Podcast Summary: The Interview with Leslie Heaney – [REVISIT] Mental Health Matters feat. Corinne Catarozoli, Ph.D.

Introduction to the Episode

In the April 29, 2025 episode of The Interview with Leslie Heaney, host Leslie Heaney engages in a profound conversation with Dr. Corrine Catarozoli, Ph.D., the Co-Director of Behavioral Health Integration and Innovation at Weill Cornell Medicine. Dr. Catarozoli brings her extensive expertise in clinical psychology to discuss the pressing issue of children's mental health, particularly in the context of Mental Health Awareness Month.

Overview of the Youth Mental Health Crisis

Dr. Catarozoli elaborates on the ongoing youth mental health crisis, highlighting significant statistics and trends exacerbated by the COVID-19 pandemic. She references the 2021 US Surgeon General's advisory and the joint declaration of a national state of emergency in children's mental health by major pediatric and psychiatric associations.

"42% of high school students said they felt persistently sad or hopeless, and one in five had said that they seriously considered attempting suicide." [02:59]

Dr. Catarozoli emphasizes that the pandemic intensified pre-existing issues such as increased screen time, social isolation, and a long-standing shortage of child mental health specialists, making access to care even more challenging.

Common Mental Health Issues in Children and Adolescents

Dr. Catarozoli identifies the three most prevalent mental health concerns among youth: anxiety, depression, and behavioral issues. Each condition is examined in detail, providing parents with insights into recognition, causes, and treatment options.

1. Anxiety

Indicators and Causes

Anxiety is the most widespread mental health issue, affecting approximately one in three adolescents. While some level of anxiety is normal, parents should be vigilant for persistent and disruptive anxiety that interferes with daily functioning.

"Avoidance can be a big red flag that they're in a situation that's anxiety-provoking to the child." [07:28]

Common signs include:

• Avoidance of social events or school activities
• Excessive reassurance-seeking
• Disruptions in sleep and appetite

Treatment Options

Early intervention is crucial for better outcomes. Treatments typically include:

• Cognitive Behavioral Therapy (CBT): An evidence-based, short-term therapy that equips children with concrete strategies to manage anxiety.

  "We're equipping them with skills to manage it themselves. I tell kids I want them to become their own CBT therapists." [16:33]

• Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like Prozac or Lexapro can help reduce the severity of anxiety symptoms, often used in combination with CBT for enhanced effectiveness.

Accessing Treatment

Dr. Catarozoli advises parents to seek professional help if they suspect their child’s anxiety is beyond normative levels. Early intervention can prevent the escalation of symptoms.

2. Depression

Indicators and Causes

Depression often manifests later than anxiety, typically emerging during the tween to adolescent years. Indicators include:

• Persistent low mood lasting weeks
• Significant withdrawal from previously enjoyed activities
• Statements about death or suicide

"We encourage parents not to just write that off as though they're just being dramatic." [20:09]

Treatment Options

Similar to anxiety, depression is effectively managed through:

• CBT and SSRIs: These can be administered separately or together to address depressive symptoms.

• Dialectical Behavior Therapy (DBT): A comprehensive treatment involving individual therapy, group skills training, and phone coaching to manage suicidal thoughts and self-harm urges.

  "DBT is a very comprehensive program that involves a range of different therapies and interventions." [22:23]

Accessing Treatment

Parents should monitor for persistent depressive symptoms and seek professional evaluation if necessary. Integrated care models can facilitate timely interventions.

3. Behavioral Issues

Indicators and Causes

Behavioral issues are characterized by disruptive actions across multiple settings, such as home, school, and extracurricular activities. Key indicators include:

• Repeated uncooperative or defiant behavior
• Disruptions that interfere with learning and social interactions

"If they're being disruptive to the learning environment, it's not that they're intentionally being oppositional." [30:38]

These behaviors may stem from underlying conditions like ADHD or may occur independently.

Treatment Options

Effective treatments involve parent-focused interventions:

• Parent Management Training (PMT): Teaches parents strategies to reinforce desired behaviors and manage problematic ones.

  "Parent management training... involves teaching parents how to positively reinforce behaviors that they want to see." [28:04]

• Parent-Child Interaction Therapy (PCIT): Enhances the quality of the parent-child relationship and modifies the child’s behavior through structured interactions.

ADHD and Its Relation to Behavioral Problems

Dr. Catarozoli discusses how ADHD can often be mistaken for oppositional or defiant behavior due to symptoms like inattention and hyperactivity.

"A child is distracted and not able to attend or sustain their attention for a long period of time... but really they've just gotten distracted." [30:38]

Indicators and Causes

Symptoms include:

• Inattention and difficulty following directions
• Hyperactivity and impulsiveness

Treatment Options

• Medications: Stimulants are the first line of treatment, particularly effective in managing ADHD symptoms.
• Behavior Therapy: Supports executive functioning skills such as organization and prioritization.
• School-Based Accommodations: Adjustments like preferential seating help minimize distractions and enhance focus in the classroom.

Accessing Mental Health Services

Dr. Catarozoli addresses the significant challenge of accessing mental health care due to workforce shortages, especially in rural areas.

"It's really tough right now." [34:52]

Steps for Parents:

1. Consult Pediatricians: They often have referrals to trusted mental health providers.
2. Reach Out to School Counselors: They can connect families with local resources.
3. Utilize Insurance Directories: Search for in-network providers within your area.
4. Use Online Resources: The Association for Behavioral and Cognitive Therapies (ABCT) offers a comprehensive search tool for finding CBT specialists.

Notable Resource Mention:

The Maya app, developed by New York Presbyterian and Weill Cornell, provides CBT-based skills to promote wellness and is available on the App Store. While currently targeted towards adults and young adults, it exemplifies innovative approaches to accessible mental health support. [35:50]

Integrated Care Model: Behavioral Health Integration and Innovation

To combat the accessibility issue, Dr. Catarozoli introduces the Integrated Care Model employed at Weill Cornell Medicine. This approach embeds mental health specialists within various medical settings, ensuring that mental health support is readily available alongside physical health care.

"It's efficient, it's immediate, they can get access right away without having to get sent somewhere else with a six-month wait list." [39:18]

Benefits of Integrated Care:

• Immediate Access: Reduces wait times and provides timely interventions.
• Comprehensive Treatment: Addresses both mental and physical health, recognizing the mind-body connection.
• Collaborative Approach: Enhances communication between medical and mental health professionals, improving overall care quality.
• Economic Advantages: Reduces costly ER visits and improves physical health outcomes through better mental health management.

Implementation Example: In endocrinology clinics, adolescents with diabetes are routinely screened for depression, enabling early identification and treatment, which in turn improves their diabetes management. [43:00]

Resources for Parents

Dr. Catarozoli recommends several resources for parents seeking to understand and address their children's mental health needs:

1. Association for Behavioral and Cognitive Therapies (ABCT): Offers a directory to find CBT specialists based on zip code.
2. Maya App: Provides interactive CBT skills for wellness promotion.
3. Books:
   • "You and Your Anxious Child" by Dr. Ann Marie Albano
   • "Taking Charge of ADHD" by Russell Barkley
4. Children’s Books:
   • "In My Heart": A picture book that explores a range of emotions, aiding young children in understanding their feelings.

"These are all the different considerations that I think of in the decision tree on whether where to start and what type of treatment recommend." [17:59]

Websites:

• New York Presbyterian Center for Youth Mental Health: Provides extensive information on when to seek help, finding a therapist, and communicating with children about mental health.

Conclusion

Leslie Heaney and Dr. Corrine Catarozoli conclude the episode by emphasizing the importance of early intervention, open communication, and utilizing available resources to support children's mental health. Dr. Catarozoli highlights the innovative Integrated Care Model as a promising solution to the mental health crisis, ensuring that children receive comprehensive care without unnecessary delays.

"We're really excited about this initiative and really see it as an innovative way to address this youth mental health crisis that is ongoing." [48:16]

Leslie thanks Dr. Catarozoli for her invaluable insights, encouraging listeners to take proactive steps in supporting their children's mental well-being.

Key Takeaways:

• Youth Mental Health is a Critical Issue: With alarming increases in anxiety, depression, and behavioral issues, timely intervention is essential.
• Effective Treatments are Available: Evidence-based therapies like CBT and DBT, alongside appropriate medications, can significantly improve outcomes.
• Accessibility Remains a Challenge: Integrated care models and leveraging available resources are vital in bridging the gap between demand and supply.
• Parental Involvement is Crucial: Educating and empowering parents through training and resources enhances the support system for affected children.

For those interested in delving deeper into this topic, the episode provides a wealth of resources and actionable advice to navigate the complexities of children's mental health.