Dr. Ken Duckworth is the senior Medical Director for Behavioral Health at Blue Cross Blue Shield of Massachusetts (BCBSMA). Prior to coming BCBSMA, Ken spent 6 years as a Medical Director at Vinfen Corporation, the largest human service agency in Massachusetts. He has also served as both the Chief Medical Officer and Acting Commissioner for the Massachusetts Department of Mental Health (DMH). He is a double board certified adult and child and adolescent psychiatrist. He is also an assistant professor at in the psychiatry department of Harvard Medical School.
Ken is nominated as a HUBweek Change Maker by BCBSMA for his advocacy of and work dealing with the opioid crisis. He chats mental health, the opioid crisis, BCBSMA's innovative Narcan toolkit, and how we can eliminate the stigma surrounding these topics with Maria Liang, HUBweek's Digital Marketing and Social Media Manager.
Maria Liang: What is your background and how did you find your way into psychiatry?
Ken Duckworth: My dad was a fabulous human being with devastating bipolar disorder. I would say my route into psychiatry was fated by the time I was eight years old, even though I had never met a psychiatrist. I don’t happen to have a psychiatric vulnerability, but I feel so connected to the people who have these problems because the most influential relationship of my youth was this man who had a devastating illness. So, that’s why I became a psychiatrist.
KD: What’s your interest in mental health? Is this something that you have a passion about? Or did you just happen to find me because I was nominated as a Change Maker?
ML: You know, it’s a little from column A, a little from column B. I’m the Digital Marketing and Social Media Manager at HUBweek so conducting this interview is certainly in my wheelhouse. But when I started reading into your background, I became really excited to speak with you because I personally deal with depression and anxiety and I have many friends with mental health issues, so it’s a topic I’m also passionate about.
ML: I noticed while you were speaking that you used the term “psychiatric vulnerability.” I’ve never heard that term before.
KD: Well, that’s how I think about it, because nobody wants to have a mental illness. When I think about the human condition, you can have a cardiac vulnerability, a psychiatric vulnerability. I’m a cancer survivor so I have a cancer vulnerability.
Depression and anxiety are ordinary human problems. If you don’t address them, they can impact your work and love life, your parenting. I just think it’s really important to do what you’re doing and share your experience. I think society has gotten better on the idea that this is part of the human condition, because it’s one of the most common vulnerabilities that people have.
I think it’s important to talk about this, just like a man talks about his hypertension, right? It’s just part of life. And it’s not some amazingly secret thing that we have to hide, and the more that we can make it okay to get help, the better off we’ll be as a society. Suicide rates are at an all-time high, overdose rates are at an all-time high — clearly we have more work to do. It’s a crucial space-changing attitude. That’s why this little project that I’m working on is part of an attitudinal conversation.
ML: How did this project at BCBSMA come about?
KD: My two passions are the mental health crisis and the opioid use crisis. So I said, “Wait a minute, what if we could think creatively about working with employers to help people have discussions about opiates in their workplace, to improve their attitudes and reduce the stigma? Why couldn’t the biggest and most progressive health plan in Massachusetts make it easy for employers to recognize that Narcan is a tool, that we can train people to give it if they need to, that you can go to any pharmacy and get it?”
ML: Tell us more about this toolkit.
KD: Physically, it’s the size of a little makeup kit. You open it up and there are two doses of nasal Narcan in it. It instructs you on how to recognize if somebody’s had an overdose, when to call 911, and the basics of how to use the spray.
ML: How is BCBSMA testing the toolkit?
KD: We’re working with four of our employer customers to pilot this: the town of Ware, the city of Brockton, Shawmut Construction, and New England Regional Council of Carpenters. Blue Cross is also introducing the toolkits and training into our own workplaces. We’re meeting with each organization and asking them how they want to employ the toolkit, which can go one of two ways. If you’re a town, you could do it as a public health first aid model, keeping the kits at pools and libraries, for instance. If you’re a company, you could find out which of your employees wanted to learn more about it, or keep the toolkit in the same place you keep your defibrillator. The crux is getting employers engaged in the opiate crisis because this is an all hands on deck public health crisis.
ML: Does BCBSMA offer other resources for opioid addiction?
KD: Getting help for addiction is OK. We’re here to support you and figure this out. BCBSMA has an online opioid resource center with information on family support, medication safety, pain management and opioid use disorder treatment care options, including information on how to access medication-assisted treatment. You can check it out at bluecrossma.com/opioid.
ML: What does it mean for you and this project to be nominated as a Change Maker, as someone making positive change for our future?
KD: This project is novel and creative; it’s pushing the envelope of what a health plan does, so I’m proud of that. I’m constantly talking to people about this. Now that I’m nominated maybe I’ll quiet down.
ML: (laughs) No, please never quiet down.
KD: I’m kidding! Because this is it, this is my life’s work.
ML: Do you have any advice for our HUBweek readers on how they can help spread awareness of the opioid crisis, and how they can help change attitudes around this particular issue?
KD: I thought it was so beautiful that you shared with me the pieces of the puzzle that you deal with. To me, this is how it needs to happen. If we can talk about it, not with the hushed tones or the moral blaming tone, the sooner we can problem solve about it and the better off we’ll be. It shouldn’t be a secret, stigmatized corner of the human condition. We’re losing thousands of people to overdose death. We need to be able to talk about it, engage about it, and problem-solve about it.
I’m looking to your generation to change this conversation around addiction as well. You guys have already done so much work as a group. And I’m not saying that people in their fifties aren’t making a difference; they are. But there’s a generational transformation around mental health that’s happening. The challenge, I would say, is can the younger generations make the same transition around the ordinary and deadly process of addiction, because this is common and serious.
ML: That’s excellent advice and I’m excited to share that with our readers.
KD: And you can do it! You can do it!
ML: (laughs) I know we can. When I was in high school, we didn’t talk about mental health. I’m 27 now so the amount of change I’ve seen in just 10 years is astounding.
KD: It’s happening! And it needs to happen in addiction too. Because these things are commonly occurring together. People have panic attacks and they use substances to self-medicate. There are people who are in psychological pain, who may be using opiates. So to me, the idea that they’re separate and distinct just isn’t true. This is a common area of human vulnerability that we need to do better with.
ML: To close out this interview, I wanted to ask what this year’s HUBweek theme, We the Future, means to you, and how you interpret it.
KD: We the future will enjoy a time when mental health and substance use vulnerabilities are as ordinary as blood pressure and diabetes. We’ll have a treatment system that’s as well organized as the medical one, and people will openly share this without a sense of shame or stigma. We have to do this, together.
The HUBweek Change Maker series showcases the most innovative minds in art, science, and technology making an impact in Boston and around the world.
