Vail Health to research emerging mental health treatments with new Behavioral Health Innovation Center

Vail Health announced this week that it is establishing the Vail Health Behavioral Health Innovation Center, a research-based entity focused on studying emerging and novel behavioral science in Eagle County.

Chris Lindley, Vail Health’s chief population officer, said the new innovation center follows the “collective impact” mindset the Eagle County community has had over the past six years in building Vail Health Behavioral Health.

“It’s been a collaborative effort; everybody is working together for the same outcome, which is improved mental health for our community, reduced substance abuse for our community,” Lindley said. “With this research collaborative, no one knows what the best treatment modality — or the combination of those treatments — will ultimately be. But we’re all open to studying those and trying those with our community and our partners to find the best care for all of our members.”

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The organization named Dr. Charles (Chuck) Raison to lead the Innovation Center as its director.

While Mike and Mary Sue Shannon provided a donation to start the new research entity, it was also Mike Shannon — who previously served as the chair of Vail Health’s board of directors — who first connected Raison with Lindley and the Vail Health Behavioral Health team last year.

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“None of this would have happened had it not been for Mike and Mary Sue Shannon. They made the connections, brought everybody together, and then there was an immediate synergy, thought and enthusiasm for what we wanted to do,” Lindley said. “They really were the lightning rod to get us going.”

Raison, who knew Mike Shannon through his research and work at the University of Wisconsin-Madison, said the initial idea was “that we could do something in the research space that was as remarkable, novel and cutting edge as what Chris and his crew had done for clinical mental health in the Vail area.”

The connection was immediate, Lindley and Raison agreed.

“I was so amazed by what they had done in terms of clinical care. I’d never seen anything like this vision of equitable community care and the openness to more holistic ways of treating people,” Raison said. “I was so inspired by what was going on out here that last summer when I came out for a visit, I said, ‘Man, if there’s any way I can be involved with this, this is unique.'”

Part of the synergy, Raison added, was that Lindley and his team were “interested in bringing some of these novel treatments into the valley and then also doing it in a way that would allow the development of really world-class, cutting-edge research.”

Rooted in innovation

Raison himself has a background in studying new and emerging treatments in the behavioral and mental health fields. He began his career in medicine at age 29, going to school to become a psychiatrist and then spending his first seven years running the psychiatric emergency room at UCLA.

Around that time, Raison said that through an interest in Tibetan Buddhism he became friends with the Dalai Lama’s sister, remarking, “it’s a long story for how that happened,” but that this drew his attention to the esoteric meditation practiced by the monks, which they did to “induce these crazily, positive moods.”

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“It sounds very nerdy, but I got obsessed with what these guys were up to because these meditations were all about raising the body temperature,” he said. “So my research career actually started because I was obsessed with the question of: ‘What’s the relationship between mood and body temperature?'”

While he was never able to study those monks, the question did lead him down a path of researching new treatments for depression that were also rooted in ancient practices.

“I realized that I had a career where I was retrofitting ancient practices. If you think about meditation and heat — which is really saunas, sweat lodges — I was really looking at whether some of these ancient wisdom traditions really held any promise as novel treatments for depression,” Raison said. “In that context, I began to realize that sort of the ‘queen’ of the ancient practices were psychedelics, and they were just then beginning to come into study in a serious way.”

This road led him to his most recent role as a professor of Human Ecology and Psychiatry at the University of Wisconsin-Madison, with appointments in the School of Medicine and Public Health and the School of Human Ecology, as well as his recent research into assessing the psychedelic agent psilocybin as a novel treatment for major depression.

Delving into hypothermia and psychedelics in Vail

In this context, the first three research studies conducted by the Vail Health Behavioral Health Innovation Center will continue down this trajectory.

“All of them are novel treatments that are really, really based very strongly in emerging science, but that are not widely used in mental health in America, which is still very much about giving people an antidepressant pill very often,” Raison said.

Optimizing psilocybin

The center’s first study is being referred to as the Opt-In study, which is “designed to answer some really key questions in terms of how to optimally use psychedelics; things that the field doesn’t know yet,” Raison said.

The study will be conducted at Vail Health Behavioral Health’s Innovation Center and will assess the use of psilocybin on depression and anxiety, assessing not only its impact on social behavior but also the risks and benefits of its use in a legal situation given Colorado’s recent legalization.

“The other piece that’s really important is, with these novel treatments, specifically psilocybin or psychedelics, is how do you do it safely and effectively,” Lindley said.

“People can take (psilocybin) in the state of Colorado now without fear of prosecution, but that’s not necessarily the appropriate way. And what we want to see is licensed clinicians administering the treatment in the most effective way, to bring about the most effective results. … So when we do use those new plant-based medicines, we do them as safely and effectively as we can for our community.”

With this, Raison said comes finding answers to questions like “Can we identify people who are likely to have a difficult experience? Can we help them through the experience better? Can we early on predict who’s going to do really well so that we can help support that?”

This study will likely be the first that the innovation center tackles, with the goal of starting hands-on research within the next six to eight months.

Cold, heat and depression

The center’s second study, which it hopes to have up and running in the next 12 months, will investigate the relationship between cold, heat and depression. It has been coined as the “Chill*d study,” which is an acronym for “cold and heat investigation to lower levels of depression.”

Raison said that heat or “hypothermia as we call it” has been “shown to have a really striking antidepressant effect.”

“It’s not new, people have been using saunas and sweat lodges for thousands of years, but it’s new as a treatment for depression,” he added.

“We’ve done studies showing that if you take people that are very depressed and put them in a machine that’s sort of like a fancy sauna and you really heat them up for a couple of hours, they will be way less depressed for weeks and weeks afterward. So we’re going to do that here,” Raison said.

This study will examine unanswered questions about the treatment, including whether adding elements of cold treatment will enhance the heat treatment’s antidepressant effects.

Following up

The center’s third study will be conducted at the University of Wisconsin-Madison and will supplement the local psilocybin research.

“We’re modulating how the psychedelic experience works to see if we can understand what is it about this psychedelic experience that produces such a long-term outcome,” Raison said. “So how is it that you take one pill and then you feel better for six months? How’s that possible? What is it doing that is so different than a regular antidepressant that you have to take every day?”

More innovation ahead

Starting with these ambitious studies, Raison commented is “aggressive, but we tend to be aggressive in terms of pushing things.”

“For a young organization, that’s a really good way to start, and it’ll keep us plenty busy,” Raison said.

However, looking to the future, the goal for the center is “to really expand this out and keep an eye out for opportunities to study other innovative treatments,” Raison said.

He said this could include studying things like substance abuse, post-traumatic stress disorder as well as preventative strategies.

The center is also working to have education opportunities, starting with a monthly lecture series called “Novel Strategies for Behavioral Health Innovation.” The series — which kicked off this week — will have Zoom lectures on the first Thursday of every month.

“We’ve kind of gone around and hand-picked some of the most interesting people in the country doing things that are relevant to what we want to do here,” Raison said, adding that this includes world leaders in psychedelics, the former heard of the National Institute of Mental Health and more.

This not only will serve as an opportunity for nurses, doctors, physician’s assistants, pharmacists and other providers to earn educational credits, but it will be open to the community as well.

Built with the Eagle County community in mind

While the Innovation Center and the bulk of its “cutting-edge studies” will be run in Eagle County out of the Edwards Community Health Campus, it also will have a large focus on collaboration, Raison said.

“This new Vail Health Behavioral Health Innovation Center is part of a consortium between the University of Wisconsin-Madison and Vail Health, but there’s other leading universities like Emory (University), that we brought in to do this. So we’re leveraging the top experts from around the country in the study of these novel treatments for mental illness,” he added.

Ultimately, the goal is to build “a really independent research institute” — similar to the Steadman Philippon Research Institute — with researchers located in the community.

“There’s so many opportunities, so much support from the community, and things move so quickly and so well here that it gives us an opportunity to do things that are very rigorous scientifically, but that are very, very difficult to do in large academic centers where there’s a lot of red tape and bureaucracy,” Raison said.

With that, the ultimate goal is to address patient needs in the local community.

Raison said that one of the main complaints with current research and academic studies in the field of psychiatry is that “people have these intense psychedelic experiences in a study,” are followed up with for a short period of time, but then are ultimately left alone by researchers.

“One of the fascinating things about our ability here is that when these studies come on board, for the people in the studies, it won’t just be over at the end of six weeks. These are people who will be able to access ongoing care here. Nobody has ever done that that I know of in a study. So that in itself is really highly novel,” Raison said.

What’s exciting about the research studies, Lindley added, is that “it’s right in line with the therapy that we already do today that is so effective.”

“It’s the individual working with a provider, talking about past experiences, feelings, emotions and really helping the patient understand that and find coping mechanisms and tools to be more successful day to day,” he said. “Psilocybin just makes that experience easier for the patient and gives them a different view of themselves, a different view of the problems.”

This means that after the research and study experience, “we fully expect all of our patients to continue to see their therapist. We always say we want people to go to their therapist more frequently than they go to their dentists,” he said.

With that, these new treatments and opportunities are meant to fill a need in the community.

“None of these novel treatments, as we described, are going to be the panacea and solve everything,” Lindley said. “But they’re new tools that will have positive effects on a percentage of the population. But the excitement for us, and what we hope for our community, is there’s new opportunities to help our community.”

The research studies will be open to anybody who qualifies, Lindley added.

“We want all of our community members to have the same access to all the different levels of care,” he said.

In addition to the center and its research increasing equitable access to these types of care, Raison added that it also meets patient needs in another way.

“If you look at our current treatments — antidepressant, psychotherapy — they help a percentage of people, but lots of people are left needing more. And so part of this research work is to actually test out some of these new treatments that we’ve been developing that show real promise and often in ways that are just profoundly helpful for people that have not been adequately helped by things like SSRIs or antidepressants.”

In this way, it also enhances what local providers can offer to their patients.

“We want to make sure our providers, which are the most critical element of our whole system, have access to the best tools, whatever those tools are,” Lindley said. “We’re very excited that there’s new tools that are becoming available, specifically the ones that Chuck is studying, that hopefully our providers will be able to use with our community members in the future.”

At the end of the day, the Vail Health Behavioral Health Innovation Center is seen as another instrument with which it can serve the behavioral and mental health needs of the local community.

“We’re very much focused on these new tools and optimizing current tools. But at the end of the day, we want people to be healthy and happy, right?” Lindley said. “To me, the most exciting part about all of this is we’re continuing to move back to whole person health; putting everything together and really optimizing the mind, body, spirit, all of that together for folks to live their best life. I think this is another step in that direction because you can’t really separate the two, they’re all connected and they impact each other every day.”