As the Deputy Executive Commissioner for Texas Health & Human Services, Mike is responsible for ensuring strong patient and staff experiences across 10 state psychiatric hospitals and 13 state-supported living centers. This means he must constantly analyze everything from the physical environment of his care facilities, what it takes to attract and retain staff, virtual healthcare, patient safety, shifting legislation and countless other considerations.
With 25-plus years of experience in public mental health and substance abuse service delivery, Mike is well-equipped for his role. He’s also a staunch advocate for stronger mental health care, helping develop policy and formerly serving as the president of the National Association of State Mental Health Program Directors.
Mike kindly took time out of his busy schedule to speak at our recent HORIZON Houston event on mental health and wellness and participate in a Q+A about what he sees as critical to delivering world-class care into the future.
You’re responsible for a great number of care facilities and people within them. What’s the biggest challenge that keeps you up at night?
Patient safety is always the thing that keeps me up at night. There are individuals in the patient population we serve that try to hurt themselves, and they’ll try to do so in myriad ways.
Knowing this, we have to be extremely thorough and creative with the design of our facilities to eliminate these possibilities for harm. But at the same time, people can’t just live and/or receive treatment in cells. These are healthcare environments and we want to offer positive, recovery-focused experiences for them. We work tirelessly to create care environments where patients can recover and be safe in every way.
One of the biggest challenges in mental healthcare in Texas is the lack of standardization when it comes to facility design. How are you dealing with it?
The lack of standardization is a real challenge and you wish there were clear guidelines more consistent with The Joint Commission. In the absence of that, we’re all working together to create our own standards and learning from each other as we go. Our team has a database where we log best practices for specific issues. It might be something as specific as doorknobs that passed review by the Joint Commission; let’s share that with our partners.
It really does come down to partnerships. We invest great efforts in working with academic medicine, patients, staff and families to hear from them and understand their needs, wants and ideas. That engagement is powerful for us as we shape care delivery and our facilities. Sure, it would be great to have clear, approved guidelines, but it’s not holding us back. As long as we have people willing to listen, learn and embrace new ideas, we’re evolving and helping patients to the best of our ability each day.
What’s one way your facilities are evolving that readers might find unexpected?
Our mental health facilities have a larger purpose than just treatment. We help a population that faces very serious challenges – schizophrenia, bipolar disease, etc. – and so in addition to creating a space where they can be treated with patient rooms and access to the natural environment, we also need to create spaces where they can practice living out in the world.
We’ve designed facilities with treatment malls that mimic what they’re going to experience once they’re out in the community – when they’ll have to get out of bed themselves and travel to the doctor’s office, for example. We have facilities with courtrooms so patients who have court hearings can get a feel for what their court appearances may be like. We want every individual to live the highest quality life they can. Creating spaces that help them transition back to everyday life is important.
You referenced the importance of telemedicine during our panel discussion, can you elaborate on how your team is using it?
Telemedicine is a critical piece of our care delivery. We wouldn’t be able to function at our current scale and help all the patients we do without it. Some of our hospitals are in rural areas of Texas where it’s not always easy to recruit staff. By partnering with the University of Texas (UT) Health for telehealth services, we can better reach patients in those areas.
I think we’re just scratching the surface with telemedicine, and it has value way beyond just rural areas of the country. Anyone designing a new mental health facility needs to consider how telehealth is part of the strategic plan and spatial solution. We’re even seeing staff applying specifically for telehealth jobs; there’s a ton of potential in this field.
You’ve referenced partnerships a few times in this interview and during our panel discussion. How critical are they to the future of care delivery?
Partnerships amplify our efforts and make care-delivery possible. We’ve partnered with CannonDesign to assess facilities across our state; we’ve partnered with UT Health on telemedicine; we’ve partnered with UT Houston in building new facilities. We learned a great deal about how healthcare, research, medicine and education can work together.
The mental health challenges our patients face are so complex, and the facilities we create need to deliver leading-edge care for decades, if not a century. You need to invite every perspective to the table to ensure you invest wisely for the future.