Q & A with national board member Dr. Sergio Aguilar-Gaxiola

Peer Health Exchange Team
Peer Health Exchange is honored to welcome Dr. Sergio Aguilar-Gaxiola to our national board of directors. In his own words here, Dr. Aguilar-Gaxiola tells us more about his career and passion for helping young people live healthy lives. Q. What was your first job? A. When I came out of medical school, I worked

Peer Health Exchange is honored to welcome Dr. Sergio Aguilar-Gaxiola to our national board of directors. In his own words here, Dr. Aguilar-Gaxiola tells us more about his career and passion for helping young people live healthy lives.

Q. What was your first job?

A. When I came out of medical school, I worked in Mexico with the Mexican Ministry of Health. I was a new young physician and the Ministry deployed me to a rural area. My first job was in a small city outside of Guadalajara, the second largest city in Mexico. Also, shortly after I got a second job. I had the great fortune of partnering with a seasoned psychiatrist to co-found a detoxification clinic for drug addicts and alcoholics. I had then two jobs. On the one hand, I was serving patients with health conditions in a rural area. On the other, I was also working in a big city serving individuals with addictions and their families at the detoxification clinic we founded. Based primarily on the work experience I had treating individuals with severe addictions (alcohol, barbiturates, heroin, glue sniffing), I decided that I needed much more training and that’s the main reason I came to the U.S. — to get more training and I did.  I obtained a master and a PhD degree at Vanderbilt University.  I went on to do a couple of years of training at the University of California at San Francisco, including a postdoc on health services research.

Q. What attracted you to Peer Health Exchange?

A. A friend and colleague of mine, Barbara Lubash, who was the chair of the board of the California Health Care Foundation introduced me to Peer Health Exchange. She said that it was a remarkable organization and based on what she knew about me and the work I had done she anticipated that it would be a good fit and I would be very interested. When I started to learn about Peer Health Exchange I was very impressed. I had a chance to join the 15th-anniversary celebration in San Francisco and I met and spoke with Louise and other PHE leadership. I liked the fact that the organization was focused on empowering youth and providing them with the knowledge, skills, and resources to help them navigate more successfully in life. There is so much need in this area.  One of the big gaps in the U.S.  and in California, is that we don’t have a good, comprehensive, and coherent youth policy. In other words, take a better stock on how our youth is growing to their potential and what opportunities and resources are needed to make that happen. We don’t pay enough attention to children and youth. Therefore, kids very much navigate life themselves and when that happens they don’t have enough exposure to role models that would help them acquire and refine those skills. When they lack the skills, resources or knowledge, it’s easier for them to make wrong decisions. Decisions that will literally determine their lives thereafter.

Q. What do you enjoy most about working in the physical and mental comorbidities?

A. One of the spaces that I have worked a lot in is health/mental health and substance abuse. A lot of my work is in the co-occurrence of physical and mental health conditions—what is called commodities. In other words, the interface between physical health and mental health conditions (such as people who suffer from diabetes and depression). It is key to address the integration of both conditions. Unfortunately, in the U.S. and many other countries, physical health and mental health conditions are administratively treated separately. For example, if someone is suffering from both diabetes and depression, it is common that she or he will go to a physician to look at the diabetes and to a mental health provider for the depression. In other words, treatment services are often fragmented. Rarely is this person suffering from diabetes and depression seen by a provider who can treat effectively both. A lot of the work I have done is in those comorbidities. Comorbidities are very frequent. In fact, they are the rule rather than the exception. In the case of behavioral health disorders (mental health and substance abuse), about 50% of the US population will suffer from one or more of these disorders in their lifetime. I’m convinced that when it comes down to behavioral disorders either on oneself, a family member, a friend, neighbor, or co-worker, no one escapes. The real story is who has access to healthcare and who utilizes these services when they need them.

Q. What is a major challenge facing the mental health field?

A. There is a big disconnect between the frequency of behavioral disorders in the population and their impact on daily life and the extent to which the public knows about it. The public often doesn’t know what is happening when someone they know suffers from behavioral disorders and/or comorbidities. They may know something is happening but sometimes don’t even have the words to explain what is happening to them. There isn’t enough knowledge and skills to deal with the frequency and impact of mental disorders. One challenge we have as a society is how we can connect the dots and help the public connect the dots. I think Peer Health Exchange is good at connecting dots and can further help with connecting those dots. Unfortunately, there are significant disparities in terms of which population groups have access to care. In some cases, 1 out of 3 of those who are in need of behavioral treatment use the services and in some population groups only 1 in 10— this is what we call the treatment gap. What really makes me passionate is to come up with solutions on how to address the treatment gap and how to address these unmet health/mental health needs especially in young people. Based on studies we have been involved with regarding those who suffer from severe mental illnesses, approximately 50% are manifested by age fourteen and 75% of mental disorders occur by age 24. One of the formidable challenges is that most of those who need services don’t have access to timely care and that’s something that I strongly believe can be remedied, I believe Peer Health Exchange is well poised to help address some of these issues.

Q. What is one fact that would surprise us about you?

A. I am a very passionate person that really gets involved in what I consider good causes. I am extremely committed to the local, state, national and international level. For example, here in the U.S., I was involved with Mental Health America, which is the oldest mental health advocacy association. I served for two years as the chair of their board, and that came to be because I was frustrated at being a researcher and discovering knowledge and not knowing truly how to advocate more effectively. It is key to effectively translate and disseminate that knowledge to policy and decisions makers and I didn’t quite know how to do that.  That’s one of the reasons why I decided to get involved with advocacy. I’m very invested in not only being a scientist but also help translate the knowledge we generate for effective public use and change. It is how we translate the knowledge into ways that the general population can incorporate and utilize it in their daily lives. That keeps me busy.  What gives me a thrill though is to be with my family. I am a strong family man and I love to be with my wife. I have been with my wife for forty-four years. We have four children and four grandchildren and it’s a pleasure for me to enjoy all of them and each other. Forget about fame and fortune, I feel like I am the richest man in the world because of the family I have.

Q. What are you most looking forward to in 2019 related to Peer Health Exchange’s work?

A. The goals for 2019 resonate a lot with me. For example, reaching out to almost 20,000 young people through the program in large cities across the U.S. and doing so with volunteers who are diverse is great. What I heard from Peer Health Exchange is that there is a strong commitment to reaching out to vulnerable populations. I’m also interested in integrated models for health education. It is not only the basic skills that are needed to be successful as a person or student but also someone that can help themselves and others—to identify what is happening to themselves and do something about it through prevention and early intervention. PHE is a high performing health equity organization—there’s a lot of synergy with my work.  I am excited to play a role as a board member. I am also hoping that Peer Health Exchange is going to expand the training to behavioral health issues. To provide the basic skills needed to recognize as early as possible signs and symptoms related to behavioral health is key and a formidable contribution.

Dr. Aguilar-Gaxiola is Professor of Clinical Internal Medicine, School of Medicine, University of California, Davis. He is the Founding Director of the Center for Reducing Health Disparities at UC Davis Health and the Director of the Community Engagement Program of the UCD Clinical Translational Science Center (CTSC).  He is a past member of the National Advisory Mental Health Council (NAMHC), National Institute of Mental Health (NIMH). He is Past Chair of the Board of Directors of Mental Health America (MHA; formerly the National Mental Health Association) and Past Chair of the Board of NAMI California.  He is currently a board member of the California Health Care Foundation, a member of the California Future Health Workforce Commission’s Technical Advisory Committee and co-chair of the Behavioral Health Subcommittee, a member of the California Medical Association, and a member of the California Department of Public Health Office of Health Equity’s Advisory Committee. He is a national and international expert on health and mental health comorbidities on diverse populations.  He has held several World Health Organization (WHO) and Pan American Health Organization (PAHO) advisory board and consulting appointments and is currently a member of the Executive Committee of the World Health Organization (WHO) World Mental Health Survey Consortium (WMH) and its Coordinator for Latin America and the Caribbean, overseeing population-based national/regional surveys in Argentina, Brazil, Colombia, México and Peru.

Dr. Aguilar-Gaxiola’s applied research program has focused on identifying unmet mental health needs and associated risk and protective factors to better understand and meet population mental health needs and achieve equity in health and mental health disparities in underserved populations. He is also very active in translating health, mental health and substance abuse research knowledge into practical information that is of public health value to consumers, service administrators, and policymakers.