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Introduction:
54 million American adults live with mental illness, but many lack access to quality mental health care. The University of Notre Dame is establishing a new psychology clinic to help address this problem. By adding faculty, students, and researchers, Notre Dame is educating more clinicians to make a profound difference in a field so underserved.
What would you fight for?
To combat America's mental health crisis. We are the Fighting Irish.
Andy Fuller:
So that was a 30-second edition of the latest story featured in the University's What Would You Fight For series. Welcome to Notre Dame Stories, I'm Andy Fuller.
Jenna Liberto:
And I'm Jenna Liberto. And that's what we'll be bringing you on this season of Notre Dame Stories. You know, you see these mini "Made For TV" movies, whether you're sitting on your couch during the football game or if you're in the stadium, and they're inspiring because they have all those elements of, you know, going to the movies and being inspired by what you see on the big screen—the swells of music, the characters that are fighting the good fight. In this case, though, they're not characters they're real people. They're our faculty members and our students fighting for important work that's happening on our campus.
Andy Fuller:
Yeah. Which is why I've loved the What Would You Fight For series over the years. They've been really great at embodying sort of the entire University story. From the Athletics tradition, you know, what we are, the "Fighting Irish" to research which is, you know, these are research stories first and foremost and as you kind of indicated, they're really mission in action, these stories. And no better example than this one, mental health.
Jenna Liberto:
Yeah. We're diving right into a topic that affects every person, every family, our communities across the country, and two people here at the University who are fighting to make a difference in that space. So you'll listen to our conversations with Dean Sarah Mustillo—she's the Dean of the College of Arts and Letters—and Austin Wyman, who's a graduate student. This is a personal fight for them. They're motivated to make a difference and I think, through our conversations, you'll see exactly why.
[Music]
Jenna Liberto:
Dean Mustillo, thank you so much for inviting us into your office to talk about your work. So excited to get into that, into the heart of your research and its impact on the mental health crisis in our country right now. But before we go there, the title of our series is Notre Dame Stories, so I'd love to hear your Notre Dame story. How did you get here and how did you become the Dean of the College of Arts and Letters?
Dean Mustillo:
I did my undergrad here and my husband did as well. This is where we met. We got married in the Basilica. When I went to graduate school and decided I wanted to be a faculty member, I always had the dream of coming back here someday. What Notre Dame is doing in the landscape of research universities is, we like to say, "on par with but distinct from our peers." And the sense of mission here and kind of what we stand for and who we are was really appealing to me. And so I had always hoped to make it back here as a faculty member and was able to do so 10 years ago.
Jenna Liberto:
Can you talk a little bit about your trajectory then? Joining as a faculty member and now the role that you're in today?
Dean Mustillo:
It was unexpected. I had never intended to become an administrator or a leader at this University. I was really excited when I first got here about, you know, really setting up my research here and doing my research on mental illness. My department chair announced he was stepping down when I had been here about 18 months and I thought, oh they'll never ask me to be department chair because nobody knows who I am yet, and sure enough, I was in this office being asked to be department chair.
And so I became department chair. And then I had been chair for 18 months when my predecessor who's now the Provost, John McGreevy, announced he was stepping down and he pulled me into his office and said, "I think you know you should consider applying for this." And so that's, you know, that's kind of how I got here.
Jenna Liberto:
But you do remain so connected to what brought you here into your research. Let's talk about that. Tell me, for someone who's never met you, tell me about your research. Why it's so important to you and just kind of give us the scope.
Dean Mustillo:
So I, yeah. My research is in the area of childhood mental illness. My first job out of graduate school was in the Psychiatry Department, in the child psychiatry unit at Duke University Medical School and I had the opportunity to work with amazing people—mentors and collaborators in this area. Yeah, so it's been important to me.
So I'm a sociologist not a psychologist, which always surprises people. But mental illness is, you know, kind of a multifaceted thing and so there's, you know, there's genetic causes, there's family causes, there's environmental causes. And so, sociologists tend to study, you know, the social aspects of mental illness. And so that's what I study and, in particular, I focus on adverse childhood experiences. Stressful life experiences that happen in childhood and how that impacts people's mental health over their lifespan.
Jenna Liberto:
Sarah take us back to the beginning of this work for you. Personally, what inspired you to dedicate your life to mental health research?
Dean Mustillo:
There has been mental illness in my family. There has been substance abuse in my family, really, since I was a child. And so I have experienced it as a family member, kind of, from childhood through parenthood and I see the, you know, the suffering that people who experience mental illness go through but also the impact that it has on their entire family. And that, you know, has really inspired me to want to make a difference in this area.
Jenna Liberto:
So when you're working with families or talking with children as part of your work, or even looking at the data and thinking about the person behind the numbers, you can go there because you, you're part of that.
Dean Mustillo:
Absolutely. Absolutely. I have definitely experienced, firsthand, the impact that this has on individuals, on families, and on communities, and to the extent that I can help make a difference in making this better for people. And so, to me, that was kind of what drew me to this area of research is that it's such a vulnerable time, and so many kids are resilient to the ups and downs of what happens, but many, many people that experience, you know, stressful life events in childhood will go on to have physical and mental health problems.
And so it's just kind of a critical time for prevention and intervention that can have long-term impacts, and those connections haven't always been made, right? I mean, for how long have we actually been talking about that? These experiences impact what we may be dealing with today as adults, probably '80s and '90s, but really the '90s was when the key studies in this area, the adverse childhood experiences studies started. And, you know, people started putting together these connections, and so it's a very new area of research.
Jenna Liberto:
Is there someone along the way that inspired you to really dig into this side of the mental health discussion?
Dean Mustillo:
I've been really blessed to have collaborators and, you know, I've just been surrounded by researchers that are super talented and have always been really generous with helping me. You know, thinking about my questions, but really the inspiration for me has been that the children and families that struggle with these things every day, and kind of what they go through, and how hard they work to, you know, to get help for their family members, that's where my inspiration comes from.
Jenna Liberto:
I want to even dig a little further into your research with adverse childhood experiences again. Just restate for us what that really means and how, within that topic, how do you focus your work?
Dean Mustillo:
So adverse childhood experiences, it's a fairly broad topic. The original studies in this area kind of focused on about 10 particular experiences, having a parent who's incarcerated, having a parent with a mental health problem, things of that nature. Since that time, we've kind of broadened the definition to include more diverse stressful experiences that children are exposed to. And so, yeah. So my work is fairly broad. I look at everything from kind of poverty in childhood, and that it matters at what point children experience poverty or for how long they're in poverty, so things like that, to parent mental health issues. The, you know, the environment that children live in when they're growing up has an impact on how they develop.
Jenna Liberto:
How does your, this may be a silly question, but how does your research, how do you go about your research and what are those interactions like with the people you work with?
Dean Mustillo:
So my work is kind of large-scale. Sociologists tend to do, you know, studies with a thousand kids or 600 kids or 1500 kids, and so it's not, you know, kind of intimate intervention studies where I'm working directly with children, it's very large scale. I'm analyzing data from typically multiple waves of, you know, working with the same families so that we can study them over time and study their development. So that's kind of the kind of work I do.
Jenna Liberto:
You touched a little bit on parent mental health and its impact on a child's mental health or the family. Can you talk more about that?
Dean Mustillo:
Sure. I mean, certainly, as I mentioned before, there's a genetic component to mental illness and so, having a parent that has a mental health problem kind of automatically puts you at greater risk of having one—if you're related biologically. But in terms of what I study, it's more about the environment. And so, if you picture a parent who's struggling with depression, they might not be able to provide the, you know, kind of nurturing and support to their children, you know, that children really need to thrive. Or if a parent is struggling with a substance use problem, you know, there might be more chaos in the home than, you know, than otherwise. And so there's aspects of, you know, the parents' struggles that then impact the children.
Jenna Liberto:
Talk about that substance use piece and how that fits into your own research or study.
Dean Mustillo:
Yeah. Oftentimes people consider substance abuse as kind of separate from other mental health disorders. And some people will often talk about, you know, psychiatric disorders and then substance use, but really substance use is a psychiatric disorder. I mean it's not the same as depression or anxiety, but it's very related to other mental health issues. And so that's kind of the, how I look at it is, you know, it's another mental illness. It's often comorbid with depression or anxiety or other types of mental illnesses but I just, you know, kind of grounded in that, in that framework. That it's another mental illness that people struggle with.
Jenna Liberto:
This is day-to-day work in a very serious space. What gives you hope? The statistics are bleak, at times, and we know what those are. What gives you hope and do the numbers, in some ways, does that continue to propel your research?
Dean Mustillo:
That's a great question. I often say that I'm really no fun at cocktail parties because people ask me, you know, what do you do for a living, I'm like, "Oh, I study the impact of childhood trauma on mental illness." And they find somebody else to talk to with their, you know, with their drink.
It is a, you know, in that sense, it's a sad topic because we're really talking about people suffering. And so where's the hope in that if you look at the, you know, as you alluded to, if you look at the statistics, the statistics are very jarring. That about one in five Americans has a diagnosable mental illness—you're more likely to die from a motor vehicle ac… I'm sorry, from an accidental overdose in the United States than from a motor vehicle accident, and suicide is one of the leading causes of death in the U.S. And so it's pretty bleak if you just look at the numbers. But there is hope.
And the hope is in the research. And I think the hope is in working with people that, you know, even kind of going back to when I started this work, mental illness was so stigmatized. People did not want to talk about it. People did not want to admit that they were struggling with it or that it was in their family. So, as a society, we've really come a long way in destigmatizing these disorders, and in kind of treating mental illness just like any other disorder that people may have. And so, there's a lot of hope in that. There's a lot of hope in what we're finding with the research and that we, you know, are getting to better treatments every day. And there's just a lot of hope in people.
Jenna Liberto:
Speaking of, there's so much hope in, as you mentioned, talking about it, and we are talking about it at the University of Notre Dame at a level that we never have before. And I see you smile because that's got to be energizing and exciting. And here we are, so let's talk about Notre Dame's bold commitment to mental health because it is that we are equipped and we are ready to be a leader in this space.
I guess my question for you is, why is that? Why is Notre Dame now poised to lead the way?
Dean Mustillo:
Notre Dame is in a great position for a lot of reasons. I mean, so first of all, we could talk about, we have excellent faculty across a variety of disciplines in Psychology and Sociology. In Econ, they're studying, you know, the opioid epidemic, so across a variety of disciplines, we have really strong scholars in this. But the University has also made a bold commitment to, you know, to having this as a University-level initiative and to, you know, putting our resources into it and, you know, the University is really in a position of privilege with the resources we have access to. And so, to make that commitment, to use our resources to work on this problem is, you know, is a real gift of being at Notre Dame.
And then this really ties into our Catholic identity as well. And so, if you think about, you know, tenants of Catholic Social Teaching, for example, if you think about the dignity of the human person, or about the preferential option for the poor, we, you know, have come to understand that the poor is not just people who are economically poor that, you know, John Paul II, I think, was the first Pope to say that, you know, the poor really encompasses other categories, you know, including those with mental illness. And so we have a responsibility to take an active role in trying to mitigate the suffering of the poor, you know, broadly defined.
Jenna Liberto:
I would say too, for some people, struggling with my mental health and wrestling that adjacent to my faith could be a challenging thing, and here you have a Catholic university like Notre Dame leading the way and saying, "No, this is a space we need to be in." That's helpful to me, as well.
Dean Mustillo:
Absolutely, and it also means that we are willing to take on aspects of this that maybe other universities are not studying as much like, because we have the resources of Notre Dame and the, you know, and the mission of Notre Dame, we can look at, even within the areas of mental illness. Potentially areas that are less commonly studied such as suicide prevention.
Jenna Liberto:
So again, for someone who's coming into this not knowing that Notre Dame's been in this space, what would you share with them?
Dean Mustillo:
I would say we're very new to this space. I mean, certainly, we've been studying mental illness for, you know, for quite a long time in our various departments and through our various faculty, but really making this commitment to advance in this area, this is very new. So we are kind of in the process of the early steps of this, we are hiring new faculty, we are expanding our graduate program, we are about to break ground on a new building that's located in the community.
We have a small clinic right now but we are, in order to expand it to provide more access to care, we are building a new building that's going to be located right, you know, kind of on the edge of downtown by the medical, the Memorial Hospital Medical Complex and the Beacon facilities, Epworth. So we're really going to be a part of the community in this and just working on our expansion to provide more research and more access to care.
Jenna Liberto:
So that was just announced earlier this year—the Veldman Family Psychology Clinic—that's the clinic you reference. So that is the future in a lot of ways. Talk more about that work that's just now starting.
Dean Mustillo:
So thanks to the generosity of the Veldman family and their various family foundations, they are providing the funding for this new building and, as part of that, new faculty and new clinicians. So the goal is, or the vision is, to really expand our program. To expand the kind of the volume of research that we do because we need more research in these areas we're working in, as I said, kind of some areas that are really underserved even within this underserved area. And then really expanding our graduate program because those are the, you know, graduate students are the future in terms of research but also in terms of providing care.
And so, they're going to take what they … the interventions and the treatments that they learn here, and they're going to go out across the country when they graduate and provide services kind of nationwide. And then, while they're in graduate school, they will see clients in the community as part of their training supervised by, you know, faculty—faculty clinical psychologists—but, so that's a big part of how we can expand access to care in this community.
Because if you think about the statistics that I was saying before, about one in five people having a diagnosable mental health disorder, one of the big problems is that fewer than half of people that have a diagnosable mental health disorder get treatment. And once upon a time that used to be because of stigma, but now, you know, thanks to what we've been talking about, it's more about access to care. There's just not enough access to care and particularly, you know, in this community, as in many communities nationwide. We just don't have enough providers and so, by expanding our program, we not just contribute to finding treatments for these problems through our research, but also to providing care in the local and regional communities.
Jenna Liberto:
I'm going to restate what you said again. So less than half of people with a diagnosed mental health challenge are actually getting treatment. Less than half.
Dean Mustillo:
Yes.
Jenna Liberto:
So how do we scale that here? How is the work that will be done at the clinic here on campus—in our community—how does that grow? You talked about the grad students—and I know our students are a big piece of this—how does that scale, then, to impact across the country and, more broadly, the world?
Dean Mustillo:
It's about growth. We are expanding as quickly as we can. It's often frustrating because it's very hard to hire people in these areas, you know, because there is a shortage nationwide. So we are working as hard as we can to expand our program, but it's, you know, it's often frustrating that we just can't go as fast as we'd like to go. But that's, I mean, that's really the key is just expansion, expansion, expansion. We need more faculty members. We need more graduate students. Undergrads are really involved in our work, as well.
There's a high demand for research experience among undergraduate students. In some of our psychology labs right now, we have 25 students—28 students—all trying to get research experience. And so, by expanding our clinical faculty, we're going to be able to better serve our undergraduate students, as well, who are trying to prepare to become psychologists and psychiatrists themselves.
Jenna Liberto:
What is that experience like for our students, for our undergraduate students and grad students, what is the work like for them? I mean, how close are they able to get to what's actually happening?
Dean Mustillo:
For the graduate students, very. The graduate students actually see clients in our, you know, clinical facilities. And so, will meet with people and do therapy, do interventions, either in our clinic or they often go out into the community as part of their placements—their community placements—and work in the community, as well. So they have direct interaction with clients.
The undergraduates, not so much. But they participate in studies, research assistants on studies, and so they get, they get up close but they're not, of course, providing treatment.
Jenna Liberto:
As we talk about this clinic, Sarah, is what's happening now what you dreamed of or would you ever have dreamed this big when you came to Notre Dame?
Dean Mustillo:
That's a great question. I, you know, as I said, I never thought I was going to be an administrator. And so, when I came here, I thought I would just be, you know, kind of running my own research and doing my own thing. This, being in this position, has given me an amazing opportunity to think big. And I would say that's one of the real gifts of being at Notre Dame is that, if you have a good idea, you can make it happen here.
And so, it's been a real privilege to be able to push this project forward kind of on a grander scale than just me and my research. This is, you know, this whole project should have a real impact in our community and, hopefully, in our country.
Jenna Liberto:
You had to have found like-minded peers, leaders, friends here that you had those conversations with, that you dreamed about this with. Can you take us back to any?
Dean Mustillo:
Oh, absolutely. I mean, so I would talk about it with Father Gerry who's the vice president for Student Affairs. You know, I'm thinking about this in terms of research and in terms of prevention and intervention, and he's thinking about it in terms of our student body. Just like, you know, the numbers have kind of been increasing nationwide. They've been increasing among college students, as well. And so Father Gerry was really grappling with, how do we better serve our students here, because we cannot meet the demand for, you know, for mental health services on campus.
And so, he and I kind of started at the same time in leadership positions and we used to take walks around the lake … just talk about different things we were struggling with and, when we got to the issue of mental health, we realized we had something in common there. That he's really working on this for the students and I'm thinking about this in terms of the community and in terms of our research. And so, we partnered on this, on some of our fundraising efforts and on some of our efforts of things like hiring clinicians, hiring a psychiatrist.
It's super hard to hire a psychiatrist right now just because they're so in demand and there's so few being trained. Not nearly as many as we need. And so, we were able to partner on that and hire one together that will partly serve the students on campus and then partly work in our clinic that we're building. And so, things like that. So we were able to, yeah, kind of see where there were synergies between Arts and Letters and Student Affairs and that, you know, is helping both of us advance these efforts.
Jenna Liberto:
That's a beautiful example of what our leadership talks about all the all the time, getting out of our silos across campus, and look what's happening as a result.
Dean Mustillo:
Yeah.
Jenna Liberto:
Well, I do want to, again, take you, OK, we went back, let's flash forward a little bit to when this clinic opens. When you're there cutting the ribbon or when the first patients, maybe, walk through the doors. What will that feel like for you?
Dean Mustillo:
It honestly, it gets me choked up just thinking about it. It's, I think it's going to be a really important day for the University and for the community. To really see these efforts come to fruition and to really be able to kind of move more fully into this space and really make a difference, it's going to be a great day when that happens.
Jenna Liberto:
As we close, Sarah, we know mental health is such a personal subject for a lot of people. It's hard to talk about, as we alluded to, it's also a helpless feeling to want to make a difference here, love someone who struggles with their mental health. We can't all be involved in research like you are, or in groundbreaking for this clinic, but is there something we can all do? Or what hope can you give someone who might be listening or watching—what difference can we make?
Dean Mustillo:
There is something that everybody can do to be a part of this effort, not just us on campus. But one of the important things about mental illness and, I would say, even more so than physical illness, is that everybody can be a part of supporting people, walking with people, who are struggling. Everybody knows somebody who's struggling with depression or anxiety or substance use. And so everybody can kind of play a part in supporting other people and helping to destigmatize mental illness. But also, I think, kind of back to John Paul II, you know, or even the U.S. Conference of Catholic Bishops, kind of talk about that we really, we all have to play an active role in this. In supporting our brothers and sisters, but also in advocating for legislation and policy, for better access to care for people, and things of that nature.
So there is something that each and every one of us can be doing to help alleviate the suffering of people with mental illness.
Jenna Liberto:
Thank you for all you're doing. Thank you for talking to us about it. We can't wait to talk to you again a few months down the road.
Dean Mustillo:
Thank you so much.
Jenna Liberto:
Yes. Thanks, Sarah.
Dean Mustillo spoke of graduate students as the future of mental health care in this country. One of those grad students is also featured in this What Would You Fight For episode. His name is Austin Wyman, and we sat down with Austin and found out that, like Dean Mustillo, his Notre Dame story is deeply intertwined with his personal story.
[Music]
Jenna Liberto:
I like to start by asking our guests about how they got to Notre Dame, so tell us a little bit about your Notre Dame story. How did you get here?
Austin Wyman:
OK, so I'm originally from New Orleans, Louisiana, and from about like fifth grade to 12th grade, I went to a private Catholic school down there called Holy Cross, and that was a part of the same Congregation that Notre Dame is a part of.
In fact, they were founded like really close together. I think my high school was founded in 1849, and Notre Dame, you know, was founded in 1842, so right back-to-back. These schools are like really closely tied together and, I guess, I had never really heard of Notre Dame before until, I think it was maybe my eighth-grade or ninth-grade year, the Notre Dame band had come to perform at one of Holy Cross's games while they were just doing a tour around the country. And that was my first time hearing about it and hearing about the connection to my high school. And I really loved the culture of my high school growing up so, I thought, why not try to continue that legacy a little bit?
And so I applied to Notre Dame and got in and, I guess, I've been here for about six years now.
Jenna Liberto:
And you're in Graduate Studies now, right? But think back to when you came as a first-year student. What was that like arriving to campus?
Austin Wyman:
I was blown away because I actually didn't get a chance to visit the campus before I had got admitted. Yeah. I didn't have enough money to pay to fly up to see the campus, so I ended up seeing the campus for the first time when I did a Pre-college Program the summer before actually entering Notre Dame. And when I stepped on campus, I had no idea what to expect, but I just kept asking myself, "How did I get accepted here?"
It's just such a beautiful campus—a beautiful atmosphere. Everybody was friendly, the weather was perfect, and that feeling just kept mounting the longer I stayed here.
Jenna Liberto:
The weather wasn't always perfect, though. Eventually, right?
Austin Wyman:
Yeah, I had to deal with my first South Bend winter, which was my first winter, period. Really. I mean, Louisiana doesn't get that warm. But I've been able to adapt.
Jenna Liberto:
What else stands out to you, again, now that you're in this Graduate Studies phase of life, what stands out to you about your undergraduate experience?
Austin Wyman:
I guess what stands out to me about my undergrad experience is just how dedicated the faculty, staff administration are to students having a voice and a role on campus. Like, whenever I came to Notre Dame, I decided that I wanted to be a Mental Health Advocate. That's what I was going to leave and do as my career. But I thought that, in order to be a Mental Health Advocate, I needed to have a degree. I needed to have some sort of reputation, some sort of prestige that would make people want to listen to me and respect me and hear what I had to say about mental health.
But I found out that didn’t necessarily need to be the case. At Notre Dame, I would talk about mental health and people would listen. I’d go to the administration and say, these are the problems that I’m having, these are some potential solutions, I wanna work with you on these solutions, and they were very receptive to it.
Jenna Liberto:
How does that make you feel, to think you came in worried that you could make a difference, maybe, as soon as you wanted to, as soon as you were, you know, energized to, and then to find that people were ready to listen. What does that feel like?
Austin Wyman:
It feels encouraging. It feels inspirational. I think that’s really one of Notre Dame’s big talents, is inspiring students and letting them know that they have the ability to actualize their dreams.
Jenna Liberto:
Let’s get into your work. You are focused on studying Mental Health in a few different capacities, and we’ll get into that. But, first of all, can you talk about what drew you to this field—to this discipline? I know it’s very personal for a lot of people and you as well, so how did you get on this track?
Austin Wyman:
Sure. So, I guess I’ve always been interested in mental health, even if I didn’t realize it, because my family has a really close connection to mental health. So, the first time this really came up is in about 2005. I had an uncle that had serious problems with his mental health and he tried to seek help but, unfortunately, there were a lack of mental health professionals in New Orleans at the time and his psychiatrist wasn’t able to see him until the end of the following week when he had asked for help. But that wasn’t soon enough, and the following morning it evolved into a domestic violence issue where both him and my grandpa died.
In responding to that incident, I think my family took on many different attitudes regarding mental health where some people saw the actions that my uncle did and thought that it was just a responsibility of his character, it was a flaw in him. It's something that we see with all people with mental illness and we should worry about mental illness because of that. Other people saw it as something that they did while raising him, like, if there were more they could have done to support him along the way, he wouldn’t have turned out this way, and that’s the big regret that comes with the incident.
Whereas other people realize that the problem isn’t with Jeremy or the family, it’s with society and the lack of support that we give for mental health, in general. That discourages people from taking on mental health careers. That makes mental health careers appear unappealing so that nobody wants to take them on. And so we have a lack of mental health professionals in society, we have a lack of resources for indivduals that want to pursue and support their mental health when they recognize the problem pops up.
And I think, when I transitioned more to that attitude, I was able to start seeing myself as a professional that is able to improve some of these issues in society, whether from a stigma perspective, whether from a policy perspective or, as I've more come to understand now, the research perspective. And I think, specifically, how I came to psychology is through this medical conference that I attended when I was in high school. That was my first time hearing a psychiatrist speak.
And when he talked about mental health, he talked about it in a positive way that I had never heard anybody talk about. Where he talked about psychology as a study of who you are and why you struggle and that [as] we learn more about our brains, we can take those findings and apply them to improve our daily life and improve the lives of other people. And so, I studied more about psychology and got into Notre Dame and decided that I was going to go down this path and, I guess, towards the end of it, realized that graduate school was the best way that I could contribute to sort of these issues with mental health in society, and then other issues within the literature.
Jenna Liberto:
Austin thanks, thank you for sharing that story. I’m so sorry that happened to your family and that your family carries that burden. Let's talk more about the stigmas attached with mental health and with this topic. You’ve seen some of those play out in your own experiences, your personal experiences, and I’m assuming in your work, as well, so how would you explain those to us? And then, how do we address the stigmas?
Austin Wyman:
Sure, I think, first of all, how to address the stigma is a very difficult question, and it differs a lot for different people. But I can talk about some solutions that I’ve seen and other solutions that other people are trying to develop and test and that such. But generally, the mental health stigma refers to the idea that a person that has mental illness is less than or weak or any of these things. Insufficient. And in that way, it discourages them from seeking the help that they need because they don’t want to call attention to themselves, that they have this problem. They don’t want to call attention to themselves that they may be weaker than a normal person. Normal by the definition of stigma. But it also manifests in even, not internalized, but how you see people with mental illness around you, as well.
Like when people talk about their own mental health conditions, you may be less likely to extend support to them because you see it as a taboo. You don’t want to talk about anxiety or issues of depression in public, that’s something that should be done more privately. Which also discourages people from even considering things like mental health careers where you’re dealing with those types of taboo issues on a daily basis. But especially when you think about other stereotypes of people with mental illness, for example with serious mental illnesses like Bipolar Disorder or Schizophrenia. You think that this makes people unstable or violent or dangerous. That also discourages people from going into mental health careers because like these are the most dangerous people in society, what would happen to me if I were to become a psychiatrist or psychologist? I’d have to work with these people on a daily basis and that’s just not safe.
And that's the reason we see people not want to go into mental health careers and just widen this gap between individuals and the care that they need. So, there’s many different ways to address it because they’re all rooted in different places. Like sometimes stigma comes from the way that you’re raised. Sometimes it comes from your environment, whether that be school or work environment. Sometimes it’s rooted in the culture. There are a lot of cultures that don’t have mental health at the core of it or think that mental health can only be addressed in certain ways. And so realizing that there are other ways to deal with mental health, sort of a wide range of opportunities for support and taking care of yourself and managing overall well-being, those tend to improve attitudes of stigma.
Sort of a lot of analogies pop up when it comes to mental health vs. physical health. That physical health is more important. You take care of physical health. The various doctors you go to, there’s no shame in going to the doctor if you have a broken leg or if you have a sore throat or a cough, but it’s a little bit different when you have depression or anxiety. You don’t want to go to a doctor for that. But it doesn’t make sense why it’s different, it just feels different.
And so one strategy for dealing with stigma is sort of calling attention to that disparity and realizing that yeah, it doesn’t make much sense. If I’m willing to take care of myself in this aspect, I’m willing to take care of myself in another aspect. Because both of those aspects are equally important and equally contribute to this idea of overall well-being. And the more value we place on overall well-being, rather than just physical health or just mental health, sort of helps to emphasize the importance of mental health.
Jenna Liberto:
Mental health, too, is such an ongoing journey, right? I mean, it’s not linear. It … sometimes things are working well and then it feels… might feel like two steps back. Is that part of the challenge but also part of the opportunity? I mean, even for you personally, this is a journey for you.
Austin Wyman:
Yeah, and one of the biggest problems with how we talk about mental health is that it's relying on a categorical system which is based on sort of the dominant model of psychopathology or mental illnesses. The Diagnostic and Statistical Manual for Mental Illness—or the DSM—it’s a categorical system, meaning you either have a diagnosis or you don’t have a diagnosis. So you either have depression or you don’t have depression. You have an anxiety disorder or you don’t have an anxiety disorder. You have a personality disorder or you don’t have a personality disorder.
That’s how their diagnostic system works but that’s not how mental health works. It’s easier to talk about that because it’s easier to get treatment if you say you have a disorder or don’t have a disorder for insurance purposes or such, but when we’re thinking about how these disorders function in the natural world, how the science behind mental illness works, it’s not a categorical system. It’s a continuum. It’s a spectrum. It’s a gradient. Everybody has these traits, everybody has these symptoms, just to lesser extents. Everybody deals with sadness. Everybody deals with lack of pleasure or loss of motivation. Those three are at the core of depression just how intense they get is closer to how we perceive depression, if that makes sense.
Jenna Liberto:
It does, I think the way you’re explaining it is so powerful because these are just very basic parts of being human, is what you're saying.
Austin Wyman:
Exactly. And that’s what contributes to stigma too, is that we focus on this categorical system. That there is something inherently different from having a DSM diagnosis of depression from having depressive symptoms and traits. Having a DSM diagnosis of an anxiety disorder vs. being anxious from time to time. They are fundamentally the same thing. There’s nothing that separates either of those groups. It could be a one-point difference on a test that you take while you’re stressed out that may determine whether you’re in this sort of mentally ill bucket vs. a normal functioning person bucket. And that sort of dispels the stigma more. Once you’re able to move past that point and recognize mental health as a continuum it’s a lot easier to not only get help for yourself, but understand how these symptoms function in a normal world and realize what is necessary to address them.
Jenna Liberto:
Let’s get into the heart of your research. OK, Quantitative Psychology. Explain what that is, first of all, and that’s a little bit different, as I’m understanding, in terms of how we normally would think of psychology, is that correct?
Austin Wyman:
Yeah, definitely. Just to start off with, psychology is sort of disadvantaged when it comes to making scientific inferences compared to a lot of the other, what you would call "hard sciences" or "natural sciences" because, with biology, we can directly observe things. With chemistry, we can sort of directly observe things. Physics—same thing. Psychology, that’s not the case. You can’t pull out a ruler or a meter stick and measure how much depression somebody has. You can’t look at something and say that’s depression. You sort of have to tease it out because it’s what we call a latent variable. Something that’s unobserved. And how you tease it out is by looking at indicators.
We look at somebody’s negative affect. We look at somebody’s lack of motivation or low mood or lack of pleasure, and we realize that the reason why somebody has these symptoms, and the reason why these symptoms correlate together, is because there’s something bigger. There’s a factor that is influencing all of those equally. And that factor is depression.
Depression influences how much energy somebody has. Depression influences how much somebody's able to experience positive emotions or how strongly their negative emotions are. And so if you’ve gone to a doctor and taken a questionnaire, that’s fundamentally what psychometricians or quantitative psychologists do. They come up with different ways for how to measure these latent variables, how to tease out the latent variables, so that we can measure them more directly. So like, they’ve taken a lot of different assessments like that. Standardized tests are another example of it, where the latent variable there isn’t mental health but it’s intelligence or aptitude or ability, or whatever.
The test is designed to measure for, sort of the outcome of the results. But, quantitative psychologists specialize in the measurement techniques to uncover these latent variables, as well as coming up with new statistical techniques that are responsible for analyzing them. Because you’re dealing with latent variables, there’s usually a degree of measurement error. And so we need special statistical techniques that handle that measurement error, just to make sure that we’re measuring what we actually intend to measure and to sort of confirm how successful the statistical findings and the inferences that we make are about psychological constructs.
Jenna Liberto:
OK, I want to talk about your research which is based on quantitative psychology, but before we get to what that means, a potential practical application for your research is really fascinating and something that we’re talking about in our society a lot. Tell us what that is and tell us what your research, what opportunities your research might bring in that space.
Austin Wyman:
So a lot of quantitative psychologists have both Applied and Methodological interests. So one of my big Applied interests is the issue of violence in society. Violence is really complex and like any other latent variables, it’s really hard to measure directly and even harder to predict directly. And so, one specific aspect of violence that I’m interested in is police misconduct, which is very prevalent in society. And so, if we look at things that are being done to prevent police misconduct in the status quo, most of it happens while police are being entered into the system. While they’re going through academies, while they’re going through initial psychological screening and such.
The go-to measure that's used to screen police officers is the Minnesota Multiphasic Personality Inventory, or the MMPI, which was not designed directly to screen police officers. It's a general psychological assessment battery that includes a lot of different measures and a lot of different constructs, just a general all-purpose tool for assessing how somebody is doing at that moment or tends to do over a period of time. And because it wasn’t designed specifically to assess police officers, it doesn’t have much validity for predicting which police officers are going to commit police misconduct.
Furthermore, like the specific police screening assessment section of the larger assessment is mostly focused on things that would make police officers better employees than better police officers. Basically, are you brave? Are you somebody that follows instructions pretty well? Things that would make you seem like, this is a person that is going to be a good employee for a police department, rather than, are they fit for active duty where they have somebody’s life or death in their hands? And that’s an important issue. So I think it’d be important to develop a new screening measure that has an explicit purpose of preventing police misconduct, as something like that doesn’t currently exist. But in order to do that, some additional work needs to be done to sort of identify better ways to be more precise with precision in assessment.
For example, one of the go-to predictors of police misconduct, as it exists presently, is something called "externalizing behavior" or "externalizing traits" which consists of a wide variety of different traits which even larger variety of outcomes. So the traits that it includes are stuff like disinhibition, antagonism, aggression … and what it predicts is everything from violence to substance use, Pyromania, Kleptomania—it includes so many different outcomes. So saying somebody is high in externalizing traits could predict many of these other things but, we don’t know.
So it becomes fundamentally useless to us to say that somebody has high externalizing traits and so they’re more likely to do XYZ because of all of these different outcomes. And that’s the issue of heterogeneity. Saying that somebody has externalizing traits could mean that they could be higher for substance use, could be higher for police misconduct, could be higher for Kleptomania or Pyromania or shorter, limited versions of aggression. And so it’s harder to make decisions about it like you would with any other screening or assessment tool.
And so, what my research focuses on is sort of taking different strategies from other assessments, for example, traditional psychometrics, and more new AI techniques, sort of finding how those techniques overlap and intersect with each other because, a lot of times, they’re used in competition with each other. Like you can either have this approach or you can have that approach, but I think there’s a lot of ways that you can use them together. So, using them together, I hope to develop a new screening measure that’s able to better attack this issue of heterogeneity and more precisely predict whether an individual is going to commit police misconduct or not commit police misconduct within a certain degree of time after joining the police force.
Jenna Liberto:
So this will be oversimplifying it, but if I’m understanding, if we see more data on the subject, we have a greater understanding, we have these tools like AI now to help facilitate this work, we can dial it in even more, right? We can have more accurate predictors that this might mean that, with more certainty.
Austin Wyman:
Data is definitely an important issue because of stuff like power, you definitely want to have enough available data to make sufficient inferences about this type of stuff. But it really is the type of variables that we’re collecting and having a more firm understanding about the relationship between the variables. Because the issue of heterogeneity isn’t just needing to know what’s correlated with police misconduct. We also need to know what’s not correlated with police misconduct. And the ideal predictor is one that is highly, highly correlated with police misconduct but isn’t correlated with anything else.
So that if somebody is really high with this trait, we know that, without a doubt, they’re going down this trajectory. There’s no other trajectory that is possible for them, they are in this risk category. That would be the ultimate goal of the measure is to provide information about risk. That, if you were to continue in active duty, there’s a high likelihood that it would result in an incident of police misconduct of this level or that level or that level.
Jenna Liberto:
So why is Notre Dame the right place to do this work? To do your work?
Austin Wyman:
Notre Dame is the best place to do this work just because of how interdisciplinary the University is. It is very supportive of scholars and any field collaborating with scholars and others. Whether that’s within the department, different areas, for example, within my area, I get to talk to clinical students and clinical faculty, developmental kind of faculty, I don't have to just stay in my quantitative area. I could take my knowledge and work with these other students and benefit from all these different collaborations together. But I can also go to other areas, as well.
For example, I’m a part of a fellowship on campus that is focused on interdisciplinary education research. And as a part of that, I get to work with sociologists, political scientists, economists within the University—there’s so many different possibilities for reaching out to other researchers on campus and developing these types of projects. And that’s really important because, no one field has all of the answers to these types of problems. Especially problems that affect society at such a large scale. It’ll take all of us to work together in order to come up with an effective and equitable solution to these problems.
They also provide a lot of support for these collaborations in terms of research funding, as well. The University is very in tune to how research is progressing, what new directions are popping up, and are really encouraging of pursuing those directions. For example, the way they’ve been handling the rise of AI over the past couple of years. And so, last semester, I was able to get a pretty large grant from the University to develop a new measure of emotional regulation ability using artificial intelligence where the measure utilizes emotion detection AI, which is algorithms that have been pre-trained so that you can feed an image or video to it and it’ll say, the person within the video, what emotion they are presenting at each frame of the video.
And so using emotional detection AI, I was able to create and fit indices to it so that it could automatically detect someone’s emotional regulation ability. So that, if you feed it, say, 20 minutes of your time, it can make an assumption on how well you are at managing your emotions in three key domains: intensity, being the relative strength of your negative emotions, liability, how frequently your abilities change, and then latency, how quickly you’re able to return to baseline emotions after experiencing a spike of negative emotions. So something like this is really helpful because it could also be used as an assessment tool, and one that’s minimally invasive. Something that any footage, a series of photos, any video you can feed into the algorithm and instantly get information about their emotional regulation ability even if the study that you’re doing didn’t actually collect data on emotional regulation ability.
So you can analyze previous data assessments with that, you can plan future studies with it. I think one thing that’s real interesting is how much you can build it into something called ecological momentary assessment, which is like going into somebody’s natural environment and collecting data from them. So what …. How it most often pops up is, say, as a part of the study, you’re given a ping on your phone five times a day and you have to complete the short five-minute survey during those pings. In like, in the previous history of psychology research, you have to come into a lab to do a study, or like, sit down at a computer and do it for a long period of time. But this, actually, gets you information about
a participant, how they’re going through their normal day, like when they first wake up, whenever they’re eating lunch, whenever they just get off work, whenever they’re just at the gym, just being a normal person.
So we get a better idea of how mental health functions within the natural world, which is what we would hope for. I mean all of these develops are really built on how we observe them within the labs but we don’t really have that generalization piece of how people actually function in the real world. So tools like this that are like non-invasive, that easily collect people’s information while they’re in their natural environment really push the envelope towards more naturalistic understanding of what mental health is.
Jenna Liberto:
I just have a last question for you and it’s, what are you most excited about when you look at the future of what you’re studying? What is the most inspiring to you?
Austin Wyman:
I think what’s most inspiring to me is how much people are increasing in awareness of quantitative methods. Like, maybe 50 years ago, quantitative methods was very very niche, there were a select few people that studied quantitative methods and very few people that read quant methods papers or talked to quantitative methodologists. But now people are understanding the importance of methods and are collaborating with methodologies in new and exciting ways.
So methodologists are on like every major clinical paper, they're on every major grant—we’re talking about NIH grants, NSF grants—there are just so many different opportunities to have strong quantitative methodology in psychology research now. Because latent variables are at the core, and we're the people that are most equipped to deal with it, that means that the findings that are coming from [indiscernible] research are just elevated in rigorousness.
It means we can have so much more confidence about the statistical inferences we are making, which means that we can start making even bigger trajectories towards some of the goals that NIH and all of these other mental health organizations have outlined for decades, actually pushing the envelope towards reducing cases of violence in society, reducing the number of suicides in society, improving people’s access and benefit from mental health disorders, to the point that mental health, and the stigma surrounding it, and all these other consequences that I've talked about before are going to move forward as well.
Jenna Liberto:
It sounds like progress and we’re so glad you’re here at Notre Dame with us. Thanks, Austin.
Austin Wyman:
Thanks for having me.
[Music]
Jenna Liberto:
He’s outstanding isn’t he, Andy? What strikes me about Austin—sitting across the table from him is—here’s a young person who is simultaneously coming to terms with how mental health has impacted his family, but he’s decided to embrace it, and so, he’s able to start this next phase of his journey and start the work, start his own fight to make a difference for, not only his family but other people.
Andy Fuller:
Yeah. You know, it’s called "What Would You Fight For?" and to fight for something, you’ve gotta have personal stake, personal interest and, when we think about Notre Dame being a global Catholic research institution—the premiere such institution—it’s because of people like that, Austin and Sarah.
And that’s what we have this season on Notre Dame Stories and What Would You Fight For?
Jenna Liberto:
We can’t wait to bring you more of these stories, we promise you’ll be inspired. If you’d like to know more right now you can go online to fightingfor.nd.edu and learn more. We also hope you’ll subscribe to this podcast wherever you listen to podcasts, or you can find us online at stories.nd.edu. We’ll see you next time.
