Disruptors are Too Much and We're Not Wrong

I have always been a disruptor. I have only recently come to a place in my life where I don’t feel as though being a disruptor is a personal or professional liability.? And I just have to say that it is incredibly liberating.

My name is Andrea Lustfield.? I grew up on a farm outside a small town in Northwest Iowa where girls were expected to act like young ladies and boys, well, boys could be boys regardless of their age. I talked too much. I asked too many questions. I didn’t take no for an answer.? I had a problem with authority. I didn’t know when to quit. And I certainly did not “just accept it and move on already.”? Girls don’t act like that. Girls look pretty, sit quietly, and aren’t expected to think. I was too much and too much was wrong.??

Fast forward a few years.? (And by a few, I mean 25…maybe 27…ok, 29).? I’ve completed a Bachelor’s degree with a double major in Psychology and Human Services, a Master’s Degree in Forensic Psychology, a Postgraduate Certificate in Clinical Mental Health Counseling and am a Doctor of Behavioral Health Candidate.? My professional career has included some of the most challenging jobs in the field including Child Protection Social Worker, Adult Protection Social Worker, Treatment Director at intensive residential treatment, Program Director of observation and inpatient psychiatric units serving involuntary patients, therapist, and Deputy Assistant Director in the Division of Behavioral Health and Housing at the state Medicaid agency.?

I still talk too much and I ask too many questions. I continue to have a problem with those who wield their authority irresponsibly, though I’m much more discerning and diplomatic about it. I rarely take no for an answer and when I do, it’s usually “not now.” I don’t accept things and just move on, unless it warrants acceptance. One thing has changed; I know when to quit.? I’ll quit when the work is done.? And the work is done when anyone who needs physical and behavioral health care can access quality care regardless of who they are, where they live, or how much money they have (or don’t have).? The work is done when this system exists in a manner that serves our patients and the professionals tasked with service, not the system serving itself.

Patients are whole people, living in one body, with one mind and one spirit. Our system needs to function in a manner that respects this totality by treating it as one.? A truly integrated healthcare system delivers all of the services necessary to heal a person in a fluid and congruent manner.? A team of multi-disciplinary professionals work together with the patient at the center, allowing the patient to focus on healing.??

The US Department of Health and Human Services, Agency for Healthcare Research and Quality outlines this model in their Lexicon for Behavioral Health and Primary Care Integration (https://integrationacademy.ahrq.gov/sites/default/files/2020-06/Lexicon.pdf).? The Lexicon operationalizes integrated care for systems, patients, families, and professionals.? Implementation, however, requires change…a lot of change…to the way our systems currently operate.? People with a passion to influence changes such as these need to be disruptors.? We need to insert ourselves into positions to influence these changes and we need to know how to do it when we get there.??

Knowing what to do requires understanding of how our healthcare systems currently operate including financials, policies, protocols, procedures, statutes, codes, legislative actions in addition to being able to analyze community/social needs, populations, governance, and resources to practically enact necessary change. These are the key skills I will gain throughout my Doctor of Behavioral Health program at The Cummings Graduate Institute of Behavioral Health Studies.? Disruptors need to ask a lot of hard questions.? We need to think.? We need to talk too much and then talk some more. We need to challenge ourselves and those in authority to make change. As it turns out, my “too much” is not wrong. It is what motivates me to do the work until the work is done.