In the behavioral health field, ten years of continuous service is a long time. 15 years is outstanding. When we heard our friends at New Roads Behavioral Health are coming up on their crystal anniversary this year, we reached out.
Their focus on evidence-based programs and clinical excellence is what makes them truly shine. Over the years, our leaders have gotten to know one another, sharing best practices to better support our clients and clinicians.
New Road’s CEO, Eric Schmidt, was kind enough to sit down with us so we could learn more about New Roads and his take on the industry we both proudly serve. Below is our interview with Eric.
1. Congratulations on 15 years of service! Can you tell me a little bit more about New Roads Behavioral Health?
We’re primarily mental health. When we started 15 years ago, we offered both mental health and substance use treatment. There was a substance use track that is pretty much gone now. We became primarily psych within the first few years. We were doing mental health before mental health was cool. New Roads now focuses on borderline personality disorder, attachment difficulties, fear, abandonment.
On the night I met my wife, she asked what I wanted to do with my life, what were my goals and aspirations. She said she would like to do things like climb Mount Everest, but I said I’d like to work with women who self-harm and are suicidal.
I wanted to work with that population forever, but I started with a substance use foundation since it’s easier to train. We rely heavily on Dialectical Behavioral Therapy, or DBT, by Marshall Linehan. It’s proven to work well with borderline personality disorder (BPD). We decided to have a track for those underserved patients with BPD. About 80% of BPD patients were suicidal and will also self-harm. About 10% would die from suicide. A lot of clinicians don’t like working with suicidal or self-harming people; they don’t want to assume the liability. But a lot of those wanting to die, self-harm, they’re all alive.
About one-third of our clients are men with severe mental illness and psychotic disorders.
New Roads has multiple levels of care focused on specific populations. These include residential facilities, partial day treatment, outpatient, and different levels of supportive housing. With this model, clients can be with us longer term. We hold hope and the fundamental belief that all clients can get better.
2. Tell me about the emphasis you place on evidence-based practices.
DBT takes ongoing training to do and do well. There are 30 skills, specialized therapy, and a supervision group—or a consultation team—and case management to help clients organize their environments. I knew we couldn’t take suicidal clients on day one, so I devoted myself to doing the training myself, and bringing in some trainers, so we could be knowledgeable and deliver evidence-based treatment.
By the middle of our second year in operation, we started taking psychiatric clients, and formed an Acceptance and Commitment Therapy (ACT) treatment team to better serve those who are psychotic. Rather than referring those clients out, we decided to do it ourselves. Along the way, we stopped getting addiction referrals because we did the mental health piece so well.
I personally just hit the 35-year mark in my career, with 31 of those being a clinician. I have a Masters of Science in Social Work from UT Austin, as well as a Masters of Business Administration. That makes me a unique CEO in this space.
3. We touched on this, but I see you’re a clinician as well as CEO. How does that set you apart in the field?
I also train people to train others. There’s not a lot of people in my role with a clinical background. When I go to conferences that cater to CEO’s or director-level, not a ton have the background of both business and clinical.
This has helped me to hire better and improve training protocols. I’ve worked hard on becoming a trainer for evidence-based methodologies. I recently completed a certification for prolonged exposure therapy from the Center for Treatment and Study of Anxiety at the University of Pennsylvania. It is the most-studied treatment for PTSD.
I counted how many trainings I’ve done over past two years: 91 hours. At New Roads, we conduct weekly trainings. About one-third of my staff has been here more than ten years; that’s because we ensure they continue to learn. When staff feel competent in their skills, they are more confident and engaged in their work.
4. What are some of the biggest changes you’ve seen in the industry in the last 15 years?
There have been both good and bad changes over thirty-something years. A few of the biggest are the parity laws and the Affordable Care Act, which provide behavioral healthcare that many couldn’t access before. Most people like these changes; the Affordable Care Act has been very helpful. Now insurance providers are more willing and required to provide services.
We’re realizing too that primary care physicians treat many things with psychiatric origins, like heart problems or irritable bowel syndrome—both have an anxiety base. Insurance companies are getting wise to it, too, integrating primary care and behavioral health services.
On flip side, when people started realizing they could bill insurance, around 2008-2010, it invited a lot of fraud into the field. Another downside is people taking clients they aren’t equipped to serve because they aren’t appropriately trained. But there are dollars associated to providing those services. Whenever clinical and finances collide, clinical should always win. I got that quote from Bill Bailey, Cenikor’s President and CEO.
5. I understand you’ve helped Cenikor diversify its payor mix. Can you go into more detail on how you and Bill have worked together?
Did I? I think I introduced him to outside billers and billing companies, and had our reps talk to Cenikor’s billers about a variety of pathways besides state- and federal-level funding for clients. There were other avenues, like insurance plus room and board or strictly private pay. At the time he and I had conversations, Cenikor relied on little state funding. Most of the revenue was from vocational services, which is one component of therapeutic community.
You have to remember: the idea of rehab means someone was, at some point, habilitated. Yet most people start using at a young age—here in Utah, it’s about 13 years old—so it becomes a habilitation program. You’re not trying to recoup effective life skills that they once had. They typically have little skills to fall back on, nothing to draw upon, so all have to be built, including holding down a job, becoming responsible citizens, and caring about their peers.
6. What are you most excited about for New Roads in the future?
That’s a great question. At a retreat a couple of weeks ago, we were going over New Road’s vision statement. If we’ve achieved this vision, then it’s no longer a vision, so now we want to keep on doing what we’re doing.
What’s most important is creating clinical excellence. The nice thing is, if a clinician who has been here for a number of years, goes to work at another place, clients will be meeting with a proficient, well-trained, competent clinician. Now, 15 years later, I can pay it forward.
I’m excited to keep adding important components to our program. We now have an eating disorder track that was based on DBT for complex eating disorders and trained our staff by woman in Canada. We’re working with people with autism spectrum disorder (ASD), and our clinicians just completed a training to better support our clients with ASD. We’re bringing trainers back in the fall to teach newer clinicians, because not everyone has had the breadth of training we offer. We’re continually learning and growing.
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