Q&A: Dr. Gene Beresin

June 11, 2017

There is something immediately familiar about Dr. Gene Beresin. Perhaps it is because, as a national expert on the mental health of young people, he has appeared on numerous television and radio shows. It may be that his unique background as a musician, educator, and clinician makes him as relatable as he is credible.  

>Credibility is a big deal to Beresin. As the Executive Director of the Clay Center for Young Healthy Minds, an educational institute at Massachusetts General Hospital (MGH), he has advised Hollywood on the authentic depiction of mental health and has produced a platform of multi-media resources for parents, teachers, and students on how to recognize and address mental illness.

Beresin started the Clay Center to fill a critical gap in evidence-based information about the mental health of children, adolescents, and young adults. Now in its fourth year, the Center is increasingly focused on college students, a cohort with a confluence of mental health issues contributing to what Beresin and others see as a national crisis.  

The Center’s “sweet spot” is presenting information in multiple ways over media platforms to make it accessible and effective for young people.

This spring, the Center released its first film, “Looking for Luke,” which follows the parents of Luke, an Asian-American Harvard sophomore who took his own life, as they try to understand their son’s suicide. It is now being pre-screened on select campuses across the country, and in September, the Center will launch its formal tour with an accompanying discussion guide on suicide prevention.   

Beresin believes that stories and humor are the best ways to reach people. Both were in ample supply as we sat down to talk about the Clay Center’s latest work and its aspirations for the future.

Mary Christie Quarterly: Tell us about the Clay Center. How did it come to be?  

Gene Beresin: A lot of my clinical work has been focused on the 14 to 26 age group, so middle school through to young adulthood. I specialized in eating disorders for a long time, which is of course a huge issue among high schoolers and college students, but the Clay Center work came together around a couple of important dynamics.  

I was a musician before I became a doctor — I was very ambivalent about medical school. I knew I wanted to work with kids and families, and I always wanted to bring art, media, and narrative to my work.  

I first got involved in the media when “ER” started. At the time, Neal Baer (writer and producer of “ER) was a Harvard Medical School student I knew, and after his pilot was produced, he asked if I would be the psychiatric consultant for the show. I ended up spending six years consulting on the psychiatric problems patients and characters had on “ER.”  I worked on a number of different TV projects, including four HBO specials, such as “Through a Child’s Eyes,” which was about young children’s understanding of the terrorist attack on 9/11.  

The more I got involved in TV, the more it became clear to me that the “pop culture” education the public was getting about mental health was awful: It was providing a lot of misinformation and reinforcing stigma, which is already rampant in our society and globally.

As a result of my work with TV, I started to get calls from news stations to talk about mental health. If someone said, “Let’s bring in the shrink,” they often called me.

It became clear to me that many reporters didn’t know what they were talking about. Many were asking all the wrong questions and didn’t have a good sense of mental illness at all. Where were the mental health beats? Did we really have to get all our information from Dr. Phil?  

Eventually, I came to the realization that I wanted to do public education on these issues. I was very fortunate to receive a generous grant from the Clay family, philanthropists who do a lot of great work in medical research and education.

So, the first assumption in founding the Clay Center was that a lot of what is being disseminated out there is not accurate. You Google mental health diagnosis and treatment and guess what?  You get a lot of garbage. And then you get more garbage because the Internet knows how to follow you to barrage you with similar, inferior information. I sometimes try to trick Google by Googling information that doesn’t indicate I am a psychiatrist.

The second assumption is that when you work with kids this age, you really can’t get around pop culture. You have to know what’s going on in music, in movies, in social media, and you have to communicate with them in a way that allows them to receive the information. That’s true for all audiences. We have the best data and the most highly regarded researchers in the world right here at MGH, but who wants to read citations?

Reliable information for the public always has to be backed by evidence-based research, but it also has to be entertaining and compelling. It has to be driven by narrative.

MCQ: What is the basic product?  

GB: We founded the Clay Center as an online platform that provides education about mental health sourced from medical professionals.

We have three main areas of focus: normal development, current events, and psychiatric disorders. From the very beginning, we’ve tried to be the go-to place for this information. It’s a website where anyone can come and get evidence-based information in a simple-to-understand, narrative style.

Storytelling is best done in multiple modalities, so we provide text, podcasts, and videos. People all learn differently, and we want our resources to be accessible to everyone.  

MCQ: Who is your primary audience?

GB: We started with a baseline of information-rich material focused primarily on answering parents’ questions: How do you know what’s normal? If something does not seem right, or if your child has a disorder, what are the sound tips for taking care of things? How do you talk to your kids about traumatic events?  

We have 300 posts on a variety of subjects from psychiatric disorders (“What is bipolar disorder?” “What is ADHD?”) to normative issues in families (“How do I deal with the death of a pet?” “What should I look out for at prom?”)

Over time, however, we found that a third of our audience is actually transitional-age youth.  We are now revamping our material so it’s more tailored to that age group. We’re building out more multimedia. We need to reach that pre-millennial and millennial audience who wants to listen to a podcast while working out or watch a quick video on the train.

We also want to write blogs in a style they can relate to. This fall, when we launch our new multimedia platform, we’ll be putting out videos tailored toward both adults — parents, caregivers, school administrators, therapists — and younger audiences, such as college-age students. We will also include webinars for both groups, to provide an interactive component to the Center.

MCQ: What brought you to focus so intentionally on the college age population?  

GB: The Clay Center is the psychiatric consultant to SAAD (Students Against Destructive Decisions), and we have worked with groups like Active Minds and other peer counseling organizations. It became apparent to me that we have a major college mental health crisis in this country and more has to be done with this population and with parents, teachers, counselors, and university administrators.

When kids are in high school, they’re still at home under supervision with a support structure. When they go off to college or into the “real world” at 18, we treat them like autonomous adults.

But they aren’t. College students are at high risk – there’s a lack of supervision, their brains don’t fully develop until 26, and they do stupid things, often out of impulse and driven by emotions in the moment.

It’s a very vulnerable population. When I started looking at the onset of psychiatric disorders, 50 percent occur before age 14, and up to 75 percent occur by age 26. College-age students are at high, high risk. Half of college students will have a mental health crisis.

The ratio of counselors to college students averages about one certified counselor for 1,000 to 2,000 students, which is woefully inadequate. Just about every school has long waiting lists for an appointment with a therapist.

The students probably don’t have easy access to the counseling services they need. Even if they did, they might not reach out to the counseling center because there’s huge stigma on college campuses about going for psychiatric help.

There are all kinds of barriers to seeking help, including the fact that students worry what others in their life will think, that this will remain on their permanent record, or that it will not be confidential.

The good news is that they’re seeking out the information on their own. Today’s college kids are eager to learn about themselves, and they’re used to going online and looking things up.  

We can be an enormous resource for them as part of the solution. They also appreciate forums where they can talk about their challenges.

MCQ: How are you helping administrators deal with these issues? What are some of the things colleges can do?

GB: It’s very similar to the approach we take with parents: Here’s the data, and here’s what the experts are advising. So it’s education, education, education. We also give them ideas for what they can do to actually change the culture around mental health on campus.  

Ultimately, there needs to be a cultural change. We can’t just say, “This is just a phase that’s going to take care of itself.” I think the culture will change when the parents and students demand it. Some of this is going to cost money, but a lot of it can be integrated into what they already do.

I think that ongoing programming is key. Freshmen get one or two talks on mental health during orientation that usually say, “If you’re stressed, we have this service. If you’re depressed, we have that service.” And that’s it.

There’s no reason why they can’t have ongoing reminders and seminars that continually reach out to students and provide them with information that’s pertinent to their year in the college trajectory. I think making this education an ongoing, four-year part of the college experience would be incredibly valuable.

Schools could also establish required group discussions around stress, anxiety, and depression to catch these things early. We know that there’s chronicity to mental illness; the more episodes you have, the more you’re going to get. If a mental health concern is going to start in college, spotting it early can often prevent it. Many already have peer-counseling services such as Active Minds.

But more ongoing work in seminars, group discussions, film, and art forums is needed. But — and this goes back to the culture change — it also needs to be acceptable, if not mainstream, to seek professional guidance, whether it is about a relationship problem, a learning issue, a traumatic experience on campus, or a bona fide psychiatric disorder, such as depression.

Are we going to eliminate psychiatric disorders? No, because some of the genetics that are involved and some of the unfortunate traumas that we endure are going to happen, but preventative programs, starting in grade school and continuing through college, would be very helpful.  

MCQ: What are some of your new initiatives?

GB: We screened our first film “Looking for Luke” in April to an audience of over 500 Asian and Asian-American parents, faculty, and students at Harvard.

We made this film to document the life of a student, Luke Tang, who died by suicide while at Harvard, after suffering from depression since he was 13. The real power of the film is de-stigmatizing depression and suicide in the Asian-American culture, which typically does not recognize depression as a mental illness.

The narrative largely focused on his parents’ realization of depression as an illness and their mission to help educate other parents about depression and its risks. We will launch a full tour of the film, along with a tutorial, this fall.

Overall, our game plan for the Clay Center is to go from “informational” to “interactive,” so we will supplement pre-produced video podcasts and blogs with webinars and other live, online venues, like Facebook Live, where people can ask questions. We want to interact with the public and answer concerns in real time. If I had my druthers, I’d host a talk radio show with Steve Schozman.

For colleges, my goal would be to not just have a platform of material that’s going to be shared, but a strategy for schools on how to organize all of this information in a customized fashion for their own campuses.

There are certain modes that will change, but most of this information is timeless. We’re always looking for the next Snapchat or the next Instagram, but so many of these interventions — peer counseling, group work, the use of art, narrative and self-expression, as well as learning how to better understand the mind-body-environment relationship — can last a long, long time.

Dr. Gene Beresin is a full professor of psychiatry at Harvard Medical School and senior educator in child and adolescent psychiatry at MGH. He received a B.A. in music from Princeton University and an M.A. in philosophy, along with his M.D. from the University of Pennsylvania.