28that I truly believe will
• 44:29facilitate
• 44:30all the other things that
• 44:31you've been hearing are happening?
• 44:35And so on that point,
• 44:36actually, I want to return,
• 44:38to where I began a
• 44:39moment ago.
• 44:42And I want to return
• 44:44to
• 44:45reflections on centering children
• 44:47and centering children and what
• 44:48we do and in the
• 44:50profession that we have.
• 44:52And here are the three
• 44:54news stories.
• 44:56The first one is by
• 44:58Margaret Ringle,
• 45:00on December twenty third.
• 45:02The second is December twenty
• 45:04ninth about present past president
• 45:07Carter.
• 45:09And then there was one
• 45:10on December twenty fourth
• 45:11about the government changes in
• 45:13Bangladesh.
• 45:15And you may wonder how
• 45:16in the world
• 45:17what are these all connected
• 45:19by?
• 45:21So here's some of the
• 45:22things that I think connect
• 45:23them, and then I'll fill
• 45:25each one out.
• 45:27First, I think that values
• 45:29can light a path forward.
• 45:30If you are clear about
• 45:32the values that you want
• 45:33your community to have,
• 45:35it lights a path forward.
• 45:38The second is that persistent,
• 45:40persistent,
• 45:41small efforts, they may feel
• 45:42small, they may feel inconsequential,
• 45:44but they nonetheless can make
• 45:46huge change over time.
• 45:50Ask questions, please ask questions,
• 45:52Please
• 45:53challenge. If I ever say
• 45:55if you say something to
• 45:56me and I say, well,
• 45:58that's the way we've always
• 45:59done it,
• 46:00please challenge me.
• 46:02Please say challenge the orthodoxy.
• 46:05Please.
• 46:06The power to make a
• 46:07difference is in all of
• 46:08us
• 46:10and that helping children
• 46:12is a moral imperative,
• 46:14not just an imperative, but
• 46:16it's a moral imperative.
• 46:18And so to the first
• 46:19one,
• 46:22Margaret Rinkl's article
• 46:24was also and that article,
• 46:25she also cited
• 46:27of earlier one in October
• 46:30by, as you know, a
• 46:31favorite author of mine of
• 46:33Wendell Berry.
• 46:34And Wendell wrote a piece
• 46:36called,
• 46:37he's very famous for his
• 46:39bracketed titles,
• 46:40a piece that he was
• 46:41against killing children.
• 46:45And at the same time,
• 46:46and a little bit earlier,
• 46:48Nicholas Kristof wrote a piece
• 46:49in the New York Times
• 46:50about we Americans neglect our
• 46:52children.
• 46:54The point of these three
• 46:56pieces
• 46:57centered around Margaret Winkle
• 47:01was that in these times
• 47:04of enormous
• 47:06discord
• 47:07of hate,
• 47:08of violence,
• 47:10we often lose sight
• 47:12of the impact of children
• 47:14more broadly,
• 47:15not just the children we
• 47:16care for, not just the
• 47:17children in our families, but
• 47:19the children that we care
• 47:20for.
• 47:22And that I'm not making
• 47:23a political statement here, I'm
• 47:25actually making a moral statement
• 47:28that we as professionals
• 47:30have the obligation
• 47:32to actually raise up
• 47:34raise up
• 47:36the centering of children in
• 47:38our society
• 47:39as the future for our
• 47:41society.
• 47:42And actually to say that
• 47:44our moral integrity
• 47:46is grounded in how we
• 47:47value and protect all of
• 47:49our children.
• 47:52A society's value,
• 47:53a society's worth, a society's
• 47:56endurance
• 47:57is based not just on
• 47:59how it protects the most
• 48:00vulnerable,
• 48:02but also in how it
• 48:04cares for its children.
• 48:06And a society thrives and
• 48:08moves forward if it centers
• 48:10its children.
• 48:12So that is, I think,
• 48:14an imperative for us. It's
• 48:16a very complicated, it's not
• 48:18an easy solution,
• 48:20but we
• 48:21as mental health professionals caring
• 48:23for children
• 48:25have the opportunity
• 48:26to shift the national dialogue.
• 48:29We have the opportunity
• 48:31to raise our voices
• 48:32and to say,
• 48:34we in America
• 48:36need to value our children.
• 48:39And I it's not simple.
• 48:40It's not a one editorial.
• 48:42It's not a one conversation.
• 48:44It's continuing to have that
• 48:46awareness and continuing to have
• 48:48that as a part
• 48:49of what we put forward
• 48:51when we do our podcast,
• 48:52when we do whatever.
• 48:55But that also the idea
• 48:56of shifting the national dialogue
• 48:58brings me to the next
• 48:59one.
• 49:01And President Carter now with
• 49:04his funeral happening
• 49:05and at his death, there's
• 49:07an awful lot of going
• 49:08on about
• 49:09the legacy of his presidency
• 49:11and his post presidency.
• 49:13Nicholas Kristof wrote a piece,
• 49:15Nicholas Kristof actually had a
• 49:17personal relationship with Carter, had
• 49:19a chance to interview him.
• 49:20And a day later, another
• 49:22individual Samantha Powers wrote a
• 49:24piece about
• 49:26Carter. And what's not often
• 49:28mentioned
• 49:30is that Carter was the
• 49:32first person
• 49:33to raise human rights
• 49:36as an imperative
• 49:39to bring it wasn't politically
• 49:41expedient.
• 49:42It actually wasn't
• 49:44it was potentially politically
• 49:47the wrong direction.
• 49:49But he put it in
• 49:50the dialogue
• 49:51of the state department.
• 49:53He was the person to
• 49:54actually bring it into diplomacy,
• 49:57to bring it into something
• 49:58that this is how we
• 49:59think about our relationships
• 50:02with other nations and other
• 50:04cultures.
• 50:05He brought human rights forward.
• 50:08It emerged from a lot
• 50:10of his own personal experiences,
• 50:13but it also emerged from
• 50:14his values.
• 50:16He led with his values.
• 50:18And he changed.
• 50:20He changed the way.
• 50:21He changed in a quiet
• 50:23way, in a persistent way.
• 50:24He changed the way
• 50:26we think about
• 50:27diplomacy.
• 50:29He brought human rights into
• 50:31the discussion.
• 50:32I have no doubt
• 50:34Carter was very, very committed
• 50:36to the disadvantaged,
• 50:38but I have no doubt
• 50:40that he would very much
• 50:42center children and in his
• 50:43thinking about human rights,
• 50:45no doubt.
• 50:48And that brings me then
• 50:49to the third story, which
• 50:50may seem like
• 50:52the, and that is the
• 50:53point being to advocate for
• 50:55the most disadvantaged
• 50:57than those who can't speak
• 50:58for themselves.
• 51:00But the third story you
• 51:01may think, where in the
• 51:02world is the change in
• 51:03government in Bangladesh here fit?
• 51:07Well, here's the interesting story
• 51:08about that. I'm not suggesting
• 51:11about change. I'm not suggesting
• 51:12about revolution
• 51:13or overthrow or any of
• 51:15that.
• 51:16But the change in government
• 51:17in Bangladesh
• 51:19came about
• 51:20as some university students
• 51:22decided
• 51:23they needed a different government.
• 51:25They wanted to focus on
• 51:27human rights and social justice
• 51:29and they managed
• 51:31to actually
• 51:34kick out if you will,
• 51:36the current leader, she's exiled
• 51:38to India,
• 51:40but then brought in
• 51:42this eighty seven year old
• 51:43Nobel Laureate who does work
• 51:45in microeconomics
• 51:47and work in microeconomics
• 51:49and disadvantaged
• 51:50communities
• 51:51to work together to design
• 51:53a new government.
• 51:54They may fail, they may
• 51:56succeed,
• 51:57but the idea of this,
• 51:59which I think is very,
• 52:01very applicable to us,
• 52:03is you engage many voices
• 52:05across generations to address key
• 52:07challenges.
• 52:08Whether the key challenges is
• 52:10designing a new government in
• 52:11a place that's never experienced
• 52:13this kind of government
• 52:14or addressing
• 52:16child children's mental health and
• 52:18the surge in children's
• 52:19mental health.
• 52:20You bring voices across many
• 52:22many generations.
• 52:24That's the relevance of that
• 52:26to me.
• 52:28And all of these things
• 52:29tie together
• 52:31with a voice of change.
• 52:32And so I wanna make
• 52:33two
• 52:34concluding comments.
• 52:37One is that I know
• 52:38that we have a huge
• 52:39amount of change going on
• 52:41internally
• 52:42in this department, in the
• 52:44health system, in the school.
• 52:46And I know that change
• 52:47can at times be disorienting
• 52:49as well as exciting
• 52:50and that it change inevitably
• 52:52involves loss as well as
• 52:54gain.
• 52:55A part of my role,
• 52:56a part of my task
• 52:58is to think about that
• 53:00change and its impact on
• 53:01all of you,
• 53:02to make it manageable,
• 53:04to make it understandable,
• 53:07to make it bearable.
• 53:09So I really want to
• 53:10be aware of that. I
• 53:11want to return to the
• 53:13metaphor of light from dark.
• 53:16And also here's a couple
• 53:17of other articles. Can you
• 53:18tell that I was reading
• 53:19a lot over the holiday
• 53:20break?
• 53:21A couple of articles also
• 53:23about how to find light
• 53:24in the winter,
• 53:25metaphorically, how to think about
• 53:27finding
• 53:28your, your stable point
• 53:31in the midst of change.
• 53:32And again, Margaret Rinkle
• 53:34on keeping your own soul
• 53:35safe in the dark.
• 53:37Those are not political statements.
• 53:39They are taking care of
• 53:41ourselves
• 53:42so that we can take,
• 53:43push this mission forward.
• 53:46And it returns me then
• 53:48to the theme
• 53:50from
• 53:50September,
• 53:51which was restoring community.
• 53:55And so then my very
• 53:55last point
• 53:57is actually about community and
• 53:59shared mission,
• 54:00being together
• 54:01and just one other story
• 54:03about that.
• 54:06You may remember that in
• 54:08twenty nineteen
• 54:09Notre Dame, the cathedral in
• 54:11Paris
• 54:12burned.
• 54:14Terrible image as on this
• 54:16screen,
• 54:17twenty nineteen.
• 54:20And over these five years,
• 54:23it's been a remarkable transformation.
• 54:26A group
• 54:28of woodworkers,
• 54:30stonemasons,
• 54:31crane operators,
• 54:35carpenters,
• 54:36people who restore things, people
• 54:38who
• 54:39glass blowers, glass where all
• 54:42artists come together
• 54:44and they brought from where
• 54:46you see
• 54:47the charred remains,
• 54:49brought it back to its
• 54:51opening now in October.
• 54:54But the message for us,
• 54:56the shared mission, shared value
• 54:58message
• 55:00comes from the fact that
• 55:01the group of all those
• 55:02people that did that
• 55:04from the men that swung
• 55:06by ropes to pull up
• 55:07those charred remains from the
• 55:08crane operators,
• 55:10all came together
• 55:11to form a choir
• 55:14as a shared mission to
• 55:15form a choir
• 55:17and to sing in this
• 55:19cathedral that they brought back
• 55:20to life.
• 55:22So if the sound works,
• 55:24I thought we could close
• 55:27and see if the sound
• 55:28works.
• 55:31Move
• 55:32this.
• 55:34If it works, I thought
• 55:35we could close on some
• 55:36music from them.
• 55:37Can you hear it? No.
• 55:38Probably not.
• 55:44These are all the people
• 55:46that made this transformation
• 55:48happen.
• 55:49This is like our community.
• 55:51Everybody
• 55:52who makes children
• 55:54better.
• 55:59They're standing in front of
• 56:00the cathedral
• 56:01that they brought back.
• 56:03They did it.
• 56:14I'm glad to share the
• 56:15whole thing with you.
• 56:19And with that whoop. Hang
• 56:21on.
• 56:24Let me see if I
• 56:24can change the slides.
• 56:29With that, I hope that
• 56:30we can have some discussion
• 56:32and I thank you very
• 56:33much for your attention.
• 56:40Any questions or things you'd
• 56:42like to pick up?
• 56:50Anders, anything online?
• 56:52Yeah. I'm on. Okay. Alright.
• 56:54Thank you. Oh, Larry. Just
• 56:55quickly
• 56:56that was really inspirational.
• 56:58And, you know, the thought
• 56:59of using art and coming
• 57:01together and
• 57:03and
• 57:04and celebrating and acknowledging. I
• 57:06was thinking about the effort
• 57:07of the Shakespeare reading. You
• 57:08know? Right. Right. How wonderful
• 57:10that was for me Right.
• 57:11That day.
• 57:12That bunch of us got
• 57:13together to get under,
• 57:16a social work,
• 57:17fellow in. Yeah.
• 57:19Organized this and and and
• 57:21the importance of that. And
• 57:23it does take the green,
• 57:24so I thank you for
• 57:25that. You're welcome. Mike? I
• 57:26was just gonna say,
• 57:29the lack of questions reflects
• 57:32how well you presented. Oh,
• 57:33thank you. In a sense,
• 57:34the depth, the breadth, and
• 57:35the you know, it's it's
• 57:37like if someone said, what
• 57:38do you think about Shakespeare?
• 57:40You know? Give me a
• 57:41while to think about it.
• 57:43Well, thank you. Appreciate that.
• 57:45Well, thanks thanks again. Appreciate
• 57:46it. I'll share the slides.