Creating Access to Mental Health: Lisa Shannon, President and CEO, Allina Health

Bobbie Dressen  01:22

Hello, everyone, and welcome to the Medical Alley podcast. My name is Bobbie Dressen. And I'm delighted to host today's episode. We're joined a by a leader and an innovator in the Medical Alley community, Allina Health President and CEO Lisa Shannon. Lisa also serves on the Medical Alley board of directors and was recently named by Modern Healthcare as one of the top women leaders in healthcare for 2023. We're excited to talk with her about her leadership journey, and how Allina is addressing the extra ordinary need for mental and behavioral health care. Lisa, it's great to speak with you today and to see you as well. How are you doing?

 Lisa Shannon  02:10

Hi, Bobbie, it's so great to be here. I am doing well and looking forward to our discussion.

 Bobbie Dressen  02:15

Thank you. I wanted to start with you and your path to leadership. Can you share a bit about how you started working in healthcare and what brought you to Allina? Let's dive into the topic of mental health. We're facing a true crisis fact we talked about that together when we were at the Piper Heartland conference this fall. Rates of suicide, anxiety, depression, and other mental health illnesses are rising, especially in young people. This is putting a tremendous strain on health systems to meet a rising demand for care. What's your assessment of the state of mental health care in the United States? We'll start there first. 

Lisa Shannon 

You bet. Healthcare's been my whole career. My early career, Bobbie, was as a dietitian on a burn and trauma team. I knew I wanted to contribute to health and well being. And for me, the path toward clinical dietetics was the right path. I started early in having two passions: preventive health, or critical care I found very interesting. And I still call on my critical care experience, which really grounded me and the reality that the best care and outcomes for patients is really developed and delivered by teams of people with different roles that come together in service of our patients. And I carry that with me all these years. I moved quickly into leadership, and wasn't a path that I had intended. But a path that found me, and I've been in three other states and four other health systems. And I would say Allina Health by far and away has brought me to a place where I feel like I can bring all that we do with complex care and my passion for preventive health, or population health and whole person care. So I love it here. And I'm thrilled to be here.

 Bobbie Dressen
Let's dive into the topic of mental health. We're facing a true crisis fact we talked about that together when we were at the Piper Heartland conference this fall. Rates of suicide, anxiety, depression, and other mental health illnesses are rising, especially in young people. This is putting a tremendous strain on health systems to meet a rising demand for care. What's your assessment of the state of mental health care in the United States? We'll start there first.

Lisa Shannon 
Thanks for the question. We care deeply and I care deeply personally about all that surrounds in our country, mental health. And mental health for me as a broad category of conversations which include ranging from neuro diverse patients to addiction to mental health care and largely driven by what we also care a lot about which are the social determinants of health. By the time a patient gets to a provider in our country or here in Minnesota, we've failed them in society largely. Now there are really deep clinical conditions that need our complex care and diagnoses and treatments. And yet what we're seeing and the rising especially you mentioned the youth, it is a significant concern for us. And I would say every colleague of mine around the country on how do we work in collaboration to solve some of our communities' and country's biggest problems. We are really proud at Allina Health of the mental health and addiction services that we provide. We have worked really hard to create more access for the community. And that access is how can we get as far upstream as we can, meaning how do we know the vulnerabilities in our patients as early as possible in their journey? So one of the things at Allina I'm really, really proud of as we engaged in social determinants of health screening to know the stressors in life that are contributing factors. It could be housing insecurities, food, insecurities, unsafe living conditions, transportation issues. We ask those questions so that when a patient's seen at Allina Health, we understand other contributing factors — we call those social determinants of health. And it is in the knowing that we can begin to identify what early intervention can be done. That said, we are seeing a tremendous increase year over year in patients that we're discharging from our emergency departments for outpatient programs, which ideally, mental health and addiction care would be delivered in early intervention in the outpatient setting. We know that patients do need inpatient care as well. And so those are very complex needs. And ideally, the inpatients that we serve are just that: those that really need inpatients. Unfortunately, the greatest challenge for Allina and all our colleagues is there is I would call it a crushing demand. And the demand far outweighs capacity for most health providers in our country. 

Bobbie Dressen  05:57

And so when you reflect on that, what do you think is the biggest challenge that faces you with Allina today? Well, and you're touching exactly on what my next question is, because at Medical Alley, as you know, health equity has been one of the things we've been working on that and a sub topic has been mental health. And as we've looked at it, we've wanted to address reducing barriers to access. And one of those barriers is not only availability of workforce trained in that space, but also the availability of workers that are like serving like. And we published a year long study about that this year and put it out in January, and we know how important it is. And it's one of the things you'll see us to continue to focus on. But you know, what are you guys looking at in terms of getting more professionals into the workforce pipeline?

 Lisa Shannon  08:42

Well, first of all, I want to say thank you to medical ally, we really appreciate your focus on this. I appreciate our conversation about it. I think it's very important that we as a community, and frankly, as a broad cross cutting industry talk about these things and what do we need to do? So a couple of things I would lift up on the workforce pipeline. We know that having the right providers across our continuum from psychologists to Master's level trained addiction and behavioralists to identifying individuals and communities that may not have exposure. So for example, we have an accredited psychology training program. And that's been a great pipeline for employment. Once that psychology trainees completed their program, they can move in with a year long post doctorate program of employment, where we can continue to do clinical supervision. We're really excited about that. And we have just incredible colleagues in that area. We also have a comparable Master's training program that support students after they graduate and employment and can go into one of seven different mental health programs. And we really want to make available and help all of our community. And we've really paid close attention to our our diverse community and our equity people want to be cared for by those that they see themselves in as well. So we've implemented a BIPOC training program for those pursuing licenses in alcohol and drug counseling, which is yet another pipeline and support some of our diversity, equity, inclusion and belonging strategy. Frankly, there's a lot more that needs to be done for this. And it's my hope that both our state and our federal colleagues see the opportunity to expand the horizon to a workforce and skilled professionals, and really thinking about whole person care and behavioral health.

Bobbie Dressen  11:06

I think the words you pull on there in terms of whole person care is something that's been lacking overall across the spectrum of healthcare and something that I've watched Allina a lead in. As I think back to even the Penny Bill George integrative medicine center, I think guys have been trailblazing that space for quite some time.

 Lisa Shannon  11:29

Thank you Bobbie. Maybe if I could lift up, I really appreciate your acknowledgement that Allina has really been focused for, for a very long time. It's frankly what attracted me here, that we think of health really broadly and holistically. We are excited by and are yet staying tuned for what it's going to look like. CMS recently announced a behavioral health strategy for 2024 that uses language and talks about prioritizing whole person health and behavioral health care. Now, there was a CMS news release, I believe it was November the second, and that rule expands if it's it's got more steps to go. But what it appears to do is expand and allow marriage and family therapists, mental health counselors, eligible addiction, alcohol drug counselors, to perhaps enroll in Medicare for the first time and potentially go for services. There is a crisis and where we're aligning payment and economics based on where our communities need it the most. So I would just say, the more that we can be part of a solution with our federal government and our payers to look at how do we provide for the growing need, intervening as early as possible in our community, and really, from a whole person focus, and bring other professionals in to support the need. We'll see where it goes.

 Bobbie Dressen  13:07

Yeah. Well, and I hope within that they include virtual care, versus needing it to be in person so that it expands your reach even more. So you know, I mentioned at the beginning that you're an innovator. And there's plenty of evidence to back that up since your arrival at Allina. But what steps have you taken to innovate mental health treatment and support? 

 Lisa Shannon  13:33

Well, first of all, I think the credit goes to leaders that have been on Allina Health for many, many years, and absolutely fantastic mental health and behavioral health and addiction team that I am just so proud to work alongside and support. We have, I mentioned, years ago as part of a CMS program for accountable care communities been assessing for those social determinants of health. That led to Allina cannot, nor can any individual entity solve all of the social challenges our society and community's facing. But what we did do was innovate ways that we can be a connector and a conduit, and we're going to keep working on that. We do both. I personally believe that partnerships are key to solving some of the most gnarly problems that we have. And oftentimes, hospitals and health systems are left as the only door always open, meaning the emergency department. And so when society and communities do not have requisite services, we end up being the place that in desperation, whether it's a neuro diverse or another challenge, may not be a hospital or a clinical need, but there's no place else to go We have to innovate against the need and find partners. So I would use many examples. First of all, seemingly proud of our primary care model of care that understands and screens for depression and anxiety so that we can get patients in. We have a digital, self guided tool for low depression and anxiety. And we've been piloting that. Today we've had over 1000 patients successfully using that tool. And we can refer those individuals and so they can get the right level of care as early as possible. The other thing that we've done as many of our primary care offices have, behavioral health and psychologists or psychiatrists access within the facility. And most certainly, you mentioned telehealth. I couldn't agree with you more that access to telehealth mental health care has reduced barriers and created more access. So we are going to continue — we all went there in COVID — we're going to continue to amplify telehealth services, which sometimes for those who have other factors preventing them accessing support services, sometimes in the safety of a telehealth environment. We need to advance that further. So we're going to keep looking for partnerships, finding a pipeline and ways that we can serve our patients.

 Bobbie Dressen  16:33

And one of the things we talked about on stage, right, this fall was just even you have our commitment that we're going to continue to push for the reimbursement for all of that, because at the end of the day, Allina has been providing health care and mental health care since you practically opened your doors. And it's not something new to the healthcare system. But what keeps mounting is the whole subject of reimbursement. And it's what brings challenges, and the fact that you've been able to be as innovative as you've been, and that you're being as holistic in your care is a testimony to your commitment to the patient, and to the community, working with the best boundaries that you have available to you. So I applaud you for that. And I applaud you for your innovation and taking the steps, you know, for the future as you're working on it. So thank you. 

 Lisa Shannon  17:26

Yeah, thank you, Bobbie. We know your advocacy makes a difference. 

 Bobbie Dressen  17:31

I want to get a little personal, if you'll allow me. You oversee one of the largest health systems in Minnesota. Twelve hospital campuses, more than 28,000 employees across Minnesota and western Wisconsin. How do you manage your own mental health? How do you take care of you, Lisa?

 Lisa Shannon  17:52

It's a great question, Bobbie. And maybe I'd offer, remember my background as a dietitian. Doesn't mean I always do what I say. And yet, what I would offer is that wellbeing and whole person care has been important to me for a very long time. And stepping into this role, yeah, I believe there's a responsibility to model what we want for our patients, but also our employees. So back in 2021, early '22, we launched the CEO council for wellbeing. We were initially focusing in on our providers, who were facing huge challenges with what has happened now and through the pandemic, but a host of other mounting cumulative factors that are affecting the well being of our teams. We have for a long time had a benefits and structure, and provided resources. You mentioned the Penny George Institute for our health and healing. We want to make those available to our teams. And I believe it's my responsibility to model that. So for me personally, it is about keeping an eye on what I do for movement, my fitness. It's what I do for my nutrition, my time out if I talk about well being and I'm not modeling that. And it's not easy, and I'm very open that I have for a long time believed in that we need to have our fitness, however that works for us, our food and nutrition therapists and an executive coach that helps me think about the sustainability. These jobs are all consuming and how we show up — and I don't do everything perfect. And I want to be able to say I'm trying alongside you the things that we think are important for our workforce and our patients.

 Bobbie Dressen  20:01

Good for you. I need to follow in your footsteps there. Looking ahead five years and beyond, where do you see the most significant needs in the mental health space? Or to put it another way, what are your hopes for the future of mental health care?

 Lisa Shannon  20:19

Yeah, it is my hope that every school, every family, and our communities will normalize the conversation of mental health care and tending to the whole of people in a very comprehensive way. That starting early and modeling families having our children know that what is typical stressors that we need resiliency and the world around us has them, and what is more than typical? And what do you do when it's more than typical? And I think that has to start very early. I hope that my children, my grandchildren, and future generations begin to see a world, an environment where they know their own ability in these lower acuity mental health environments, and there are many patients that have very complex clinical diagnosis for mental health care. And it's my hope that those become more accessible as the lower acuity needs of our community are seen as a shared — that we have a shared solution. And that we as society and community believe it is our shared solution to bring forward these lower acuity programs, services and offerings, and that allows providers like Allina Health and my colleagues to focus on the very clinical needs that are more significant for sure.

 Bobbie Dressen  22:03

You know, one thing I've watched evolve within this, and it's been if I were gonna say, a good outcome of the pandemic, has been recognition and acceptance of people talking about their mental health and not having it be a stigma. And as what I hear you describing is helping young people create tool sets, just like we do in other areas of their life, to not only be able to notice it, but then know how to be able to deal with it and talk about it. And I hope we can create community around that and the way that you're describing to support them so that for those who are reaching a stage based on what they continue to experience and aren't able to deal with that we're able to create an environment where maybe it's not reaching that high point, because they've been dealing with it all along. And for those who are chronically impacted beyond their control of what's going on chemistry wise in their body, that you do have the ability to be freed up in terms of space and time and professionals to help them.

 Lisa Shannon  23:07

I think that's really well said and I, as the need in our community rises, a private, public and philanthropy partnership for all of our communities will be important. No one of us can solve it by ourselves. But working with Medical Alley, Allina Health and other colleagues, including our state and federal government, we need to get after this and do it together.

 Bobbie Dressen  23:34

I agree. I couldn't agree more. Well, Lisa, thank you. Thank you so much for your time and your insight and a special thanks for your leadership in this community. The organization of Allina is over 100 years old. And your you're leading it with dignity and grace and a commitment to the patients that you serve each and every day. And it's visible in how you lead. So thank you. Thank you on behalf of Medical Alley, thank you on behalf of the state of Minnesota and the patients and families that your organization touches each and every day.

 Lisa Shannon  24:11

Thank you, Bobbie. It's a tremendous gift in honor of a lifetime to be here.

 Bobbie Dressen  24:16

And thank you to everyone for listening. This has been another episode of the Medical Alley Podcast. If you're not already a subscriber, head over to medicalalley.org Or you can find us on Apple, Spotify, or anywhere you get your podcasts.