mental health

The Peril of Good Intentions

Recently our President Antony Chiang shared a blog post, "It’s Time To Restore A Sense Of Mission To Mental Health," by Octavio Martinez, CEO of the Hogg Foundation for Mental Health. The author argues that reason and knowledge are insufficient to face the most pressing challenges of our time: "Without an old-fashioned sense of shame at the suffering we allow to endure through neglect and selfishness, we don’t have the motivation to act. Without a shared sense of values, about who we are and what we care about, we won’t know where and how to act even if we can mobilize a sense of moral urgency."

The article struck a chord with our leadership team, with some asking questions like:

  • "How do we approach our work with a sense of mission?"
  • "Do we relate to our community authentically from the heart versus relying on theory and technique?"

It's a compelling argument. I believe that all of us are capable of moments of true moral clarity and sense of purpose, where the course of action seems clear and incontrovertible. I also believe this state is relatively rare for most of us. Why should this be? Why are we unable to maintain a clear-eyed view of the world, its needs and our proper role? Because along with passion, creativity and love lurk other human traits that can corrupt the purest of intentions. Here are three of my personal greatest hits:

Confirmation bias, or "the tendency to search for or interpret information in a way that confirms one's preconceptions, leading to errors." I have witnessed and practiced this in virtually every endeavor in my career. Once we have invested our time, energy and talents in a particular direction, it becomes almost irresistible to shape new data to fit our mental model. As John Kenneth Gailbraith put it, "faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy with the proof."

Fundamental attribution error, or the tendency to interpret our own behavior as a logical reaction to circumstances, while see others as driven by their particular character. When you see a homeless teen on the street, have you ever told yourself a story about how they got there? Did it involve a poverty, abuse, mental illness or other external factors, or did you focus on their failure to pull themselves up? This is not to say there is no individual responsibility, but rather that we cast more of that burden on others than ourselves.

Humans are herd animals and we breathe in our culture like air. The most telling example I've ever heard came from Nelson Mandela's autobiography: "We put down briefly in Khartoum, where we changed to an Ethiopian Airways flight to Addis. Here I experienced a rather strange sensation. As I was boarding the plane I saw that the pilot was black. I had never seen a black pilot before, and the instant I did I had to quell my panic. How could a black man fly an airplane? But a moment later I caught myself: I had fallen into the apartheid mind-set, thinking Africans were inferior and that flying was a white man’s job. I sat back in my seat, and chided myself for such thoughts." If it happened to him, it happens to all of us.

That's not to dismiss the value of moral clarity and conviction. For me those are treasured gifts that seem to come from somewhere beyond me. I can try and create the conditions that will lead to them, but I cannot will them to happen. And all the while, inner forces are at work trying to bump me off the path. 

Thankfully I am not alone, and there are ways to control for the effects of our faulty perceptions. Some of the ones we use at Empire in our work include:

Wisdom of Crowds: In 2004, James Surowiecki showed how groups tend to be consistently wiser than any individual member for problems ranging from making predictions to locating a lost submarine. This power can be hard to harness in teams, with uneven participation and a tendency toward 'groupthink' but there are ways to counter this.

Diversity of Teams: Recent research has demonstrated that socially diverse groups (race, ethnicity, gender and sexual orientation) are more innovative than homogeneous groups. Interestingly this effect has nothing to do with the individual attributes of the team - but rather "simply interacting with individuals who are different forces group members to prepare better, to anticipate alternative viewpoints, and to expect that reaching consensus will take effort."

Design Thinking: pioneered by David Kelley and colleagues at IDEO and the Stanford, it helps us build empathy with those we are trying to serve, by experiencing their reality as closely as possible. It also encourages frequent prototyping with rapid feedback cycles, so we are continually adapting to the client's actual needs as opposed to our perception.

Lean startup: one of my favorite maxims from this approach (which drives much innovation in Silicon Valley) is the 'pivot.' Startups are encouraged to hold their business model lightly, and continually test their assumptions. We should expect that feedback will lead to significant changes in direction (the pivot) and that the willingness to sometimes dramatically adjust our course is perhaps the single greatest predictor of success.

On one level, relying on techniques versus moral clarity as a daily guide seems like a poor bargain. Yet the power of techniques like these lies in their ability to mitigate the impact of our own flawed perceptions. In the same way, free societies often feel unguided and disorderly, but tend to correct problems over time. As Winston Churchill put it, "democracy is the worst form of Government except for all those other forms that have been tried from time to time."

-Mike Yeaton, Chief Strategy Officer for Empire Health Foundation

Matt Layton and Sue Lani Madsen talk mental health


Check out a fascinating conversation between our former and current Board Chairs Sue Lani Madsen and Matt Layton on Sue Lani's podcast on Spokane Talks Online.  In part 1 of their discussion, Matt and Sue Lani cover the difference between psychiatry and psychology, and the history of mental health care in the United States.  Part 2 goes deeper into supporting friends and loved ones struggling with mental illness.

You can check out more of Sue Lani's podcasts at Spokane Talks Online, and in case you missed it, you can learn more about Matt's journey and why he is so passionate about behavioral health in his feature interview.

Meet Matt Layton, October's Featured Board Member

We are excited to continue our monthly series highlighting our Board of Directors!  This month we are delighted to feature our current Board Chair Matt Layton.  Take a look at his interview below!
And in case you missed it, you can check out our first Board Member interview with Sue Lani Madsen here


EHF is a new chance, a new opportunity. We got attention at the state and national level once they saw our outcomes, and others see how we can help accomplish their visions.
— Matt Layton

Who are you and what do you do?

I am a psychiatrist MD with a PhD in pharmacology; I like to say “I got my MD to put people on medications and my PhD to take them off!”  I am passionate about mental health, and I play different roles in the community in this capacity, including research and teaching roles.  I am a full-time Washington State University employee, as well as the medical director for the opioid treatment program at Spokane Regional Health District, where we currently serve over 650 patients.  My research interests are in the areas of smoking cessation and alcohol and methamphetamine addictions. 

Tell us a little about yourself and your background.

I’m from Kansas.  I met my wife, who is from Boston, at Kansas University in Lawrence.  We spent six years in Seattle before we had kids, and now we have three – ages 14, 11 and 8.  We joke that Spokane is where the Midwest meets the Northwest.   I did my undergraduate medical degree at Kansas University, and my residency at the University of Washington in Seattle.

One of the most powerful things that has cemented me in the Spokane medical community happened when our now 11-year-old daughter was diagnosed with leukemia seven years ago.  Judy Felgenhauer, who was my fellow when I was an intern at Children’s in Seattle 15 years prior, was part of our daughter’s medical team here in Spokane when she was diagnosed.  I knew that my family was in great hands with her and with the team, and my daughter got wonderful medical care for three years.  She is in now in remission for four years.

What is your favorite book?

Catcher in the Rye byJD Salinger.  While I was never kicked out of private school, I did get kicked out of advanced science in middle school, and one of the best things that ever happened to me is that I was put into wood shop instead.  I have spent 16 years working on our 1915 farmhouse – another passion of mine.

The thing I like about the book is that Holden has a rebel aspect, but also cares about others.  That is what I want to do.

How long have you been a member of the EHF Board?

I’ve been on the EHF board for five years.   I was brought on because of my mental health expertise with a focus on the strategic opportunity to integrate medical with mental health services, which has continued to grow.  I first got involved in the Finance Committee, and have served as Treasurer, Vice Chair and now Chair. 

What attracted you to the Empire Health Foundation Board of Directors?

When I first came to Spokane, I was having meetings with Empire Health Services providers regarding mental health issues, which I had already been working on for 11 years.  I was watching very closely as EHF, a significant new financial resource, was formed.  When I was approached, I had a sense of relief that what I was seeing as important to the health of the region also resonated with the founding board members.  

What most excites you about our work and mission?

That what we are doing now aligns with founding board members’ recognition that mental health and addiction are significant health determinants.

Has anything surprised you about Empire Health Foundation?  If so, what? 

I was surprised at how rapidly we grew!  We have partnered with various funders and local agencies to leverage our endowment and get return beyond our wildest dreams, achieving 10-year goals in less than 2 years.  We found that people needed this foundation to step in and set aside turf for greater health of our region.  EHF is a new chance, a new opportunity.  We got attention at the state and national level once they saw our outcomes, and others see how we can help accomplish their visions. 

Finally, when you have an out-of-town guest visit, what is your “must do” in your community?

The same thing I do with my children.  We go downtown, and take a long walk in Riverfront Park.  The kids love to ride the carrousel.  Then we grab a bite to eat somewhere, and head to Boo Radley’s.