A long driveway cuts through a peaceful, almost bucolic, 53 acres in Mason. A visitor passes a thicket of trees, an old barn on the left, and then, around the final turn, a building emerges that looks like a cross between a medical facility and a newish ski lodge.
It is, in fact, the Lindner Center of Hope and Dr. Paul Crosby greets you in the lobby. Crosby is the president and chief executive officer of the center, and he has worked his entire career in the mental health field – a specialty known for slow progress and deep frustration. Just getting a diagnosis right, literally the first meaningful step, can take years and years.
But decades into his career, Crosby has an unshakeable belief in the work he is doing. “People do get better,” he said. “Everybody can improve.”
There are 80 beds at the center for patients to stay at the facility, but teams at Lindner see an additional 200 to 250 patients a day through outpatient care.
The Lindner Center of Hope opened in 2008 because of the passion of Craig and Frances Lindner. Craig is the co-CEO of American Financial Group and a member of the Lindner family long associated with United Dairy Farmers, the Cincinnati Reds and American Financial Group. Despite nearly unlimited resources, Craig and Frances have been affected by the mental health issues of friends and loved ones just like everyone else. They decided to do something about it.
“Frances and I felt called to do something about the serious lack of quality mental healthcare in our nation,” Craig said. “The lives of our loved ones and friends have been touched by mental illness. We witnessed how devastating it can be if the illness goes untreated, and also witnessed how healthy, productive lives can be restored with the proper diagnosis and treatment.”
That commitment involved donating a lot of money to the center, convincing people how important the work is and how prevalent the problem is. “An estimated one of every four people face mental health issues at some point in their life,” Craig said. “But only a fraction receive the care they need.”
There is no denying the need. When the center opened, it was the first stand-alone psychiatric facility to open in more than 35 years in this country, according to Crosby. “The Lindners knew that care could be better, and it could be closer. They wanted to participate in the conversation of making care better.”
The center focuses on mood disorders, eating disorders, anxiety disorders, obsessive-compulsive disorders, addiction and, frequently, co-occurring psychiatric disorders.
Crosby was named head of the Lindner Center of Hope in July 2021, but he has been a member of the medical staff of the center since it opened. He is only the second CEO at the facility, replacing Dr. Paul Keck, who was there from day one.
Crosby’s expertise is providing psychiatric care to children and families, particularly in the assessment and treatment of ADHD and the conditions that frequently accompany it, such as anxiety disorders, mood disorders, learning disabilities and substance abuse disorders.
But much of his work is cultural, as he tries to reduce the stigma associated with mental illnesses. This is almost always relevant when Crosby is working with a child or young adult and his or her parents. And mental illness frequently visits the young. The American Psychiatry Association says that 50 percent of mental illnesses begin by age 14, and 75 percent of cases begin by age 24.
Many of those young people are confused and frightened. They have a condition they do not fully understand. The parents feel the same way and they feel guilt. Crosby starts reminding them of important facts from the very beginning. He relies on a handful of truths to help people stop feeling guilty and start getting ready to work.
“It’s a physical illness,” Crosby tells patients and their families. “It is not willpower, and it is not bad parenting.” He also reminds them that they are not alone. “There are a lot of really sick people.”
So many, in fact, that Crosby keeps adding staff. There are now 65 medical personnel at the center, including psychiatrists, nurse practitioners and therapists. Twenty of them have been hired in the past year, trying to keep up with an increase in demand since the start of the COVID-19 pandemic laid bare so much suffering. “Mental health workers are the ‘last responders’ of the pandemic,” he said.
While COVID-19 will never be considered a good thing, it has brought the topic of mental health to the forefront. The pandemic was too pervasive, and the consequences too dire, for people to ignore. Especially when so much of the suffering landed on school-age children who were stripped of their routines. It was suddenly time for people to move mental health to the front burner.
“America is not good about talking about this,” Crosby said. “Mental health is threatening.”
One group, however, is more willing to talk about how they are feeling and what needs to be done about it. “Younger people are far more comfortable talking about mental health,” Crosby said. He finds that development “wonderful and inspiring.”
And necessary. Crosby acknowledges that mental health is legitimately hard for people to talk about. He does not think that’s because they don’t care. It is more complicated than that. It is, he said, an “authenticity paradox.”
People know how debilitating mental illness can be, that it can affect anybody, and they know it is deeply unfair. Rather than building empathy or concern, however, this leaves people frightened. They respond to that fear by trying to believe that people with mental illness somehow did something wrong, or that perhaps they are just not strong enough to handle it. Instead of talking it through, people choose to simply ignore it. Or avoid it, anyway.
But this problem is not going to go away; it is pervasive. Somewhere between one in four and one in five people will experience a diagnosable mental illness. Some situations, of course, are less urgent than others. It is often the most dire cases that walk through the door at the Lindner Center of Hope, which has seen patients from all 50 states and 10 foreign countries.
“We spend a lot of time on complex comorbidities,” Crosby said. This means many patients are living with not one, but two or more different mental illnesses. Sometimes they are related, sometimes not. Sometimes one treatment will help trigger healthy responses in all the different illnesses, sometimes each has to be treated distinctly.
And there are no scans or X-rays to help get the diagnosis right. Crosby notes that many patients who end up in his facility have been undiagnosed or misdiagnosed for a decade or more. It would be difficult to overstate how cataclysmic this can be for a patient or his or her family.
“Mental health affects every decision you make in your entire life,” Crosby said. So when a new patient arrives, the first step is diagnosis. This can be tricky, but it is doable. Even without scans and blood tests to pinpoint the problem.
“We are not technological, but we are not unsophisticated.
Our tools are our eyes and our ears and our time.” – Dr. Paul Crosby
Craig Lindner has complete confidence in Crosby as both a doctor and the person running the center. Treating mental health is complicated, and insurance companies can be slow to catch up to it, which often means being slow to approve treatments or to pay for them.
“We are blessed to have Paul Crosby as the leader at The Lindner Center of Hope. He is a gifted clinician who is well respected by his peers,” Lindner said. “Paul also has a very good business mind. This is critically important given the financial challenges that result from very poor reimbursements for mental healthcare. Our goal is to provide the highest quality of care, and also have a sustainable business.”
Crosby says the Lindner Center of Hope is enhanced by its partnership with UC Health and its affiliation with the University of Cincinnati College of Medicine. All of the work at the center is also informed by the fact that it contains a research institute. The goal of research is to inform patient care in the short term with the latest information, and in the longer term by shortening the period of time between research and actual application. “We have to shorten the gap between theory and practice,” Crosby said. “It can take years.”
The annual budget of the center is roughly $40 million, and it all goes to the goal of “trying to make you feel like yourself again.” It is a simple mission, but not one easy to achieve. The Lindner Center of Hope treats people who have often been looking for answers for years. They arrive frustrated, wary and desperate for help.
Crosby is not daunted by the experience. This is all he has ever done since graduating from the UC College of Medicine. He focused on young people at least in part because getting them to “feel like themselves again” will change their lives and the lives of the people they love. Crosby understands this as a scientist, as a doctor and as a father of six children.
“If you treat a kid, that is so rewarding. But it is not just the kid,” Crosby said. “There are so many ripples. You are helping their parents, their siblings, everyone in their life, and everyone who will be in their life. It is nearly immeasurable.”