Dr. Benjamin Maxwell: Community can help youth thrive psychologically and flourish
Alright. Welcome back to another episode of Stop and Talk. Thanks for stopping by. I'm your host, Grant Oliphant, and I'm joined by my co host, Crystal Page. Hi, Crystal.
Crystal Page:Hi, Grant.
Grant Oliphant:How are you doing today?
Crystal Page:Excellent, and I'm looking forward to today's topic.
Grant Oliphant:I love today's topic, and I find it a little bit daunting. We're gonna be talking about youth mental and behavioral health with, doctor Benjamin Maxwell from Rady Children's Hospital, a trained child psychiatrist and a person who has been deeply involved with this issue. It's an extraordinary conversation we're going to be having in part because of the subject matter and in part because of how he approaches it.
Crystal Page:You know, because I hear about this topic every day in the news, and as a part time slash foster parent, I, I'm really interested to hear what doctor Maxwell has to say because kids are up against so much these days.
Grant Oliphant:They are. And and 1 of the things I think you and I would both want to stress going into this conversation, and I know, doctor Maxwell would as well, is how incredibly resilient young people are, how incredibly creative they are. We were joking before we went on air about the slang that they use and how we're desperately trying to keep up with the terminology.
Crystal Page:You know, Grant, I would try. I would so try to keep up with it. I go to urban dictionary.com all the time, but I don't wanna be very cheugy at all.
Grant Oliphant:Cheugy.Okay. Explain.
Crystal Page:So according to the TikToks or an Instagram video of the TikToks, cheugy is like someone who's outdated or trying to be trendy.
Grant Oliphant:Oh, okay. So
Crystal Page:let's not be cheugy.
Grant Oliphant:Yeah. Alright. I think by definition, we are. We are. But I, you know, all joking aside, I think the point is that, in talking about young people, it's important not to pathologize everyone in making generalizations.
Grant Oliphant:There is a crisis, there is a challenge, there is a problem, and we've got an extraordinary generation coming up that, offers a lot of promise. And as we talk about the challenges, let's not lose sight of that. I love this conversation with Ben. He is, I should say doctor Maxwell, but I I love this conversation with Ben, and I say Ben because he's so approachable, because he's doing hard important work and thinking about how to help an entire community and society respond to the challenges that we're facing.
Crystal Page:Can't wait to hear what he has to say.
Grant Oliphant:Let's dive in. Doctor Ben Maxwell, thank you for being here.
Ben Maxwell:Thanks for having me.
Grant Oliphant:It is really a pleasure. You and I have had the opportunity to talk a few times, but we're gonna dive into a conversation today about your work in youth mental and behavioral health, sort of what the landscape as you see it, and what's going on. But let's let's start by talking about what you're loving doing right now. Do you have a project that you're working on that feels especially exciting?
Ben Maxwell:Well, I I really think, the project I'm working on is bringing lots of different pieces together. You know, I've been a big picture person really, throughout my training. And what we're doing now at Rady Children's Hospital is really looking at how do we create a system of care that works from newborn babies and new parents all the way up to 17, 18 year old kids that are struggling with more severe mental illness. So looking at the health care system from that perspective, to me, is just a really, really exciting way of looking at it. Whereas in the past, potentially, I would look at a single clinic or a single patient.
Ben Maxwell:This is really taking a step back and trying to understand how we might serve the community better.
Grant Oliphant:I really love that framework of of trying to look at people in a community context, which seems like medicine doesn't often do, but there's tremendous value in that. Maybe a place to begin because this is a subject that so many people in our world are concerned about right now is the the apparent crisis of youth mental and behavioral health. And I guess the logical first question to ask is, is there a crisis?
Ben Maxwell:It's a great question. You know, I I started my work as a child psychiatrist here in 2010 here at Rady Children's Hospital here in San Diego. Remember walking into my first shift in an emergency in our emergency department. That first year where I was working in our emergency department at Rady, we saw a 167 kids in psychiatric emergency show up at our at our front door. Last fiscal year, we saw over 47100.
Ben Maxwell:So the, the question of whether there's a crisis or not, I think it's really clear that kids and families are feeling overwhelmed. I think our health care system is feeling overwhelmed, And that's why I think it's it's just so important that we look at how do we get kids care early and how do we create a system of care that we care for them?
Grant Oliphant:And to people who who would argue that that dynamic is driven by just better reporting or more awareness or more acceptance? How do you answer that? Or does it really matter?
Ben Maxwell:Well, I mean, I think what we're seeing is not only do we see kids that are reporting these things, but we see suicide rates go go up. Mhmm. We see kids reporting that they feel lonely more and more. We see companies struggling to hire young people that can manage the stress of the day to day work. We see people families becoming disintegrated based on psychological well-being or lack of psychological well-being of some of those people. So I I think it's being seen throughout society and throughout, throughout the different parts of the community that that we serve. And so to me, it is, yeah. I mean, I think there's more awareness. Mhmm.
Ben Maxwell:There's more willingness for people to talk about it, but that doesn't make it any less real that these people are suffering, and and and we need to find a a better solution.
Grant Oliphant:Yeah. Well, III appreciate the clarity of your response on that, and the the reality is, as you're describing it, real real young people having real problems and significant challenges, and you have been, in your work, looking at the environmental and lifestyle contextual roots of what's happening in our society to drive these dynamics. I'm curious what inspired you to do that work in the first place.
Ben Maxwell:Well, I mean, as a clinician, you can only hear the same thing over and over again so much and not question why. You know, that that data point I've mentioned of this really massive increase in number of kids presenting to our services, at some point, we have to say, well, what's driving all that? Mhmm. What what what's caused this change?
Grant Oliphant:Yeah.
Ben Maxwell:And so I've been fortunate enough to partner with a group called Sapien Labs, a nonprofit that's a it's really a data science organization looking at what are the environmental and psychosocial context or underpinnings of psychological wellness and psychological suffering. And that's been just a really rich conversation that I've had with those folks because they haven't sit they haven't sat in front of a patient or a family.
Grant Oliphant:Right.
Ben Maxwell:So they don't have that, awareness or learning that I've had throughout my career. But I have no idea how to manage big data or the data analytics that they use to to really find what are some of these root causes and what we might be able to do about them.
Grant Oliphant:I I love the fact that you're engaged in that search for the signal in the noise to figure out what's what's going on. You opened by talking about your excitement about working in a community context, and I think part of where this journey has led you is to working with organizations that 1 would not normally associate with a medical doctor's work, including the YMCA of San Diego and an entity called Outdoor Outreach here in San Diego, which works with kids and helping them become familiar with nature and the outdoors. Talk to us about that. Why?
Ben Maxwell:Yeah. Again, it's, you know, I feel, on the 1 hand, the work I can do individually with patients is is really wonderful. To take a step back and try to understand how can I have a bigger impact, that's something I've always been interested in. And I remember very early on in my medical training, I was lucky enough to go on some international medical trips trying to help out where I could on these international medical trips. And 1 of the first places I went, we were in a rural place in Latin America.
Ben Maxwell:And a lot of the people were coming in with a diagnosis of Giardia. And we were doing the good thing of giving them metronidazole, which is the treatment for Giardia. But at some point, a group of us asked the question, I wonder why all these people have Giardia. And the reality is they were going home, taking the pill, and drinking it with water that had Giardia in it.
Ben Maxwell:So the taking a step back and understanding the cause and then being able to hopefully have impact on that is something that's driven me ever since. Yeah. And so in this context where we're seeing more and more kids struggle with psychological challenges, asking, hey. What's happening in the community? What's happening in their psychosocial context?
Ben Maxwell:What's happening to their their health behaviors that might be having some cause of this? Because we know now our brain and our mind is shaped by our environment.
Grant Oliphant:That is a particularly poignant example of the cure containing the contaminant. Yeah. Really interesting. So let's go to that question right now. I was gonna I was gonna ask you this a little bit later, but since you brought up that example, let's go to what are the causes of the crisis that we're experiencing in your opinion?
Grant Oliphant:What are you seeing in your analysis that helps to explain the crisis in youth mental and behavioral health that we're experiencing and that you described?
Ben Maxwell:Yeah. You know, it's it's 1 of the questions I've been asked a lot and 1 of the questions I've dodged a lot at the end of talks and whatnot.
Ben Maxwell:But I but I think the data is coming out more and more clear. So social isolation and loneliness is an epidemic in our country, and it's even worse for kids. Surgeon general Vivek Murthy has come out really strongly on that, and I think he's done a great job with that messaging. The second, that I think is really important well, even related to that, just to take a step back, the nuclear family, especially in young people, more and more data is showing that kids and families are becoming disin disintegrated. They're not they're not connected like they used to.
Ben Maxwell:Older generations have more connection with family, younger generations have less. So that's an interesting data point that I didn't really expect, but an an example of social isolation outside of even having friends or community outside of the home. The the next 1 I'd point to is, what the role of screens and social media has done to our drive to seek social connection. So I think a lot of people are sort of looking for that social connection that they all feel they need . Through their screen and not necessarily getting what they ultimately need on a deeper level of that in person social connectedness.
Ben Maxwell:The the the screens, I think, also create this domino effect of if you're on your screen more and more, And let's face it, kids are on their phones something like 2 thirds to 3 quarters of their waking hours now.
Grant Oliphant:Let wait a minute. I have to stop you. 2 thirds to 3 quarters. They're on their phones.
Ben Maxwell:Not necessarily phones, but phones, computers, TV. Screens are taking up a bigger and bigger percentage of all of our lives, and I think you can see that just walking around town. Yeah. But kids, I think, are bearing the brunt of that even more, and young people as well. So those under 30 have higher higher time that they're spending on on screens.
Ben Maxwell:So, you know, that's a reality of the modern world we're living in. What do we what are we gonna do about that as a question of how do you grow up in the modern world with these things present and still be able to maintain your psychological well-being? That's a question that I'm really on a journey to find. What are some answers for? How do we inspire people to change their attitudes and behaviors in that way?
Ben Maxwell:But if you're on your phone that much, what also happens to your sleep? And we know kids are sleeping less, and the quality of their sleep is less now than it was in the past. Mhmm. So there's sleep, social connectedness, the the being present in this unregulated world of the Internet that exists on social media and other places. So I think all these things are sort of boiling the frog, so to speak, of, like it's just slowly changed over time.
Ben Maxwell:When you look at it now, you look around and you think, oh, that's just the way the world is, but it's having real implications. And I think we're getting to a point where we've really got to think about what direction do we want the world to go in.
Grant Oliphant:I I appreciated your, thank you for that answer and I think it is a terrific survey of the causes. I also appreciated the confession with which you began, which is that this is a question you used to duck. Yeah. And I know some aspects of this answer are controversial, you know the sociologist Jonathan Haidt has done a lot of work in terms of the impact of screens on young people.
Grant Oliphant:Demographers like Jean Twenge have been looking at this issue of the correlation between social harms for youth and or negative social outcomes for youth and the rise of social media. The intellectual connections that you just made make perfect sense. You know, Vivek Murthy, the surgeon general, is talking about the crisis of isolation in America. Of course, young people would suffer it more. Why is it controversial to talk about that?
Ben Maxwell:You know, it's a great question. You know, I I hear a lot of, people say, well, there's pros and cons to this, that, or the other. And I think there are pros and cons to this, but there's, you could say, there's pros and cons to driving without your seat belt on or pros and cons to smoking cigarettes.
Grant Oliphant:Mhmm.
Ben Maxwell:It's not the way we typically frame it. So I think on balance, a lot of these things are, clearly, problematic. Mhmm. This question of how do you contain some of that, what do we do about it? You bring up Jonathan Haidt, and some of his recommendations from his recent book seem pretty reasonable.
Ben Maxwell:The idea of kids not having smartphones at school, kids not having smartphones until 16, or waiting for social media until these later ages seems pretty reasonable. We're we're not in a world where anybody's doing any of that. And so I think the question of how do we communicate this in a different way to inspire people to change, and maybe it's just flipping what's the priority. How could we, you know, people could still be on social media or other other technologies, but maybe the priority is in person social connectedness within their community, within their schools, within their neighborhoods. That's always been the thing that's helped humanity deal with challenges and deal with struggle.
Ben Maxwell:And so to me, that's it's almost this generational challenge that we face. How do we get young people to be psychologically strong, thriving, able to deal with the sort of stresses of the modern world so that we can deal with some of these other major issues that we face as a human society. Climate change, democracy, you know, all these challenges that we face, we can't do any of it unless there's young people that are able and willing to be a part of that struggle.
Grant Oliphant:You, it gave me goosebumps when you just said that part of the reason we're not talking about this is that we're not in a world where we're not living in a world where, people are doing any of those things that would respond to the crisis you're describing, which is pretty scary. Say a little bit more about the disintegration of the family that you're seeing. You said you were surprised by that result.
Ben Maxwell:Yeah. That's a data point from, Sapien Labs, the group that I've, collaborated with over the past couple of years. And they found this globally that if you ask people, do you have 0 contact with any of your immediate family? More and more people in younger and younger generations are saying yes to that question.
Grant Oliphant:zero contact.
Ben Maxwell:0 contact. So, you know, there's there's that's a real struggle. You know, I think the 0 contact is 1 thing. Think the United States, we find ourselves in this individualistic society where there's a lot of geographic mobility, which can have great impact on economics or job prospects or individual growth.
Ben Maxwell:A lot of people also find themselves in as a young person in new cities on their own, struggling to make new friends and finding a place that they can find that community and connection, which is 1 of the reasons what what you are doing with this podcast is just so incredible because you're telling that story and showing people the different ways in.
Grant Oliphant:Well, I you know, I think we believe, that community is the antidote to a lot of the problems we face. Community is sometimes also the challenge Yeah. By the way. But I very much appreciate your identifying community as a way in which we can rally around, young people. Let's go back to the basics for a moment.
Grant Oliphant:When we describe this, is this a mental health challenge or a behavioral health challenge? What's the best way to talk about it?
Ben Maxwell:I I think the they can be used interchangeably, personally. I mean, mental health challenge, challenge of behavioral health. I think there's I think all of those work.
Grant Oliphant:Yeah. And when, when you think about the dynamics that you just described, it's a pretty big universal picture, you know, you're describing problems with the nature of the family. We've created a society. I just got back from the TED conference and, you know it's a it's in in many ways, TED is a celebration of technology and its implications for society.
Grant Oliphant:There's also a lot of soul searching about the impact of of technology on society, but you've just described a world in which our kids are spending up to 3 quarters of their waking hours on screens, they're experiencing little to no contact with their family members, they're, as a result suffering from a loss of sleep. It can feel like an overwhelming set of challenges. Here you are, a doctor, at Rady Children's Hospital in San Diego. Great institution, by the way.
Ben Maxwell:Yep.
Grant Oliphant:And you're 1 guy. Yeah. And and you have counterparts all over the country who are struggling with the same sort of things, but they're up against these mammoth social forces. How do you begin to find hope and to convey hope to parents as they're navigating this world. You know, we're we're talking to an audience of people who care about these issues.
Grant Oliphant:What are the sources of inspiration for them?
Ben Maxwell:Yeah. I mean, 1 of the things that is inspiration is looking to our history. You know, at what point in our history were we not up against insurmountable odds? We've always been up against insurmountable odds as humans. And, you know, in that, I can see, you know, I recently had a chance to meet Jim Kim, the the former president of the World Bank, and he was involved with Partners In Health Yeah.
Ben Maxwell:When the HIV AIDS crisis was killing millions of people around the world and people were saying, well, it's it's it's not economically possible to get them medications or, you know, we we just don't have an infrastructure to do it. And they were part of a movement to say, that's not good enough. We have a cure for this. Why don't we go and and and get people that those those treatments that can that can really help? And so they they were able to, you know, effectively put an end to the AIDS crisis.
Ben Maxwell:There's still obviously people living with HIV and AIDS, and there's still a lot of work to be done in that space.
Grant Oliphant:It's a great example.
Ben Maxwell:But they were able to make progress there. And so finding things like that where, hey, we're up against all these odds, but we don't need a new piece of technology or a new, research breakthrough to figure out how to move forward. We we know what's happening with kids. We know that in our past, kids have been psychologically thriving and flourishing for the for the main part. We can get back to that.
Ben Maxwell:And I do believe community is 1 of the answers to to get us there.
Grant Oliphant:For parents who are listening, I you know, 1 of the things I read recently that surprised me was that how how significant a percentage of parents have kind of just resigned themselves to this soc technological social media world in which their kids are growing up. It's easier or necessary for them in their view to let their kids engage with screen time so that they're preoccupied. It just feels like it's woven into the culture, and they just have to let their kids swim in it. And I know that's not universal. That's that's not even the majority of parents.
Grant Oliphant:But for a lot of parents, that's how they're perceiving it. When you talk to the adults in the room when you're working with young people, what is your message to them about what they can proactively and positively do to help young people?
Ben Maxwell:Yeah. I mean, I think the proactive approach isn't saying, hey, no phone. I think it's cultivating alternatives that people really feel good about. So we're not asking people to do things that are boring or painful. It's things that are actually fun.
Ben Maxwell:Hey. What does the kid want to be involved with? Is it, you know, horseback riding, squirrel catching on the weekend, going to the local park, skateboarding? There are things that most kids really enjoy being involved with and really trying to support kids so that they can find community with that activity.
Ben Maxwell:I think that's a easier approach than, hey, no more phone. You reached your phone time limit for the day, and the kids left thinking, well, what am I gonna do? Stare at the wall the rest of the day? So I think really that cultivation of the alternative is really important.
Grant Oliphant:You know, I'm I'm going to compliment by myself by saying you and I are generally in the same age cohort. We're not, but you're young.
Ben Maxwell:You fooled me.
Grant Oliphant:You're you're younger, but, but around, you know, sometime between when my kids grew up and when you grew up, society shifted from what Jonathan Haidt calls a play based childhood to a tech based childhood, and part of the thinking there was not only was the technology available, and new, and snazzy, and interesting, and captivating, but parents were afraid about letting their kids go out and play. When I grew up, you know, you would go out in the morning, and, you know, the legend would have it that you wouldn't come home until the end of the day. It was kinda like that. Yeah. We don't do that today, for good reason.
Grant Oliphant:The world's a big, scary, complicated place. There was the whole fear of stranger danger, that rose up in the nineties, and parents today would be loathed to do that even to the point where they're afraid of being sued if they let their or or prosecuted if they let their kids go out and play on their own. You're describing a set of alternatives, playing in the outdoors, participating in experiences in nature, you know, I assume art comes into play here too. That feels like a wonderful hearkening back to a time that was. How do we get back to that?
Grant Oliphant:As you think about this, and and how community can be the antidote to some of what we're experiencing. How does community play a role in that?
Ben Maxwell:Yeah. You know, I think each individual has a role to play. We can't do this alone, and that's a lot of the times the feedback I get from parents is, well, I'd love to do that, but nobody else is doing that thing. So how how do we create some sort of conversation around this topic so that people can do it in communities? Now I regularly as a child psychiatrist, and I have a 6 year old daughter, many of the the parents of the kids in the school will talk to me about, hey.
Ben Maxwell:Do you think I should get my kid a phone? Or what do you think about this, that, or the other thing? And most of them have the same feeling that I have that kids really thrive when they have an opportunity to fail, opportunity to fall down, get back up again, learn independence, learn resilience, do it in in the absence of an adult saying, oh, be careful with that. Be careful with this. But also the adults have, as you point out, this fear about the, you know, exposing their kid to all the big bad world that's out there.
Ben Maxwell:There, I think, is a a middle ground there, and that's why places like Outdoor Outreach or the YMCA, the things that they're allowing for is people to come together in a safe space, have community, be involved in new activities, learn, grow your self esteem because of mastery of new skills. Those are things that kids really, really can thrive with, and there's a number of avenues by which kids and families can do that. I do think it's possible. So, yeah, there's a lot of things that feel like insurmountable obstacles, but I think we can do it if we really put our put our effort to it.
Ben Maxwell:Just just 1 anecdote on that. Whereas, I was recently in the Basque Country in Spain reconnecting with a pediatrician I lived with when I was in medical school. He had been the pediatrician of this town for 41 years. And while I was there, he was talking about this idea of saving the Basque language.
Grant Oliphant:Mhmm.
Ben Maxwell:So the Basque language for a long time was oppressed and go to jail if you spoke it. And now the young people speak Basque better than the old people. They valued it. They put effort towards it, and they've been able to teach all the kids through this school system that they've set up. So I think just because we're on this feels like this cusp of losing some of the things that we all harken back to and think, oh, these are great things.
Ben Maxwell:If we value it and we put effort towards it as a community, I do think we can preserve some of those things.
Grant Oliphant:I really appreciate that message. I think it is incredibly powerful. And actually there's a through line between your story about the Basque Country and your story about AIDS, because in both cases, both could feel like lost causes, and in both cases, we figured out a way past society, community figured out a way past that. You have talked about the importance of moving past the crisis conversation that we're having today to a message that is more inspiring. Yeah.
Grant Oliphant:So is that your example of it? Is that is that is that the more hopeful message that we can do this by, reacquainting our young people with the value of being out in nature, or the value of expressing themselves through art, or the value of community? Or let me not put words in your mouth.
Ben Maxwell:No. I mean, III think it's it's it's all of that. In the health care space, there are solutions to kids that are struggling with psychological suffering. Depression, anxiety, schizophrenia, all these things have good treatments. A problem is most people don't get access to those treatments.
Ben Maxwell:So there's hope in the idea that humans can come together and figure out a way to provide high quality access to care. And and we're doing that at Rady Children's Hospital. We're doing that here in San Diego County. It's not sufficient to stop there in my estimation. I'd like to be living in a world where mainly people are psychologically thriving, and they're part of a community and they're feeling connected.
Ben Maxwell:And so there are, again, ways by which we can do those things. I think that's the the conversation that needs to happen as opposed to the sound bite that gets quoted for me is how many new kids have come to our emergency room and psychiatric crisis in creating this doom and gloom about this topic. We're in a tough spot, and we can get out of it with the current knowledge that we have, but it it does take more than me as you point out. I mean it's going to take a community working on it.
Grant Oliphant:Yeah but it takes a few people like you who are on the ground seeing the challenge and able to see the bigger picture at the same time. I mean, the classic formulation that I heard even when I arrived in San Diego, 2 years ago was that this crisis was really primarily a crisis of the lack of availability of treatment, and that somehow we just needed to figure out how to treat more kids, which meant provide more treatment professionals. And then and then some people started doing the math and realized it was not possible actually to hire enough people to do all of that treatment. That has to be a humbling experience for somebody who is a clinician and who, you know, you just said, we we we know the treatments to apply with with, kids who have very specific needs. You have laid out for us A-A view of of a way for society, broadly, to get out of the thicket of our apparent paralysis over the youth mental health crisis.
Grant Oliphant:That's a longer term solution in some ways. In the near term, there are young people in crisis Who need help and need to talk to someone, and there aren't enough someone's for them to talk to, and you're experiencing that in the statistics that you shared. So how do you balance that long term and near term, I guess, is what I'm really driving at?
Ben Maxwell:Yeah. I mean, I I think the the balance is it's it's a tough one to have. I I think the idea, though, when you see a newspaper article saying that the thing we need to figure out is the number of inpatient psychiatric beds per capita and make sure that that's the right number so that all people with that need can can get care. I think that's just insufficient. I don't wanna be living in a society where we wait till people need inpatient psychiatric care before we do something about it.
Ben Maxwell:What I'm interested in is how do we find a way to, at every step of the way, create an off ramp so that people have a place to go towards psychological well-being. That includes new parents. Now I was a new parent not that long ago. You think I'd know what I was doing when I took the baby home. I didn't know what to do.
Ben Maxwell:We we needed support. And so to find support early on, help get people off on the right path. If people fall off that path, have something in place that they can get back on. And that is places like, community centers, schools, families, neighborhoods even just coming together. You know, when you have the choice when you drive home tonight of whether you wanna wave at the person walk the dog or blow by him at 35 miles an hour on your neighborhood street.
Ben Maxwell:You know, I think there's things that we can all do that ultimately help the kids. It trickles down to their psychological well-being. If they can be enveloped in a community that has that sort of richness, people start to trust each other and have each other's back.
Grant Oliphant:Ben, how do you model psychological well-being to your kids?
Ben Maxwell:How do I model that? You know, I think I talk to my daughter about what I'm trying to do when I go to work is make the world a better place and help kids and families. And that that fills me with, joy and compassion that I think ultimately leads leads me to my own psychological well-being. I demonstrate the importance of, for me, exercise and being out in nature and eating healthy. We invite people over, so we have barbecues and community regularly.
Ben Maxwell:So my daughter can feel lost in the buzz of sort of lots of people being around, especially as an only child. We feel that's important. So it's all the things, you know, social connection, connection to family, exercise, nature, eating healthy, all these things that, you know, if I got out, and said, hey. These are the things that you need to do to be psychologically well. Most people aren't gonna be surprised by those ideas.
Grant Oliphant:Right.
Ben Maxwell:But it's how do you do it? And so I try to demonstrate to my daughter how do we do it, but I also try to live that for other people to see as well and and hopefully make an impact on on how they see they might be able to do it.
Grant Oliphant:Now as I listen to you describe that, it's kind of a it's a beautiful list for any parent out there who is struggling with how do I do this in my own child's life, some simple steps that you just described.
Ben Maxwell:Simple steps, and and we've got to acknowledge as well that there there are people that are overwhelmed with 2 parents working 2 jobs, and not everybody can do that. And so how do we create something that is it takes a village to raise a child and have something in place so that other kids can do that when their parents might not be around?
Grant Oliphant:So let's talk about that for a moment. The because what you just pointed to is disparities in youth mental health, and they are real. You know, we we know that LGBTQ youth experience youth mental health issues at a rate, that is very high because of the challenges that they face. What disparities do you see in in the challenges that young people are facing?
Ben Maxwell:Yeah. I mean, early on, I think in our conversation, I mentioned the idea that our environment shapes our brain and our mind. And so if you're growing up in an environment with a lot of toxic stress, poverty, access to food is unstable, these sorts of things have real impact on the kids that we see at Rady Children's Hospital. And so, you know, if a kid comes in and says, hey. You know, I don't have any friends at school.
Ben Maxwell:My parents work 2 jobs. My closest friend is some person I met online that lives in Tennessee, and we've never met in person. And, you know, I don't really feel all that good about my life, and I'm wondering what I should do next. In many ways, that feels like the natural, outcome of that environment. So is it a medical problem, or is it an environmental problem?
Ben Maxwell:And I think we have to start thinking about those social determinants of health in a more comprehensive way than just, hey, there's a health care system, and within the 4 walls of the health care system, we're gonna stay there. That's the conversation I wanna be a part of is how how do we help the community in a way that can help people that are in that position? And you were saying earlier, doctors aren't usually involved with YMCA and outdoor outreach and all these other things. That's the reason I'm involved with those is I think it can have an impact.
Grant Oliphant:Well, and I I it makes a it makes a beautiful statement about the type of society I think we need to rebuild. I imagine it's also a little controversial within the halls of the medical establishment. So your rewards are probably to do the clinical work that you were trained to do. Yeah. What happens to a guy like you when you step out and start talking about, hey.
Grant Oliphant:We should partner with the y on these on these things, and we should think about community solutions to some of these problems. How is that received?
Ben Maxwell:I mean, I I think I've just been really fortunate to be at Rady Children's Hospital where we are the only children's hospital in San Diego, and and they really have stated, hey. We have a commitment to this community to build and do what's important for kids and families. And so I was worried about that, and I'll I'll tell you that quite frankly. I was worried about saying these things early on, and then, fortunately, I brought a few of these things up with leadership, and they said, hey. That sounds great.
Ben Maxwell:We don't know how that fits into what we're doing, but keep doing it and we'll figure it out.
Grant Oliphant:That's remarkable, actually.
Ben Maxwell:Remarkable. Yeah. So not only the senior leadership of the hospital, but also in meeting board members of the hospital and worrying about what they might think, and them also being totally committed to the idea that Rady Children's Hospital and its employees are here to protect childhood, to figure out a way to help families. And there isn't some, hey. You know, we we need to get you back in the clinic and just generate clinical revenue for us.
Grant Oliphant:How about more broadly? So it's great that Rady's has had that reaction to you. How is your position received when you speak with colleagues nationally about it?
Ben Maxwell:I I think a lot of my colleagues nationally have a more zoomed in look at what are they gonna do in their clinic, what are they gonna do with their program. And I think that's where I'm just trying to sort of create my own lane of I think there's somebody needs to be in this position. Somebody needs to be saying, hey. This is what we're seeing on the clinical side of things. How how can I act as an intermediary to other parts of the community so so we can connect the dots and really try to create a cohesive environment for kids to grow up and develop well?
Grant Oliphant:I'm I'm I still struggle with the idea, I wanna come back to something you said earlier. I still struggle, or or maybe I'm just, it it feels so bad, that there are kids who feel that they get 0 contact with their family. And yet, when we were talking about disparities, you sort of perfectly described circumstances in which that happens naturally. Right? You know?
Grant Oliphant:You have a parent who's working all the time, so you never see them because they're trying to keep bread on the table. You know, other life circumstances interfere. Health issues may interfere. So a young person can come to feel disconnected. And and you're also saying, on a very positive note, that there's a way of dealing with this, which is for community to re embrace its role and to connect kids with community more broadly.
Grant Oliphant:Here's the question I'm wondering about, which is why should society care? I, you know, I think I think we both know the answer, but I don't think the answer is a given in our culture. So when you're talking with folks who maybe don't understand that it's their responsibility, what happens with quote, unquote other people's kids, Why is why is this a community responsibility and not just opportunity?
Ben Maxwell:Yeah. You know, 1 of the things they taught me in med school was kids become adults. I don't know if you know that.
Grant Oliphant:Yeah. Oh, that thing.
Ben Maxwell:Yeah. Yeah. So, you know, we're talking about 15 year old kids a lot of times.
Grant Oliphant:Right.
Ben Maxwell:They're adults in 3 years. Who are the
Grant Oliphant:Yeah. That's such a good reminder.
Ben Maxwell:Who who are the people that are staffing, maintaining the electrical grid, flying the planes, taking care of, our our parents in in hospitals? Who's gonna care for us? So, ultimately, this is critical to society that we are able to have kids go through childhood and become functional adults that can deal with the stresses that come with the modern world. And that's a challenge that we're seeing right now. So you look you look at there's a recent survey, 18 to 24 year old Californians.
Ben Maxwell:I think it was a year or 2 ago. 2, 3000 Californians, young Californians, were asked lots of different questions. 1 of the questions they were asked was, have you thought about ending your life in the past 12 months? 31% said yes. So this data that a lot of times is thrown out there of 1 in 5 people struggle with psychiatric illness, something like that, that data is old and it's no longer relevant to what's happening with young people. If we're living in a world where 18 to 20 18 to 24 year olds, a third of them are thinking about killing themselves every year, we're doing something wrong. Mhmm. And we have to find a new way forward or has implications on all aspects of society.
Grant Oliphant:It's almost impossible to know where to go from there because it's such a sobering fact, And you're drawing the through line from that a statistic like that to the world that will be here in 3 years, for everyone, is an important way for the rest of society to look at this. I deeply appreciate the connection you're drawing between these dynamics and the opportunity that exists by reconnecting young people with experiences of nature, with self discovery. I I believe profoundly important is the opportunity for self expression through creativity and art. Yeah. Your your work on this, by the way, has affected the work that we're doing in thinking about how we help young people.
Grant Oliphant:And it is a promising storyline that begins to counter what the surgeon general has talked about with the epidemic of loneliness and what Jonathan Haidt and others are talking about with screen time and so forth. I wanna honor the fact that part of the way you come to your own mental health is through surfing, which is which feels to me not like a community act, but a solitary act. And solitude, by the way, is also an important feeder of mental health. But I'm curious if you have gained any lessons from being out on the waves that have informed the work that you're doing as a child psychiatrist dealing with these exceptionally challenging, sobering, some frankly, depressing Situations sometimes.
Ben Maxwell:Yeah. Absolutely. You know, it's solitude and it's, community. You know, for me, I have a group of guys that I regularly meet up with at at Sunrise before work. And when we go out and we talk about what's going on in each other's lives, and it can be this really beautiful, quiet time where I can be with other people and have meaningful conversations.
Ben Maxwell:Sometimes, they're not available, and I go by myself. And it can be this time where I think about what I'm going to do during the day, sort of transition towards my work life, from my my home life. But the act of surfing, I mean, there's a lot of metaphors and cliches to life. You know, there are times that I'm out there where a wave is coming to hit me that looks like it might kill me. And, you know, I have to find a way to be calm and find peace through that.
Ben Maxwell:There's other times that there's just exhilarating rides that I'm at the at the discretion of the wave, so to speak, to see what happens. So for me, it's been, that's all been, it's just a great way to start the day. It's a very San Diego way to start the day.
Grant Oliphant:It is a San Diego way to start the day. Not my day, by the way.
Ben Maxwell:Yeah. Well, you can do that. We should we should go out sometime.
Grant Oliphant:We'll talk later. Yeah. But definitely, you know, the other the other thing that comes up for me around that, Ben, is just, sports sometimes gets overlooked in this equation too with with helping helping young people, reconnect with with opportunities for seeing themselves in a larger context.
Ben Maxwell:Yeah. It's just great for kids to learn new skills, find mastery, build self esteem.
Grant Oliphant:Yeah.
Ben Maxwell:And that can be just really pivotal for the way kids grow up.
Grant Oliphant:Ben, what inspires you?
Ben Maxwell:Man, w you know, grant, you inspire me. When I, when I first, and I'm not saying it.
Grant Oliphant:That's the ultimate play to the host.
Ben Maxwell:You you you can cut this out if you want. But but in all sincerity, when I first met 1 of your, colleagues at the Prebys Foundation before I met you, she said, you know, you're really gonna love Grant. He's a visionary. And so, you know, quite frankly, I I don't hear people say that to me that frequently. So I looked into what you'd been able to do and what you're trying to do here.
Ben Maxwell:And I think exactly what we've talked about. I've been trying to figure out how to communicate and message some of these things around the importance of community, and it's what you've done so well, I I know here and I think throughout your career. So, honestly, like, trying to understand how to message better and having somebody that, has done that is inspiring to me. I think the other thing that inspires me are people that push up against the odds and say, hey. Like, I could just cave to this, but I'm I'm gonna try to find a better way forward.
Ben Maxwell:And so there are people like Paul Farmer as a a person that had the Partners in Health. And so very early on in my, medical career, I saw a documentary film and read his book and thought, yeah. I mean, that's that's sort of person I wanna be to push back against these insurmountable odds to try to have an impact for positive, in in the world.
Grant Oliphant:Well, I love that you would have a hero like him because he really is somebody who took on an impossible challenge and figured out a way for society to move forward on it. And I And thank you for the nice words. I think you know what I believe about San Diego and I really believe you're embodying is that we have the capacity in this community because of some of the great work that is being done here to demonstrate the power that still exists for this country, through the magic of community. Right. And if we just set our sights high enough, you know ironically what people often think when things are bad, and you spoke to this earlier.
Grant Oliphant:Ironically what people often think when things are bad or challenging is that you have to dumb down your response, and you have to accept having less. And what I hear you doing is saying, no we need more. Yeah. You know what we actually needed to do is up our game, and the way we up our game is by connecting young people with each other, and with community, and with nature, and with art, and you know, outdoor experiences, and that bigger vision will save us. And III love everybody I meet who embodies that sort of spirit, and you absolutely embody this that spirit.
Grant Oliphant:So thank you for the work you're doing really on behalf of everyone listening. I think I speak for us all in saying thank you for what you're doing.
Ben Maxwell:Thank you, Grant. Great being here.
Crystal Page:You know, I have to say I have a lot of hope listening to what Ben or doctor Maxwell had to say.
Grant Oliphant:I do too. I have a lot of admiration too, you know. I I think that probably came across at the end of that interview, but it is not easy for a medical professional to step outside of his clinical role and talk about what society has to do or what community can do to address a challenge this large. But III really my primary takeaway from this conversation above all else, and we'll go through some others, is just the way he pointed to how we faced hard challenges before, and we've dealt with them, and he believes that's possible here.
Crystal Page:And I think where he said that he really wants to live in a world where people are thriving and connected, that's a vision of a future that I also wanna live in.
Grant Oliphant:And so do I. And it's you know, if you think about it, of course, we do. It's fundamental to our work, but it's why we do the work that we do because we believe that that is the path forward for not just San Diego, but for people in general as we navigate this constantly changing world. If we break down what he talked about and why that connection is so important, you know, I I love the 3 challenges that he laid out. And and 1 was that we that young people, like everybody else in our society, faces this crisis of loneliness and isolation, which surprisingly according to the data is manifest in an increasing disintegration of the family, which is sad and scary, followed by and associated with the second point, which was the amount of screen time, and I found Crystal his data there to be shocking frankly, you know, that young people are spending 2 thirds to 3 quarters of their waking lives on screens tells you a little bit about what's feeding this crisis of isolation for them.
Grant Oliphant:And then 3rd, the connected piece, you know, the the impact on their health and their well-being and sleep. And and of course when you're constantly being stimulated that way, you're not gonna sleep well, and you're not going to be able to to attend to your wellness in the way that you otherwise might. So he painted this picture of very real challenges that are baked into the lives young people face, and then the antidote was exactly what you spoke to. Do you wanna say a little bit more about that?
Crystal Page:You know, I appreciate you going through the the 3 items because the loneliness piece is not unlike what seniors are going through or what we all went through during the pandemic. The difference is all of us as adults had had a, hopefully, a community connection beforehand. We weren't born into this type of world. So I think painting that vision instead of getting lost in the despair and the gut punch of 1 out of 3 kids or 1 out of 3 18 to 24 year olds wanting to end their life, which is such a gut punch. How do we turn that around and say, let's let's set up this vision where we're all connected and where people matter, and we're putting down our phones and taking the time just to reconnect.
Crystal Page:You know? Like, that is a step we can all take. Like, he said the thing about, like, do you wanna drive past your neighbor at 35 miles an hour or slow down and wave to him? You know? I think we all wanna live in the world of the 35 slowing down instead of the 35 miles an hour.
Crystal Page:But it's hard on a grumpy day or a different day, but every action matters.
Grant Oliphant:It does. And I by the way, I think that I love that. Every action matters is maybe 1 of the most important takeaways from this whole interview because what he is describing is a set of of solutions that individually, each 1 may not seem like that much, but collectively, they amount to a lot. Right? So he's talking about reconnecting young people with nature.
Grant Oliphant:He's talking about reconnecting young people with opportunities for self expression through art. We talked about sports at the end. We talked about the community that comes from those activities. We talked about broader community connections, And the reason that every single 1 of those is important and doable is that, the young people who are experiencing today's crises are the adults who are gonna be supporting society and driving society in as little as a year, 2 years, 3 years, 4 years. That by the way was also a gut punch, you know, his his his point about that that we make this sort of artificial divide between young people and adults, but as he pointed out, young people turn into adults, and then they become And
Crystal Page:And I think even when he talked about whether it was surfing or being in nature, you know, as a kid who grew up in Vista, California, we would fundraise in middle school to go to sea camp.
Ben Maxwell:Yeah.
Crystal Page:And I would kayak. And let me tell you, being a 12 year old little girl out on the water in my own kayak, surrounded by nothing but ocean and some other kids doing the same thing is, like, the most freeing feeling in the world. Like, you feel like there's something you can control and there's this whole big world you can't control. I want kids to have that even before they're adults. I want them to feel how magnificent nature is, you know, and and how being connected just feels good.
Crystal Page:You know? So
Grant Oliphant:Yeah. His positive framing around that was, I thought, really helpful because so much of this conversation is negative. You know? It is about the the 1 in 3 young people having contemplated suicide, extraordinary. And it and it is easy to fall into despair because as you and I have discovered in our work at the foundation, there simply isn't enough money in society nor is there are there enough people to provide the clinical treatment to everyone who needs it as if that's the solution, You know?
Grant Oliphant:If that's the if that's the primary modus operandi. If we really wanna solve this over the long term, we really have to attend to the root causes, and we will get at far more young people, and we will create far more, well, better outcomes at in the end because we do that. I was really struck by the way he described our individualistic society and acknowledged some of the causes of it that are not just a a way of looking at the world that's unique to America. Partly it's that. But partly it's also disparities in our economy.
Grant Oliphant:It's parents who have no other choices in in how they care for their children, it's parents who are just too busy working multiple jobs, it's it's people not having been given exposure to other opportunities. It's their kids not having access to the sort of natural amenities that, more affluent families take for granted. It's all of that. And if we can begin to just acknowledge that and find ways of reconnecting kids with those opportunities, then we have a path forward in addressing on a very broad scale the challenge that we're facing in youth mental and behavioral health.
Crystal Page:But I also loved when you asked him the question, how do you model this for your daughter?
Ben Maxwell:Yeah.
Crystal Page:And you're a dad and grandpa, so so how did that his response hit you?
Grant Oliphant:Well, I you know, I was partly asking that question out of self interest because I think it's so hard for you for parents raising kids today to figure out the right thing to do by their kids. And I his answer was perfect. It was to the extent that you can, to take care of yourself, to do the things for your child that also are good for you, and vice versa. To to take opportunities to recharge, and to find the sources of joy that you can share with your child. You know, I think he he talked about it in a way that almost every parent, even the ones who are way stressed out, could identify with.
Grant Oliphant:And, and it's important to realize that to a certain extent, everybody's dealing with that in our culture. And we have tools. We have tools.
Crystal Page:I feel empowered. How about you?
Grant Oliphant:I feel empowered, and I feel more hopeful than I did when even when we began the conversation because there is a path forward, and somebody who has studied this issue way more than we have has identified that, yeah, we can do this.
Crystal Page:Yeah. And it's gonna continue to show up in our work. So this conversation has only begun. Right?
Grant Oliphant:It it is. III think for us in our work, what we're we're seeing over and over again is, especially in our community, the convergence of nature and art and creativity and, youth mental health is huge, and we're going to see a lot more of our activity steered towards that particular meeting point.
Crystal Page:With that, I think we have had another great episode, Grant. It's been great
Grant Oliphant:Crystal, I love doing this with you. Thank you for,
Crystal Page:Ditto my friend.
Grant Oliphant:For sharing this conversation, and look forward to doing it again.
Crystal Page:See you next time. Alright.
Grant Oliphant:This is a production of the Prebys Foundation, hosted by Grant Oliphant, and co hosted by Crystal Page. The program is co produced by Crystal Page and Adam Greenfield, and it's engineered by Adam Greenfield. Production assistance is provided by Tess Karesky. And our new theme song is by mister Lyrical Groove, a local San Diego artist. Download episodes at your favorite podcatcher or visit us at stop and talk podcast.org.
Grant Oliphant:If you like this show, and we really hope you do, the best way to support it is to share, subscribe, and review our podcast. Thank you for your support, your ideas, and most of all, for listening. This program has been recorded at The Voice of San Diego Podcast Studio.
