Dennis "Denny" Morrison, PhD - Chief Clinical Officer, Eleos Health

What does responsible AI actually look like in behavioral health?

In this episode of Tim Talks: Behavioral Health, Timothy Zercher sits down with Dennis "Denny" Morrison, PhD, Chief Clinical Officer at Eleos Health, to explore how AI can reduce the burden on clinicians without replacing the human side of care.

Denny shares his journey from aspiring musician to behavioral health leader, why ambient AI is one of the most promising technologies he has seen in his career, and how organizations can use technology to help clinicians focus on what only they can do.

They also discuss leadership, changing organizational culture, attracting and retaining great clinicians, and the risks of using general-purpose AI tools as substitutes for purpose-built behavioral health technology.

It’s a practical conversation about using AI to strengthen care, not replace it.

Transcript

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Timothy Zercher 0:00

Denny, thank you so much for joining us. We really appreciate you taking time. You met Tim. Glad to be here. Absolutely. Looking back, what first inspired you to dedicate your career to behavioral health? Because you've had a pretty illustrious career in behavioral health.

Denny Morrison 0:13

Or notorious, depending on how you look at it. True. No, I actually I started college as a music major, and it took one quarter to find out I wasn't quite the drummer I thought I was. And I changed as one does when you're a music major, I changed to chemistry, which, believe it or not, was better. But I really didn't know what I wanted to do. And I put myself through college, and one of the ways I did that was I got a job working in a local hospital, and they placed me on the psychiatric unit as an orderly. And that was an eye-opener for me. I mean, I've never seen people behave like that. We saw everything from depression, mild depression, to full-on schizophrenia, psychosis. And I just was amazed by it and curious and switched to psychology and got a psych and pre-med major and chemistry minor, and just that's what kicked it off. So that's how I got into this.

Timothy Zercher 1:04

That's cool. That's cool. I think a lot of people end up in in behavioral health on accident, but yours is a farther departure from where you started for sure. Certainly was, yeah. Yeah. F from drummer to doctor. That that could be your the name of your book. Yeah, I like that. Yeah, it's not bad. It's not bad. So you've spent decades now helping shape behavioral health technology. What innovation today excites you the most in life?

Denny Morrison 1:30

Well, unless you're living under a rock, AI has gotten popular. And I think that's probably the one that is excites me the most. As a recovering clinician, I think AI for clinicians is really the most exciting thing that's happening right now, particularly with ambient listening for the helping them do their jobs. In this industry, we have seen every form of technology that's been introduced in this industry, especially electronic health records, promised to help clinicians' jobs get easier. And they never did. But AI, ambient listening AI for individual group medication management, psychotherapy sessions, is doing that. I mean, the data's clear, it is helping. And so to me, seeing clinicians who were just overburdened to begin with documentation requirements, particularly in the community behavioral health side, they seeing them get relief from that and to be able to do what only they can do, which is to provide treatment and not worry about the documentation burden that they have to face is to me one of the most exciting things I've experienced in my career.

Timothy Zercher 2:34

Absolutely. Absolutely. And you've often said technology should strengthen care, not replace it. What do you think most organizations are still getting wrong about AI and behavioral health?

Denny Morrison 2:44

Well, there's still that worry that we saw really in all sectors. Will AI take my job, for example? Still see some of that, a little less, but still some. People have ethical concerns about AI. It was largely centered around the data center problem, which it is a problem, there's no question. But the reality is that the usage of AI like ambient listening or really anything, Facebook, Chat GPT, any of those things, the usage of those things isn't what's driving the build in data centers. It's the training models that have to have all that capacity. And so when I when we talk to people who try to point to data centers as a reason not to use ambient listening AI for their psychotherapy sessions, I say that's a personal choice. And I understand that. First recognize that that will likely be symbolic more than anything. But does that also mean that you'll stop using GPS, Facebook, Amazon, all the other online tools that we use, which you have been using AI for many years now? I mean, you Amazon provides you with suggestions of what to buy because you you bought a kayak and you now might want some ores or something. And no, I know it's listening to me, so I'll probably get an ad for kayak here in a minute. But now, yeah. But that is an AI engine on the back end. And so if you're going to be ethical about this, then you should eliminate all of those from your lives, not just I am listening for AI.

Timothy Zercher 4:12

Yeah. I think it makes complete sense. And I think that is a it is such a common pushback, the data centers and they're using our water and our energy and all those things. And I think that's definitely a significant issue. But I've had very similar conversations with my team. It's like, yep, absolutely. It's definitely a problem. Yeah. And we can't stop using everything online. And if we can't stop ever using everything, then we better start being smart about what we are using.

Denny Morrison 4:33

And I think that I've seen some good kind of movement on that with the data center problem where Microsoft, I think, came out with a five-point program where they say we will assure that we pay for all the energy we use. We will do everything responsible. They do all the right things. And we're seeing some legislation starting to be introduced that says that a data center has to replace, they have to create more electricity than they use. And so we're starting to see some action on that front. So it's not, I'm not as pessimistic as I was for a while. There actually, my son and daughter-in-law live in a location where they're looking at getting a data center nearby and they're going to protests and all those kind of things. And I get it. I don't blame them.

Timothy Zercher 5:12

Yeah, absolutely. Absolutely. I do think that like all things, the first phase of expansion is always the messiest and the worst for the environment and the worst for people. And mostly things level out eventually. Shifting topics a little bit into some of your leadership experience. What have you found is the hardest part of growing your team?

Denny Morrison 5:32

Yeah, I was a CEO for 17 years. And in my current role, I'm a solo practitioner. But so I call upon those experiences back when I was in the leadership roles. And I think, you know, there's a lot of things about that. One is kind of changing culture. Culture is the hardest thing to change in an organization. And then I think there's that balance, particularly at the senior level, between doing leadership in a way that engages others and that you have a participatory and actually even somewhat antagonistic set of advisors, people who will give you disparate opinions about things, but at the end of the day, it's not a democracy, and somebody has to make the final call, and that is the CEO, and that's what you're getting paid for. And so, from my perspective, I always believe that there should, I should never get a decision across my desk that's a black and white decision. That should have been already made by somebody else. Every decision I ever made was shades of gray and required a judgment call of some kind. And that's the way it should be. When I inherited my organization, my predecessor was the exact opposite. He signed everything. And I was getting five dollar chits to sign off on so somebody could get lunch. We're not doing that here anymore. That's not quite what they hired me to do, is to sign off on a $5 lunch chit. And that that was a that's what that was a cultural change that required a huge amount of communication internally. We had quarterly all staff meetings where anything was fodder for conversation. And when people said we don't like that you're doing that, I said, I am open, give me alternatives. If you have them, I'm but you can't just say I don't want to do that without giving me a constructive alternative that is realistic. So there's lots that we could talk about in terms of leadership. But I think that that issue of engaging others to be part of the decision, but also being ready as a CEO, particularly, to be able to say, thank you for your input, but I'm not we're gonna go a different direction. You have to be able to do that. That's part of it.

Timothy Zercher 7:30

Absolutely. That is the hard part of the job of why CEOs get paid the most in most organizations. You have to make that hard call.

Denny Morrison 7:37

As a consultant, I've been in organizations and it's been just incredible to me that people, the leadership that doesn't do that. It's like I used to think of organizations, particularly in the community behavioral health space, as being mom and pop shops at one end and the large sophisticated organizations. Now I think of it as the large organizations, sophisticated. And how in the heck are you still in business, folks? Because they're doing things. It's like, and largely it's the leader who doesn't want to take the leadership role and do the things that all the leaders can do. That's kind of the job of leadership. Do your job, make hard calls. So yeah, we could have a long conversation about that.

Timothy Zercher 8:12

Absolutely. And to go just a little farther, I think a lot of the a lot of the time where the mistake is in leadership is it's your job to make the hard call, to make the decision, and to know when you don't need to make the decision. To make the decision to trust your team to make decisions for you. I think that's probably the scariest place for most leaders. That's like the final boss to conquer, is now passing that responsibility on, but knowing you're still responsible. If your team makes a mistake, it's still on you, even though it wasn't your decision.

Denny Morrison 8:40

Well, and it's interesting you mentioned that because I think that ties together what we were talking about previously, that the whole goal of augmented intelligence is to help clinicians do what only they can do and to get the other stuff off their desk, knowing that they are still responsible for it. And it's exactly the same process and leadership that if you were working for me, I have to say I have to trust that Tim can do his job and you contact me if you want some help. But but that's why I hired you to do your job. I should not know how to do your job better than you know how to do your job. I can help you, but that it shouldn't be that way. But that's I think that is one of the concerns that a lot of clinicians have about the idea that a good AI does not write the note for you. A good AI provides suggestions and ideas, insights that you may not have noticed, and you decide what goes in there, what does not go in there. But at the end of the day, it is the clinician, when they sign that clinical note, they are attesting to the fact that note is accurate and it represents what happened in that session. And that that I think a lot of clinicians, until they see how AIs should work, they tend to think, okay, this thing's sort of write my note for me and I'm not comfortable with that. No, it doesn't write your note for you. It gives you help so you can write the note faster, easier, better. But your point is exactly right. It's like the whole goal of this is to help people work at the top end of their license or at their jobs and get the detritus off of their desks.

Timothy Zercher 10:08

Absolutely. Exactly. So shifting topics to the last time here, since we're a marketing agency that works in this space, we always ask a couple of marketing type questions. And because you've had so many roles, I'm sure you have some good perspectives on it. But what have you found works best when it comes to acquiring talent, especially outside of word of mouth? What works best to attract good talent to an organization?

Denny Morrison 10:28

Generically, I think if you create an environment that is attractive and that you clearly are helping people do their jobs better. I always thought my job was to help people do their jobs and to get barriers out of their way. It wasn't to fix things, but it was just to remove barriers they could not remove. But I think the culture has a lot to do with it. I mean, we meant word of mouth is still one of the primary ways in which people engage in organizations. On a more specific level, what we're seeing now is that people are using, in the case of Ilios, for example, where that I consult to, organizations are now using the fact that they're using Elios as a differentiator when they recruit. So they can go out and say, you know how hard it is to write your notes at your current organization? We've got a tool that can help you expedite that. And because there's a networking among clinicians, somebody will call a friend who works there and say, is that true? Is that hype or is that really true? And no, that's true. And it really does help literally to the point where we have heard on many occasions clinicians who have told their bosses, if you get rid of this AI tool, I'm leaving. Because it's helped them that much in their in their work. So people are using it as a differentiator in recruitment right now. I love that.

Timothy Zercher 11:42

I love it. That's a strong case for the service. Last question then is what is one marketing tactic or strategy that you or your team is either watching or just considering in the marketplace right now?

Denny Morrison 11:55

Well, I don't know that we're there's any one that we're looking at to implement. There's one particular one, though, that's really got me worried. And that is, like every technology, you mentioned this, once it gets going, there's buzz and then there's knockoffs, and there's all kinds of things. And one of the things I'm one of the things I'm really concerned about is organizations, vendors that are bringing a generic AI like ChatGPT or something off the shelf that you and I would use for our kind of day-to-day work, putting a psychological wrapper around that and selling it as a psychology-related AI, when in fact it's nothing but ChatGPT or Claude or Perplexy or something on the back end, and they just put some kind of wrapper around it. That to me is worrisome because we know that, for example, ChatGTV chat was their large language model was trained on something between 16 and 30 percent of vetted content, books, magazines, and things like that, which many of them are being sued for copyright infringement, but that's another story. But the rest of it was just scraped from the internet. And that's why you and I can log into one of those off-the-shelf tools and ask it a general question. And it's very good because it's pulled information, but it's not psychotherapy, it's not what it's not what it's created for. It's a little bit like asking Siri to interpret an x-ray. Siri does a lot of fun things and it can be very helpful. That ain't one of them. And it's the same thing here where, you know, people they conflate just general conversation and interactions. That's the same as psychotherapy. And, you know, in AIs, their base models are trained to be sycophantic. They're trained to keep you engaged and to tell you what you want to hear. Well, that's caused a lot of problems, particularly for kids and adolescents who are using these off-the-shelf tools as a quasi-therapist. And there are many cases of kids who've committed suicide in concert while they're in conversation with these AIs, and they do nothing to refer them to 988 or to get them involved in some kind of crisis prevention or to dissuade them from thinking about committing suicide. So those are probably the biggest things that I see the idea of using AI in general in a way that it wasn't meant to be used for.

Timothy Zercher 14:08

Absolutely. I appreciate that. I appreciate your insights. I appreciate you taking time out of your day for us. Thank you, and thank you for the work that you're doing in your community.

Denny Morrison 14:16

You bet. Thanks, Tim. Glad to be here.