Episode 7
Behavioral health - why does it have to be so hard?
Why is behavioral health so impossibly hard to access, navigate, and survive—especially if you’re wired a bit differently? Maybe you’ve asked yourself that before. We have too.
Heck, we’ve made a whole business (and apparently, a whole podcast) out of asking exactly that: Why does it have to be so hard?
Welcome to “Different, Not Broken”—the podcast where bureaucratic tangles, soul-draining waitlists, and “bring your own magic decoder ring” healthcare red tape get ripped apart, re-examined, and (when possible) outsmarted.
I’m Lauren "L2" Howard and I can promise you this:
In this episode, I peel back the curtain and share how a simple (if stubbornly repeated) question—"Why does this have to be so difficult?"—became the engine for everything I do.
Clinical dead-ends? Check.
Six-month waits and insurance mazes for autism and ADHD care? Rechecked.
People winding up in the ER instead of finding someone who could actually help, before the crisis boiled over? Double-checked and regrettably, deeply familiar.
But what if you didn’t have to run that gauntlet?
What if someone just built a bridge?
When my team and I ran face-first into the “that’s impossible” wall, we started looking for secret doors.
Sometimes, all it took was radical honesty and a burning refusal to accept the status quo.
PLUS: In this week’s small talk, the community asks, “How do I answer, ‘Tell me about yourself?’ without feeling like I’m humble-bragging my way to nowhere?”
Hit that follow button, share with your friends, or drop us a note about your own impossible-seeming battle with the system.
Every listen helps us make it just a little less hard for the next person.
And if you need daily reminders that you’re good enough, weird enough, and human enough—even without a signed diagnosis? You know where to find us.
Let’s make behavioral health make sense… for all of us.
I'll talk to you as soon as you click play...
Timestamped summary
00:00 Access Barriers in Mental Health
04:32 Simplifying Crisis Care Access
07:19 Streamlining Adult Autism Testing
10:23 Streamlining Healthcare Processes
14:44 "Rethinking Autism Diagnosis Necessity"
17:11 "You Deserve Softness and Light"
20:17 "Championing Self-Accomplishment Over Stereotypes"
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Transcript
Most fields, I think healthcare especially, but also behavioral health within healthcare especially, tend to be mired with red tape.
Speaker A:And once you're in it, it can be really hard to see around it.
Speaker A:And one of the things that we have grappled with and I think have finally found our way to the other side of on the mental health side, is just stopping and asking, why does this have to be so hard?
Speaker A:And it's where most of our best solutions have come from, is how do we simplify this?
Speaker A:Why does this have to be so hard?
Speaker A:And we'll talk about that a little bit more.
Speaker A:Here we go.
Speaker A:I'm going to pretend I'm pushing record, because that feels right.
Speaker A:Okay, I'm pressing record.
Speaker A:Boop.
Speaker A:Hi, everybody.
Speaker A:I'm Lauren Howard.
Speaker A:I go by L2.
Speaker A:Yes, you can call me L2.
Speaker A:Everybody does.
Speaker A:It's a long story.
Speaker A:It's actually not that long a story, but we'll save it for another time.
Speaker A:Welcome to Different Not Broken, which is our podcast on exactly that.
Speaker A:That there are a lot of people in this world walking around feeling broken.
Speaker A:And the reality is you're just different, and that's fine.
Speaker A:We have four ground rules that I'll go through really quickly.
Speaker A:The first one is I'm gonna say fuck a lot.
Speaker A:It's just gonna happen.
Speaker A:There's gonna be lots of bad words.
Speaker A:I've got a potty mouth.
Speaker A:Second is, I tell stories about everything, and then my stories have stories, and then we end up like three miles away from where we started because the side quests are various and sundry.
Speaker A:Three, we're gonna tell dead dad jokes.
Speaker A:If those make you uncomfortable, please say hi to both of your living parents.
Speaker A:Four, anything that comes out of your face is appropriate here.
Speaker A:We do not police language.
Speaker A:We do not police access to feelings.
Speaker A:Whatever you feel, whatever responses you have, they are perfectly appropriate and welcome here.
Speaker A:You are not expected to change anything about yourself.
Speaker A:And we do not apologize for being human.
Speaker B:So.
Speaker A:We opened a mental health practice about a year ago, and this is my second mental health practice.
Speaker A:I ran a practice for about 10 years.
Speaker A:It was a different time.
Speaker A:It was in.
Speaker A: It actually was not in the: Speaker A:It was in the bodies.
Speaker A:But before telehealth really took off, before this idea of, like, fully virtual practices was a thing, even on a small scale, people were not doing fully virtual practices, at least much at that point.
Speaker A: ntroduced Telehealth in, like: Speaker A:We treated it as almost a loss leader.
Speaker A:Like, we have people who need to be seen.
Speaker A:And the problem is not that we don't have clinicians, it's that we don't have clinicians who are all in the same place at the same time.
Speaker A:And so in order to speed up the process of getting people to care, like, maybe we can use this telehealth thing, right?
Speaker A:And it was very effective.
Speaker A:And also, like, the number of people who were like, I think your malpractice insurance is not going to cover that.
Speaker A:And I was like, you don't think that was my first phone call just about malpractice insurance?
Speaker A:Like, do you think this is my first day on planet Earth?
Speaker A:And so we took a very similar approach then, which is like, it just doesn't have to be so difficult.
Speaker A:It does not have to be so hard to get to care.
Speaker A:Care, for the most part is so tied up in red tape that is representative of this much larger bureaucracy of healthcare.
Speaker A:When in reality, you should be able to find somebody who is capable of helping and get help for whatever.
Speaker A:I mean, it shouldn't be a matter of six months to get questions about why you have a stomachache, right?
Speaker A:Like, that should be the way it is across the board.
Speaker A:Now, it isn't that way in a lot of places.
Speaker A:But like, that should be it.
Speaker A:And so then, I mean, this again is more than 10 years ago, the situation that we were seeing was people who would end up in the emergency room rather than with us because they either didn't know we were there and didn't know where to go, and these were not people who needed to be hospitalized.
Speaker A:These are people who just needed to talk to somebody or find a place that could help them, whether they were in crisis for some reason, whether they were feeling severely depressed, where they were having thoughts of harming themselves, but no, you know, no plan or intent.
Speaker A:But they kept ending up in the emergency room.
Speaker A:And then the emergency room, after they were already there for several days, would send them to us.
Speaker A:And it was so backward because by the time they got to us, who they never needed to be in the emergency room to begin with, by the time they got to us, they were worse.
Speaker A:Because I don't know if you know this, the emergency room is not fun, especially if you are having some sort of mental health crisis.
Speaker A:And most people don't need to be there for mental illness.
Speaker A:And so people would get to us.
Speaker A:And the question we should have been asking was, how do we get them here first?
Speaker A:They shouldn't be going to the emergency room.
Speaker A:We need them to come to us.
Speaker A:First.
Speaker A:And so we partnered with some people in the community, and we started operating as an urgent care, and we started having patients look for mental health urgent care.
Speaker A:Finding us instead of your nearest emergency room, we made ourselves available.
Speaker A:We had a very small team who were willing to come in when appropriate if there were patients in crisis.
Speaker A:That meant sometimes we worked weekends, it meant sometimes we worked nights.
Speaker A:And it also meant we started using telehealth because sometimes it was just easier to, you know, get the provider on a video screen rather than waiting for one of 17,000 different solutions to fall into place where there were so many moving pieces.
Speaker A:The point being that that problem was fairly quickly fixed.
Speaker A:It didn't take us that long to build out that program because we took the approach that I don't think this has to be so difficult.
Speaker A:I understand why it is.
Speaker A:I understand how we got here, but maybe we can do something really simple and make it not that.
Speaker A:My dad always used to tell me that I didn't know that I couldn't do things until I'd already done them.
Speaker A:So it is not surprising that that attitude has followed me into whatever this phase of life is.
Speaker A:But, you know, we now have this very innovative program for autism assessments and ADHD assessments that is available through our mental health practice, available in all 50 states.
Speaker A:And it very much came from a similar place, which is the same thing keeps popping up.
Speaker A:Then it was patients are ending up in the emergency room when they just need to come to our office instead, or any office.
Speaker A:It didn't need to be our office.
Speaker A:It just needed to be an office who could help them.
Speaker A:We just happened to be the one that was willing to kind of figure out this program.
Speaker A:And this is very much the same thing.
Speaker A:We started dealing heavily with burnout.
Speaker A:We've talked about this before, and our primary topics that we were talking about through groups and mental health services were burnout, toxic work environments, workplace trauma, the overlap between those things and autism spectrum disorder, or suspected autism spectrum disorder.
Speaker A:Very high.
Speaker A:Very high.
Speaker A:And autistic burnout is a different beast all its own.
Speaker A:And so we would get people.
Speaker A:And I feel so fortunate that these people felt comfortable coming to our groups, because in hindsight like that, in and of itself, was a triumph that we ended up with so many neurodivergent people who were willing to just go talk to strangers on video on the Internet and find out where those resources were to get the assistance that they needed.
Speaker A:But we just had a lot of people coming to us after groups saying this was super helpful.
Speaker A:I.
Speaker A:The more I talked about this.
Speaker A:The more that I think that this is coming from what I think might be autism.
Speaker A:Can you help me find somebody who can do that assessment?
Speaker A:Our answer was always like, no.
Speaker A:I mean, we'd love to, but no.
Speaker A:Because there just aren't that many groups, there aren't that many people who offer this service.
Speaker A:It's complicated, it's expensive.
Speaker A:And it led to me doing what I always do, which is asking the question of, like, why does it have to be so difficult?
Speaker A:Why do I feel like we are failing our patients?
Speaker A:Because we can't offer a service that seems to be right in front of me.
Speaker A:I kept looking at it going, I feel like there's another way to do this.
Speaker A:What I kept finding, because we did try really hard to research different solutions in different states and facilities that would do the testing and individuals who would do the testing.
Speaker A:And what we found was it was very hard to find anybody who did testing for adults.
Speaker A:There were some, but they were very rare.
Speaker A:Most people focused on kids, and that makes sense.
Speaker A:But still we changed the guidelines for or the criteria for Autism Spectrum disorder when the DSM 5 came out, and that meant that there were a lot more people who met the criteria for what was this now expanded version of autism who always met the criteria for something.
Speaker A:To be very clear, they always met the criteria for something.
Speaker A:We just didn't intervene a lot.
Speaker A:In previous generations, we let kids be quirky and uncomfortable, and that caused a considerable amount of trauma for a lot of people.
Speaker A:Point being, though, we changed the criteria but didn't make services available to all of these people who were now technically autistic.
Speaker A:And so there's this whole world of adults who are just coming around to this idea that, like, hey, maybe my brain works differently for a reason.
Speaker A:Maybe I'm not just an oddball.
Speaker A:And first off, you're allowed to be an oddball, and being an oddball is great.
Speaker A:And second off, your brain working different is not a problem.
Speaker A:It may need to be supported, but it is not a problem.
Speaker A:Different is not broken.
Speaker A:Funny how that works.
Speaker A:But our patients, again, they just.
Speaker A:It kept coming up.
Speaker A:I mean, over and over, it kept coming up, and we would reach out and find people, and they were either booked out for a year or they didn't see adults.
Speaker A:The testing that was available for adults, not great.
Speaker A:It was basically modified versions of measures that were targeted toward children.
Speaker A:And if you look into the research behind all of those, the research shows that they are targeted toward young white males.
Speaker A:So, like, 80% of the population is not even considered in a lot of the testing that's there.
Speaker A:And then more than that, there is this incredible emphasis on testing, which is a.
Speaker A:I get it.
Speaker A:I understand we need clinical data.
Speaker A:We want as much clinical data as we can possibly get.
Speaker A:But the emphasis is not on clinical skill or clinical expertise, which is important.
Speaker A:It's so important.
Speaker A:It's the most important part of this.
Speaker A:The testing does not make a diagnosis.
Speaker A:The clinician makes a diagnosis.
Speaker A:And so, of course, I feel like I'm drowning in data.
Speaker A:And all of these different problems that clearly I did not unearth, they were well documented before, but I felt like I had stumbled upon this thing that it was absolutely on me to fix.
Speaker A:Welcome to my brain.
Speaker A:I just kept saying it over and over, this.
Speaker A:I don't think this needs to be this hard.
Speaker A:I don't think this needs to be this hard.
Speaker A:We are very fortunate that we have some clinical advisors from a number of different institutions.
Speaker A:And I spoke to a bunch of them, and I will never forget talking to one of them and saying, like, am I oversimplifying this?
Speaker A:Like, am I making a very, very simple solution out of what is a very complex problem because I don't know what I'm doing, or is this correct?
Speaker A:I said, I feel like we could simplify this process a whole lot by removing some of the kind of bureaucracy in the paperwork in the process.
Speaker A:And our advisor said, oh, you're right, you can definitely do it, but you're going to make a lot of people mad.
Speaker A:And I kind of went, yeah, I don't think that's a deterrent for me.
Speaker A:I feel like it should be, but it's not.
Speaker A:And so I went to my clinical team and said, figure out how to build it.
Speaker A:And it took them a little while, but they came back with this thing that we then put in front of all the powers that be and contacted a whole lot of psychologists and said, hey, do you want to come do this thing?
Speaker A:It has not been without criticism, to be honest.
Speaker A:I mean, there's an old guard for a reason.
Speaker A:They've been around a long time.
Speaker A:Some of them are not super sure about this quirky, innovative new way of doing things.
Speaker A:But the number of people who have just been on board because this is a thing that somebody needed to do has blown my mind.
Speaker A:And I still look around every day going, this is ours.
Speaker A:We get to do this.
Speaker A:We get to work with these people who are magical and wonderful and special and just need to be told that they are all of those things.
Speaker A:And it all came from this idea of why is it that there is a human in this world who says, I think I need help, I think I need support.
Speaker A:And the answer is, okay, well, first dig through and find the needle in this haystack to find the three providers in your community who do these services.
Speaker A:Once you find one of them, find one of them that takes your insurance.
Speaker A:If none of them take your insurance, find one of them who you can afford.
Speaker A:If you can find one that you can afford, get on their schedule.
Speaker A:If you can do that, wait the year then if you could do that, sit down for 8 to 12 hours of testing to answer questions about things that you don't necessarily understand on paper.
Speaker A:Questions that are often binary states that do not align with how neurodivergent brains work.
Speaker A:I understand that you're here because you struggle with executive function, so please sit still for 12 hours.
Speaker A:That makes sense.
Speaker A:And when you're done with that, we will make an assessment based on guidelines and criteria that don't think that women and non binary people exist.
Speaker A:That all sounds like a winning situation.
Speaker A:Right?
Speaker A:And I don't say that to be critical of the way it has historically been done.
Speaker A:We need full neuropsychological batteries.
Speaker A:We need the ability for somebody to sit for those eight to 12 hours of testing, if that's what it is.
Speaker A:I've seen people who do it in three or two.
Speaker A:I've seen people who do it in 16, so it could be either end of that.
Speaker A:That is not to be negative toward those individuals.
Speaker A:It's certainly not to be negative toward their wait times.
Speaker A:Those wait times, like they come around honestly, it's because they only have so many people who can do these assessments and they take time.
Speaker A:What they charge is commensurate with the amount of time that they spend.
Speaker A:I have not seen a lot of people who are charging something that I feel like is just an exorbitant amount for very little work.
Speaker A:That is not anything that I've seen in this field.
Speaker A:I've seen people who put in a lot of hours and a lot of assessment and a lot of time writing reports and all of that is very expensive.
Speaker A:We need those services the way that they are.
Speaker A:But people are still struggling and they still want answers about their brains and they still want to feel like maybe there's a reason why they're wired the way they are and it didn't have to be so hard to get them that answer.
Speaker A:And then on the other side of that, to get them really basic supports that are just not available for Adults at all.
Speaker A:At all.
Speaker A:They are not available for adults.
Speaker A:I always want to say this though, when we talk about our diagnostic programs and access to diagnosis and the importance of diagnosis.
Speaker A:Like if you feel like you need an autism diagnosis or you feel like it might be something that is applies to you, you know, you've read about it, you've researched it, which you all have, and you think it's important to you, great self diagnosis is valid for a number of reasons, one of which including, you know, your brain.
Speaker A:I literally run a company where we do assessments for autism every day and it is the bulk of our income.
Speaker A:And I am telling you that if an evaluation would not change your life in some positive way, if getting that official diagnosis would not make your life better, would not get you access to accommodations, would not get you access to support structures or support services, skip it, right?
Speaker A:If it's not going to make your life better, if it's not going to change the way you operate, if you don't need validation from a clinician, which a lot of people do, a lot of people really want that, save your money.
Speaker A:There are other ways that we can support you, that other organizations can support you that are much less expensive than going through a full evaluation.
Speaker A:On top of that, one of the reasons that people, and they say this to us all the time, and I think I've said this before, but I'm going to say it again.
Speaker A:One of the reasons that people come to us to see if their diagnosis or their self diagnosis is correct and it sometimes it isn't, to be honest, sometimes it isn't, is because they feel like if they talk to a clinician and that clinician confirms that they have whatever diagnosis they think they have, that they will have permission to be nicer to themselves.
Speaker A:That's bullshit.
Speaker A:You do not need permission.
Speaker A:You do not need somebody else to make it okay.
Speaker A:You do not need anything other than the fact that you are supposed to be nice to yourself as the reason to be nice to yourself.
Speaker A:If you feel like the benefit that you are going to get from an assessment is that now you don't have to be your own bully, you don't need an assessment.
Speaker A:You are allowed to be nice to yourself.
Speaker A:You are allowed to give yourself grace.
Speaker A:You deserve softness, you deserve light, you deserve all of it.
Speaker A:Whether you have an official diagnosis or not, whether it's autism or not, whether it's a purple spotted unicorn or not, it doesn't matter.
Speaker A:The reason to get an assessment is because there's some tools, resources, there is guidance there's explanation, there's descriptions that you want.
Speaker A:You better understand the sensory processing parts of your brain so that you can make better decisions about how to handle situations and what to avoid.
Speaker A:All of that perfectly valid, 100%, a diagnosis should not be the reason why you grant yourself grace and humanity.
Speaker A:You deserve that regardless.
Speaker A:And if I need to say that to you every day for the rest of your life for you to believe it, I will literally, you could just like, replay this.
Speaker A:But also, I will actually just say it to you, too.
Speaker A:That's fine.
Speaker A:I can just, like, send you a voice note every morning.
Speaker A:That's fine.
Speaker A:It doesn't have to be so hard.
Speaker A:That's how we built this program.
Speaker A:That's how we build all of our programs.
Speaker A:How do we make this the most accessible thing we can to as many people as possible without giving them 10,000 hoops to jump through just to exist?
Speaker A:And also, if you are jumping through those hoops just because you want to know that you are worthy of kindness, skip the hoops.
Speaker A:Doesn't have to be that difficult.
Speaker A:You are worthy of kindness.
Speaker A:Okay, so for this week's small talk again, remember, this is something we do every week.
Speaker A:And now with this week's question from our community, here's Alison.
Speaker B:All right, so this first question that we have is how to answer tell me about yourself in a way that can be used to break the ice in a networking situation or job interview and feels natural and not boasting.
Speaker A:So I think there's the way people expect me to answer this question, and then there's the way that I'm actually going to answer this question.
Speaker A:My advice is answer or respond to situations like that with the confidence of a mediocre white male.
Speaker A:You could worry about boasting or you could not because they don't.
Speaker A:And just be honest about who you are.
Speaker A:And odds are the person you're talking to will appreciate it.
Speaker A:So if somebody comes up to me and says, hi, I'm Fred, tell me about yourself, I'll say, hi, I'm Elle, too.
Speaker A:I'm the CEO of LB Health.
Speaker A:We're a 50 state mental health company.
Speaker A:We developed a assessment for adult autism that has significantly reduced time to care in our community.
Speaker A:And I love what I do and I'd love to know more about you.
Speaker A:Was that bragging?
Speaker A:Maybe a little, probably.
Speaker A:But also, like, it was honest, it was true.
Speaker A:I can back it all up with information and details.
Speaker A:And they're probably going to have questions about what I said because I just said a bunch of Stuff that nobody expected.
Speaker A:Nobody who doesn't know me expected.
Speaker A:Like, nobody thinks that that's going to be the next thing that comes out of my mouth.
Speaker A:I was at a conference not that long ago, and afterward I was kind of small talking with this lady.
Speaker A:And I had just done the conference as the CEO of my company, where I stood on stage and as an expert, talked about the things that I know that led us to founding our company.
Speaker A:And the first question this woman had for me was, what does your husband do?
Speaker A:And I said, he ironed my suit jacket before I got here.
Speaker A:That is what he did that day.
Speaker A:So, first off, I think you need to worry less about bragging because talking about your accomplishments is not bragging.
Speaker A:You're not saying, I'm the best vice president of sales in the whole country and maybe even the world.
Speaker A:I checked on the galaxy.
Speaker A:I'm like number three.
Speaker A:That's not what you're saying.
Speaker A:You're saying, this is my job.
Speaker A:I really enjoy it.
Speaker A:I also go to school part time.
Speaker A:I'm a parent or I am a caretaker for someone, or in my free time, I really like Formula one racing or whatever.
Speaker A:And it's very.
Speaker A:It's direct.
Speaker A:Nobody is expecting you to be humble when you're literally telling them who you are.
Speaker A:But also, anyone who is going to think you are not humble enough when you tell them who you are is probably not somebody you want to be talking to.
Speaker A:Go find somebody else to network with.
Speaker A:Thanks for being here, guys.
Speaker A:Have a good day.
Speaker A:Love you.
Speaker A:Mean it.
Speaker A:There are people in this world who don't like Tom Hanks, and he's the most likable person on the planet and has never done anything wrong.
Speaker A:And I was like, now there are also people in this world who don't like Henry Winkler, also the most likable person on the planet.
Speaker A:Also played one of the most iconic characters in TV history.
Speaker A:They don't like each other.
Speaker A:So, like the world's most famous, most beloved dad and the world's most famous Jewish mobster, I don't know.
Speaker A:They don't like each other.
