March 17, 2025 • 39 mins
Dr. Michael Groat, President and CEO of the Lindner Center of Hope, talks with us this week about how therapeutic communities break free from traditional care silos and embraces a truly integrated approach.
Our conversation explores how the Lindner Center's unique continuum of care—from acute hospitalization to residential treatment and outpatient services—creates seamless transitions for patients navigating complex mental health challenges. At the heart of this approach lies the therapeutic community philosophy that fosters belonging, collaboration, and mutual support. Our talk reveals how creating a positive staff culture directly impacts patient outcomes through neurobiological mechanisms that transmit emotional states before conscious thought occurs. This science-backed insight illuminates why environments where staff feel valued and engaged consistently produce better healing outcomes.
Dr. Groat emphasizes the importance of collaborative care and making the shift from "sickness care" to "wellness care"—a transformation that requires providers to look beyond symptom management toward cultivating a vision of what recovery and thriving can look like for each individual. This creative, person-centered approach stands in stark contrast to assembly-line psychiatry that often leaves patients caught in cycles of crisis. Listen now to discover the powerful difference integrated, community-based treatment makes in people's lives.
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Episode Transcript
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Speaker 1 (00:00):
Hello folks, Thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment, with experts from
across the country sharing theirthoughts and insights on the
world of behavioral health care.
Broadcasting on WPBM 1037, thevoice of Asheville independent
commercial free radio, I am ToddWeatherly, your host
(00:21):
therapeutic consultant andbehavioral health expert.
Joining us today is theesteemed and distinguished, but
first and foremost, a caring andcompassionate human being, Dr
Michael Grote.
Dr Grote is the president andCEO at the Linder Center of Hope
and non-profit mental healthcenter, providing psychiatric
hospitalization, assessment andresidential treatment, as well
as extensive outpatient servicesjust outside of Cincinnati,
(00:43):
Ohio.
Dr Grote has received his PhDin counseling psychology at the
University of Albany StateUniversity of New York.
He completed his postdoctoralfellowship in the treatment of
refractory personality disordersat the Austin Riggs Center of
Residential TherapeuticCommunity up there in
Stockbridge, Mass.
He is the Associate ClinicalProfessor of Psychiatry and
(01:04):
Behavioral Health Neuroscienceat the University of Cincinnati
College of Medicine.
He was previously ChiefClinical Officer and Director of
Psychology and Assessment atSilver Hill Hospital, where he
was also Associate ClinicalProfessor of Psychiatry at the
Yale School of Medicine.
He's also former CEO of CooperRees, a residential healing
community with two campuses herein the Asheville area.
Former CEO of Cooper Rees, aresidential healing community
(01:25):
with two campuses here in theAsheville area.
Dr Levine was just on our show,actually, as well as former
director of adult services atthe Menninger Clinic, prominent
psychiatric assessment center inHouston, Texas, and associate
professor of psychiatry andbehavioral sciences at the
Baylor College of Medicine.
While there, Dr Grodd is aresearch fellow of the Anna
Freud and Yale Child StudyCenters.
He is a fellow of the AmericanPsychoanalytic Association and a
(01:46):
recipient of the Pillar Awardfrom the Miniker Clinic.
He has lectured widely ontopics related to
psychotherapeutic treatments,acute and intermittent levels of
care, suicide prevention,personality assessment and
recovery.
I might get to see him in Junein Arizona.
In fact, I have had thedistinguished privilege of
working with Dr Grote as amember of the Lindner Center of
(02:07):
Hope Referral Advisory Committeeand work regularly with his
team there at the Sipsy andWilliams House programs.
Dr Grote, welcome to the show.
Speaker 2 (02:17):
Thank you.
Thank you, Todd, for thatincredibly gracious welcome and
introduction.
Speaker 1 (02:25):
Appreciate it you, uh , you probably know dr john
santo pietro.
Did you know him?
At all yeah yes, he was he.
I did his intro and he's likewho is this guy?
Speaker 2 (02:40):
I know, I was thinking that guy has really
been busy.
Speaker 1 (02:43):
He has been busy.
Speaker 2 (02:45):
Yes, you have been busy man, I tell you it's.
Speaker 1 (02:50):
I mean, how long have you been with Linder Center?
Now A couple years.
Speaker 2 (02:54):
I've been with Linder 13 months.
This is my 14th month.
Okay yeah, so relatively newhere to Linder.
Speaker 1 (03:09):
Center and the state of Ohio and the Cincinnati
region.
Well, I'll start with thispiece, which is I rely fairly
frequently on the Linder Centerfor something that it's very
hard for me to get in otherplaces around the country.
It's pretty unique and and it'sapproached.
There are some places you canget this done, but linder is one
(03:31):
of those places that's got anacute, an acute, uh, psychiatric
hospital, so a person can behospitalized, which means which
means keeping them against theirwill.
Sometimes, if they're unsafe tothemselves or others, they meet
criterion for detainment, ifyou will, psychiatric detainment
.
But it sits right there on theunit, it doesn't feel like a
(03:55):
hospital.
And just outside of thatthere's Sipsy and Williams House
, the assessment center and thestabilization acute care
treatment center or side of thehouse where people can kind of
come out of that environment,have a care team that figures
out what's going on for them,give them not only a diagnostic
(04:15):
you know diagnostic profile oryou know identify what it is
that's going on with them, butalso come up with a treatment
plan and help them engage in theinitial stages of treatment so
they can kind of follow throughwith, you know, a lot of times
residential care after that, orpotentially outpatient care, and
so it's this.
You know, at the acute levelit's a continuum of care that's
(04:35):
very robust and very useful to aperson who's having some pretty
serious symptomology or mentalhealth conditions.
And you guys have gotdevelopments to the building.
You're adding on.
The outpatient servicescontinue to grow.
You've got strong alliances tothe university there, where you
(04:58):
know you help provide them withexpertise and teaching and other
kinds of stuff.
Where, like, what brought youhere?
And I think I have some of thatanswer.
But where and where are youguys going?
Like I think that you're thisprominent feature, not only in
the local community but in thenational community.
What's your, what's your vision, what you got going on?
Speaker 2 (05:19):
Yeah right, great question, john.
So you know you've touched onsome of the features of the
Linder Center of Hope.
You know I learned about Linderback in the mid 2000s when Dr
Keck, who is the foundingpresident, ceo, was working with
the Linder family onestablishing this program as a
(05:42):
national referral center.
Establishing this program as anational referral center and, as
you have pointed out, a placewith a robust offering of a
continuum of care all under oneroof.
This is one of the fewindependent, non-for-profit
psychiatric hospitals I've seenin the country where you have
that entire continuum under oneroof.
You can walk from inpatient toresidential to outpatient
(06:04):
without having to leave thebuilding, and that was an
intentional design to providethis.
You know, total range ofservice for people, for
individuals and families.
So you know what I learnedabout the Linder Center years
ago.
You know I knew that Dr Keckand the Linder family were
working closely with the Collegeof Medicine in wanting to
(06:27):
establish a rigorous,comprehensive treatment program,
but one that was infused with aMidwestern sensibility, a
Midwestern warmth andhospitality.
Midwestern warmth andhospitality and one other thing
(06:51):
is a certain kind ofauthenticity and genuineness
that people have a really downto earth type of approach.
So it's a really nice blend ofcombining people who you know
are at the forefront of thinkingand leading-edge research but
also have a really down-to-earth, humble, caring way of relating
to people.
So that really drew me toconsider working here.
(07:15):
Dr Keck, a few years ago, talkedto me about coming to join the
center.
He and I were speaking at aconference together in Arizona
and he spoke with me aboutwhether I might be interested in
taking another look at theLinder Center.
It is something I hadconsidered in the past and two
years ago when he spoke with me,we began a series of
(07:37):
conversations and he introducedme to the Linder community,
introduced me to the Lindercommunity and I came on to
continue really that trajectoryof work that I've done with
other hospitals, which is, youknow, advancing clinical
excellence, you know, continuingwork to provide an optimal
experience for patients andfamilies.
(07:58):
So now, as I assume theleadership role of the center
and as you point out, we'reembarking on a $30 million
expansion which includesbuilding a four-story
52,000-square-foot medicaloffice building and it includes
another wing to our SIPC HouseResidential Assessment Program,
(08:20):
there's huge opportunity here tothink about who else can we
serve and take care of in theCincinnati region and around the
Cincinnati area down inKentucky and then throughout the
state of Ohio and to Indianaand West.
Virginia and Kentucky andTennessee, and you know we aim
(08:42):
to be a premier mental healthresource right here in the
Midwest as well as for peoplethroughout the country.
So you know I think of it inconcentric circles.
We are expanding the range ofservices for the local community
, being a real strong powerhousein the Cincinnati region for
(09:02):
mental health care powerhouse inthe Cincinnati region for
mental health care.
The number of people seekingmental health care has been and
the providers that we have formental health care has doubled
in the last four and a halfyears.
So there's just enormous needsin the community that we're
rising to meet.
And with our assessment program, we know that people around the
(09:23):
country are looking fordiagnostic expertise that we
offer and we're growing to meetthat need.
So my vision is, you know, firstlooking at how do we really
leverage all this wonderful newspace that the board of
directors and the Linder familyare providing and use it in a
(09:46):
way that advances mental health.
And to do so, what I'm doing inparticular is looking at how do
we build partnerships thatallow us to do new things.
So, for instance, ourconnection to and our
affiliation with the College ofMedicine.
In fact we're owned in part bythe College of Medicine.
(10:09):
What that allows us is theopportunity to do more
partnerships around.
You know, dissolving thatdisconnect between you know,
medical care and mental healthcare.
There's a way to bring themtogether in a more integrated
fashion, such that you know ifI'm a woman who is, or someone
who's, you know, bearingchildren, I can go in for an
(10:32):
OB-GYN appointment and, whileI'm there, also know that there
is mental health care availableto me as well, and I've been
having discussions with OBGYNregarding an integrated clinic
for maternal health.
I've been in conversation withthe sleep disorders clinic at
(10:53):
the university regarding whatmore can we provide people
around sleep disorders, whichtend to be underdiagnosed or
undiagnosed for many individualsstruggling with mental illness,
but having conversations withthe Department of Endocrinology
because we know a number ofindividuals who particularly are
living with long-term mentalillness vulnerability may be
(11:17):
struggling with various forms ofmetabolic disorders like
diabetes and what can we provide?
them.
So part of my vision is lookingat what partnerships can we
build to better serve a range ofpeople, to meet the needs of
youth, to meet the needs ofolder populations.
Looking at our demographics,the majority of our patients are
(11:39):
between 18 ages of 18 and 30,and then the other big portion
of our patients is,interestingly enough, people
over the ages of 65.
So really looking at, how do wemeet the needs of these
populations, how do we adapt andinnovate our services?
to best meet the needs andbecause we are a freestanding,
(12:00):
independent hospital, of courseaffiliated with the College of
Medicine, I think we work bestwhen we work as a team and we
work in partnership with otherpeople.
Speaker 1 (12:10):
Yeah, it's a team.
John said this it's a teamsport.
Speaker 2 (12:15):
It's exactly a team sport.
Speaker 1 (12:17):
That's exactly right.
Well, you know, one of thethings that and as you know, in
our practice we spend a lot oftime working with families and
individuals who are kind of 40plus.
That's right Not just kind ofhitting 40 or hitting 50
(12:43):
perimenopause and having a lotof mood dysregulation and
depression and anxiety, some ofwhich is connected to endocrine
systems and or hormonal levelsand all these other pieces.
And you know, one of the issuesand part of the reason I enjoy
working with Lindner Center isbecause you can.
(13:05):
You could go to a place thatthat offers psychiatric services
, but there, but you find waytoo often they live in a silo
and and that person may get whatis more or less a decent
psychiatric evaluation or aneuropsych, but they've left out
these other pieces.
They haven't done blood testing, they haven't done hormonal
(13:27):
testing, they haven't done someof the things that might be
impacting this person andpotentially at levels that are
not going to be reconciled.
If you just come out exclusivelywith a psychiatric assessment
and a psychiatrist throws somemedications at you for symptom
management, but the hormones arestill off and the person just
(13:48):
keeps, you know they're on a medthat doesn't work, they still
feel bad, their conditioncomplicates as a result and
we're coming up with a worldwhere people are grasping at
straws to find answers for stufflike this.
And you know not a lot ofpeople know exactly what a
therapeutic consultant is and bythe time they get to us.
(14:08):
We're one of the things thatit's that's very much at the
front of our minds is let'sfigure out what's going on first
, before we start treating youyes, yes um, and that's
something that lender has alwaysdone incredibly well uh, the,
when you are in the expansion ofthe, the that you're talking
(14:29):
about.
You've got a new building,you're talking about more
partnerships and things likethat.
Something that came to mind asyou were speaking and I know
this is part of your historycoming you've got Meninger, but
you've got Cooperese and you'vegot Silverhill.
You've got this background.
That's not only highlysophisticated psychiatric
assessment, diagnoses, treatmentand the like, but there's a
(14:55):
thread there of therapeuticcommunity, which is a philosophy
.
We approach treatment togetheras a philosophy.
We approach treatment togetheras a team.
How are you weaving that threadof therapeutic community into
the developments and theprogramming that you're putting
(15:16):
into place now and what's partof your team as it stands?
Speaker 2 (15:21):
That's a terrific question and insightful
observation.
I I love your use of the wordsilo, because community and
integrated care is a way ofabolishing silos and really
(15:42):
bringing people together.
That's right.
Inclusivity I'm thinking aboutcollaboration, I'm thinking
about things that foster a senseof belonging and that I think
that you know, going back to theidea of a team sport, you know
(16:02):
I have also learned inhealthcare that oftentimes our
best thinking is done togetherand that you know, for example,
in partnering with someone likeyou who is working with a family
, working with someone who'sstruggling and learning from
your experience, you know thatbecomes a really important data
point to be holding in mind andthinking about and bringing into
(16:25):
our work spirit that recognizesthe value of everyone, at the
very least, and creating forums,creating opportunities for
people to really have a voiceand to have their perspective
heard and understood and thoughtabout.
(16:46):
And you know from there kind ofI think it was like building
blocks you know, creating anenvironment where people feel
safe and encouraged and welcometo participate, and that you
also set up structures andprocesses that foster
collaboration, that foster asense of working together at
(17:07):
things.
So in my career I have donethis through how I have set up
staffing structures.
You know, when I was at SilverHill, I set up a clinical
leadership team that didn'texist prior to that where all
the clinical leaders gottogether and we worked at
reducing silos.
We worked at thinking aboutpatients, but then also meeting
with patients and meeting withfamilies and learning from them
(17:29):
about you know, what are yourneeds and how can we best
partner together.
You know, here's some of whatI'm thinking.
What do you think of this?
And all these types of stepsover time, I think are
cumulative and they create, theyfoster a sense of we're in it
together, we're working at ittogether, and then you can
actually have, you know,community events that you know
(17:51):
kind of mark that we are acommunity and, you know, have
various kinds of rituals,whether it's, you know,
celebrating staff throughemployee appreciation or
celebrating people's recovery.
You know patients in recovery.
You know, some of my favoriteexperiences in my career have
been sitting with patients atthe time of discharge as they
(18:14):
reflect on their experience andthey share words of wisdom with
other patients and have talkedabout what they gained and their
new outlook.
You know, those are incrediblyrewarding moments and I have
found that they most often bestoccur in the context of a
community and in the variouskind of therapeutic communities
(18:36):
I've been part of oftentimesresidents of communities,
patients of communities,whatever kind of context it's in
they'll talk about the peersand the relationships with
people that they've formed inthe community, and the sense of
belonging and support from thecommunity was in many cases the
most beneficial thing thatpeople gain from the treatment
(18:58):
experience.
And so, knowing that and knowingthe power of community, I'm
always attentive to how do weharness that power and really
make the best use of it inwhatever program I'm in and so
here at Lender, you know I'vebeen really very behind our
(19:23):
Employee Engagement Committeeand Employee Well-Being
Committee and you know they havejust early on said let's grow
the membership of thesecommittees and they have grown
in size and there's all thesestaff coming together from
across the organization.
We're saying you know we'reinterested in fostering a sense
of community and celebration andappreciation and we're now
(19:49):
sponsoring a record number ofcommunity activities here at
Lender.
That's great, yeah.
This week we have candy gramsfor Valentine's Day and then we
just had cocoa and karaoke theother day in the gym where staff
came together we sang karaoke,we had fun.
(20:10):
We had hot cocoa in the coldweather, and then, right before
that, we had 2024 music rap,where everyone picked out their
favorite music and artists fromthe year 2024, and uh.
And then you know, two weeksfrom now we're starting the
march madness bracket and thenwe're having a food truck come
(20:31):
to celebrate the c Reds openingday in their training camp.
And of course, you know justyou know bringing people
together, fostering a sense ofconnection, and you know we're
in this together, we're.
You know we're enjoying eachother, we're working side by
side.
You know we're all here aroundthe mission of taking care of
people and, you know, helpingthem find hope.
Speaker 1 (20:50):
Well, I think that I mean you talk about staff
culture, of course, and it'ssomething that has to.
It's not just a concept, youknow, it has to live inside of
it, that's right.
You know, it's this thing thatyou know you do every day.
I think I don't know if peoplereally realize the, what a
(21:11):
culture like that does tosupport a healing environment,
how you, in ways that you can'treally name sometimes and can't
be said, you pass it off to thepeople that you're caring for,
yeah, and and just the.
They see it, they witness it,they feel a part of it.
Uh, and it and it and itprovides this I don't know, know
(21:32):
magical base.
If you will, I'm sure we coulddo a bunch of neuroscience and
brain scans on it if we wantedto.
Speaker 2 (21:39):
I think you probably could, because one thing I think
about is when we humans arestressed and taxed and let's say
, I'm in a workplace and I don't, and I feel I don't feel
supported and I don't feel safeand I don't feel valued, don't?
Speaker 1 (21:58):
feel respected.
You're talking about a largeportion of the community health.
Speaker 2 (22:01):
Yeah, and there's kind of an underlying strain to
that, and there's something kindof miserable about it that you
carry with you in contrast to,you know, having people feel
free of that kind of burden andbeing able to have the kind of
emotional freedom to relax andfocus on being present.
(22:22):
And so I think you're right, ifwe can be present and really
present for patients and theirfamilies, I think there is
something you know reallyimportant that happens.
Speaker 1 (22:34):
You know, when I was at Cooper Rees a place that you
and I share and having been apart of there, and we had a
presentation that was, they weretalking about the brain banana.
And it's basically the region ofthe brain and the
(22:54):
parasympathetic nervous systemand the mingles part of it, part
of the prefrontal andeverything else, but the center
that processes emotions andstores information.
That is long-term.
At any rate.
The study they were doing withit was how this portion of the
brain processes what's on yourface of the brain processes
(23:17):
what's on your face like youwalk in the door and my brain is
processing information that itsees registering from what
you're, what you're expressingin your facial structures and
and basically category is this athreat?
Is this person upset?
Are they a friend of mine?
Like what is what do I need tobe prepared for as this?
person walks in uh, and you knowthey were.
They were seeing that if aperson, like before they could,
(23:40):
before they could uh registeranything cognitively, their
brain was already responding,the body was already responding
to the person was walking in theroom yeah um, I can help but
think, based on that, that thateffect is also cumulative.
If you've got an environment ofpeople that are stressed and
(24:00):
disenfranchised and notappreciated in everything else.
They're passing that stuff offto the people they care for.
The opposite is also true.
Speaker 2 (24:10):
That's a lovely point .
That's fantastic.
Yes, that does actually uh, youknow, integrate neuroscience,
right and?
Yeah yeah, the importance ofhow we show up and the
difference that that makes,especially, as you say, over
time.
Speaker 1 (24:28):
Yeah, the, the, how we show up piece, and you know,
one of the things just as acompliment to you and your team
and something I think thatyou've been very intentional
about it's not just partneringwith these other agencies.
You know there's the universityand there's other professionals
and everything else.
Let's see what we can do toalign ourselves and be better at
(24:49):
the assessment work andtreatment work that we do Great.
But I also happen to know youknow, as a person who's a
referrer and has worked fairlyclosely with members of your
team, that you know they do areally good job, especially
these days, of being inclusiveof others who are involved in a
person's treatment and careprocess.
(25:11):
So you know, maybe they have atherapeutic consultant or maybe
they have a referring clinicianor a referring doc or all of
those, and the team's reachingout, wanting to get information
from this person, making suremaybe the referent feels
included or has some, you know,knows what the process is for
this person and is pulled in ona team meeting that gives an
(25:32):
update and those kinds of things.
And for a lot of places I haveto go after that stuff and with
you guys it's just part of theregular makeup of how you do
things and I think that that wasa process for Lender Center, as
it is for many to try and justlet's be open to the people who
(25:55):
are partnering with us andsending their clients or the
people that they've been workingwith, to us for their care.
That's a trust that they'vegiven to us and we want to
return the favor by making surethat they feel included and that
their contribution is honored.
Feel included and that theircontribution is honored and it's
.
You know, there's no small feat,because if you go in other
(26:15):
places, the silo, the walls comedown and the silos start to
start to incorporate.
When.
What is it that you did?
You know what was, what was inyour time there.
You know the 13 months.
Um, even since then, I thinkthis has been something that's
on your mind and you wanted tomake sure it was part of your
team.
What is it that you did toimpart the importance of all of
(26:39):
that, even as it passed off, topeople who are not necessarily
collaborative provider partners?
What was it that was the keypoint or points that you made
for your team and what is itthat caused them to get it?
Speaker 2 (26:52):
Because they seem to really get it yeah, no, it's a
um really thoughtful questionand and point you're making.
Um, I think there uh are a fewthings and you know, as you were
talking, todd, I um, you know,I had this kind of image of the
(27:13):
heart, and not necessarily thephysical heart per se, but more
the sense of having your heartin the work, and a positive
sense.
And I mentioned that because Iexperience a lot of folks and
this is true.
You know a lot of people inmental health care go into it
(27:34):
because they want to help others.
There's an altruistic kind ofmotivation and bent many people
have.
Like you have yourself right,you care about people, and so I
think it's not a lot of stepsfor staff to consider.
You know, part of really caringfor somebody is to make sure
(27:56):
that we have everything we needto provide the best care, and
that includes our openness tolearning and including everyone
who's involved in this person'slife life because you know we
(28:17):
don't you know we have theprivilege of, you know, working
with people, for you know acertain period of time, whether
it's 10 days or 28 days or twomonths, and you know families
have related to their loved onesfor years.
So have outpatient providers, sohave people like you with
therapeutic consultants.
You may have been working witha given family for months and
have had lots and lots ofinteractions and experiences,
(28:40):
and so I think part of it isrecognizing that we deprive,
potentially deprive, the patientof the most informed care when
we don't include others, themost informed care when we don't
include others.
(29:00):
So and that taps into you know,our care or the best interest
of the patient is reallyparamount.
So that's one way I've talkedabout it.
Another thing I've done andthis is interesting I reminded a
number of team members that youknow we're a national referral
center and I think you know anumber of team members that you
know we're a national referralcenter and I think you know a
(29:21):
number of staff they may havegrown up in this area and went
to school here and work here andhaven't really, you know,
traveled.
Speaker 1 (29:26):
Well, I'm Midwestern kind of mind, you know, or
whatever.
Speaker 2 (29:29):
They haven't necessarily traveled the country
like you and I and may notappreciate what that means.
That you know, hey, we'repeople, respect us, people look
up to what we're doing and wewant to honor that respect and,
you know, maintain that trustthat people put in us.
I talk a lot about theimportance of trust and how you
(29:52):
know how hard it is to reallyearn trust, to maintain the
trust.
And part of maintaining thattrust is recognizing that
therapeutic consultants, otherpeople refer to us, they want to
be included, they need to beincluded.
It helps foster trust, it helpsfoster good relationships and
(30:13):
it's good work, helps fostertrust, it helps foster good
relationships and it's good work.
So I think I have, you know, Iprioritize it.
I, you know, even this morning,during I lead the treatment
rounds on residential still, andyou know, even this morning we
were discussing someone who'sdischarging today and one of the
(30:34):
conversations we had is talkingthat this person's consultant.
You know, let's talk with themtoday, let's, you know, see if
there's anything they need, asthis person's about to head out
the door.
You know, even though we talkedto them just yesterday, we're
going to talk to them againtoday, the consultant, because
it's that high touch.
Speaker 1 (30:52):
Troublesome consultants.
What's that Troublesomeconsultants?
Speaker 2 (30:56):
Oh no, I think it's high touch.
It's an awareness of, you know,high touch, care matters right.
Yeah, we do want to stand out,as you know, really take on the
extra miles as best we can andyou know, I just think it's part
of you know doing good businessif you will, and I think it's
just part of good relationships.
Speaker 1 (31:19):
Well, as you say, it's part of good care.
I mean, if you go certainlyyou've had this frustrating
experience I know you have, I'vecertainly had where someone
goes into care in a psychiatrichospital somewhere in the
country and sometimes you get agood doc who's just truly
compassionate and everythingelse.
(31:39):
A lot of times you're going toget somebody who, like we say,
is a little siloed but, moreimportantly, they they literally
don't look at anything.
They don't look into the head,the past or any of the meds they
were on before they put them on, whatever the regimen they
think that they should be onbased on the symptoms they're
seeing in a 30-minute meetingand they're out the door and
just as likely to get it wrong.
About half the time they do getit wrong and two or three days
(32:02):
the person's on the street,right back into crisis again and
they repeat the cycle.
This happens a lot.
It really happens a lot.
Now, as a person, you've got avery distinguished career
walking through being a part oftreatment programs that have a
(32:24):
lot of sophisticated clinical Iknow for a fact they're all
connected to hospitals and othertreatment providers and
everything else and everythingelse.
Where do you think thedisconnect is between what you
help orchestrate and the kind ofcare provider you have become
and try to give to others, ofcourse, in your organization and
(32:45):
say the hospital system thatkeeps this cycle that we see
that's broken alive.
Where do you think thedisconnect is?
Is it in training?
Is it when they get their lightLike?
Where is it, in your opinion?
Speaker 2 (32:59):
Yeah, good question.
Well, the first place I go toin my mind is you know, thinking
about the system you know someof these clinicians are embedded
in and you know, which I thinkgoes back to you know, our
conversation about theimportance of the communal
(33:22):
spirit, the importance of aplace where our brains can relax
and we can feel increasedfreedom.
To take a little extra time to,you know, get to know someone in
more depth, take a little bitto the work, yes, and which is
different than a, than a systemwhere there's enormous pressures
(33:42):
and where people don't feel thefreedom and they become more
kind of, you know somewhat,automatons, you know going
through checking boxes andfilling out paperwork.
Yeah, and you know I'msympathetic to you, know being
(34:03):
part of that system can snuffout some of the care and passion
people may have gone intomedicine for in the first place.
You know you don't go throughmedical school and all these
other trainings if you don'thave some desire to make a
difference.
And I think you know over time,you know a variety of pressures
(34:23):
can really make it moredifficult to feel free to
practice the way one might wishto.
Speaker 1 (34:31):
Right.
Speaker 2 (34:32):
People kind of give up.
Sometimes People are resignedor feel like they have to, you
know, adapt, and so I do thinkthe systemic culture plays a big
, big role what's rewarded,what's incentivized, the
leadership and what theleadership talks about in models
.
That's why I think about youknow what I'm conveying to staff
(34:53):
all the time I try to make surethat I'm a presence and I'm
conveying that time matters,that people matter, that care
matters.
But you know that can bedifficult to uphold.
Speaker 1 (35:08):
Yeah, especially if you're in a system that's not
sharing it with you.
Speaker 2 (35:10):
Yeah, that's right, right, well, you know young
providers of course they getinto these things.
What's the quote?
Speaker 1 (35:13):
The last.
Yeah, that's right.
Well, you know young providers,of course they get into these
things.
What's the what's the quote?
The last thing to realize,that's surrounded by water is a
fish.
You know they're just they'rejust swimming through this thing
and they think this is the waythat this is done.
Speaker 2 (35:28):
Well, that's right, yeah, you know that's right.
Yeah, and then maybe theythey're told, you know, hey,
keep up the great work andyou're very efficient.
And and, uh, you know, onething I'd really do appreciate
is in my meetings with the, theLinder family.
Um, you know, even on the onehand, they have, um, you know,
(35:49):
they have an appreciation forthe realities of the business
world and they've beensuccessful in business.
Uh, but Mr Linder has said tome a few different times, and I
was like Michael, you know, Iwant us to be good stewards of
our resources and cost efficient, but quality is number one.
And you know, hearing that fromthe chair of the board, from
(36:12):
the person who you know hasinvested so much of, you know,
their family resources, sayingyou know we want quality, that
counts for a lot.
Speaker 1 (36:22):
It really does.
You know it's more than lipservice.
Absolutely Well, it's.
You know.
I think that you're something.
I think that would be asolution to a lot of just the
health care system in general,not be a solution to a lot of
that, just the health caresystem in general, not just
psychiatric, but a lot of thehealth care system is to and is
incentivized positive outcomesas opposed to you know, it's a
(36:43):
lot of it is sickness careversus wellness care yeah,
that's right, um, and I thinkthat you know part of what lynda
does well and I've.
All I've been able to experienceand witness is a person comes
in with severe conditions andwith lots of symptoms that
they're struggling with, butthey come into an environment
where they feel cared for.
You cultivate a vision of whatwellness can look like.
(37:08):
Help them, take some of theinitial steps towards being well
and give them a plan for it tofollow so that they can just
keep working on that path.
And it really is focused atwellness.
Sure, we're assessing sicknessand we're treating sickness.
We're focused on wellness andthat's where we want to go.
(37:29):
And I think that that's a braintrick you've got to do in a
culture and as a provider or aperson that cares for people.
It sounds simple, I think, butit's subtle in many ways and in
my practice and I've seen it inthe practice that you have there
at Lender Center but it causesme to be creative.
(37:51):
If I think something's gettingstuck, I'm like all right,
where's our path to wellnesshere?
We're running into blockageshere and we've got some
limitations here and there arethings that we can't do here.
So where's this path forwardthat we can find so this person
can return to life and have ashot at recovery, and when you
ask those questions, you come upwith things that may not
(38:12):
necessarily just be obvious, andI think what you're doing is
you're maintaining a culturethere at Lender that causes
people to be creative about waysin which a person can get well,
because they really want themto do that.
I really want you to get well,and that's something I hear
repeatedly over and over, notonly with your team, but from
(38:33):
you and it sounds like from theleadership, not only with your
team, but from you and it soundslike from the leadership.
I've never met the Lindnersmyself, but I take it on good
faith and love the center thatthey've created and I'm really
appreciative of you taking thetime with me today and just
being the kind-hearted,warm-spirited person that you
are leading the charge out thereat Lindner Center outside of
Cincinnati, Dr Grote.
Speaker 2 (38:54):
It has been a pleasure and a privilege to have
you on the show.
Yeah, it's been a real pleasureto talk with you about this too
, Todd, and thank you so muchfor this opportunity and
privilege.
Speaker 1 (39:05):
You're most welcome.
Well, this has been Head InsideMental Health with Todd
Weatherly.
Dr Grote's been our guest withLindner Center of Hope.
We look forward to being withyou all next time.
Take care Outro.
Music.
Hello folks, Thanks for joining us on Head Inside
Mental Health, featuringconversations about mental
health and substance usetreatment, with experts from
across the country sharing theirthoughts and insights on the
world of behavioral health care.
Broadcasting on WPBM 1037, thevoice of Asheville independent
commercial free radio, I am ToddWeatherly, your host
(00:21):
therapeutic consultant andbehavioral health expert.
Joining us today is theesteemed and distinguished, but
first and foremost, a caring andcompassionate human being, Dr
Michael Grote.
Dr Grote is the president andCEO at the Linder Center of Hope
and non-profit mental healthcenter, providing psychiatric
hospitalization, assessment andresidential treatment, as well
as extensive outpatient servicesjust outside of Cincinnati,
(00:43):
Ohio.
Dr Grote has received his PhDin counseling psychology at the
University of Albany StateUniversity of New York.
He completed his postdoctoralfellowship in the treatment of
refractory personality disordersat the Austin Riggs Center of
Residential TherapeuticCommunity up there in
Stockbridge, Mass.
He is the Associate ClinicalProfessor of Psychiatry and
(01:04):
Behavioral Health Neuroscienceat the University of Cincinnati
College of Medicine.
He was previously ChiefClinical Officer and Director of
Psychology and Assessment atSilver Hill Hospital, where he
was also Associate ClinicalProfessor of Psychiatry at the
Yale School of Medicine.
He's also former CEO of CooperRees, a residential healing
community with two campuses herein the Asheville area.
Former CEO of Cooper Rees, aresidential healing community
(01:25):
with two campuses here in theAsheville area.
Dr Levine was just on our show,actually, as well as former
director of adult services atthe Menninger Clinic, prominent
psychiatric assessment center inHouston, Texas, and associate
professor of psychiatry andbehavioral sciences at the
Baylor College of Medicine.
While there, Dr Grodd is aresearch fellow of the Anna
Freud and Yale Child StudyCenters.
He is a fellow of the AmericanPsychoanalytic Association and a
(01:46):
recipient of the Pillar Awardfrom the Miniker Clinic.
He has lectured widely ontopics related to
psychotherapeutic treatments,acute and intermittent levels of
care, suicide prevention,personality assessment and
recovery.
I might get to see him in Junein Arizona.
In fact, I have had thedistinguished privilege of
working with Dr Grote as amember of the Lindner Center of
(02:07):
Hope Referral Advisory Committeeand work regularly with his
team there at the Sipsy andWilliams House programs.
Dr Grote, welcome to the show.
Speaker 2 (02:17):
Thank you.
Thank you, Todd, for thatincredibly gracious welcome and
introduction.
Speaker 1 (02:25):
Appreciate it you, uh , you probably know dr john
santo pietro.
Did you know him?
At all yeah yes, he was he.
I did his intro and he's likewho is this guy?
Speaker 2 (02:40):
I know, I was thinking that guy has really
been busy.
Speaker 1 (02:43):
He has been busy.
Speaker 2 (02:45):
Yes, you have been busy man, I tell you it's.
Speaker 1 (02:50):
I mean, how long have you been with Linder Center?
Now A couple years.
Speaker 2 (02:54):
I've been with Linder 13 months.
This is my 14th month.
Okay yeah, so relatively newhere to Linder.
Speaker 1 (03:09):
Center and the state of Ohio and the Cincinnati
region.
Well, I'll start with thispiece, which is I rely fairly
frequently on the Linder Centerfor something that it's very
hard for me to get in otherplaces around the country.
It's pretty unique and and it'sapproached.
There are some places you canget this done, but linder is one
(03:31):
of those places that's got anacute, an acute, uh, psychiatric
hospital, so a person can behospitalized, which means which
means keeping them against theirwill.
Sometimes, if they're unsafe tothemselves or others, they meet
criterion for detainment, ifyou will, psychiatric detainment
.
But it sits right there on theunit, it doesn't feel like a
(03:55):
hospital.
And just outside of thatthere's Sipsy and Williams House
, the assessment center and thestabilization acute care
treatment center or side of thehouse where people can kind of
come out of that environment,have a care team that figures
out what's going on for them,give them not only a diagnostic
(04:15):
you know diagnostic profile oryou know identify what it is
that's going on with them, butalso come up with a treatment
plan and help them engage in theinitial stages of treatment so
they can kind of follow throughwith, you know, a lot of times
residential care after that, orpotentially outpatient care, and
so it's this.
You know, at the acute levelit's a continuum of care that's
(04:35):
very robust and very useful to aperson who's having some pretty
serious symptomology or mentalhealth conditions.
And you guys have gotdevelopments to the building.
You're adding on.
The outpatient servicescontinue to grow.
You've got strong alliances tothe university there, where you
(04:58):
know you help provide them withexpertise and teaching and other
kinds of stuff.
Where, like, what brought youhere?
And I think I have some of thatanswer.
But where and where are youguys going?
Like I think that you're thisprominent feature, not only in
the local community but in thenational community.
What's your, what's your vision, what you got going on?
Speaker 2 (05:19):
Yeah right, great question, john.
So you know you've touched onsome of the features of the
Linder Center of Hope.
You know I learned about Linderback in the mid 2000s when Dr
Keck, who is the foundingpresident, ceo, was working with
the Linder family onestablishing this program as a
(05:42):
national referral center.
Establishing this program as anational referral center and, as
you have pointed out, a placewith a robust offering of a
continuum of care all under oneroof.
This is one of the fewindependent, non-for-profit
psychiatric hospitals I've seenin the country where you have
that entire continuum under oneroof.
You can walk from inpatient toresidential to outpatient
(06:04):
without having to leave thebuilding, and that was an
intentional design to providethis.
You know, total range ofservice for people, for
individuals and families.
So you know what I learnedabout the Linder Center years
ago.
You know I knew that Dr Keckand the Linder family were
working closely with the Collegeof Medicine in wanting to
(06:27):
establish a rigorous,comprehensive treatment program,
but one that was infused with aMidwestern sensibility, a
Midwestern warmth andhospitality.
Midwestern warmth andhospitality and one other thing
(06:51):
is a certain kind ofauthenticity and genuineness
that people have a really downto earth type of approach.
So it's a really nice blend ofcombining people who you know
are at the forefront of thinkingand leading-edge research but
also have a really down-to-earth, humble, caring way of relating
to people.
So that really drew me toconsider working here.
(07:15):
Dr Keck, a few years ago, talkedto me about coming to join the
center.
He and I were speaking at aconference together in Arizona
and he spoke with me aboutwhether I might be interested in
taking another look at theLinder Center.
It is something I hadconsidered in the past and two
years ago when he spoke with me,we began a series of
(07:37):
conversations and he introducedme to the Linder community,
introduced me to the Lindercommunity and I came on to
continue really that trajectoryof work that I've done with
other hospitals, which is, youknow, advancing clinical
excellence, you know, continuingwork to provide an optimal
experience for patients andfamilies.
(07:58):
So now, as I assume theleadership role of the center
and as you point out, we'reembarking on a $30 million
expansion which includesbuilding a four-story
52,000-square-foot medicaloffice building and it includes
another wing to our SIPC HouseResidential Assessment Program,
(08:20):
there's huge opportunity here tothink about who else can we
serve and take care of in theCincinnati region and around the
Cincinnati area down inKentucky and then throughout the
state of Ohio and to Indianaand West.
Virginia and Kentucky andTennessee, and you know we aim
(08:42):
to be a premier mental healthresource right here in the
Midwest as well as for peoplethroughout the country.
So you know I think of it inconcentric circles.
We are expanding the range ofservices for the local community
, being a real strong powerhousein the Cincinnati region for
(09:02):
mental health care powerhouse inthe Cincinnati region for
mental health care.
The number of people seekingmental health care has been and
the providers that we have formental health care has doubled
in the last four and a halfyears.
So there's just enormous needsin the community that we're
rising to meet.
And with our assessment program, we know that people around the
(09:23):
country are looking fordiagnostic expertise that we
offer and we're growing to meetthat need.
So my vision is, you know, firstlooking at how do we really
leverage all this wonderful newspace that the board of
directors and the Linder familyare providing and use it in a
(09:46):
way that advances mental health.
And to do so, what I'm doing inparticular is looking at how do
we build partnerships thatallow us to do new things.
So, for instance, ourconnection to and our
affiliation with the College ofMedicine.
In fact we're owned in part bythe College of Medicine.
(10:09):
What that allows us is theopportunity to do more
partnerships around.
You know, dissolving thatdisconnect between you know,
medical care and mental healthcare.
There's a way to bring themtogether in a more integrated
fashion, such that you know ifI'm a woman who is, or someone
who's, you know, bearingchildren, I can go in for an
(10:32):
OB-GYN appointment and, whileI'm there, also know that there
is mental health care availableto me as well, and I've been
having discussions with OBGYNregarding an integrated clinic
for maternal health.
I've been in conversation withthe sleep disorders clinic at
(10:53):
the university regarding whatmore can we provide people
around sleep disorders, whichtend to be underdiagnosed or
undiagnosed for many individualsstruggling with mental illness,
but having conversations withthe Department of Endocrinology
because we know a number ofindividuals who particularly are
living with long-term mentalillness vulnerability may be
(11:17):
struggling with various forms ofmetabolic disorders like
diabetes and what can we provide?
them.
So part of my vision is lookingat what partnerships can we
build to better serve a range ofpeople, to meet the needs of
youth, to meet the needs ofolder populations.
Looking at our demographics,the majority of our patients are
(11:39):
between 18 ages of 18 and 30,and then the other big portion
of our patients is,interestingly enough, people
over the ages of 65.
So really looking at, how do wemeet the needs of these
populations, how do we adapt andinnovate our services?
to best meet the needs andbecause we are a freestanding,
(12:00):
independent hospital, of courseaffiliated with the College of
Medicine, I think we work bestwhen we work as a team and we
work in partnership with otherpeople.
Speaker 1 (12:10):
Yeah, it's a team.
John said this it's a teamsport.
Speaker 2 (12:15):
It's exactly a team sport.
Speaker 1 (12:17):
That's exactly right.
Well, you know, one of thethings that and as you know, in
our practice we spend a lot oftime working with families and
individuals who are kind of 40plus.
That's right Not just kind ofhitting 40 or hitting 50
(12:43):
perimenopause and having a lotof mood dysregulation and
depression and anxiety, some ofwhich is connected to endocrine
systems and or hormonal levelsand all these other pieces.
And you know, one of the issuesand part of the reason I enjoy
working with Lindner Center isbecause you can.
(13:05):
You could go to a place thatthat offers psychiatric services
, but there, but you find waytoo often they live in a silo
and and that person may get whatis more or less a decent
psychiatric evaluation or aneuropsych, but they've left out
these other pieces.
They haven't done blood testing, they haven't done hormonal
(13:27):
testing, they haven't done someof the things that might be
impacting this person andpotentially at levels that are
not going to be reconciled.
If you just come out exclusivelywith a psychiatric assessment
and a psychiatrist throws somemedications at you for symptom
management, but the hormones arestill off and the person just
(13:48):
keeps, you know they're on a medthat doesn't work, they still
feel bad, their conditioncomplicates as a result and
we're coming up with a worldwhere people are grasping at
straws to find answers for stufflike this.
And you know not a lot ofpeople know exactly what a
therapeutic consultant is and bythe time they get to us.
(14:08):
We're one of the things thatit's that's very much at the
front of our minds is let'sfigure out what's going on first
, before we start treating youyes, yes um, and that's
something that lender has alwaysdone incredibly well uh, the,
when you are in the expansion ofthe, the that you're talking
(14:29):
about.
You've got a new building,you're talking about more
partnerships and things likethat.
Something that came to mind asyou were speaking and I know
this is part of your historycoming you've got Meninger, but
you've got Cooperese and you'vegot Silverhill.
You've got this background.
That's not only highlysophisticated psychiatric
assessment, diagnoses, treatmentand the like, but there's a
(14:55):
thread there of therapeuticcommunity, which is a philosophy
.
We approach treatment togetheras a philosophy.
We approach treatment togetheras a team.
How are you weaving that threadof therapeutic community into
the developments and theprogramming that you're putting
(15:16):
into place now and what's partof your team as it stands?
Speaker 2 (15:21):
That's a terrific question and insightful
observation.
I I love your use of the wordsilo, because community and
integrated care is a way ofabolishing silos and really
(15:42):
bringing people together.
That's right.
Inclusivity I'm thinking aboutcollaboration, I'm thinking
about things that foster a senseof belonging and that I think
that you know, going back to theidea of a team sport, you know
(16:02):
I have also learned inhealthcare that oftentimes our
best thinking is done togetherand that you know, for example,
in partnering with someone likeyou who is working with a family
, working with someone who'sstruggling and learning from
your experience, you know thatbecomes a really important data
point to be holding in mind andthinking about and bringing into
(16:25):
our work spirit that recognizesthe value of everyone, at the
very least, and creating forums,creating opportunities for
people to really have a voiceand to have their perspective
heard and understood and thoughtabout.
(16:46):
And you know from there kind ofI think it was like building
blocks you know, creating anenvironment where people feel
safe and encouraged and welcometo participate, and that you
also set up structures andprocesses that foster
collaboration, that foster asense of working together at
(17:07):
things.
So in my career I have donethis through how I have set up
staffing structures.
You know, when I was at SilverHill, I set up a clinical
leadership team that didn'texist prior to that where all
the clinical leaders gottogether and we worked at
reducing silos.
We worked at thinking aboutpatients, but then also meeting
with patients and meeting withfamilies and learning from them
(17:29):
about you know, what are yourneeds and how can we best
partner together.
You know, here's some of whatI'm thinking.
What do you think of this?
And all these types of stepsover time, I think are
cumulative and they create, theyfoster a sense of we're in it
together, we're working at ittogether, and then you can
actually have, you know,community events that you know
(17:51):
kind of mark that we are acommunity and, you know, have
various kinds of rituals,whether it's, you know,
celebrating staff throughemployee appreciation or
celebrating people's recovery.
You know patients in recovery.
You know, some of my favoriteexperiences in my career have
been sitting with patients atthe time of discharge as they
(18:14):
reflect on their experience andthey share words of wisdom with
other patients and have talkedabout what they gained and their
new outlook.
You know, those are incrediblyrewarding moments and I have
found that they most often bestoccur in the context of a
community and in the variouskind of therapeutic communities
(18:36):
I've been part of oftentimesresidents of communities,
patients of communities,whatever kind of context it's in
they'll talk about the peersand the relationships with
people that they've formed inthe community, and the sense of
belonging and support from thecommunity was in many cases the
most beneficial thing thatpeople gain from the treatment
(18:58):
experience.
And so, knowing that and knowingthe power of community, I'm
always attentive to how do weharness that power and really
make the best use of it inwhatever program I'm in and so
here at Lender, you know I'vebeen really very behind our
(19:23):
Employee Engagement Committeeand Employee Well-Being
Committee and you know they havejust early on said let's grow
the membership of thesecommittees and they have grown
in size and there's all thesestaff coming together from
across the organization.
We're saying you know we'reinterested in fostering a sense
of community and celebration andappreciation and we're now
(19:49):
sponsoring a record number ofcommunity activities here at
Lender.
That's great, yeah.
This week we have candy gramsfor Valentine's Day and then we
just had cocoa and karaoke theother day in the gym where staff
came together we sang karaoke,we had fun.
(20:10):
We had hot cocoa in the coldweather, and then, right before
that, we had 2024 music rap,where everyone picked out their
favorite music and artists fromthe year 2024, and uh.
And then you know, two weeksfrom now we're starting the
march madness bracket and thenwe're having a food truck come
(20:31):
to celebrate the c Reds openingday in their training camp.
And of course, you know justyou know bringing people
together, fostering a sense ofconnection, and you know we're
in this together, we're.
You know we're enjoying eachother, we're working side by
side.
You know we're all here aroundthe mission of taking care of
people and, you know, helpingthem find hope.
Speaker 1 (20:50):
Well, I think that I mean you talk about staff
culture, of course, and it'ssomething that has to.
It's not just a concept, youknow, it has to live inside of
it, that's right.
You know, it's this thing thatyou know you do every day.
I think I don't know if peoplereally realize the, what a
(21:11):
culture like that does tosupport a healing environment,
how you, in ways that you can'treally name sometimes and can't
be said, you pass it off to thepeople that you're caring for,
yeah, and and just the.
They see it, they witness it,they feel a part of it.
Uh, and it and it and itprovides this I don't know, know
(21:32):
magical base.
If you will, I'm sure we coulddo a bunch of neuroscience and
brain scans on it if we wantedto.
Speaker 2 (21:39):
I think you probably could, because one thing I think
about is when we humans arestressed and taxed and let's say
, I'm in a workplace and I don't, and I feel I don't feel
supported and I don't feel safeand I don't feel valued, don't?
Speaker 1 (21:58):
feel respected.
You're talking about a largeportion of the community health.
Speaker 2 (22:01):
Yeah, and there's kind of an underlying strain to
that, and there's something kindof miserable about it that you
carry with you in contrast to,you know, having people feel
free of that kind of burden andbeing able to have the kind of
emotional freedom to relax andfocus on being present.
(22:22):
And so I think you're right, ifwe can be present and really
present for patients and theirfamilies, I think there is
something you know reallyimportant that happens.
Speaker 1 (22:34):
You know, when I was at Cooper Rees a place that you
and I share and having been apart of there, and we had a
presentation that was, they weretalking about the brain banana.
And it's basically the region ofthe brain and the
(22:54):
parasympathetic nervous systemand the mingles part of it, part
of the prefrontal andeverything else, but the center
that processes emotions andstores information.
That is long-term.
At any rate.
The study they were doing withit was how this portion of the
brain processes what's on yourface of the brain processes
(23:17):
what's on your face like youwalk in the door and my brain is
processing information that itsees registering from what
you're, what you're expressingin your facial structures and
and basically category is this athreat?
Is this person upset?
Are they a friend of mine?
Like what is what do I need tobe prepared for as this?
person walks in uh, and you knowthey were.
They were seeing that if aperson, like before they could,
(23:40):
before they could uh registeranything cognitively, their
brain was already responding,the body was already responding
to the person was walking in theroom yeah um, I can help but
think, based on that, that thateffect is also cumulative.
If you've got an environment ofpeople that are stressed and
(24:00):
disenfranchised and notappreciated in everything else.
They're passing that stuff offto the people they care for.
The opposite is also true.
Speaker 2 (24:10):
That's a lovely point .
That's fantastic.
Yes, that does actually uh, youknow, integrate neuroscience,
right and?
Yeah yeah, the importance ofhow we show up and the
difference that that makes,especially, as you say, over
time.
Speaker 1 (24:28):
Yeah, the, the, how we show up piece, and you know,
one of the things just as acompliment to you and your team
and something I think thatyou've been very intentional
about it's not just partneringwith these other agencies.
You know there's the universityand there's other professionals
and everything else.
Let's see what we can do toalign ourselves and be better at
(24:49):
the assessment work andtreatment work that we do Great.
But I also happen to know youknow, as a person who's a
referrer and has worked fairlyclosely with members of your
team, that you know they do areally good job, especially
these days, of being inclusiveof others who are involved in a
person's treatment and careprocess.
(25:11):
So you know, maybe they have atherapeutic consultant or maybe
they have a referring clinicianor a referring doc or all of
those, and the team's reachingout, wanting to get information
from this person, making suremaybe the referent feels
included or has some, you know,knows what the process is for
this person and is pulled in ona team meeting that gives an
(25:32):
update and those kinds of things.
And for a lot of places I haveto go after that stuff and with
you guys it's just part of theregular makeup of how you do
things and I think that that wasa process for Lender Center, as
it is for many to try and justlet's be open to the people who
(25:55):
are partnering with us andsending their clients or the
people that they've been workingwith, to us for their care.
That's a trust that they'vegiven to us and we want to
return the favor by making surethat they feel included and that
their contribution is honored.
Feel included and that theircontribution is honored and it's
.
You know, there's no small feat,because if you go in other
(26:15):
places, the silo, the walls comedown and the silos start to
start to incorporate.
When.
What is it that you did?
You know what was, what was inyour time there.
You know the 13 months.
Um, even since then, I thinkthis has been something that's
on your mind and you wanted tomake sure it was part of your
team.
What is it that you did toimpart the importance of all of
(26:39):
that, even as it passed off, topeople who are not necessarily
collaborative provider partners?
What was it that was the keypoint or points that you made
for your team and what is itthat caused them to get it?
Speaker 2 (26:52):
Because they seem to really get it yeah, no, it's a
um really thoughtful questionand and point you're making.
Um, I think there uh are a fewthings and you know, as you were
talking, todd, I um, you know,I had this kind of image of the
(27:13):
heart, and not necessarily thephysical heart per se, but more
the sense of having your heartin the work, and a positive
sense.
And I mentioned that because Iexperience a lot of folks and
this is true.
You know a lot of people inmental health care go into it
(27:34):
because they want to help others.
There's an altruistic kind ofmotivation and bent many people
have.
Like you have yourself right,you care about people, and so I
think it's not a lot of stepsfor staff to consider.
You know, part of really caringfor somebody is to make sure
(27:56):
that we have everything we needto provide the best care, and
that includes our openness tolearning and including everyone
who's involved in this person'slife life because you know we
(28:17):
don't you know we have theprivilege of, you know, working
with people, for you know acertain period of time, whether
it's 10 days or 28 days or twomonths, and you know families
have related to their loved onesfor years.
So have outpatient providers, sohave people like you with
therapeutic consultants.
You may have been working witha given family for months and
have had lots and lots ofinteractions and experiences,
(28:40):
and so I think part of it isrecognizing that we deprive,
potentially deprive, the patientof the most informed care when
we don't include others, themost informed care when we don't
include others.
(29:00):
So and that taps into you know,our care or the best interest
of the patient is reallyparamount.
So that's one way I've talkedabout it.
Another thing I've done andthis is interesting I reminded a
number of team members that youknow we're a national referral
center and I think you know anumber of team members that you
know we're a national referralcenter and I think you know a
(29:21):
number of staff they may havegrown up in this area and went
to school here and work here andhaven't really, you know,
traveled.
Speaker 1 (29:26):
Well, I'm Midwestern kind of mind, you know, or
whatever.
Speaker 2 (29:29):
They haven't necessarily traveled the country
like you and I and may notappreciate what that means.
That you know, hey, we'repeople, respect us, people look
up to what we're doing and wewant to honor that respect and,
you know, maintain that trustthat people put in us.
I talk a lot about theimportance of trust and how you
(29:52):
know how hard it is to reallyearn trust, to maintain the
trust.
And part of maintaining thattrust is recognizing that
therapeutic consultants, otherpeople refer to us, they want to
be included, they need to beincluded.
It helps foster trust, it helpsfoster good relationships and
(30:13):
it's good work, helps fostertrust, it helps foster good
relationships and it's good work.
So I think I have, you know, Iprioritize it.
I, you know, even this morning,during I lead the treatment
rounds on residential still, andyou know, even this morning we
were discussing someone who'sdischarging today and one of the
(30:34):
conversations we had is talkingthat this person's consultant.
You know, let's talk with themtoday, let's, you know, see if
there's anything they need, asthis person's about to head out
the door.
You know, even though we talkedto them just yesterday, we're
going to talk to them againtoday, the consultant, because
it's that high touch.
Speaker 1 (30:52):
Troublesome consultants.
What's that Troublesomeconsultants?
Speaker 2 (30:56):
Oh no, I think it's high touch.
It's an awareness of, you know,high touch, care matters right.
Yeah, we do want to stand out,as you know, really take on the
extra miles as best we can andyou know, I just think it's part
of you know doing good businessif you will, and I think it's
just part of good relationships.
Speaker 1 (31:19):
Well, as you say, it's part of good care.
I mean, if you go certainlyyou've had this frustrating
experience I know you have, I'vecertainly had where someone
goes into care in a psychiatrichospital somewhere in the
country and sometimes you get agood doc who's just truly
compassionate and everythingelse.
(31:39):
A lot of times you're going toget somebody who, like we say,
is a little siloed but, moreimportantly, they they literally
don't look at anything.
They don't look into the head,the past or any of the meds they
were on before they put them on, whatever the regimen they
think that they should be onbased on the symptoms they're
seeing in a 30-minute meetingand they're out the door and
just as likely to get it wrong.
About half the time they do getit wrong and two or three days
(32:02):
the person's on the street,right back into crisis again and
they repeat the cycle.
This happens a lot.
It really happens a lot.
Now, as a person, you've got avery distinguished career
walking through being a part oftreatment programs that have a
(32:24):
lot of sophisticated clinical Iknow for a fact they're all
connected to hospitals and othertreatment providers and
everything else and everythingelse.
Where do you think thedisconnect is between what you
help orchestrate and the kind ofcare provider you have become
and try to give to others, ofcourse, in your organization and
(32:45):
say the hospital system thatkeeps this cycle that we see
that's broken alive.
Where do you think thedisconnect is?
Is it in training?
Is it when they get their lightLike?
Where is it, in your opinion?
Speaker 2 (32:59):
Yeah, good question.
Well, the first place I go toin my mind is you know, thinking
about the system you know someof these clinicians are embedded
in and you know, which I thinkgoes back to you know, our
conversation about theimportance of the communal
(33:22):
spirit, the importance of aplace where our brains can relax
and we can feel increasedfreedom.
To take a little extra time to,you know, get to know someone in
more depth, take a little bitto the work, yes, and which is
different than a, than a systemwhere there's enormous pressures
(33:42):
and where people don't feel thefreedom and they become more
kind of, you know somewhat,automatons, you know going
through checking boxes andfilling out paperwork.
Yeah, and you know I'msympathetic to you, know being
(34:03):
part of that system can snuffout some of the care and passion
people may have gone intomedicine for in the first place.
You know you don't go throughmedical school and all these
other trainings if you don'thave some desire to make a
difference.
And I think you know over time,you know a variety of pressures
(34:23):
can really make it moredifficult to feel free to
practice the way one might wishto.
Speaker 1 (34:31):
Right.
Speaker 2 (34:32):
People kind of give up.
Sometimes People are resignedor feel like they have to, you
know, adapt, and so I do thinkthe systemic culture plays a big
, big role what's rewarded,what's incentivized, the
leadership and what theleadership talks about in models
.
That's why I think about youknow what I'm conveying to staff
(34:53):
all the time I try to make surethat I'm a presence and I'm
conveying that time matters,that people matter, that care
matters.
But you know that can bedifficult to uphold.
Speaker 1 (35:08):
Yeah, especially if you're in a system that's not
sharing it with you.
Speaker 2 (35:10):
Yeah, that's right, right, well, you know young
providers of course they getinto these things.
What's the quote?
Speaker 1 (35:13):
The last.
Yeah, that's right.
Well, you know young providers,of course they get into these
things.
What's the what's the quote?
The last thing to realize,that's surrounded by water is a
fish.
You know they're just they'rejust swimming through this thing
and they think this is the waythat this is done.
Speaker 2 (35:28):
Well, that's right, yeah, you know that's right.
Yeah, and then maybe theythey're told, you know, hey,
keep up the great work andyou're very efficient.
And and, uh, you know, onething I'd really do appreciate
is in my meetings with the, theLinder family.
Um, you know, even on the onehand, they have, um, you know,
(35:49):
they have an appreciation forthe realities of the business
world and they've beensuccessful in business.
Uh, but Mr Linder has said tome a few different times, and I
was like Michael, you know, Iwant us to be good stewards of
our resources and cost efficient, but quality is number one.
And you know, hearing that fromthe chair of the board, from
(36:12):
the person who you know hasinvested so much of, you know,
their family resources, sayingyou know we want quality, that
counts for a lot.
Speaker 1 (36:22):
It really does.
You know it's more than lipservice.
Absolutely Well, it's.
You know.
I think that you're something.
I think that would be asolution to a lot of just the
health care system in general,not be a solution to a lot of
that, just the health caresystem in general, not just
psychiatric, but a lot of thehealth care system is to and is
incentivized positive outcomesas opposed to you know, it's a
(36:43):
lot of it is sickness careversus wellness care yeah,
that's right, um, and I thinkthat you know part of what lynda
does well and I've.
All I've been able to experienceand witness is a person comes
in with severe conditions andwith lots of symptoms that
they're struggling with, butthey come into an environment
where they feel cared for.
You cultivate a vision of whatwellness can look like.
(37:08):
Help them, take some of theinitial steps towards being well
and give them a plan for it tofollow so that they can just
keep working on that path.
And it really is focused atwellness.
Sure, we're assessing sicknessand we're treating sickness.
We're focused on wellness andthat's where we want to go.
(37:29):
And I think that that's a braintrick you've got to do in a
culture and as a provider or aperson that cares for people.
It sounds simple, I think, butit's subtle in many ways and in
my practice and I've seen it inthe practice that you have there
at Lender Center but it causesme to be creative.
(37:51):
If I think something's gettingstuck, I'm like all right,
where's our path to wellnesshere?
We're running into blockageshere and we've got some
limitations here and there arethings that we can't do here.
So where's this path forwardthat we can find so this person
can return to life and have ashot at recovery, and when you
ask those questions, you come upwith things that may not
(38:12):
necessarily just be obvious, andI think what you're doing is
you're maintaining a culturethere at Lender that causes
people to be creative about waysin which a person can get well,
because they really want themto do that.
I really want you to get well,and that's something I hear
repeatedly over and over, notonly with your team, but from
(38:33):
you and it sounds like from theleadership, not only with your
team, but from you and it soundslike from the leadership.
I've never met the Lindnersmyself, but I take it on good
faith and love the center thatthey've created and I'm really
appreciative of you taking thetime with me today and just
being the kind-hearted,warm-spirited person that you
are leading the charge out thereat Lindner Center outside of
Cincinnati, Dr Grote.
Speaker 2 (38:54):
It has been a pleasure and a privilege to have
you on the show.
Yeah, it's been a real pleasureto talk with you about this too
, Todd, and thank you so muchfor this opportunity and
privilege.
Speaker 1 (39:05):
You're most welcome.
Well, this has been Head InsideMental Health with Todd
Weatherly.
Dr Grote's been our guest withLindner Center of Hope.
We look forward to being withyou all next time.
Take care Outro.
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