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March 29, 2020: Dr. Dana Udall from Ginger joins us today for the next installment of our COVID-19 series. Ginger is a full-stack, behavioral health system, offering care and content of different types to their clients. The focus of our conversation today is how Ginger is doing this in the context of the current health crisis. One of the most important points that Dr. Udall makes during our conversation is to reframe this period as not only a health crisis, as is often stated, but also as a crisis of mental health. We touch on the article that Dr. Udall authored about eating disorders and our guest's thoughts on simple practices for healthcare professionals in this stressful situation. We discuss coping mechanisms, helpful strategies and why self-care and downtime are so important for everyone. Dr. Udall also stresses the utility of exercise, intentional thought and better communication. She believes that it is only together that we can make it through these challenges and the hurdles of isolation and loneliness need some effort in order to be avoided. We discuss creative ways to combat these issues and Dr. Udall shares some info on the great free service that Ginger is providing to healthcare professionals.

Key Points From This Episode:

  • The general overview of Ginger and the services they provide.
  • Dr. Udall's article on overcoming an eating disorder and how it came about.
  • Important aspects of mental health for professionals working long hours in a crisis.
  • Coping skills for these stressful periods of long hours and isolation. 
  • Emphases on self-care and downtime in order to make work more sustainable. 
  • The danger of catastrophic thinking; keeping in things in perspective and reframing thoughts. 
  • Hitting the sweet spot of communication with a team in order to facilitate calm decision-making. 
  • Reaching out to an isolated and anxious population and the proper support for them. 
  • Creative ways around remote lifestyles and pervasive loneliness. 
  • Open and honest channels at home and at work; approaching issues together.
  • How to sign-up for Ginger's free service that is available for all healthcare professionals. 
Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Welcome to this Weekend Health It. With our continuing Coronavirus series, we've moved from understanding the health it problem really to looking at a set of solutions. My name is Bill Russell Healthcare, CIO Coach. I. Creator of this week in Health, it a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

Uh, before we get going, I wanna give you three resources for those in Health IT During Crisis, the First for CIOs. I'm currently helping my coaching client CIOs as a sounding board and advisor through this time. If you'd like to connect with me over the next two, two months to experience coaching at no cost, shoot me a note at Bill at health lyrics com.

For anyone in health it who finds themselves in uncharted territory with, which is just about everyone right now. Uh, and you wanna start crowdsourcing solutions, uh, with a team of seasoned professionals and other health systems, we've set up two ways for you to do that. The first, uh, we now have Slack channel that is, uh, supported by our sponsors, VMware, Galen Healthcare Series, healthcare Starbridge Advisors, and Pro Talent Advisors.

Uh, the Slack channel allows you to get your questions answered, you. Pose questions around telehealth, scaling V-D-I-E-H-R, performance leadership. Whatcha doing with your teams? We're seeing a lot of health systems just sharing their best practices. We saw a really cool, uh, actually a couple of cool, uh, solutions that I think are interesting, uh, that, uh, you know, we are.

Literally watching an episode of MacGyver here, that these, uh, IT organizations are putting together some really cool solutions. If you want access to these things, send a note to Slack at this weekend, health it.com, and we'll get you set up. There's already 15 health systems represented, and that's growing by the.

Uh, by the day. So we'd like to, uh, have every health system represented and sharing your best practices with each other. Uh, our sponsors are also supporting an email channel. We know that some of you Slack might not be, uh, your cup of tea. You can just send an email to support it this week in health it.com.

And if you have a question, we will route that to someone who can help, uh, get an answer. Uh, and I really wanna thank our sponsors for stepping up to provide these services, uh, to our listeners, I also want to thank. Last thank here before we get to our guest, I, I really want to thank, um, our, uh, sponsor for these shows.

Sirius Healthcare has, uh, stepped up to sponsor all these, uh, these episodes over the last couple of weeks, which is great 'cause our production cost has gone up. We're doing a show every day and, uh, they have graciously stepped in and I appreciate them doing that. And also their commitment, uh, to the industry and providing this information out there.

Okay. To our guest today, Dr. Uh, Dana Del is, uh, the Chief Clinical Officer for Ginger and online mental health system, uh, coaching therapy and content type company. Uh, good morning Dana. Welcome to the show. Good morning. Thanks for having me. So, uh, give us, I I really, I have a bunch of really practical things that we're gonna talk about, what managers should do with their staff and how they should be thinking about it.

We're gonna talk about families and things people are doing at home and those kind of things, but before we get into that, give us, uh, give us the, you know, couple second overview on, on Ginger. You guys are a really interesting company. Yeah, well we have been around for almost a decade at this point, and we are a full stack behavioral health system.

So we offer various levels of care, coaching, therapy, and psychiatry, as well as content, uh, all within an integrated network. So this means that we can really tailor care. People have access to coaching 24 7, and then we can bring in therapists and psychiatrists as needed. So we're able to serve the great majority of most populations and work with many, many employers, uh, from around the globe at this point.

Yeah. And I, I appreciate you coming on the show. I mean, you are one of the people that has been hurt by my learning curve of coming up to speed as a, uh, podcast host. I actually did an interview with you, uh, at one of the conferences and that the audio was so bad I couldn't air it. I felt so bad and you, that that's only happened to me twice.

So I'm, I'm getting better at it, and I, I apologize for that. Um. The other thing I wanted to call out you, you, uh, wrote an article recently and I, I, I thought it was fantastic. Uh, when hiding is no longer an option, recovering from eating disorder, um, my journey to control less, trust more, and embrace vulnerability, I thought it was a fantastic article.

I, I highly recommend it, uh, to people who haven't been out there. And I, I'm not sure what site it's on, but if you just search for the, for that title in your name, uh, it'll come up. Uh, what, what, how did, how did you come up? How, how did that article come about? Well, it's obviously a story that is many years in the making and my own experience with an eating disorder was, uh, gosh, 25 years ago, something maybe 30 years ago.

So a long time ago. But I think part of what I was really hoping to do is to de-stigmatize mental health and to really talk about, I. Kind of coming out of the shadows and saying, you know, I have had this issue. Many people have had similar circumstances, and we can go on to live really full and productive lives.

Um, as well as highlighting the importance of mental health for my own journey. So I have received, you know, many, many years of great therapy and really come a long way as a result. So that was really the intention and I think that, uh. C-suite executives, other leaders, can really talk about their own experiences and come forward.

I think it can change the tenor in the country in terms of people feeling like it's okay. I can ask for help, and we're all human. And you know what's interesting? I think I did the interview with you at the health conference and that's when Bernard Tyson had gotten up on the stage and said, you know, we have a problem in healthcare and it's that we've separated the head from the rest of the body.

And he talked about mental health. Um, and just following that, he, uh, he's no longer with us just following that, that talk, but that will be part of his legacy is, is removing the stigma and talking about this to that audience, I believe. Mm-Hmm, . Um, alright, let's get to, we, uh. You know, these are, these are, uh, interesting times.

These are extraordinary times for many, and a lot of health workers are working 12 hour shifts. And, uh, or, and even more, um, you know, what are some things that we should be considering from a, from a mental wellness standpoint for those people who are putting in so many hours on the frontline? Yeah, this is something we've given a lot of thought, uh, to over the past few weeks, and we are really hearing that these workers are extremely stressed and obviously healthcare workers are dealing with their own fears of contagion, right?

Having to be out there supporting folks in hospital settings very often. Um, and then also helping people who potentially have c Ovid 19 on a regular basis, so they're both potentially exposed to it, having to be in this very intense work setting. And then going home and having to probably deal with their own anxieties, whether that's about financial status, their own health, their family's health.

So there is an intensity, and I think for these workers, it's very hard to get time off or downtime. One of the ways that we are really trying to address this is through a new offering that all, uh, frontline, uh, healthcare workers are now able to get Ginger . Coaching, uh, free through their employer. So this is really important to us.

We really wanna support those who are supporting others. Um, so it's something that is really top of mind and we're working hard to really get this community of folks connected. The other thing I just wanna say is that I think this is where on demand behavioral health becomes really important. So you are working a 12 hour shift.

I mean, the idea of. Taking time out and going to meet with a therapist, something like that just isn't reasonable or practical. So I think what is much more feasible is going in your break or at lunch, we hear this all the time, right? So somebody's chatting in with their coach and saying, I'm so stressed.

I just had this terrible interaction with a patient or. I feel like I don't have any support right now. And then within a matter of minutes, they can be taught coping skills, reminded of the resources they have so that they can go back onto the floor, work with patients again, and be much more resilient.

Yeah. So what I mean, that's a phenomenal service. And the thing I liked about, and that drew me to your, your, uh, solution, uh, that Ginger had is you did have a, or you do have a, an online solution that people can really sign up very rapidly. I mean, it's. You know, within 60 seconds you're actually talking to somebody.

And then you have multiple tiers all the way up to psychiatry, um, that can be sort of referred, uh, through, through the tool. Uh, but which is, which is amazing. What are, what are some of the coping mechanisms that people, and, and now granted this is, this week in health, it, we're probably not talking to a lot of people that are frontline, uh, clinicians.

We're probably talking to, uh, you know, a lot of people who are. Working long hours. They even might be in their homes working long hours, their door shut, their family's on the other side, but they have to be working 'cause they just have so much to do. Um, what are some coping skills for those people? Yeah, absolutely.

Um, you know, we are able to look at data across a wide spectrum of populations so we can understand how individuals are doing. And then across our system we're hearing things like, I'm so isolated, I'm so lonely, I'm anxious. Um, I'm really worried about my financial prospects. Um, it's hard to work with the kids right outside.

So we hear these things from our members all of the time, and some of the things that we're talking with people about are things like, uh, breathing techniques, so learning how to use mindful meditation. We've actually started doing this as a gender staff, so we offer three drop-in meditation groups for our staff over the course of a week, because that's a really important skill.

It's very effective. It's very . Quick so you can do it within a matter of minutes and regulate your nervous system so you can be more effective. We're also talking to people about how they can increase their social support, how they can reach out to others through technologies like Zoom or hangouts, and have conversations, have happy hours.

Um, so increasing that connection. Um, and then there's other things like, you know, getting exercise in your home. What does that look like? You know, are there yoga classes you can do, are there at home workouts that you can do? Because we know there's a lot of evidence that exercise can really decrease levels of anxiety and help people feel better.

I. So I think having access to that kind of on-demand coaching, um, really access to social supports, managing the anxiety. Those are some of the main ways that we're really talking to people about are, are there bad like thought processes that are sort of, um, that, that. You could sort of identify like, you know, somebody's gonna try to be the hero here.

They're gonna try to work, you know, 80 hours and they're going to, you know, forsake all the other things that are going. I mean, are there, are there those kinds of things that you just look at and go, okay, that's a bad framework. You're operating from a bad framework, you're gonna get yourself in trouble.

Yes. And I think what has happened and what we've seen is that people, very early on, I think there was a lot of like, okay, I can do this. Um, and what's happening now is we don't know how long this is gonna last, and people need to be able to make work sustainable. So that means trying to not be the hero and saying instead, how can I be most resilient?

And for most people, that means building in breaks, really emphasizing self-care. So it's not a luxury, but getting that physical exercise, talking with a coach, doing meditation. Is key to being sustainable over time. The other thing in terms of thinking errors that we see a lot is catastrophizing. And I think what's really confusing about this situation is it can feel really catastrophic and it may have catastrophic effects for our economy and for some people's health, but if we get into the thinking of like, oh my gosh, what if, what if, what if?

And then we're, you know. A year down the road, we are not able to make good decisions in the moment. So that is a cognitive error and our coaches do a lot of work on helping people reframe it so they can think, what do I need to do in this moment to be successful so that I'm actually capable of long-term planning that's effective, rather than getting into that state of worry where our brains really are not very functional.

So as a manager, one of the challenges I would think is you don't have much time. So you are doing a lot of blanket managing at this point. But, you know, one of the things I've noticed with my children is that each one of 'em is so distinct in how they are, uh, dealing with this. You know, I've, I've, my, uh, youngest is in college, but she's living with us and she has one frame of mind.

My, uh, oldest, uh, lives with five girls, uh, five women. In, uh, you know, in another state. And she has a different frame of mind. And my son is, you know, a completely different frame of mind and at a different part of the country. Um, and I find when I talk to them, I have to use different language, different, uh, things to just sort of, you know, to, uh, calm them a little bit and to, you know, help them to think through these things.

How do managers sort of, I mean, I guess the first thing is recognizing that. Your staff is probably all over the board. Uh, but the second thing is how do they communicate in such a way that doesn't accentuate the crisis as much as, uh, you know, bring, bring forth calm, that we can make good decisions out of that.

I think that is the sweet spot. Exactly what you said is that managers need to be able to manage their own anxiety so that they can communicate in a way that's effective, be heard, be supportive, um, but they also, I think it is okay for managers to be vulnerable right now. I think one of the things that really is helpful for all of us is to say we don't have to be perfect, so the manager doesn't have to come in and say, I have this all figured out, or this is what we're gonna do.

I think it's helpful for managers to be transparent and to say, you know, this is a really stressful time. Um, as well as to normalize for people, so there's no one way to respond to this that's correctly. So managers can say to some folks, gosh, it sounds like this is really intense for you. Let's talk about getting you some support.

What do you need right now? Here are the benefits that are available to you and to somebody else. They might need not take that same t, they might be a little bit more kind of, you know, hey, glad to hear that things are going pretty well. So I do think tailoring the message and for the manager to get their own support so they're really well resourced, can be in the position to advise people.

That's super important right now. You know, the, um, we're gonna end on a, on a, on an up note. I'm gonna ask you for some creative things you've seen that people are doing either, you know, videos or whatever. 'cause there's a lot of creative things that people are doing out there. Uh, but one of the things I wanted to touch on before we get there is, um, this is probably, I.

The worst situation for mental health. I, I can think of. We just sent a bunch of people home. We sent 'em home without jobs, without security, without paychecks. Um, and then we told 'em, you have to stay in, uh, you know, in some cases you have to isolate and stay in place and stay at home. Um, you know what?

What, how are we protecting that group of people? How are we supporting and helping that group of people? 'cause a lot of 'em lost their, their benefits and, and those kind of things. So they're, they're probably feel isolated and alone. Definitely, uh, and we are seeing this in our data, so we are able to track sort of mentions of covid.

We saw a dramatic spike in February when the first case was identified. In the US we are seeing our members talk about things like isolation, loneliness, panic. So this is definitely reflected in what we're seeing. Um, and it is really a mental health crisis. I think we're used to thinking of this as a health crisis or the financial implications, but this really is a great test of our mental health system and our, our capacities as individuals.

So I think for, uh, individuals to find ways to connect remotely, and as you said, there are a lot of creative ways of doing that. I've heard of people watching TV shows together, um, having happy hours remotely. We've done remote play dates at Ginger, so everybody's together. We just have all the kids. We're doing story hour.

So I think that there are creative ways to do this. Um, you know, I am very aware that there are people that are isolated and don't have very many options, or they're in a community where they're not able to walk outside and engage with neighbors. Um, I think that the one upside is that because stigma has decreased with mental health.

Mental health, we are talking about this in a much different way than we would've five or 10 years ago. I don't think in at that point people would be saying, yes, this is impacting mental health to the extent that it is. So we are aware of it, we are mobilizing lots of resources, um, and we're also trying to work with employers so that they are ready and they can really meet the needs of folks so that, you know, to try to minimize those effects whenever possible.

Yeah, we did, uh, you know, for our family, we did a, uh, family reunion the other night, a Zoom family reunion, love it. And everybody was on, and the first part was fun trying to get the grandparents on Zoom. And then, and then teaching them that the camera actually is pointing at their forehead. They, anyway, it was just, and, and, and everybody enjoyed it.

Everybody had a, a good time and, and, uh, and that was a, that was pretty good. My, my daughter who, uh, is now home from college and, and doing college remotely, uh, had a once a week they get together and they watch movies together and literally. They're, they're all watching the same movie. I, I'm not sure how they're doing this.

I'm not sure what the tech is, but they're, it's synced. They're all watching the same movie and their video cameras are like on them to see their expressions and those kind of things. And they're talking through the movie, um, and having a good time that way. Uh, you know, it's, it's, it's interesting. All these things that we probably would've told our kids to stop doing two months ago are, are, are great right now.

Right, and I think that it is important. You know, a lot of times parents will say, well, how do I structure the day and what do I do? Those are important questions, and I think what's also important is the mindset so that we are being flexible, we're creating structure, and we're knowing that these are really uncertain times.

So what I always talk to people about is really leaning into their values. This is a time where if you wanna be resilient, you can really practice that and you can show your kids what that looks like. So it might be that you lose your cool at some point, and then you say. Mom needs to go sit by herself or read a book or take a walk right now, and then you're able to come back and say, I apologize.

You know, I lost my cool. I'm really trying to be resilient. This is stressful for all of us and this is what I'm gonna do to take care of myself. Those lessons, I think we are being forced to really confront, you know, our own demons and how we parent and how we live in close proximity. This is an opportunity that many of us would not have had to kind of be that intentional and get as much practice.

So whether we like it or not, there really are opportunities for people to be, um, trying to live more congruently with their values and really practice a lot of the things that we think about, but maybe aren't forced to do so regularly. So, Dana, I'll give you the, the last word. So actually what I'd like for you to do is you, you're saying health systems, people on the front lines right now, their organization can sign up for Ginger and make that available to their staff.

How can they do that? Yep, that's right. So we have information on our webpage, uh, ginger.io with all of that information on how those, uh, health systems can get in touch with us, what that process is like. We are also offering our in-app content to the public at this point. So we're in the process of rolling this out right now.

Members on our system can get access to things like breathing exercises, um, meditation practices. Activity cards and ways to kind of gain skills. We are making those available to the public on our webpage as well. So those are some of the ways that we're really trying to meet this need, trying to scale care and help those who otherwise may not have access really take advantage of our services.

That's fantastic. Thanks for doing that. And Dana, thanks for taking the time to come on the show. I really appreciate it. Absolutely. Thanks so much for your time as well. Well, that's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics and Pro talent advisors for choosing to invest in developing the next generation of health leaders that show the production of this week in Health it.

For more great content, check out the website this week, health.com, or the YouTube channel. If you wanna support the show, the best way to do it, share it with the peer. However you do that, go ahead and do that. Uh, we're shows one a day. Uh, again, starting back on Monday, we will have another show and, uh, we'll just keep doing this as long as you guys are finding value and, uh, and tuning in.

We'll continue to do it. Thanks for listening. That's all for now.

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