The Need to Think Differently

Speech

One Mind Initiative at Work

Chancellor Block’s prepared remarks:

Thank you, Garen, for that kind introduction. Thank you as well for your guidance and support — and your leadership — in the urgent quests to understand the workings of the human brain and to address the assorted conditions related to it.

You have pulled together an impressive group for this conference. The breadth of expertise in this room is remarkable. I appreciate the significant contributions so many of today’s participants have made in a field that influences my work — both as a scientist and as UCLA’s chancellor.

Before I move forward, let me pause to note that, when it comes to matters of the brain, the lexicon is always evolving along with our understanding of the science.

Over the decades, in an effort to reduce stigma and find more accurate descriptors, we have abandoned terms like “asylum” and “psych ward.” Today, we speak about “mental health care,” which has been replaced in many quarters by the term “behavioral health.”

Now, the labyrinth of brain-related conditions and treatments is being described as “brain health” — terminology that I believe better acknowledges the relationship between the functioning of the brain and human health, in all of its dimensions.

As you all know, brain science is extremely complex. It poses arguably the greatest experimental and theoretical challenges of any field of contemporary science.

Consider what’s involved:

The interactions between genes and their products… the biophysical and metabolic regulation and control of electrically excitable cell membranes, functioning under non-equilibrium conditions… the interplay of electrical and chemical signaling between neurons… and all of the external factors that impact brain function.

Let me tell you how I came to appreciate this complexity.

Many years ago, while a postdoctoral fellow in Don Kennedy’s laboratory at Stanford, I spent time working on the tail-flip escape response of the crayfish.

This is the reaction that allows crayfish to escape predators by vigorously flexing their abdominal muscles to pump their tails to dart backward in the water.

Our goal was not to build a better swim team at Stanford!

It was to understand a simple network — how the movement of a sensory hair on the crayfish’s tail fan activated neurons, causing a giant nerve fiber to fire which, in turn, produced a massive muscle contraction.

We wanted to better understand, at a neuron-by-neuron level, how the nervous system controls very simple behavioral acts. But along the way, I noticed that voluntary movements by the crayfish also stimulated sensory hairs on the tail. Mysteriously enough, these stimulations did not result in a tail flip.

It turned out that the crayfish brain generated signals about voluntary intent that neutralized the signals being sent by the sensory hairs. This is how a crayfish avoids tail flipping when going about its day-to-day crayfish business.

For a young scientist, this was a demonstration that there’s nothing … not a single thing … that is simple about brain-controlled behaviors. And I have respected the brain’s complexity ever since.

Today’s research holds tremendous promise. We have made great progress already in understanding brain function and behavior controlled by specific regions of the brain. At the same time, our knowledge of other brain phenomena, such as memory and higher cognitive functioning, remains incomplete.

Clearly, what is most critical for us here today is converting this exciting research into more effective methods for detecting, treating and preventing abnormalities in brain health.

This is not merely a great challenge. It is a human challenge — one that knows no borders.

Addressing that challenge begins with people like you, engaged in discussions like those we’ll have today.

I’d like to use my remaining time today to tell you how UCLA fits into the broader discussion of brain health. As a public research university — and each of those words has meaning — UCLA sits at a crossroads.

So many of the scientific and societal questions raised by brain health — and tremendous hope for resolving them — can be found on our campus … in our dorms, in our laboratories, and in our hospitals.

To an extent, the same can be said for each of our nation’s premier research universities. But I’ll stick to the campus I know best.

Our 45,000 students — who are some of the brightest young minds in the world are all highly motivated. Some of them are highly stressed. And most of them come to campus at an age when symptoms related to brain conditions can begin to surface.

You might have seen the Frank Bruni column in the New York Times two Sundays ago about the loneliness that can overwhelm new college students. Bruni called it a “real campus scourge,” quote-unquote. He’s not wrong. And he wrote about what UCLA and other campuses are doing to combat it.

UCLA is a city within a city. We employ more than 40,000 people — plumbers, chefs, playwrights, accountants, astronomers, engineers…you name it. Our employees are just as likely to experience brain health issues as our students.

We treat all manner of brain conditions at our network of clinics and hospitals, which includes a 74-bed acute psychiatric hospital. This work both informs, and is informed by, UCLA research.

And research, in all disciplines, defines UCLA.

My own scientific work has evolved from crayfish to focus on circadian biology — the brain’s control of rhythmic behaviors, including sleep.

Perhaps not surprisingly, it turns out that changes in sleep behavior, especially insomnia, can be an early indicator of depression and several neurodegenerative diseases.

In addition, a lack of adequate sleep affects brain health, and it can impact the severity of depression. This creates the possibility for a feedback loop. Poor sleep increases the severity of depression, which leads to insomnia and more depression.

But we still don’t fully understand the complex relationship between sleep and depression. Curiously, complete sleep deprivation for a night can be effective in the short term for reducing depression symptoms. This may be because sleep deprivation brings about increased levels of adenosine.

If we can figure out the underlying neurochemistry of that process, we may be able to develop pharmacological treatments that relieve symptoms of depression but without sleep deprivation…and all the health concerns that come with it.

I’d like to spend just a moment more on the topic of depression. It affects about 350 million people worldwide, and yet, in my view, depression remains somewhat overlooked and under-studied. That depression has not been identified as our number one health issue astounds me.

Depression has no regard for demographics. It affects one in four women, and one in six men, and people of all ages.

This summer, the One Mind Initiative at Work published a report which made it clear that — beyond the incalculable human cost — depression also exacts a tremendous financial cost. We are talking about hundreds of billions of dollars in lost productivity — in the United States alone.

At UCLA, after much consultation with faculty, we have decided that as a leading public research university, we had an opportunity — and an obligation — to rally our resources around the cause of combatting depression.

So two years ago, we introduced an initiative called the Depression Grand Challenge. It encompasses a broad range of activities, tapping the research skills of more than 100 UCLA professors from 25 departments — neuroscience, medicine, computer science, the arts, economics, and several more.

This initiative also involves students, staff and patients. At its core is a genetic study of 100,000 people, some of whom suffer from depression, some who are at risk, and others who show no depression-related traits. Volunteers are being recruited from throughout the 10 University of California campuses and its five medical centers.

With the Depression Grand Challenge, we are aiming for nothing less than a transformation in how depression is detected, diagnosed and treated. And as we develop these new tools, we will use them first to help our own students, staff and faculty.

The idea is that the new knowledge we gain by taking such a comprehensive, collaborative approach — frankly, it’s a new way of doing business — in time will be transported to other campuses, and to communities and countries around the world.

That’s the public part of being a public research university.

The Depression Grand Challenge is a work in progress. But much has been done already, and we’re very encouraged by what we’ve accomplished.

Later this month, we will welcome more than 10,000 new Bruins to campus. And as we do, UCLA will offer — for the first time in our history — voluntary screening and treatment for depression, for the entire incoming freshman class.

We’ve conducted pilot studies that convinced us this was doable, and that we could — and should — roll this out in a big way.

Students who choose to participate will be screened for depression and related traits — anxiety, mania and suicidal tendencies. And we will offer help to those who need it.

One resource we’ll use is an innovative protocol of internet-based cognitive behavioral therapy. It not only provides treatment calibrated for each patient, but also tracks progress in measurable ways — which will be good for the patient and will help us refine the program over time. It also will provide data for myriad research pathways.

To our knowledge, no other university has ever attempted screening of this nature and scale. I’m sure that those of you who work in human resources in the private sector can imagine the potential implications for your enterprises in what we hope to discover through the Depression Grand Challenge.

The Grand Challenge is an audacious program. But it continues UCLA’s track record of leadership in brain health research, which dates back to the years after World War II.

One of UCLA’s earliest pathfinders was a prominent psychologist named Dr. Edwin Shneidman, who in 1949 took up the study of suicide.

He collected hundreds of actual suicide notes. He then asked people who were not suicidal to write the sorts of letters that they assumed suicide victims might leave behind.

Then, in a blind study, Dr. Shneidman analyzed all the notes together. He discovered that he could determine with great accuracy which notes were real, and which were not.

That research helped wipe away several prevailing beliefs about suicide. Dr. Shneidman came to understand that many people were acutely suicidal for only a brief period of time — and that active intervention could prevent many suicides from happening.

He determined that the key to unlocking the suicidal impulse lay in two seemingly simple questions:

First, where do you hurt?

And second, how may I help you?

Dr. Shneidman wanted the broader community to have access to his findings, too. So he co-founded the Los Angeles Suicide Prevention Center — the nation’s first comprehensive suicide prevention center. It radically advanced the protocols for providing support services and counseling to depressed people with suicidal impulses.

Thirty years after the center opened, L.A.’s suicide rate had dropped by half. And Edwin Shneidman had shifted in fundamental ways our understanding of suicide, and how we work to prevent it — as well as how we talk about it.

And as I noted at the outset, and as you all know, the language we use matters. It can reduce painful stigmas and make it easier for people to reach out for help.

Let me tell you about a study by one of our doctoral candidates as part of the Depression Grand Challenge.

When Leslie Rith-Najarian received her undergraduate degree, there were two empty chairs at her commencement ceremony. Those seats represented two classmates who had committed suicide.

Now, Leslie is pursuing a Ph.D. in clinical psychology. And she is looking for ways to help students like those classmates who had taken their own lives — and students who were battling depression or anxiety, perhaps for the first time in their young lives.

She developed an online program for UCLA students who needed ongoing, day-to-day support, especially when college life felt overwhelming — even if they didn’t have a diagnosed brain health condition.

But first she had to persuade them to seek out her program, or similar support efforts that already existed on our campus.

Leslie decided to focus on the marketing — the language, if you will.

To convince more students to sign up for the program, she promoted it with two different names.

One was “The Happiness Challenge.” Lots of students enrolled in The Happiness Challenge, and most were women.

Leslie then marketed the same program with a different name, “Reboot Camp.” Many students who had not enrolled in “The Happiness Challenge” did enroll in Reboot Camp. And, you guessed it, most of them were men.

Nothing about the program had changed — other than the name.

Leslie’s work demonstrated the power of words. But more importantly, it has led a lot of students to finally seek out the help they need.

Being surrounded by brilliant and compassionate students like Leslie is among the best aspects of my job. It is impossible to step foot on the UCLA campus and not feel a surge of hope.

Our students not only are future business creators, civic leaders, innovators and thinkers. They are part of a generation that soon will bear responsibility for how brain health is researched and treated … how it’s handled in the workplace … how it’s perceived in the public sphere … and how it’s talked about at home.

Watching them lean in on the Depression Grand Challenge, doing their part in any number of ways, makes me confident that they will carry forward this important work.

And it is with a message of hope that I would like to close.

We have not yet reached the “eureka” moment when we can at last unravel the complexities of the brain’s functioning. But what’s important— what gives us hope — is that, finally, we are working on it. And we have powerful tools and the power of collaboration on our side.

We have not yet completed the essential task of converting research into treatment and a cure. But, we are moving steadily and confidently in that direction.

And we have not yet obliterated the stigmas related to brain health — stigmas born of misperception and ignorance. If we are to achieve this, those stigmas must be replaced by true societal understanding … in every setting — including, of course, the workplace.

We are on the right path.

Your presence today is proof of that.

I salute you for being here, and I wish you a day of productive, meaningful discussion and exchange.

Thank you!

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