In the country’s convoluted health care system, forging a path towards recovery can be frustrating at best and a setup for failure at worst. A patchwork system, grown organically over the years as need arises or funding is available, US health care encompasses a wide variety of services, both public and private, for and not-for-profit.
It can be overwhelming for individuals trying to navigate and find help for themselves or loved ones, especially for mental health services.
With its whole person approach, Walden Behavioral Care, a Waltham, Massachusetts-based mental health care system that specializes in treating eating disorders, looks to conquer the problem by providing a range of care that moves through recovery with the client.
With 17 locations in Massachusetts, Connecticut and Georgia, Walden has treated more than 20,000 people in the last 15 years and will soon open a new 100-bed facility in Dedham, Mass.
New England Psychologist’s Catherine Robertson Souter spoke with Walden’s founder, president and CEO, Stuart Koman, Ph.D, about the organization, its mission, and his own career trajectory.
Did you set out to run a mental health system? If not, how did this end up being where you focused your energy, your life’s work, and why?
Well, I was a full-time clinician working in an inpatient hospital setting after graduating from Duke University with my Ph.D in the ‘80s. My background is adolescents and families. Even then, I really wanted to be able to provide more comprehensive services and, in particular, to bring families into treatment. This is back in the day when we mostly had the “parent-ectomy.”
When you brought kids in to a psychiatric hospital, you would cut the parents out. There are things we take for granted at this point when we work with families but back in those days, it wasn’t the case. Most kids who went to hospitals wound up in residential programs afterwards.
I developed the adolescent program at Charles River Hospital with some other individuals where we were getting families involved. Then, the state made funds available to start a new program for kids so I put together a proposal and started Charles River Management to develop these services for disadvantaged kids and their families.
There was some ambivalence within the organization of doing this work and it wasn’t widely supported so I became the administrator along with being the clinical director. That was the beginning of a major shift in my career when I discovered an interest in organizations and business as well as in clinical work.
I think what I bring to Walden is an understanding of what it takes to do the clinical work but also to be able to develop organizations that can support that kind of work.
How would you describe the mission of Walden?
What Walden is really about is the continuum of care.
We are one of the few organizations that talks about and “plan-fully” develops programs that are continuous across levels of care, from inpatient to residential services, to day treatment, to intensive outpatient services.
We look at the disease process to create a rational way in which individuals can move through and recover.
I think if you look at behavioral health overall, all of the diagnoses could use a much better, more rationally organized system of care. What we have now is, in general, a system where people almost always start over every time they move from one program to another.
I think that’s why outcomes are not shown to be as good as they could be. We are constantly asking people in the throes of some sort of diagnosis to figure out what they need next or sending them somewhere that works from a different model. It is just not the way it should be; it is not rational.
That is what I think of as the innovation of Walden. We work on making sure that we are focused on each person and what they need every day in an individual way so that we don’t fall into a group mindset about one size fits all.
Walden has grown since 2003, from one location to 17. To what do you attribute that success?
I think there are a couple of things: first, services for this set of disorders were extremely under-available when we started. And, second, part of that had to do with the fact that reimbursement had not been available until we had mental health parity.
So, there was great unmet need and finally some reimbursement and enough creative clinicians who recognized this as a very under-served population and were challenged by the complexity of the diseases.
What would you say are your goals for the future for Walden? Do you have expansion plans?
Before I talk about expansion, in reality our goal is always to be better not just bigger. The commitment that we have to the system of care is very much part of that. Having that system, we think, provides a degree of hope to our patients and their families that very often they have not had before so that they can see a path to health.
So, wherever we go, our goal is to be able to provide all the services, all levels of care. And that is not an easy thing to do.
In terms of expansion, we did acquire a small company in Atlanta and we also have a set of services in Connecticut with two clinics and a 30-bed hospital unit that we manage. We are developing other services in Connecticut and we have added a residential program in Georgia.
We are probably less than six months away from cutting a ribbon in Dedham and we are very excited about having a state-of-the-art facility that will probably be not only regional but also attract individuals from all over the country and potentially from all over the world.
We are re-locating all of our eating disorders services, much of which were in Waltham, to Dedham. But we also operate a 24-bed acute adult general psychiatry program in Waltham which we intend to expand, doubling the inpatient capacity and adding 15 residential beds as well.
We are in three states now and we see ourselves over time as an East Coast program. We would continue to develop in New England, in the Mid-Atlantic and the Southeast. That is our goal at this time. It is grandiose enough as it is.
What are you most proud of about Walden?
I would always point to our staff; the people that work here are salt of the earth. They work very well with each other and they are committed to providing a healing environment and they get the job done. They make a difference in many peoples’ lives. And I don’t mean just the clinicians. I think this is true for all of our people. Everybody is part of the mission here.
I am proud of the fact that we make a difference and we have demonstrated, although it is very hard, that a system of care that provides a rational path to recovery is a very viable and a good way to go.
Catherine Robertson Souter is a freelance writer and social media agent based in New Hampshire. A contributor to New England Psychologist since its inception, she previously wrote for Massachusetts Psychologist among other media outlets.