The Ethics of Restricting Mental Health Medications: A Special Podcast Episode with Dr. Janet Cummings and Dr. Cara English

This special episode of Disruptors at Work: An Integrated Care Podcast, tackles a pressing issue in mental health: recent policy changes impacting the use of SSRI medications or antidepressants. Dr. Janet Cummings and Dr. Cara English discuss the implications of political decisions affecting psychiatric care, including concerns over misinformation, restricted access to medication, and the vital role of psychotherapy. Dr. Cummings sheds light on the Biodyne Model, advocating for therapy as a primary treatment to best to treat a patient. She also discusses the risks of abrupt medication withdrawal, the influence of pharmaceutical lobbying, and how healthcare providers must unite to advocate for evidence-based care.

This eye-opening discussion is a must-listen for mental health professionals, policymakers, and anyone concerned about the future of behavioral healthcare in the United States. Listen now for an in-depth exploration of the evolving landscape of psychiatric care and policy.

Thank you to our subject matter experts:

- Dr. Janet L. Cummings, Psy.D.
- Dr. Cara English, DBH, MA, LAC

About the Subject Matter Experts:

Dr. Janet L. Cummings, Psy.D.

Dr. Janet Cummings, Psy. D., is the daughter of Drs. Nicholas and Dorothy Cummings, an internationally-recognized psychologist and a clinical social worker. Determined not to be a mental health professional, she earned a Bachelor’s Degree in Pre-med (with a minor in Genetics/Molecular Biology) and Linguistics (with a Classical Greek minor). She went on to earn a Master’s Degree in Linguistics, with a Psycholinguistics emphasis, before deciding to earn a doctorate in Clinical Psychology from the School of Professional Psychology at Wright State University, which she completed in 1992. During her Bachelor’s and Master’s studies, Janet owned and operated a sewing business and taught English as a Second Language.While at the School of Professional Psychology, Janet participated in an experimental program aimed at preparing students for the possibility of prescription privileges for psychologists. In this experimental program, she took the same Pharmacology and Psychopharmacology classes as students in Wright State University’s medical school. Because of her Pre-med background, she excelled in her Pharmacology studies, as well as in Biological Psychology and Neuranatomy/Neurology.

While at Wright State University, Janet was awarded the university president’s annual President’s Commendation, the first to be earned by a graduate student in psychology. In 2007, she was named Wright State University’s Alumna of the Year.

Janet completed her internship and post-doctoral residency at Arizona Biodyne, and remained as a staff psychologist there for several years. With supervision from some top Biodyne psychotherapists, she became a master psychotherapist and expert in the Biodyne Model. She has continued to utilize the Biodyne Model exclusively in her private practice and other work settings.

Janet has supervised over 60 mental health practitioners, many of whom were involved in faith-based counseling. Under her direction, the faith-based counseling center where she functioned as a supervisor earned a national reputation for excellence in counseling.

In 2010, Janet moved from Scottsdale, Arizona to Reno, Nevada in order to be close to the headquarters of The Nicholas & Dorothy Cummings Foundation, which she has served as its President since its inception in 1995. Under Janet’s direction, The Nicholas & Dorothy Cummings Foundation has sponsored many projects aimed at furthering the integration of behavioral health into primary care medicine, including The Cummings Psyche Award (the premier scientific award in the mental health field, with a $50,000 prize) and the launching of the first Doctor of Behavioral Health (DBH) Program at Arizona State University.

Janet is the author of over two dozen journal articles and book chapters, and she has co-authored or co-edited ten books with her father. She served as adjunct professor at both the University of Nevada, Reno and The Forest Institute of Professional Psychology in Springfield, MO. She was Co-founding Associate Director of the Doctor of Behavioral Health Program at Arizona State University, and served as a Professor and Co-founding Sponsor until 2014 when she decided to move the DBH Program to a different venue. She taught Pathophysiology and Psychopharmacology for the ASU DBH Program, where she received outstanding student ratings and was considered a favorite Professor.

Janet resides in Reno with her two children, Mary and Kent. Of the many jobs that Janet has held, she considers motherhood to be the most important and the most rewarding.

Dr. Cara English, DBH, MA, LAC

Dr. Cara English, DBH, MA, LAC is the Chief Executive Officer and Chief Academic Officer of Cummings Graduate Institute for Behavioral Health Studies (CGI) and Founder of Terra’s Tribe, a maternal mental health advocacy organization in Phoenix, Arizona. Dr. English spearheaded a perinatal behavioral health integration project at Willow Birth Center from 2016 to 2020 that received international acclaim through the publication of outcomes in the International Journal of Integrated Care. Dr. English served as Vice-President of the Postpartum Support International – Arizona Chapter Founding Board of Directors and co-chaired the Education and Legislative Advocacy Committees. She currently serves on the Maternal Mortality Review Program and the Maternal Health Taskforce for the State of Arizona. She served as one of three Arizonan 2020 Mom Nonprofit Policy Fellows in 2021. For her work to establish Cummings Graduate Institute for Behavioral Health Studies, Cara was awarded the Psyche Award from the Nicholas & Dorothy Cummings Foundation in 2018 and is more recently the recipient of the 2022 Sierra Tucson Compassion Recognition for her work to improve perinatal mental health integration in Arizona.

Testimonials

“The totally online DBH program offered by Cummings Graduate Institute of Behavioral Health Studies is focused on the professional I have grown into: a synergistic disrupter for the healthcare industry, who is passionate about Wholistic Healthcare (e.g., health, behavioral health, and Social Determinants of Health and Mental Health), rendered skillfully through interprofessional teams. The program pillars of medical literacy, integrated behavioral health interventions, and entrepreneurship resonate loudly with me. The healthcare industry will continue to change, with doctoral level professionals needed to play a major role in any successful transformation. My goal is to further advance my knowledge-base, professional standing, and industry commitment to be part of these transformational efforts. In this way I can heed the Quadruple Aim: assuring quality-driven patient-centric care is rendered at the right time, through the right population-based treatment processes, at the right cost, and by empowered professionals embracing the work and committed to their charge.”
Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CRPDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 11, 2020

“In the time that I have been a student at CGI, I have learned that integrated healthcare is no longer the exception; providers want behavioral health clinicians on their team. My courses demonstrate that the services that a DBH can offer are valuable and the opportunities abound. I’m learning that as a DBH, I can work to create a new norm in healthcare, one that promotes holistic care provided by a collaborative team delivering diverse services. I now view behavioral healthcare as a crucial piece of the medical care puzzle, rather than a separate entity. I can see the gaps in care that a DBH can fill and why including a DBH in treatment is critical. I am beginning to see how I will play a role in disrupting healthcare to provide quality treatment while advocating for my patients. Although I may still have to explain my role at times, I am learning that once I do, others will seek out my services. I am gaining confidence in what I bring to the medical team and am continuously expanding my knowledge of what else I can do.”
Jennifer KellyDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - July 26, 2020

“As a Social Worker, I believe my main mission includes advocating for and empowering patients. The DBH degree will allow me to fully integrate the “medical side of the house” with the “behavioral health side”. My experience working side-by-side with medical providers (PCM’s, ED docs, Hospitalists, etc…) has shown that most of them do not understand behavioral health issues nor how medical symptoms or diagnoses can effect a patients’ mental health and vice-versa. Alternatively, I have worked with a multitude of behavioral health providers who have very limited knowledge of how medical issues might affect their clients. I have often wondered how many patients I have had who were diagnosed with depression or anxiety or other DSM-V diagnosis when in reality the origin was medical. Earning a DBH will allow me to push the envelope when it comes to consulting with medical providers and promote the inclusion of “behavioral healthcare” within “healthcare” as its ALL healthcare! As Mahatma Ghandi said “be the change you wish to see in the world”; earning a DBH will enhance my ability to “change the world” – even if it’s one medical provider or one patient at a time.”
Diane Scott, MSW, LCSWDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - August 7, 2020

“My friend and I were talking about the challenges and frustrations that we face daily in our careers with the clear divide between mental health and physical health and how we wished we had the knowledge and skills to shake up healthcare and bridge the gap. She brought up researching doctorate programs and how interested she was in the DBH. My reponse was, “What on earth is a DBH?” She laughed and said it was a newer doctorate degree in behavioral health, that focused directly on integrated care and doing exactly what we were dreaming of doing….shaking up healthcare and bridging the gap and treating the person as a whole. I had a hard time believing her. It sounded too good to be true. How was there a degree out there that fit my goals and aspirations to a T without me knowing about it? I had been looking periodically throughout my 20 year journey in behavioral health for a program that resonated with me. It was here all this time? How had I missed it? I immediately spent hours scouring the internet to find any crumb of information that I could about the Doctorate of Behavioral Health and the programs associated with it. Then I hit the jackpot. I found the Cummings Graduate Institute for Behavioral Health Studies.”
Amy McConnell, LCSWDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 18, 2020

“During my tenure as a student at CGI, I wrote a book review that was published in the International Journal of Integrated Care. One of my papers became a newsletter article, a pitch for my population health class became a poster presented at a CFHA conference, a book chapter was developed based on a paper I wrote for my independent study, and I am submitting my CP project to a journal this weekend. So, everything that you write during the program is potentially publishable! You have the advantage of having faculty read and give you feedback on it before submitting it. Take risks! The worst that can happen if you submit a paper for publication is receiving a rejection letter. Well, if you don’t send it you’re already acting as if the paper had been rejected. 😉 Plus, if you receive a rejection letter, it usually comes with feedback, so you can improve your paper and send it again!”
Dr. Liliane de Aguiar-Rocha, DBH, BCBADBH Alumni, Cummings Graduate Institute for Behavioral Health Studies - October 9, 2020

“There is a substantial need for integrating care between our physical, and mental health. The gap between these domains are more so overlooked among those with developmental delays and intellectual disabilities – the very population I serve as a Behavior Analyst. Filling these gaps entails work that demands for a DBH who is competent, empathetic, and altruistic.”
Pauline Pablo, BCBADBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - November 11, 2020

“My interest in a DBH degree grew out of frustration and hope. On one hand, I grew frustrated with the quality of care my clients with intellectual and developmental disabilities were receiving. As members of a marginalized population who lack the skills to advocate for themselves, the clients I serve receive subpar medical care, mental health care, and behavioral health care. Many healthcare providers are not trained to address the unique language and cognitive challenges present when serving a person with Autism and I/DD.

On the other hand, as I learned more about the DBH program, a potential solution came into view. I believe this program will allow me to acquire the knowledge and skills to become a better advocate for my clients, and new job opportunities will open up in positions in which I will be able to make a bigger impact on a system level, thus improving quality of life for many clients. A DBH degree will command interest and respect from other healthcare professionals who are evaluating their practices and noticing areas in which they are not being effective, namely the behavioral health side of the equation. As we are learning in our first classes about the Biodyne Model, the Integrated Care Model is not widely accepted or known in the healthcare field, despite its proven track record. I believe a DBH degree provides the necessary tool to change the landscape of healthcare provision by arming my passion for this topic with knowledge and concrete strategies.”
Valeria ParejoDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - January 15, 2021

“As a Doctorate of Behavioral Health (DBH) student my vision for healthcare is to disrupt the current model, close gaps to care and create healthcare improvements. In the evolving world of healthcare I believe behavioral healthcare providers (BCP) are essential to the development of integrative healthcare. Once I obtain a DBH degree, I know I will gain a leadership role and be able to add quality to the creation of integration efforts worldwide. I know I will graduate with the essential tools I need to stand at the forefront of integrated healthcare. I want to create healthcare improvements for marginalized populations that are typically underserved or forgotten. As an individual of two minority groups; woman and African American, I am very passionate about helping reduce cultural, ethnic, social economic and geographic disparities within healthcare systems.”
Ebony WatsonDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 30, 2021

“Since beginning my studies at CGI, I have been awakened to how much I truly did not know and understand despite my specialty training in Social Work and behavioral health needs. The classes at CGI allow me to explore topics that I may not have thought to investigate and encourage me to question and think outside the “normal” delivery of behavioral health services. Services that I previously thought were quality and designed to meet the needs of special populations, I now believe to be woefully inadequate to serve the needs of the patients. Patients cannot receive the best quality, efficient, and timely care they need and deserve within institutions that are not integrated. Institutions that continue to silo and do not encourage collaboration and integration are not focused on the needs of the patient.”
Amanda BarnardDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 30, 2021

“I believe, as a DBH, I will disrupt the current healthcare systemby promotingguaranteed health care for allasa right, not a privilege.I willadvocate fora national, rather than state, licensing of providers. This will allow clinicians (medical,behavioral health, etc…) to provide care across state lines using telemedicine.Finally, the skills I have learned at Cummings Graduate Institute for Behavioral Health Studies allow me to identify healthcare delivery concerns, propose alternative interventions and cost–effective solutions and evaluate theirreturn on investment.”
Diane ScottDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - March 29, 2021

“Since entering CGI, I have more confidence in discussing the need for healthcare systems to have a population health approach to care, and to put in place “upstream” programming. I have always been proud of working in a hospital and delivering care, working as a multidisciplinary team member, and making a difference. I now realize I have been part of healthcare’s focus of “treating the sick” rather than being an influencer for preventative care.

Preventative care can be part of service delivery from a hospital system; we should not rely only on public health programs to tackle social determinants of health. COVID-19 is not only impacting mental health but also how we are delivering medical care. Could COVID-19 be an unintended force for healthcare policy change? Apostolopoulos et al. (2020) reports the complexity presented to the health care system by COVID-19 has created change that will continue in healthcare for years to come. The needed changes to delivery and access will require a policy shift in all levels of healthcare (Apostolopoulos et al., 2020).”
Billie RatliffDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - December 13, 2021

“The DBH is exactly the type of doctorate degree that I’ve been searching for. A doctorate that is clinical focused is where my interest lies. I am motivated to pursue this degree, and courses like Pathophysiology, Psychopharmacology, Neuropathophysiology, only add to that excitement. One must be motivated to complete any degree program. The Doctor of Behavioral Health fits that bill for me. In fact, I would say that I am beyond motivated.”
Arthur Williams IIIDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - July 8, 2022

“As a member of the AAPI community, I’m very familiar with the barriers to mental health services and the need to break through the glass wall of cultural stigma that prevents many from receiving potentially life–saving treatment. I was the only Asian American person in my master’s cohort, the only Asian American person in many of my clinical work settings, the only Asian American person to walk into many of the professional settings that I pushed myself to show up to. In my current practice, I’m constantly reminded by my patients of how difficult it is to find an Asian American mental health provider, though this reminder constantly informs me that more needs to be done for my community. Day after day, I read stories of Asian American people who die by suicide as a consequence of our culture’s avoidance of mental health topics. As a DBH, my biggest goal is to use my expertise in whole–person care to amplify the conversation around mental health and help my community understand that mental healthcare is not a privilege that we are not entitled to, it is a crucial part of our healthcare that will manifest differently in us than what many Western psychology or psychiatry textbooks will describe, and that our unique experience of mental health issues are valid, important, and is time to be part of the larger conversation.”
Willam ChumDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 16, 2022

“Pursuing a doctorate in behavioral health is essential in helping to transform my thinking as a healthcare provider; moving from a more traditional mindset, embracing change and a “different world view” of tools for successful client outcomes. This type of advanced study will equip me with the clinical and leadership skills to be a leader on the cutting edge of behavioral health. This type of training would make me an asset to the healthcare workplace; specifically to function effectively as a change agent for the successful outcomes of the workplace and its clients.”
Judith AllenDBH Candidate, Cummings Graduate Institute for Behavioral Health Studies - September 23, 2022 Previous Slide