Rural Futures with Dr. Connie Episode 14 Featuring Howard Liu

Rural Futures Institute Author

10/12/2018 Added

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[00:00:00.380]On this podcast, we talk with rural mavericks, futurists,
[00:00:03.850]and researchers to raise bold voices
[00:00:06.240]for rural people and places.
[00:00:08.490]I'm Katelyn, producer of the show,
[00:00:10.910]and I'm asking you to do your part.
[00:00:13.230]Support the Rural Futures podcast by leaving a review,
[00:00:16.450]which helps new listeners find us, and become a sponsor
[00:00:20.320]by visiting ruralfutures.nebraska.edu/podcast.
[00:00:27.550]You know, I have this philosophy about future workforce,
[00:00:30.500]future people in any field,
[00:00:31.830]and it's that you can't just do the routine things
[00:00:34.650]if you're gonna flip something.
[00:00:36.280]Otherwise, in 25 years, guess what?
[00:00:38.490]Exact same thing, if we're gonna use the same approach.
[00:00:43.170]Rural Futures, the podcast where we connect
[00:00:46.230]thought leaders and doers at the intersection
[00:00:48.850]of technology, and what it means to be human.
[00:00:51.830]Every episode, we talk with entrepreneurs, researchers,
[00:00:55.180]and achievers to create impact for generations to come.
[00:00:59.640]And now, here's Dr. Connie.
[00:01:02.160]Hello, and welcome back to the Rural Futures podcast.
[00:01:04.880]I'm your host, Dr. Connie, and joining me today
[00:01:07.970]is a very special guest, Dr. Howard Liu
[00:01:11.450]of the University of Nebraska Medical Center,
[00:01:13.620]where he serves as Interim Chair of Psychiatry,
[00:01:17.070]but also as the Director
[00:01:18.750]of the Behavioral Health Education Center of Nebraska.
[00:01:22.330]Welcome to the podcast, Howard.
[00:01:24.130]Thanks so much, really enjoy being here, Connie.
[00:01:27.040]Well, we're excited to have you.
[00:01:28.660]You know, many listeners may not know,
[00:01:30.437]but a lot of them will,
[00:01:32.700]mental health is such a huge issue in rural areas,
[00:01:36.870]and you're one of the leaders and the mavericks,
[00:01:39.440]really finding resolution to this,
[00:01:42.230]but also innovating in the space.
[00:01:43.870]So tell us a little bit more about you, Dr. Howard Liu.
[00:01:48.817]Well, I appreciate it.
[00:01:50.090]Actually, I'm a MD,
[00:01:51.500]which means, you know, I can prescribe medications,
[00:01:54.730]and I'm still a practicing child
[00:01:57.240]and adolescent psychiatrist,
[00:01:58.790]but I also see some adults as well,
[00:02:01.160]and so I've got a fairly good sense of what the needs are
[00:02:04.450]just from a clinical practice.
[00:02:06.560]Rural needs, you know, are certainly
[00:02:08.970]one of our biggest mission areas for BHECN,
[00:02:11.080]the workforce center for the state.
[00:02:13.490]I still have some patients that will drive literally all day
[00:02:17.100]to come see me here in Omaha,
[00:02:18.700]and they have to spend overnight, and it's a real hassle,
[00:02:21.730]and then they have to take time off from work,
[00:02:23.870]and it's very challenging.
[00:02:25.830]The other piece we know is that there is stigma
[00:02:28.100]for all mental health,
[00:02:29.110]but I think it's strong in rural communities as well.
[00:02:32.960]For example, there's a higher rate of depression
[00:02:34.900]and also there's been recent data
[00:02:36.950]about suicide in farmers as well,
[00:02:39.390]and that's really been a concern.
[00:02:40.810]So really trying to find those
[00:02:42.110]that are coming from small towns
[00:02:44.220]to train in a licensed mental health profession,
[00:02:47.010]and then go back to practice where they grew up.
[00:02:49.610]Why do you think this issue of mental health
[00:02:52.420]has become such a big challenge in rural areas?
[00:02:55.630]How have you seen that transpire over time?
[00:02:58.800]Well, I think that there's a demand and supply imbalance.
[00:03:02.260]So frankly, the demand for mental health
[00:03:04.700]is increasing across the U.S., you know.
[00:03:06.900]And so, as for example, now pediatricians
[00:03:10.610]are screening all teens for depression at age 12.
[00:03:13.860]You know, imagine that there's a good number
[00:03:15.410]that would screen positive,
[00:03:17.370]and where do you then send them?
[00:03:19.167]And if you're in an urban area,
[00:03:21.020]you could probably find a specialist,
[00:03:22.800]but in many small towns and rural communities,
[00:03:26.660]you know, typically you rely on a family physician,
[00:03:29.970]family doctor, or maybe some other kind
[00:03:32.520]of primary care provider.
[00:03:35.160]And many of those docs and advanced practice nurses and PAs
[00:03:39.610]had a very short rotation in psychiatry,
[00:03:42.870]and they often feel comfortable with maybe ADHD,
[00:03:46.700]or depression, but less comfortable
[00:03:50.040]with something more severe, like bipolar disorder, you know,
[00:03:53.740]and certainly if there's issues, also,
[00:03:55.380]with what we call substance use disorders,
[00:03:57.520]you know, addiction, that also is a challenge.
[00:04:00.300]So really, not having someone to refer to,
[00:04:03.630]and then feeling like they're a bit out of their elements,
[00:04:06.650]is a real challenge.
[00:04:07.660]And most of the workforce is clustered in bigger cities
[00:04:11.970]in Nebraska, and certainly across the U.S.,
[00:04:14.190]that's true as well, so there's a geographic gap.
[00:04:17.380]Well, let's talk a little bit about the future.
[00:04:19.557]I want you to put your futurist hat on, Dr. Liu,
[00:04:23.020]and tell us how you see this evolving in the future.
[00:04:26.420]What do you think the future of mental health looks like?
[00:04:29.040]Well, there's two principles I would say
[00:04:30.830]that really should define training in the future
[00:04:33.500]and the future workforce for mental health.
[00:04:35.450]So one is that it has to be in a team,
[00:04:38.900]and right now, I would say this is true,
[00:04:41.380]not just in mental health, but many areas of healthcare.
[00:04:44.240]Everyone does things in their own silo, right?
[00:04:46.540]So you know, we have psychologists
[00:04:48.340]that train separately from psychiatrists,
[00:04:51.210]who often have limited interaction with social workers,
[00:04:54.560]and they don't really train with counselors,
[00:04:56.850]and this goes on through all the professions.
[00:04:59.250]And then everyone graduates,
[00:05:00.660]and then people in primary care
[00:05:02.800]really don't know how to navigate
[00:05:04.360]working with these individuals.
[00:05:06.210]So early in their training,
[00:05:08.640]I believe that we need to have a lot more
[00:05:11.230]interprofessional activities where people
[00:05:13.000]are working in real teams on actual cases,
[00:05:15.930]thinking through how do they function,
[00:05:18.040]at the highest part of what they call
[00:05:19.560]their scope of practice.
[00:05:22.807]There are many professions that can prescribe medications,
[00:05:26.240]but you know, typically the most complex
[00:05:28.660]that will go to a psychiatrist,
[00:05:30.000]because they have the longest training,
[00:05:31.810]you know, typically 12 years,
[00:05:33.850]whereas, you know, many straightforward cases
[00:05:36.700]can go to a physician assistant
[00:05:38.640]or advanced practice nurse,
[00:05:40.670]and then only on the more complex cases
[00:05:43.630]would they potentially refer them on,
[00:05:45.097]and I think that's a good population health approach.
[00:05:48.080]You know, the second thing is
[00:05:49.580]not every patient needs to be seen by a specialist,
[00:05:53.410]so we have to do a much better job
[00:05:55.410]of supporting those in primary care,
[00:05:57.630]and also, frankly, supporting those who are teachers,
[00:06:00.680]and even in settings such as corrections,
[00:06:03.550]where people are incarcerated,
[00:06:05.450]really making sure that those individuals
[00:06:07.480]have access to expert consultation.
[00:06:10.470]So I think just looking at different ways
[00:06:12.810]that aren't just the same old,
[00:06:14.710]well, you know, you gotta get on the wait list
[00:06:16.270]to come see me in my clinic, even if that's six hours away,
[00:06:19.680]that's not the right model.
[00:06:21.280]Yeah, I agree.
[00:06:22.150]I mean, I think this is what's so exciting
[00:06:24.080]about the work you're doing,
[00:06:25.160]a lot of what the Med Center, other partners are doing.
[00:06:28.260]You know, how do we create these new models
[00:06:30.220]that are more wholistic and really patient-centered,
[00:06:33.640]to give them the help they need, you know, in a better way,
[00:06:36.560]and just a higher quality way, but also faster.
[00:06:39.470]You know, with a lot of this,
[00:06:40.950]there's that need for speed, so to speak,
[00:06:43.180]so that people aren't out there really challenged
[00:06:46.850]in their lives and not getting the help they need.
[00:06:49.330]That's right.
[00:06:50.420]Well, and I think that speaks even in the way
[00:06:52.140]we're having this interview today,
[00:06:54.010]virtually, we're not in the same room, right?
[00:06:56.050]And I think telehealth is certainly another area,
[00:06:59.440]particularly as it eventually expands more and more
[00:07:02.010]into people's homes and mobile phones,
[00:07:04.320]you know, I think that will be another path to access.
[00:07:06.810]But I think there's no way around the idea, though,
[00:07:10.840]that even if we have the best tools,
[00:07:13.440]we'll have to face stigma head on.
[00:07:15.540]I think that there are many people
[00:07:17.500]in all professions in all communities
[00:07:19.490]that are frankly, you know, scared to death
[00:07:22.900]to admit that they may have depression,
[00:07:25.260]they may have post traumatic stress disorder,
[00:07:27.380]they may be struggling with drinking,
[00:07:29.660]excessively, whatever it might be,
[00:07:32.200]but, you know, that's something we're gonna
[00:07:34.600]have to address as a society.
[00:07:36.560]There is a place for leaders, and I see that, you know,
[00:07:40.810]there's a lot of folks that are even healthcare providers,
[00:07:43.760]or academics or even, you know, presidents of universities
[00:07:48.050]that will sometimes tell their story,
[00:07:49.920]and they may not be, you know, on CNN, you know,
[00:07:53.150]but they're certainly known to their community.
[00:07:56.370]And I think knowing someone real, that you actually know,
[00:08:00.810]that is open about having gone through that depression,
[00:08:04.370]or that severe anxiety, or whatever it might be,
[00:08:07.160]that prolonged grief when someone passed away,
[00:08:10.050]it's very helpful,
[00:08:11.270]and many of those that I've talked to
[00:08:12.803]will say when they come out of their story,
[00:08:15.200]then all sorts of people
[00:08:16.260]will come up to them, often quietly,
[00:08:18.570]just to share their own experiences,
[00:08:20.760]and that's the kind of thing that I think,
[00:08:22.370]whether you're in a small town Nebraska,
[00:08:24.140]whether you're in a bigger city, we need more of that.
[00:08:26.829](soft techno music)
[00:08:29.600]You know, there's a lot of family history
[00:08:31.130]and genetics that play into this, as you know very well,
[00:08:33.900]and some of us are more vulnerable,
[00:08:35.620]and we'll see this also in veteran populations,
[00:08:38.160]of which, you know, many rural communities
[00:08:40.360]you know, have a lot of veterans,
[00:08:41.530]and a lot of folks that are active duty,
[00:08:43.410]and you may have four individuals that are in the same,
[00:08:46.170]you know, Humvee or something, and some blast goes off,
[00:08:49.620]well, why is it that, you know, one of the four
[00:08:51.960]has more severe symptoms even though it's the same stimulus?
[00:08:54.770]You know, I think there's different factors
[00:08:57.210]that make us vulnerable.
[00:08:58.970]When would it be time to seek help,
[00:09:00.558]and what would you recommend around that?
[00:09:03.027]It's an excellent question.
[00:09:04.610]For me, sort of like asking what is normal,
[00:09:08.020]and when should you get help, right?
[00:09:09.620]And I think, it's really when you have problems functioning
[00:09:12.860]in the key areas of your life.
[00:09:14.900]So, if you are a student of any kind,
[00:09:18.130]whether it's K through 12,
[00:09:19.200]or you're higher education, grad student,
[00:09:21.730]and normally, you're a A or B student,
[00:09:24.610]and then you see that it's really
[00:09:26.540]been declining consistently, it's not just one class,
[00:09:30.130]there's an overall trend, that would be a concern for me.
[00:09:33.600]You know, if you're someone that's working right now,
[00:09:35.700]and that you normally enjoy work,
[00:09:37.630]and have a lot of energy and a lot of passion for it,
[00:09:40.670]but you're finding it much harder to go in,
[00:09:43.210]maybe having more absenteeism,
[00:09:45.570]more conflicts with colleagues, those kind of things,
[00:09:48.380]that would be a concern.
[00:09:50.320]And then your home or social life,
[00:09:52.510]I think those are areas that, particularly in depression,
[00:09:54.998]and other kind of things that might happen,
[00:09:57.000]that we'll see a really big hit
[00:09:58.240]because often, many of these disorders are quite isolating.
[00:10:01.860]If you're anxious, or you're depressed,
[00:10:04.020]you typically will find less energy to go out
[00:10:06.720]and hang out with friends,
[00:10:07.670]you may become detached from them.
[00:10:09.950]You may be isolating at home,
[00:10:11.610]even if you're living with your family,
[00:10:13.670]and spending your time in your room.
[00:10:15.260]You know, it's a lot of this pieces,
[00:10:16.940]so I would say, if you're really seeing a hit
[00:10:19.540]on your social life, your home life,
[00:10:21.690]your work, or your school life,
[00:10:23.960]I think it's time to seek help.
[00:10:25.640]Thank you for that, I think it's great
[00:10:27.180]for our listeners to know, you know,
[00:10:29.620]they don't have to power through it.
[00:10:31.480]That's not really the way this works,
[00:10:33.260]but there are people like yourself and others,
[00:10:36.030]the people you're training and teaching,
[00:10:39.010]that they can reach out to and get that help.
[00:10:41.350]And it doesn't have to be a bad thing
[00:10:43.330]or a mark on their employment record,
[00:10:45.150]but rather, it's a healthy way to live,
[00:10:48.550]because we do live in a time of, you know,
[00:10:50.920]rapid change and high stress,
[00:10:52.790]and in many ways, this rapid pace of life,
[00:10:56.370]you know, humanity hasn't really kept up with it yet,
[00:10:58.670]and we're still figuring out how to deal with it all.
[00:11:01.550]So I do think this mental health piece will continue
[00:11:04.470]to be such an important part of society,
[00:11:07.120]as is change continues to evolve.
[00:11:09.810]I think that's a great point.
[00:11:12.370]The idea of having a clean desk, or (laughs),
[00:11:15.860]I guess, an empty backpack or whatever it might be,
[00:11:18.910]you know, an empty inbox, it's a goal we all have,
[00:11:22.220]but at what cost, is always the question.
[00:11:24.830]Nowadays, with the technology, you know,
[00:11:27.360]it really is something where it's always there.
[00:11:29.860]For example, there has been a spike for adolescent girls
[00:11:33.550]in suicides across the country,
[00:11:36.100]and something that may be related to negative effects
[00:11:39.410]of social media, and cyber bullying,
[00:11:41.930]and some of those things, because they're always, you know,
[00:11:44.520]often times without the parents' knowledge,
[00:11:46.500]you know, immersed in those worlds.
[00:11:48.750]And I would say the same for, you know,
[00:11:50.560]folks that are working
[00:11:51.560]and sort of burning both ends of the candle.
[00:11:54.480]I think everyone works in administration,
[00:11:56.870]but I think everyone that's working
[00:11:58.290]and knows that, you know, when you're short-staffed,
[00:12:00.270]and you're staying extra,
[00:12:02.060]you know, it's gonna take a toll on you.
[00:12:03.720]All those who are in a so-called sandwich generation
[00:12:06.870]who are taking care of aging parents,
[00:12:09.060]their own kids, any sort of caregivers,
[00:12:12.430]there's a high risk to burnout.
[00:12:13.770]So I think, just being aware of those things,
[00:12:16.060]and sometimes your peers and your family members,
[00:12:18.730]your loved ones, may be more aware of it than you are,
[00:12:23.000]but they might just say to you,
[00:12:23.917]you know, you seem stressed lately,
[00:12:26.540]or, you really haven't been yourself.
[00:12:28.166]I haven't seen you smile in a while.
[00:12:30.110]You seen really worried.
[00:12:31.550]That might be another sign that, you know,
[00:12:33.150]maybe it's time to pause and just think about
[00:12:35.660]how do you set up your own schedule in your own life.
[00:12:39.940]Welcome to Bold Voices,
[00:12:41.470]our segment with rock star students
[00:12:43.290]from the University of Nebraska,
[00:12:45.230]who are making a difference in rural.
[00:12:48.560]It's Katelyn, producer of the Rural Futures podcast,
[00:12:51.710]and with me today is Briley Kuhudzai,
[00:12:54.730]a University of Nebraska-Lincoln graduate,
[00:12:56.990]and Rural Futures Institute Serviceship alum.
[00:13:00.660]Briley, thank you for joining us!
[00:13:03.340]Thanks for having me, Katelyn, I'm excited.
[00:13:05.280]And tell us exactly where you're joining from.
[00:13:07.650]I'm joining you from the airport,
[00:13:09.870]our international airport here outside Harare, Zimbabwe,
[00:13:13.780]and I had to come here because
[00:13:16.230]this is where I could get the best Internet connection.
[00:13:18.600]It was either this, or getting some data on my cell phone
[00:13:21.050]and climbing a rock out at the farm.
[00:13:23.100]So Briley, we wanna give our guests
[00:13:25.050]a little bit of insight into who you are.
[00:13:28.090]I would refer to myself as a entrepreneur,
[00:13:30.170]an innovator, community development-infused
[00:13:33.450]formal entrepreneurship, social enterprise, essentially.
[00:13:37.620]And let's see, I like to watch movies,
[00:13:39.510]I like to read books.
[00:13:41.000]I like the cold breeze in the evening here in Zimbabwe.
[00:13:44.160]Explain your home there in Zimbabwe.
[00:13:46.110]I'm on a small plot of land, I call it the farm,
[00:13:48.500]but if you think about it from a Nebraska context,
[00:13:50.570]you'll be misled.
[00:13:51.460]The core part of it is just 20 hectares,
[00:13:54.300]which is about 50, 60 acres.
[00:13:56.380]We've got cattle, goats, and sheep,
[00:13:58.500]and our goal is to raise the livestock,
[00:14:02.430]butcher them ourselves, and market directly to the customer.
[00:14:05.060]If you think of it kind of like a safari, savanna setting,
[00:14:08.630]so plenty of grass, you know, that browny, goldy grass
[00:14:11.680]that when you picture when you think of Africa,
[00:14:13.280]we've got that, but all the wildlife and stuff
[00:14:15.580]is in a national park, so we don't have those.
[00:14:18.010]We've got these beautiful granite, big rocks,
[00:14:20.300]that stick out of the ground in all sorts of places,
[00:14:23.270]and people that have crops have to farm around them.
[00:14:25.780]They're not going anywhere.
[00:14:26.800]But they're great to climb, they're great for kids,
[00:14:28.776]and they're great for catching cell phone signal.
[00:14:30.960]And it takes me about 30 or 40 minutes
[00:14:33.500]to get into town from where I am.
[00:14:35.680]You have to kind of tell us your story.
[00:14:37.830]How you ended up at the University of Nebraska,
[00:14:41.050]and then what brought you home?
[00:14:42.740]I left Zimbabwe just wanting to go to college,
[00:14:46.470]and it happened to be that this college
[00:14:49.060]in Michigan gave me the biggest scholarship.
[00:14:50.750]That's how I ended up there.
[00:14:52.090]Then I met with a Lexington native
[00:14:55.190]at a student conference in D.C.,
[00:14:56.900]and he basically said that he was prepared to hire me
[00:15:00.660]with no farming experience whatsoever.
[00:15:04.660]And I jumped at the opportunity,
[00:15:07.230]and that was my taste of agriculture.
[00:15:08.980]That was my first taste of rural,
[00:15:10.093]because I grew up in an urban setting.
[00:15:12.990]And it was a steep learning curve.
[00:15:15.420]After about six or eight months, you know,
[00:15:17.510]I was trying to get it,
[00:15:18.720]and kind of just fell in love with it.
[00:15:21.750]While I was doing it,
[00:15:23.150]started thinking about doing a master's degree,
[00:15:26.110]met up with Tom Field of the Engler Institute,
[00:15:29.160]and he recommended master's in community development,
[00:15:31.570]because I had future plans of going back to Zimbabwe,
[00:15:34.780]and as you know, at Zimbabwe,
[00:15:37.620]we've got a variety of economic and social problems,
[00:15:42.602]and I wanted to play my part.
[00:15:43.850]What value has your University of Nebraska experience
[00:15:48.610]and your Rural Futures Institute experience,
[00:15:51.130]what value has that brought you
[00:15:52.920]in building your life in Zimbabwe?
[00:15:55.540]Definitely, if you think about Africa,
[00:15:56.643]and you think about less economically developed,
[00:16:00.270]or developing countries, or whatever the case may be,
[00:16:02.570]you kind of think that Africa's a few steps behind.
[00:16:06.970]And we know in terms of technology,
[00:16:09.820]or the amount of value added for agricultural,
[00:16:12.730]we might be a few steps behind in that regard,
[00:16:15.060]but in terms of the people, and in terms of the community,
[00:16:17.920]and in terms of the coming together that's needed
[00:16:20.220]to bear the community, we're not so different,
[00:16:22.693]and RFI really helped me dig into that.
[00:16:26.650]RFI allowed me to put into practice
[00:16:29.150]all of the things that I was learning
[00:16:30.520]in my Community Development program.
[00:16:32.560]The Community Development program itself
[00:16:34.490]gave me a lot of, gave me a few tools
[00:16:36.390]to understand the dynamics of a community,
[00:16:39.400]be it rural or otherwise, and how it's functioning,
[00:16:41.960]I would say that that's culminating and understanding
[00:16:44.250]that we're not so different,
[00:16:45.083]and we all just need to tie our shoelaces and get to work.
[00:16:49.220]What types of experiences do you suggest
[00:16:51.550]that they embrace as a student?
[00:16:54.000]Meet someone who is not like you.
[00:16:57.130]Sit down, and have a good conversation,
[00:16:59.550]a good experience, with someone who's not like you,
[00:17:03.143]and talk about everything.
[00:17:05.433]Meet someone whose ideas and experiences
[00:17:07.590]are different from you, and engage them.
[00:17:10.890]It'll make you that much of a better person
[00:17:13.610]if you can, maybe not understand them,
[00:17:16.290]but appreciate where they're coming from.
[00:17:18.700]The ability to appreciate someone
[00:17:21.530]and respect someone that is not like you,
[00:17:23.780]is crucial in this global society
[00:17:25.910]we're developing where the world is just getting smaller.
[00:17:29.067](soft techno music)
[00:17:33.820]You know, I do a lot of work,
[00:17:34.850]'course on strategic foresight and futuring,
[00:17:36.387]but part of that is creativity.
[00:17:38.890]Part of that is innovation,
[00:17:40.520]and it's really hard for people to be creative
[00:17:44.340]when they're just focusing on a to-do list
[00:17:46.650]and a massive amount of activity,
[00:17:49.470]rather than being very intentional and using discernment
[00:17:53.130]on what's really important,
[00:17:54.840]what can you say no to,
[00:17:56.300]what's maybe not in your wheelhouse,
[00:17:58.560]how do you engage a team around these things
[00:18:00.740]and create different systems
[00:18:03.190]that really support the ability to be creative,
[00:18:05.900]because so many organizations say,
[00:18:07.530]yeah, we wanna be innovative.
[00:18:09.370]We wanna, you know, really be competitive in the future.
[00:18:13.040]But they really aren't designing the lives
[00:18:14.940]of their employees to be that way,
[00:18:17.070]because innovation does start with the individual.
[00:18:19.700]It really does.
[00:18:20.700]I think it does start with the individual,
[00:18:22.640]but I think it's fed by the culture,
[00:18:24.350]or stifled by the culture (laughing).
[00:18:26.320]No, that's true!
[00:18:27.153]That is absolutely right.
[00:18:29.960]And I know you're someone that's a futurist,
[00:18:32.100]and so you really think ahead,
[00:18:34.120]and have no doubt that you found ways
[00:18:37.070]to really carve out that time.
[00:18:39.270]I believe in two things.
[00:18:40.870]As a child psychiatrist,
[00:18:42.110]and also as a parent of four kids myself,
[00:18:44.900]I think that adults often don't take the time to play
[00:18:48.960]in the same way that kids do.
[00:18:51.140]And you know, there's something that, (laughs),
[00:18:53.727]if you grew up watching Mr. Rogers,
[00:18:55.370]but you know, Mr. Rogers actually
[00:18:57.970]was quite a profound thinker, as it turns out,
[00:19:00.720]and then one thing he said is sort of like,
[00:19:02.740]play is the work of childhood.
[00:19:04.760]You know, you really are trying things out,
[00:19:06.940]you're processing things.
[00:19:07.960]We notice in kids who have been through traumas,
[00:19:10.460]well, often you'll see in the play
[00:19:12.440]some of the terrible things they're trying to work out,
[00:19:14.620]you know, and what happened, and reenact, and so on.
[00:19:17.300]But on the positive end,
[00:19:19.010]you know, I believe that for all adults,
[00:19:21.810]you gotta have some time to play,
[00:19:23.750]but that entails two things.
[00:19:25.740]You know, one is, (laughs) it takes some risk, right?
[00:19:28.640]Because if you're gonna play, you might mess up,
[00:19:30.860]because you're probably not the world's expert
[00:19:32.960]in that thing, you're sort of, you know,
[00:19:35.020]processing in the back of your mind,
[00:19:36.460]or balancing off a couple other people.
[00:19:38.840]And then, second thing is then, if it's gonna be risky,
[00:19:40.990]you gotta be ready to fail,
[00:19:42.610]and that's gotta be okay, right,
[00:19:44.210]with the organization, with your unit,
[00:19:46.880]you know, with your boss, whatever, or your colleagues.
[00:19:49.770]And I think for a lot of people, those two things are hard,
[00:19:52.070]because it's a little bit of a risk,
[00:19:53.480]and you don't wanna put yourself out there.
[00:19:55.440]I recently read a book.
[00:19:58.150]It's about the founding of Pixar,
[00:20:00.870]and written by Ed Catmull, the president, I believe,
[00:20:04.948]and it really said the manager's job
[00:20:06.510]is not to prevent risks,
[00:20:08.020]is to make it safe to take them, and I really like that,
[00:20:11.620]because it makes you really think about,
[00:20:13.420]well, as a leader, am I stifling creativity
[00:20:16.660]by saying, oh, you know, you messed up here,
[00:20:19.310]do better next week, or do I say something different,
[00:20:22.150]you know, wow, it looks like you really
[00:20:23.660]put yourself out there.
[00:20:24.970]Maybe it didn't work this time,
[00:20:26.640]but you know, I'd love to see you keep trying new things.
[00:20:29.110]You know, I think there's different ways we can approach it,
[00:20:31.280]and kind of buffer that risk
[00:20:33.160]for our employees and our colleagues.
[00:20:35.709]So the culture norm is to be so serious,
[00:20:38.060]and really, you know, stiff.
[00:20:40.160]Right. It's nice to see
[00:20:41.510]some of that changing that, but, you know,
[00:20:43.240]a lot of the high level leaders I've coached,
[00:20:45.650]that's the thing that is missing from their lives so often,
[00:20:48.800]and part of coaching them
[00:20:51.500]is to encourage them and help them create some time,
[00:20:54.770]and make that time to actually play.
[00:20:56.850]I mean, you know, there's nothing more refreshing
[00:20:59.790]than a snowball fight with your kids, even.
[00:21:02.220]You know, go sledding, go do these things.
[00:21:04.657]Yes. They're actually fun,
[00:21:06.570]or if you were a musician and you haven't
[00:21:08.420]picked up your instrument,
[00:21:09.460]like you had mentioned earlier, for years, reengage
[00:21:13.860]that part of your health, Yes.
[00:21:15.400]because it really brings out the best in you.
[00:21:17.820]And when I used to say that,
[00:21:19.530]people would look at me like, oh my gosh,
[00:21:21.610]she's talking about having fun,
[00:21:23.340]and we're talking about leadership and futuring
[00:21:25.820]and all these things,
[00:21:27.520]but then, it's like it clicked,
[00:21:29.490]and people are like, okay, now how do I do that?
[00:21:31.820]Because it was really lacking from their life,
[00:21:34.480]but you know, I always say
[00:21:35.670]fun is the fountain of creativity,
[00:21:37.460]but it's also the fountain of youth.
[00:21:39.190](soft techno music)
[00:21:42.040]You know, I have this philosophy about workforce,
[00:21:44.970]future workforce, future people in any field,
[00:21:47.930]and it's that, kinda like what you were saying,
[00:21:51.510]you can't just do the routine things
[00:21:53.150]if you're gonna flip something like, you know,
[00:21:55.650]there's not enough people in any field, right?
[00:21:57.680]So otherwise, in 25 years, guess what?
[00:22:00.780]Exact same thing, if we're gonna use this same approach.
[00:22:03.960]But you know, there's some science,
[00:22:05.670]and I do believe there's some art to it as well.
[00:22:08.070]So my first job in this department was,
[00:22:11.530]the only formal title I had
[00:22:12.900]was to help build a psychiatry interest group,
[00:22:16.080]which was medical students,
[00:22:17.850]and there was only one (laughing) in the interest group,
[00:22:19.560]so it wasn't very successful.
[00:22:21.900]But you know, I had in my fellowship,
[00:22:24.250]encountered a really outstanding mentor.
[00:22:26.840]Her name was Dr. Paula Rausch, who's a child psychiatrist.
[00:22:30.090]And when were trying to learn development,
[00:22:32.040]normal childhood development,
[00:22:33.830]she would invite all the fellows over,
[00:22:35.380]there were nine of us, to her house for breakfast
[00:22:38.560]for I think six or nine weeks
[00:22:40.570]And we'd go sit around the table,
[00:22:42.990]and she'd serve us a very simple breakfast.
[00:22:44.770]You know, just bread and peanut butter, and whatever,
[00:22:48.990]and we'd talk about development.
[00:22:50.380]And, you know, one of the things that we then did
[00:22:53.200]was go to see a preschool where her kids had gone to school,
[00:22:57.080]and then, you know, just see what they did, you know,
[00:22:59.160]in their sort of all day recess, you know?
[00:23:02.100]And that experience always stuck with me for two things,
[00:23:05.160]you know, because one is that it takes a little courage
[00:23:09.240]to open up your home to trainees,
[00:23:11.860]or to colleagues, whatever.
[00:23:13.510]It's an extra step,
[00:23:14.890]but two was I never have forgotten it,
[00:23:17.960]and I think others have never forgotten it either.
[00:23:20.240]Many of us remember it fondly
[00:23:21.490]as one of the best parts of our training.
[00:23:24.030]And I realized that, you know, when I started here,
[00:23:26.470]and there's one person going into psychiatry,
[00:23:29.220]and that, you know, we needed to do better than that.
[00:23:31.830]And so I started hosting things in my home,
[00:23:33.900]and we'd invite, you know, students and faculty,
[00:23:36.620]and you really see outside of the work environment,
[00:23:38.930]people really let their hair down.
[00:23:40.840]You know, it's best if they can show up
[00:23:42.550]in their shorts or something,
[00:23:43.700]you know (laughing), and it's casual,
[00:23:45.950]and just relax, you know, and get to know each other,
[00:23:48.680]and I think as the students get to know the faculty,
[00:23:51.970]then I think that we're also sort of unconsciously
[00:23:54.560]sort of auditioning them as future colleagues.
[00:23:58.290]They're looking at their lives,
[00:23:59.357]and sort of auditioning their lives.
[00:24:01.310]Is this the kind of person I wanna be?
[00:24:03.520]Is this the kind of balance I wanna pursue?
[00:24:06.470]And as it turns out, the latest study on why students
[00:24:09.040]choose psychiatry, work life integration and balance
[00:24:12.750]is one of the top three factors.
[00:24:14.820]So the only way you could show that
[00:24:16.520]is definitely not in your office,
[00:24:18.470]but by showing them that thing.
[00:24:19.830]You know, maybe it's piano,
[00:24:22.110]you know, maybe it's something different.
[00:24:23.860]Needs to be something that, you know, gives them
[00:24:27.200]some sense of who you are outside of work.
[00:24:29.640]Oh, absolutely, you get to see the real person.
[00:24:32.010]I mean, in so many ways, when we go to work,
[00:24:34.270]it's not really a facade.
[00:24:35.920]I mean, I think for some people it is,
[00:24:37.360]but you don't see the family that they're raising.
[00:24:40.460]You don't see who they are, or the hobbies they have.
[00:24:44.690]You don't see them as a whole person.
[00:24:47.590]My previous position before coming
[00:24:49.270]to the Rural Futures Institute,
[00:24:50.560]I did a lot of team building
[00:24:52.260]at the Kimmel Education and Research Center,
[00:24:54.670]which is on Kimmel Orchard in Nebraska City, Nebraska,
[00:24:58.110]and we'd have companies come.,
[00:24:59.350]and we'd do things like Iron Chef cook-offs.
[00:25:01.757]That's great. You know, real active,
[00:25:04.550]very fun, but also very purposeful types of activities.
[00:25:08.970]Yes. It's the same thing
[00:25:10.190]you're saying, I mean, so often, a lot of team conflict
[00:25:13.000]is because people just really don't know
[00:25:15.810]or understand each other
[00:25:17.040]outside of the meetings they sit in, you know.
[00:25:19.580]So how can we break down those barriers,
[00:25:21.710]really understand people as people,
[00:25:23.970]and build that camaraderie, but also that compassion,
[00:25:27.990]and real like for other people.
[00:25:31.060]And we're more apt to do that if we know them
[00:25:33.480]and appreciate who they are
[00:25:34.740]rather than judging who they are.
[00:25:36.900]That's really well said.
[00:25:38.116](soft techno music)
[00:25:40.740]You are a leader in your space.
[00:25:42.650]I'd love to know more
[00:25:43.540]about your leadership philosophy, your style.
[00:25:47.570]There's a psychologist that said,
[00:25:49.080]with any organization, it's always good to be half in
[00:25:53.030]and half out, and what he meant by that
[00:25:55.160]was that if you have six different jobs,
[00:25:58.010]no one really feels like you're part of that organization,
[00:26:00.200]'cause, you know, you're running around,
[00:26:01.800]and you're not really present, right?
[00:26:04.010]And people understand that, right?
[00:26:06.090]So you have to be at least, you know, half-time in,
[00:26:08.550]you know, doing that thing, where people see you,
[00:26:10.840]they recognize what you do in that work
[00:26:11.673]and that kind of thing.
[00:26:13.500]But this goes back to your earlier point about creativity.
[00:26:16.620]You have to find that thing,
[00:26:18.520]you got passion area, and you gotta carve it out, you know.
[00:26:22.657]And it may not be there right away,
[00:26:25.040]but however you get there,
[00:26:27.010]that's what's gonna create vitality
[00:26:29.270]for you in the workplace, is having that thing,
[00:26:32.310]you know, and for some people, that's research.
[00:26:34.630]For some people, that's community engagement.
[00:26:36.480]I really enjoy that piece, for example.
[00:26:38.820]For some people, it's something different, right.
[00:26:40.460]It might be building infrastructure,
[00:26:42.410]or you know, could be anything, publishing.
[00:26:44.650]But having that space to really carve that out,
[00:26:47.740]is so important.
[00:26:49.900]And then not being too committed to too many things
[00:26:52.640]is very important as well.
[00:26:54.360]So that was one principle.
[00:26:56.700]Another one that someone told me was,
[00:26:59.010]you know, think about your portable skillset,
[00:27:01.520]because in a career, you may wear six, 10,
[00:27:05.060]you know, many different hats,
[00:27:06.910]but what do you take away from each, and have you grown?
[00:27:10.560]And as I've thought about my career,
[00:27:12.070]you know, I came in, again, really just as a clinician,
[00:27:16.210]which is a great thing,
[00:27:17.690]but I didn't really know anything about leadership,
[00:27:19.480]and so a lot of what I've learned has been on the job.
[00:27:22.570]But I do try to be intentional about it,
[00:27:24.230]and try to write some things down.
[00:27:25.460]At some point I realized,
[00:27:27.190]you know, there's some major gaps
[00:27:28.530]of what I do and don't know, you know.
[00:27:30.500]I know a little bit on managing budgets,
[00:27:32.230]but you know, I really don't know about healthcare economics
[00:27:34.720]in the same way as someone who's running a hospital does,
[00:27:37.940]and if I'm gonna ever do clinical leadership,
[00:27:40.080]I should probably learn something about that.
[00:27:41.730]So for example, last year,
[00:27:43.020]and I enrolled in an executive MBA program
[00:27:46.220]that's sponsored through our hospital.
[00:27:48.470]Having those relationships, what Gallup would say,
[00:27:51.670]is the friend at work, so important.
[00:27:54.850]So easy to neglect, but if you don't have it,
[00:27:58.530]I really feel it, you know.
[00:27:59.840]So it's the people that you can go
[00:28:01.740]and you know, really debrief with,
[00:28:03.760]that, you know, aren't doing it because of your role,
[00:28:05.770]but really, they genuinely, you like each other,
[00:28:08.320]you know, that you can share your woes,
[00:28:09.787]and they can share theirs.
[00:28:11.470]You know, that kind of thing.
[00:28:12.870]You can't just create it, you know, you have to find it.
[00:28:15.950]You gotta carve that time out,
[00:28:16.783]and then you gotta nurture it once you have those people.
[00:28:19.520]I've been lucky to have those people here,
[00:28:23.067]and it's important just for attention
[00:28:25.790]and for your own vitality as a leader.
[00:28:27.634](soft techno music)
[00:28:30.310]So I'd like to touch a little bit on BHECN,
[00:28:34.070]the Behavioral Health Education Center of Nebraska.
[00:28:37.260]Tell us a little bit more about your work there,
[00:28:40.220]and how you see that evolving into the future.
[00:28:43.280]Well, that's the half of my job
[00:28:45.290]that is, you know, creative work, I would say,
[00:28:48.060]in that there's not really another center
[00:28:51.250]like BHECN in the 50 states, that we've seen.
[00:28:54.620]It was created out of passion
[00:28:56.100]by a group that included a philanthropist,
[00:28:59.350]a you know, academic psychiatrist,
[00:29:03.110]those senior administrators, government leaders, and so on,
[00:29:06.570]but it creates, it functions almost like a skunk works,
[00:29:09.770]in that, because there's not 50 BHECNs around the U.S.,
[00:29:14.360]we don't have to do it any which way.
[00:29:16.960]And that was super important,
[00:29:18.180]because you know, I think we're trying to solve
[00:29:19.990]what we call a wicked problem,
[00:29:21.750]which is the shortage of providers
[00:29:23.530]in the highest underserved areas in the state,
[00:29:26.340]which have always been very underserved,
[00:29:28.650]and the current provider population's getting older.
[00:29:32.150]In fact, you know, I'm not calling them old,
[00:29:34.210]but the data suggests that over half of the psychiatrists
[00:29:37.790]psychologist, advanced practice nurses in psychiatry,
[00:29:40.980]are 50 or over, which means
[00:29:43.080]there's a very high number retiring every year,
[00:29:45.760]and just to retain the same number,
[00:29:48.100]you have to have, you know, a lot more people coming in.
[00:29:51.010]So when we saw that,
[00:29:53.810]we also looked at, are there healthy pipelines
[00:29:56.500]for people coming in?
[00:29:57.700]And there's some great programs
[00:29:59.020]for healthcare professionals,
[00:30:00.550]and so-called Rural Health Opportunities Program,
[00:30:02.840]RHOP Program, and so on,
[00:30:04.670]that, you know, pipeline people,
[00:30:06.277]I'd say primarily for MDs into family medicine,
[00:30:08.960]internal medicine, you know, primary care,
[00:30:11.010]you know, and those are great areas.
[00:30:12.850]But they weren't really turning out psychiatrists
[00:30:15.000]or psychologists, so we realized
[00:30:17.310]that we had to put our own pipeline together,
[00:30:19.990]and the last nine years frankly have been, you know,
[00:30:23.107]from the inception to now, have been really
[00:30:26.240]trying to get all those kinks out of that pipeline
[00:30:29.040]as much as possible, so you know,
[00:30:31.080]we started working with, you know,
[00:30:33.340]high school students, you know, from around the state,
[00:30:35.640]and that's been great collaboration.
[00:30:37.630]With a number of different training organizations,
[00:30:40.640]and we work with college students, you know,
[00:30:42.870]around the state, hosted different college symposium,
[00:30:45.310]particularly for those in highly underserved areas,
[00:30:48.430]so rural students, we've always prioritized,
[00:30:51.070]but also, you know, those from, it might be North Omaha,
[00:30:53.930]South Omaha, Native American, you know, individuals,
[00:30:58.240]so those that are missing, basically, in the workforce.
[00:31:03.400]And then we worked in medical school,
[00:31:05.040]and over the last you know, four years,
[00:31:08.150]we've increased the number of medical students
[00:31:09.990]going into psychiatry by about 63% or so,
[00:31:12.920]so really, it's gone up,
[00:31:14.620]and there's been a sustained increase in those folks.
[00:31:17.200]And now we're just about to help work
[00:31:19.390]with our Department of Psychiatry here,
[00:31:20.690]to put up a new psychiatry residency program,
[00:31:23.500]along with the one that currently exists,
[00:31:24.900]to try to increase those in that part of the pipeline.
[00:31:27.940]The last part is something we've been doing throughout,
[00:31:30.220]which is trying to support the providers
[00:31:32.440]who are already out there,
[00:31:33.890]by providing a lot of training for them,
[00:31:35.480]but not just what, you know, random training,
[00:31:37.860]but the things that really would help them in the practice.
[00:31:40.610]And the great public health needs in Nebraska,
[00:31:42.357]so you're talking about addiction
[00:31:44.840]being a major shortage area,
[00:31:46.920]how do we increase those who have expertise
[00:31:49.090]in prescribing some medications,
[00:31:51.400]or, you know, help with addiction.
[00:31:52.800]It might be to alcohol, it might be to opioids,
[00:31:54.919]that kind of thing.
[00:31:56.310]We talked about Integrated Behavioral Health earlier,
[00:31:59.030]you know, and this is a way to
[00:32:00.010]how do you train up social workers, counselors,
[00:32:02.410]psychologists, psychiatrists to really work
[00:32:04.390]with four or five primary care clinics,
[00:32:07.670]and really serve those patients in a very, you know,
[00:32:12.200]smart way, where you know, really,
[00:32:13.760]you're spreading your expertise out.
[00:32:15.710]So there's really, you know, a lot of things we've learned,
[00:32:18.620]a lot of mistakes we've made as well, I might add,
[00:32:20.700]but this goes back to taking risks,
[00:32:23.130]and really looking at the data and outcomes.
[00:32:25.580]Now, thank you for all you're doing
[00:32:27.760]to help enhance that capacity,
[00:32:30.640]and congratulations on the growth and success,
[00:32:33.180]and we're so excited to be able to promote that work,
[00:32:37.110]and really get it out to people
[00:32:38.420]so they know what you're doing.
[00:32:40.800]Yeah, I heard, I think, a statistic the other day,
[00:32:43.490]a thousand people a day are retiring right now,
[00:32:45.980]so creating this pipeline,
[00:32:48.000]helping people get to capacity, you know,
[00:32:50.340]in their licensures, so important,
[00:32:52.520]in especially the healthcare field.
[00:32:54.840]Working in this area of mental health,
[00:32:56.720]I mean, obviously we hear and see a lot
[00:32:58.730]about the challenges, and we can imagine
[00:33:00.890]it might be a difficult field,
[00:33:02.540]you know, to work in in many ways,
[00:33:04.840]so what excites you about working
[00:33:06.970]in the field of mental health?
[00:33:08.520]Well, I think the future of mental health
[00:33:09.980]is really gonna be collaboration across professions.
[00:33:13.600]And you have to practice it, you know,
[00:33:14.990]you can't just talk about it,
[00:33:16.460]and then train in the same specialty
[00:33:18.607]and then stay with your colleagues.
[00:33:20.100]You have to practice working in areas
[00:33:21.880]that are frankly uncomfortable.
[00:33:24.270]Might be scope of practice,
[00:33:26.540]might be training, you know, might be areas
[00:33:29.000]where you might not all agree, but the needs are great.
[00:33:32.400]Two weeks ago, I was in D.C.
[00:33:33.770]helping lead a behavioral prescribers summit,
[00:33:36.740]and the national group for the physician assistants,
[00:33:39.520]psychiatrists, nurse practitioners in psychiatry,
[00:33:43.060]and pharmacists, we were all together in one room.
[00:33:45.850]We were talking about the future,
[00:33:47.350]and when you look at things
[00:33:48.470]like all the opioid deaths that are happening in the U.S.,
[00:33:51.850]you can't just rely on one profession to solve them.
[00:33:55.120]And I think, as a group,
[00:33:56.500]if we can unite around a common behavioral health flag,
[00:33:59.280]and say that this is something we all will do together,
[00:34:02.060]and if I have expertise, I'll share it,
[00:34:03.620]if you have expertise, you'll share it,
[00:34:05.360]I think we'll be a lot better off.
[00:34:06.850]And I always come out of those conversations,
[00:34:09.000]especially the tough ones, a little bit more inspired,
[00:34:12.620]because I know some real work has happened,
[00:34:15.040]because you're a little bit uncomfortable, frankly,
[00:34:17.060]and that's kind of when I know we're making some progress.
[00:34:20.740]I think, too, that just, you know,
[00:34:22.700]makes sense to me, because knowing you,
[00:34:25.510]I can see how you stay on that cutting edge
[00:34:28.100]by enjoying a challenge,
[00:34:29.610]but also, you bring so many people around that,
[00:34:31.837]and a lot of capacity around that,
[00:34:34.110]to really solve those grand challenges
[00:34:36.300]in unique and innovative ways.
[00:34:38.470]Well, I would say that every one of those interactions
[00:34:40.740]kind of, that's very kind,
[00:34:42.150]I learned a lot at the table, and, (laughs) you know,
[00:34:45.670]there's all sorts of things that I just had wrong, you know,
[00:34:48.620]and then when you hear it from, you know,
[00:34:50.400]the pharmacist about what they're doing,
[00:34:52.620]and the VA hospitals,
[00:34:54.810]that was a revelation to all us of, you know.
[00:34:56.630]Many of them are running clinics like psychiatrists,
[00:34:59.260]you know, in VAs.
[00:35:00.440]So you know, I think the more conversation
[00:35:03.730]that happens, the better, and then frankly,
[00:35:05.950]it does take a little bit of spirit
[00:35:08.790]of it being a maverick, as you said earlier, to say,
[00:35:11.660]you know what, there's somethings my own profession's
[00:35:14.100]got wrong, and I'm not always gonna agree
[00:35:16.800]with our state chapter of our national organization
[00:35:19.160]because, you know, my greater duty
[00:35:21.580]is to the workforce of the state,
[00:35:23.760]and sometimes, that means some tough choices,
[00:35:25.910]but you know, if you ever ask me,
[00:35:27.480]should we protect our turf in psychiatry,
[00:35:30.600]versus, you know, should we get some more access,
[00:35:33.150]it's always gonna be about access.
[00:35:34.976](soft techno music)
[00:35:37.920]One last question for you, Dr. Liu.
[00:35:40.710]What parting words of wisdom do you have for our audience?
[00:35:44.500]Well, I would say that, you know,
[00:35:45.733]when I went through training,
[00:35:47.740]I think I got an incomplete tool kit,
[00:35:50.330]and it was really about just the nuts and bolts
[00:35:53.050]and how to take care of patients in the old model.
[00:35:57.220]And if I were to say, talk to tomorrow's students,
[00:35:59.520]if any of them are listening, if tomorrow's providers,
[00:36:03.070]I would really encourage them to learn more about two things
[00:36:05.910]which I failed to learn about when I was in training.
[00:36:08.380]So one, is population health.
[00:36:12.660]And that really means that, you know,
[00:36:14.220]my client is not just the person sitting
[00:36:16.690]with me in this exam room,
[00:36:18.720]but my client might be a neighborhood, you know,
[00:36:22.627]and it might be a school.
[00:36:24.010]It might be, you know, county corrections.
[00:36:26.420]It might be some other area.
[00:36:28.290]But how am I gonna take my limited time,
[00:36:30.910]and work as smartly as possible
[00:36:32.610]to help the entire population,
[00:36:35.030]and that's something that, you know,
[00:36:36.380]I feel like needs to be taught,
[00:36:37.720]especially in a state like ours, where there's so many gaps,
[00:36:40.840]you know, to really think about those skills.
[00:36:43.900]The second piece, which we've talked about
[00:36:45.860]in many, many ways this hour,
[00:36:47.190]is sustainability yourself.
[00:36:49.660]You know, really being thoughtful about self-care, wellness.
[00:36:53.360]We know that sometimes the work is hard.
[00:36:56.140]A lot of clients we work with
[00:36:58.020]have had a lot of trauma,
[00:36:59.750]and sometimes that can weigh on people
[00:37:01.970]who have their own trauma histories,
[00:37:04.274]and just suddenly, we call it compassion fatigue,
[00:37:06.850]and sometimes you get a little burnt out.
[00:37:08.550]So really taking care of yourself,
[00:37:10.150]making sure that you have good colleagues,
[00:37:11.800]you know, the friends at work,
[00:37:13.450]making time for those hobbies, those areas,
[00:37:16.100]I would say, that would help you
[00:37:17.180]to be retained in the workforce far longer,
[00:37:20.808]and really to thrive and have joy in your practice,
[00:37:23.160]I think that is really the key.
[00:37:25.000]So I would say those two areas,
[00:37:27.080]if there are future students that are listening.
[00:37:29.390]Yeah, I love that word joy,
[00:37:30.760]and I'm so glad that you know,
[00:37:32.810]that's really becoming something people are focusing on.
[00:37:36.530]Like, how do we create joy in our lives
[00:37:38.550]in this busy time with all this rapid change
[00:37:41.300]and so much being thrown at us all the time,
[00:37:43.210]but still, you know,
[00:37:45.770]making priorities around well-being people, joyfulness.
[00:37:49.490]I think it's an exciting time,
[00:37:50.830]and I'd love to see how that evolves in the future,
[00:37:54.010]because I think it'll become more and more priority,
[00:37:57.020]you know, for people, as they want more
[00:37:58.280]of a life experience, and not just a to-do list.
[00:38:01.989]That's good for us. So, I,
[00:38:02.822]we know you're active on social media.
[00:38:04.550]We follow you, we're huge fans,
[00:38:06.550]but where can people find you, Dr. Liu?
[00:38:08.750]Well, if they want to, if they're on Twitter,
[00:38:11.740]it is @DrHowardLiu, L-I-U is my last name,
[00:38:15.150]so they can follow me there, and you know, I pretty much
[00:38:18.940]put a few things out there almost every day.
[00:38:22.070]There's also just a tremendous community out there
[00:38:24.240]for mental health, and I think that
[00:38:27.630]if they're a consumer of mental health,
[00:38:29.970]if they're a provider of mental health,
[00:38:31.627]you know, if you just put in so-called #mentalhealth,
[00:38:34.734]or #addictions, any of those, you'll find so many advocates,
[00:38:39.360]and frankly, sometimes, when I'm a little burnt out,
[00:38:42.330]that's where I find inspiration,
[00:38:43.940]and I seek every day an act of courage online,
[00:38:47.780]that, you know, inspires me,
[00:38:49.790]people telling their stories and standing up for things
[00:38:52.970]that really, that gives me hope for the future.
[00:38:56.388](soft techno music)
[00:38:58.000]Thanks for listening to the Rural Futures podcast.
[00:39:00.750]You can find us on social media @RuralFutures,
[00:39:03.880]and we hope you will share our show with your networks
[00:39:06.370]to raise awareness and bold thinking
[00:39:08.420]for rural areas across the country.
[00:39:10.990]Next stop, rural maverick from Nebraska, Amber Pankonin.
[00:39:14.840]Amber is a Registered Dietician,
[00:39:16.720]nutrition communicator, recipe creator at stirlist.com,
[00:39:20.600]and host of the Healthy Under Pressure podcast.
[00:39:23.900]I work with a lot of students,
[00:39:25.730]and it's so interesting to me
[00:39:28.810]to hear their thoughts on food production.
[00:39:31.490]You know, they've been led to believe
[00:39:32.760]that the word process is bad.
[00:39:34.860]It's having conversations like that
[00:39:37.910]to teach them that you are going to be the future
[00:39:41.430]trusted food and nutrition professional.
[00:39:43.980]You have to be able to answer questions
[00:39:46.050]about how food is produced,
[00:39:48.000]because so often, we hear things from another person
[00:39:50.530]that are those soundbites,
[00:39:52.070]and we just pass them on as if they're truth,
[00:39:55.020]without being skeptical.
[00:39:56.900]And so I think that's a really important part
[00:39:58.610]of the conversation as well.

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Rural Futures with Dr. Connie Episode 14 Featuring Howard Liu

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