Wellness Reimagined

In our world of constant change, and with life moving faster than ever, topics such as mental health, self-care, and prevention have become popular buzzwords. People are looking to live healthier lives, and there is superb care out there that is being offered. At the same time, there are misconceptions about the meaning of self-care and exercise. Many opt for quick solutions — surgery, pills — to dull the problem without adequately addressing the underlying cause. Meanwhile, many parts of the industry are unregulated and oversaturated. People with years of training are competing with people with weekend training. Many providers are overworked, overwhelmed, and underpaid. The general public is not educated about asking the right questions when selecting a wellness provider. In the face of all this, what can be done to correct the status quo? In this interview series, we are seeking to hear from a variety of leaders in the health and wellness industries who agree that the wellness industry is in need of an overhaul and offer suggestions about what can be done moving forward. As a part of this series, I had the distinct pleasure of interviewing Andrea Turnipseed, Executive Director of Roots Behavioral Health in Austin, Texas.

Andrea Turnipseed LCSW-S, is a mental health advocate, innovator and entrepreneur with an interest in non-traditional medicines and approaches to therapy and wellness. Driven to disrupt a sector otherwise known for high out-of-pocket costs, in 2016 she co-founded Roots Behavioral Health to offer high-quality insurance-based adult psychiatric care, which later became the first clinic in Austin, TX to offer ketamine-assisted psychotherapy (KAP) as an alternative to traditional treatment. As Executive Director, Andrea currently oversees a staff of over 50 who serve more than 10,000 patients each year thanks to her efforts to make mental health care more affordable and accessible.

Thank you so much for doing this interview. It is an honor. Our readers would love to learn more about you and your personal background. Can you please share your personal backstory? What has brought you to this point in your life?

The story really starts with my decision to attend graduate school in social work. Knowing I wanted a career working with and helping people, but not being interested in becoming a doctor or a nurse, social work felt like the best option. I love the opportunity to learn from and experience new people and cultures, and being a therapist is a constant lesson in people and experiences so it seemed like a natural fit. Later, after meeting my psychiatrist husband, we decided to build a business together in order to serve a larger community. We founded Roots Behavioral Health in 2016 to meet a need in the community, providing high-quality, insurance-based adult psychiatric care as there were very few psychiatrists in Austin who accepted commercial insurance. Later, in 2018, we became the first clinic in Texas to offer KAP as an alternative to traditional treatments. Establishing ourselves as leaders in innovative and affordable treatment was a challenging road to pave, but it has paid off with the growth of our business and ability to treat over 10,000 central Texans a year.

What is your “why” behind the work that you do? What fuels you?

People! I find people and their stories fascinating. Everyone has a path marked by multiple experiences, successes, struggles, and they are all interesting and worthy of exploring. Knowing that I can help support our patients to be better versions of themselves whether it’s supporting my team or individual clients– I am honored to be chosen as a part of that journey. My hope is that if helping one person improves the life of another, we can leave the world slightly better than we found it.

What are some of the most interesting or exciting new projects you are working on now?

Presently, we are working with insurance companies to add codes for psychiatry to cover ketamine services. We have portions of our ketamine services already covered, and expanding upon that is a great way to make ketamine therapy affordable and accessible. Nonetheless, there are still costs that are being denied by some insurers that limit the ability to cover said treatments for everyone.

Company culture is important in any business, but when treating people with trauma, depression, and other mental illnesses, it can lead to employee burnout if this area is neglected. I am working to find ways to connect our teams, support their self-care, and provide a healthy work environment. This is an ongoing project as our culture and team is dynamic and constantly growing.

It has been said that our mistakes can be our greatest teachers. Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I have made many mistakes over the past seven years of running a business, but all of them felt like something I had to experience in order to learn and improve. As we grew to a company of more than 50 employees, I learned that management is a skill that must be developed regardless of your industry. With no business background, I wrongly assumed we could assign professionals to a role and they would excel in their positions. The reality is we need to manage, teach, and guide people with direction and feedback to support them and build a strong team. While it may seem obvious to many people, I learned how regular check-ins and communication with every member of the team (and across teams) are essential in order to catch problems early and find solutions.

OK, thank you for all of that. Let’s now shift to the core focus of our interview. From where you stand, why are you passionate about the topic of Reimagining The Health and Wellness industries? Can you explain what you mean with a story or an example?

As an early career social worker, I worked in psychiatric hospitals, outpatient community health, and emergency rooms. I became acutely aware of the lack of accessible health care in Austin. My role as a social worker often included setting up aftercare for everything from psychiatry to nursing home care. Inevitably, patients would need assistance in finding providers in-network with their insurance and the appropriate care they needed to maintain stability. Sadly, the reality for many patients consisted of long wait lists and high cash payments for initial visits. Psychiatry, in particular has one of the greatest shortages of doctors of any medical specialty. Austin, despite its resources, is not immune to these evident shortages.

One in five Americans will struggle with mental health during their lifetime, yet it may take months to initiate care. This is unacceptable, especially given that we are currently experiencing a depression and suicide epidemic. While people wait to establish care with a provider, they may commit suicide, engage in risky behaviors, unintentionally hurt themselves or harm someone else, or simply be unable to live their lives to the fullest. The United States does not have a mental health care system capable of meeting the demands of our population.

Lastly, mental health is getting some attention, but really it is about fully optimizing overall functioning. If we can improve people’s mental health, their overall health will improve. For example, a person with untreated depression may be unable to get out of bed, therefore be unable to go to work, exercise, care for their children, engage in their community and so on. Improving their symptoms and optimizing overall health will allow people to create healthier systems in their families, communities, and the world at large; making a change at the individual level has a ripple effect. That person will start going to work, offering support and compassion to others, become present in a child’s life, or act upon a new idea or service because they are unencumbered by a mental illness. If we ignore mental health, we are limiting the full potential of humans and therefore our society as a whole.

When I talk about Reimagining the Wellness industry, I am talking about reimagining it from the perspective of the providers as well as from the perspective of the recipients and patients. Can you share a few reasons why the status quo is not working for both providers and patients?

I think the number one problem is accessibility, which creates tension for both providers and patients. Patients cannot afford or obtain services easily, and providers that are accessible quickly reach capacity and feel the strain of demand. Patients are limited in their choices of providers, leading many providers to render average services to simply meet the demand. Providers do not have the bandwidth nor the incentive to seek out innovative treatments, improve customer service, or negotiate better care with insurance.

Why do you think there is a good opportunity now to improve and reform the health and wellness industry?

Culturally, mental health has become more widely discussed, accepted, and understood. Our society is more aware of the importance of mental health as a part of overall wellness and therefore accepting of the need for treatment and attention. The first step in making a change is having the awareness that a problem exists. For years many people didn’t know that there were ways to combat their own personal problems and accepted living with sub-optimal mental health. Now, individuals are educated and taking charge of their wellness, and the problems within health care systems are becoming more apparent to consumers, so they can finally be addressed.

Less than 10 years ago mental health was considered somewhat taboo and not often discussed. Now it is common to hear about celebrities, athletes, or other public figures opening up about their own mental health struggles. Since the pandemic, people are seeking connection– connection grows from vulnerability, and vulnerability has the effect of allowing others to feel safe to share about themselves when it is well received by their peers. People are ready to get help and talk about their experiences.

With the shift to more widespread acceptance of the need for mental health care, the industry will uncover the limitations of the field, and have the opportunity to find solutions that improve service delivery and care.

Can you please share your “5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry”?

The first is accountability for insurance companies. Mental health and substance use disorders need to be covered across the board. It is unacceptable for insurance companies to simply not provide coverage of services for certain diagnoses or conditions when the members who pay into their system need help. Insurance coverage is obtained to help support individuals with unexpected health care costs. It is impossible to know what future illnesses one may seek coverage for when choosing health care companies. Insurance companies deny medical treatment based on perceived cost benefit, though they are not held accountable for negative consumer outcomes.

Second, a standard system of payment and processing, and improving ease of use with insurance payors. Medical providers often decline accepting insurance due to the difficulty of working with a variety of companies. Patients often do not understand how their insurance works. Insurance companies should encourage and find a way to become accessible to expand their provider network. Presently, it is confusing and cumbersome for a provider to understand how to coordinate care with an insurance company.

The third thing we can do is to change the paradigm from only seeing a provider when a person is “sick”, to seeing a professional for overall health and wellness regardless of illness. I would love to see our society get to a place where it is normal to have a therapist or psychiatrist that you can check in with as needed, or even quarterly to ensure a person is on the best path to health and wellness. Individuals see a doctor for a physical and often learn things about their body that could be working better, the same is true for our mental health. A meeting to ensure individuals are exercising, meditating, eating well, getting out with friends, balancing work and life and so on, would help people become aware of the many ways they could improve their lives. Small changes and check-ins as far as lifestyle could prevent a mental health issue from derailing a person’s life.

Next, improving the ease of communication with multiple providers to coordinate care. Most people see multiple practitioners for their health care. In a given month a person may see a therapist, dentist, primary care physician, masseuse and so on. There is a wealth of information that is lost between providers that could be helpful in overall treatment. For example, a dentist may notice teeth grinding, but the person doesn’t think they are stressed and does not share this concern with a therapist. This is a missed opportunity. Even worse, a patient may have a medication interaction with another food, supplement or medication that is recommended by other providers unaware of the individual risks. Given the importance of patient privacy, streamlining this process would be challenging; however, with the technology and resources available to us, individuals could ideally provide a comprehensive list of their history and present concerns.

Lastly, with so much new information about our health, health care organizations must start with comprehensive evaluations of overall wellbeing. Technology can help alert a provider to consider root causes in order to pinpoint lasting solutions for an illness. As an example, at Roots Behavioral Health, we use a proprietary Brain Health Assessment to evaluate our patients’ gut health, inflammation, time spent outside, social media activity and other possible causes of mood disorders. By using this tool, we can focus on treating inflammation, which contributes to depression, or we might suggest a probiotic-rich diet for someone with chronic gastrointestinal problems (which directly impacts brain health). These assessments and specific treatments can address underlying causes rather than solely treating symptoms using medications; by only doing the latter, people do not enjoy long-lasting benefits. This change in health care would also reduce the demand of services over the long term. If a patient is able to correct a hormone imbalance, they may no longer need mental health services rather than continuing to see a provider for many years with no real long-term results.

From the recipient and patient side of the industry, can you please share a few ways that patients and recipients should reimagine what the wellness and health care industry should provide?

Individuals should take a more holistic view when thinking about their overall health. In a perfect world, providers would collaborate to offer the best possible outcomes and patients would be able to adhere to a plan. Patients should expect and demand, high quality care that fits their budget and lifestyle. The industry would then begin to shift with more supply, improved technology, and coverage of more services and products that increase access and compliance.

What do you think are the biggest roadblocks to reforming the industry? What can be done to address those hurdles?

Unfortunately, the biggest roadblock to reform comes down to supply and demand. There are not enough psychiatrists or therapists to meet the demand for our services. Providers need reasonable payment and assurances to render services and without proper reimbursement, it is difficult to attract talent and produce positive outcomes. If insurance companies could see how paying for services at the front end reduces the overall burden of cost later, we may begin to change the model.

Insurance reform on a national level could begin to address this problem. Insurance companies hold too much power in the provider/patient dynamic and it places limits on health care.

I’m very passionate about the topic of proactive versus reactive self-care and health care. What do you think can be done to shift the industries towards a proactive health care approach? How can we shift the self-care mindset for consumers and providers alike?

As I mentioned earlier, I believe in creating a system where people see a provider for preventative mental health care, which is essentially “proactive” care.

Proactive mental health care includes identifying and eliminating contributing factors, noticing warning signs of relapse, building a support system and structuring lifestyle to promote health and wellness. All of these factors would improve long-term results and reduce overall health care costs. If prevention or intervention can be made early, it might preclude the need for medications or hospitalization. I think change will begin with the payors seeing the benefit of proactive health care and incentivizing both patients and providers for early utilization. Many providers are on board with proactive health care but given the shortage of providers, the luxury of checking in with patients who are healthy is not available to them. We need more practitioners in the field so that patients and providers are not operating from a crisis intervention standpoint.

Thank you for all that great insight! Let’s start wrapping up. Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?

“Happiness is not in another place but this place… not for another hour but this hour.” — Walt Whitman

I love this quote as it always reminds me to be mindful of the present. We have all made mistakes in the past and there is always something to worry about for the future, but all that we can control is our mindset in the here and now. I am so grateful for my life and I don’t want to forget the little moments of joy even when the world seems overwhelming.

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them 🙂

Brené Brown. As a social worker and fellow Texan, I have followed and preached her content since her Ted Talk in 2010. She has shared her research in easy-to- understand books and programs that have vastly impacted the field of social work, improved businesses, and helped create a better understanding of individuals.

Also, Tim Ferris. He interviews many fascinating people and I have learned a lot from his guests and his thoughtful questions. I know that he is passionate about health, wellness and business, and is someone who poses questions and brings forth ideas that challenge our industry to critically think about problems and solutions.

I appreciate your time and valuable contribution. One last question, how can people reach or follow you?

Readers can visit our website www.rootsbehavioralhealth.com to learn more about us, or follow us on Instagram and Facebook @rootsbehavioralhealth.

This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.