00:26.69
CCB: Welcome to the ONEder podcast. This is your host, CCB, and we are excited to offer another outlook or exploration into one of the areas that we build spaces for. First off, I want to remind everyone that the ONEder Podcast is available on all streaming services. You can find us on Apple, Spotify, and more—just search O-N-E-D-E-R podcast. Feel free to rate us or send a note and tell us what you think. We're always excited to hear from our listeners.

00:58.92
CCB: Today’s episode, number 63, features Dr. Justin Mohatt, or Justin, as we’ll be referring to him. We're going to dive into behavioral health and the spaces created to provide the necessary services today. Everyone's heard how COVID impacted our ability to collaborate and be social, and what’s happening with kids today—the effects of technology and the isolation it sometimes brings. It’s such a prevalent topic for all of us. It’s not just about space, it’s about people and our communities, and this has a very significant impact right now. So, I’m excited to say, welcome, Justin! Thank you for joining us.

02:12.56
Justin Mohattt: It’s my pleasure, CCB. Thank you for having me.

02:15.16
CCB: Excellent. Justin is part of an amazing facility that we’ll discuss more deeply. But first, I’d like to ask you to share a bit about your background and how you came to focus on behavioral health and the segment of the population you work with.

02:38.40
Justin Mohattt: Sure, happy to. I’m currently the Medical Director at Ohana, which we’ll be talking about, and Head of Innovation there. My journey to this role was somewhat circuitous, but my interest in mental health began very early on. Like many people, personal experiences shape where we end up. Many in my family work in the mental health field. For a long time, I didn’t think I’d follow that path, but the pull was inescapable.

I had a grandmother who suffered from severe, chronic mental illness and had a traumatic upbringing. We were fortunate to spend time with her each year, which isn't always the case when someone in your family struggles with severe mental illness. It gave me a deep sense of empathy and a desire to improve things for others.

03:41.68
Justin Mohattt: In terms of this podcast and the focus on space and design, my grandmother was institutionalized most of her life in state hospitals. Visiting those places as a child was very frightening. The idea that the experience for patients and families could be fundamentally different is incredibly important to me.

04:22.82
CCB: Wow. Thank you for sharing that. It really connects to how much this conversation matters to our listeners. Mental health affects everyone. The statistics show that one in seven Americans have some form of diagnosable mental health challenge. Of course, it’s everywhere, and if we are working on environments that make people feel more comfortable and able to be their best, those spaces deserve more attention. That’s why we’re thrilled to have you here to talk about the Ohana Montage Health facility.

05:11.61
CCB: That introduces the project a bit but tell us more about who is being served at the facility.

05:21.78
Justin Mohattt: Sure. Ohana is a youth mental health program, which we define broadly. Most of our patients are 17 and under, but we also serve young adults in that transitional age. One of our main goals is prevention, so we’re not only treating mental health issues as they arise but also aiming to prevent them. We treat some adults as part of this effort, particularly expecting parents, through our reproductive psychiatry program, with the hope that we can intervene early, especially if a parent is struggling with depression or anxiety.

We see a broad range of ages, though the majority are teens and younger children. We offer various levels of care, from outpatient therapy, medication management, and occupational therapy, to day hospital programs and intensive outpatient programs. We recently opened a residential treatment center for teenagers aged 12 to 17, who need 24-hour care, though it’s not a locked inpatient psychiatric unit.

07:26.04
CCB: That makes me think about the balance between community support and safety. Since it’s not a locked facility, how do you handle crises when they arise? How was the space designed to support that process?

08:07.07
CCB: Could you explain how your staff thinks through managing these situations and how the space helps with that?

08:16.29
Justin Mohattt: We invest heavily in training from day one and make sure we have clear processes in place so that when someone is in a room with a patient experiencing a crisis, they are never alone. We have protocols for requesting help, knowing who will respond and in what timeframe. As the building and our services have evolved, these processes have become more complex, with different systems for managing patients depending on the part of the building.

08:34.22
Justin Mohattt: With that, we have a very clear protocol for how you ask for help, who responds, and within what time. As the building has evolved, with all of our services coming online, it has necessarily become more complicated. Certain parts of the building have their own systems for managing patients within those areas.

09:01.16
Justin Mohattt: From a staffing standpoint, it's all about training, effective communication, and having easy operational workflows. The building supports all of that. A lot of thought went into the design to ensure it provides a safe place for patients, parents, and staff.

09:28.69
Justin Mohattt: We recognize that kids at any level of care, whether in a regular outpatient therapy appointment or in residential care, could be in a crisis at any moment. We had to consider that for all levels of care, not just for those in residential or day hospital programs. Throughout the building, there are cool-down spaces for kids and staff—spaces that are not seclusion or restraint rooms but more like meditation or quiet reflective spaces. These spaces allow for physical and emotional space. We also have an alert system that requires just the press of a button to call for help, so staff don’t have to worry about who will respond. Additionally, the building offers ample space, which is critical for reducing anxiety and distress. The large, airy, open spaces make a significant difference.

10:52.53
Justin Mohattt: There's plenty of furniture for what we need, but also a lot of empty space to allow for a sense of freedom. Internal waiting rooms are designed to avoid making people feel overly contained. We also have outdoor spaces for patients and specific outdoor stations for staff to find space as needed. This is more about well-being than safety, but it's integrated throughout the building.

11:40.82
CCB: This leads to the thoughtfulness and planning of the entire facility. You mentioned you weren't part of the initial programming, but we'll include a link to the case study about Ohana Montage on our website so listeners can see images of the facility. The planning clearly involved a lot of time on the entire process and vision for the environment. Could you talk about that, even though it’s from your perspective?

12:34.22
Justin Mohattt: A lot of time was spent with consultants, not just hearing from us as clinicians but also from the community and some of the youth themselves about what was important to them. They were even included in some of the design process, especially around the art installed in the building. Unlike many buildings that are designed just to meet regulatory requirements, there was a lot of conversation about meeting safety and regulatory standards without making it feel institutional.

13:21.43
Justin Mohattt: When you walk into the building, it feels more like a hotel lobby or a beautiful Hawaiian resort in the hills of Monterey. It’s a spectacular space.

13:39.57
CCB: It truly is. The concept of well-being is a big buzzword today for almost every environment. It’s interesting because so many people are out of balance, so all environments should consider wellness and well-being. This has been a requirement in some types of buildings for a while and is certainly an aspiration in creating environments.

14:15.86
CCB: When talking about health and healthcare, particularly behavioral health, it steps up in priority. What are we trying to do?

14:24.44
Justin Mohattt: Thank you very much.

14:31.93
CCB: I’ll also point out that you’ve addressed the wellness and well-being of not just patients but also staff, families, visitors, and the community. Describing it as a Hawaiian spa in the Monterey Hills isn’t an understatement. The environment lowers your blood pressure just by looking at it.

15:13.83
CCB: That’s a lot of information to get us to wellness and well-being. The intention is well delivered.

15:24.88
Justin Mohattt: Zooming out a bit, you can’t have wellness if you enter an environment that makes you feel unvalued. Unfortunately, this is often the case for most youth mental health facilities. Even in well-funded children’s hospitals, it’s rare to see a dedicated and well-designed space for mental health. This facility, funded through a significant donation, aims to be a model that can be replicated in other communities with fewer resources. By identifying key elements of successful interventions and environments, we can help other communities invest wisely, which can have a broader impact.

17:53.13
Justin Mohattt: The building features high ceilings, open spaces, lots of glass, and a seamless connection between inside and outside. Every clinical office, except some internal group rooms, has large windows. Courtyards offer beautiful spaces where therapists and patients can work outside of the office walls. The art program is another key component for health and well-being. We have specific spaces for staff designed to offer breaks from work, though people sometimes work there because it’s such a pleasant environment. The idea is to help people recharge during the day because the work is demanding.

19:22.44 - CCB: Okay, so there are two things in your last comments that I want to explore further. One is the community aspect and the collaboration with the community. What does that do for patients and treatment? They're connected, these two thoughts. What does that do for moving treatment along while still being part of the community? And the other side of that is the destigmatization of an illness that might have had different connotations in the past.

19:53.64 - Justin Mohattt: Yes. Yes.

19:57.95 - CCB: I’m blanking on the word I want... kind of like the efficacy, but more about the value of moving treatment along while staying engaged with the community. Also, the destigmatization of an illness.

20:27.12 - Justin Mohattt: Yeah.

20:28.56 - CCB: So, you’ve got two things going on here: destigmatizing through the space, the environment, but also through active engagement with the community.

20:34.55 - Justin Mohattt: Yeah.

20:38.98 - CCB: Could you talk about that?

20:40.92 - Justin Mohattt: Yeah, I do think it ultimately comes back to destigmatizing. We didn’t want this building to be a "hospital on the hill" where people in town just say, “Oh, you go up the hill to Ohana to get treatment.” We wanted it to be a welcoming, safe, and desirable place where the community wants to come. In addition to providing services for patients in treatment, we do a lot of community programming. Part of the building’s design includes an education and conference center. We offer free community classes throughout the week, most of which are prevention-based programs. Our prevention team runs many of these classes and also goes out into the community, intervening in schools through our school-based program, which builds mental fitness. We aim to teach kids how to flex these muscles early, so they don’t develop mental health issues later or minimize the impact of what may come naturally through genetics.

We’re breaking stigma down not only with a beautiful space that doesn’t feel institutional, but also by going out into the community, inviting people in, and offering as many free prevention, programming, and educational services as possible. Many of these are virtual, so even families who live far away can access them.

23:04.81 - Justin Mohattt: I hope that answers your question.

23:10.01 - CCB: Yes, it does. The intentional destigmatization is interwoven into everything you're doing at Ohana. It’s obviously successful. Now, you're going to tell us how successful it is.

23:36.28 - Justin Mohattt: I think we’re still early in our development and hope to have great outcomes to measure in the future. We’re still getting programs up and running. One thing from a destigmatizing standpoint that’s critical and has helped us is the Youth Advisory Council we’ve developed. It’s made up of high school students who provide input into what we do, and they’ve been involved from early on. For example, we have a large mural in the waiting room by Leah Rosenberg, which was designed with input from the youth. They chose the colors based on what they wanted it to represent.

These students are also involved in thinking about digital interventions, and they’re brutally honest, giving us feedback on ideas. Without them, we’d get it wrong more often. Having them in their schools talking about their experiences helps break down stigma in a different way.

25:47.16 - CCB: You’re clearly proud of the art program, not just Leah Rosenberg’s piece. Tell us more about that.

25:57.14 - Justin Mohattt: It’s hard to talk about the art program without mentioning CHOMP, the Community Hospital of Monterey Peninsula, which we’re a department of. CHOMP was one of the first hospitals in the country to have an art and medicine program. They’ve had an art collection since the 1960s, with the understanding that art can be healing. That philosophy flowed into the design process at Ohana. We had art consultants and a curator who helped select art for the building. The art is meant to be engaged with in treatment, and each piece has a QR code with an explanation and prompts for reflection. The art ranges from small pieces to monumental murals, and the response has been tremendous from families.

One of my adolescent patients, who has a great sense of humor, ran into me in the entryway during our first week and said, “Mohattt, why is this place so fancy?” I instinctively responded, “Because you deserve it.” That really captures the heart of our mission—to create a space where people feel valued. It’s not just about designing institutional spaces, but about sending a message that makes people feel like they’re worth investing in.

29:05.12 - CCB: You’re a great spokesperson for the space and the programs. Could you explain what it means to be an innovation director?

29:25.41 - Justin Mohattt: That’s often the million-dollar question with this title! I’ve come to appreciate two kinds of innovation—little “i” and big “I.” Most of my work right now is on the little “i” side, making sure we’re thinking through our processes and exploring new treatments. Then there’s big “I” innovation, which involves digital interventions. We’re exploring ways to use technology to improve access and equity in care. For example, we’re looking into a purpose-built video visit platform for youth mental health treatment and remote patient monitoring devices to reduce the need for in-person visits. The goal is to ensure that families, regardless of location, have equal access to care.

31:30.82 - CCB: Those conversations about access and equity are becoming much louder, which is great. It feels like we're moving in the right direction. A quick aside—have you met the folks at Rock Health?

32:40.97 - Justin Mohattt: I met them a long time ago, but not recently.

32:46.96 - CCB: They're doing some interesting work in the digital health space. It’s worth keeping an eye on them.

33:03.26 - Justin Mohattt: Yeah, I’ve done some advising for early-stage companies, which piqued my interest in this area.

33:42.99 - CCB: So, we talked about measuring success. What’s the plan for Ohana? Are there specific metrics you're using?

34:04.30 - Justin Mohattt: That’s a good and difficult question. Our field is behind when it comes to standard quality measures. When you’re trying to do things outside the box, like reducing the prevalence of youth mental health issues in the county, it’s a long-term goal. In the interim, we’re focusing on regulatory quality requirements and working on validating measures we’ve developed, such as assessing mental fitness in families. We're also measuring outcomes for specific programs, like our adolescent partial hospital program. One unique feature of our program is Family Day, where parents spend the entire day in treatment with their child. We’re looking to see how this compares to more traditional models where family involvement is minimal.

37:28.37 - CCB: I’m so blown away by everything that’s happening. As our conversation draws to an end, how many people are at your doorstep wanting to be part of Ohana?

38:03.80 - Justin Mohattt: Demand is incredibly high. This is a largely rural county, and before Ohana, there were almost no services for families with commercial insurance. The pandemic added to the pressure, and we’ve had no shortage of patients. Things are starting to normalize, and we’re expanding our programs, including our day hospital and residential programs. However, the biggest challenge is finding enough qualified staff. There’s a national shortage of youth mental health providers, and while we’re getting patients in faster than the national average, recruiting staff is a huge hurdle.

41:40.37 - Justin Mohattt: There’s a shortage of providers everywhere, but we’re doing our best to avoid burnout and utilize our staff efficiently.

42:08.45 - CCB: To everyone listening, if you know people interested in behavioral health, encourage them to explore it as a profession to help meet this growing need. As we wrap up, Justin, any final thoughts?

42:27.21 - Justin Mohattt: I just hope that the conversation around youth mental health, which gained more attention during the pandemic, continues. Every opportunity to talk about it, whether on your podcast or elsewhere, helps. I hope more facilities will invest in youth mental health and recognize the importance of destigmatizing care. The more we talk about it, the more people will seek the help they need. Thank you for giving me the chance to discuss the work we're doing.

43:28.17 - CCB: Thank you very much, Dr. Mohattt.