Hi! My name is Seth Christman. As the founding physician and chief medical officer of East Nashville Wellness Center, I’m in charge of how we care for patients and ensuring they get the best treatment they can. Nashville is my hometown, and seeing Nashvillians struggle with mental health and substance use led me to become a psychiatrist. Our culture of music reminds us that recovering from mental health conditions is not just about fewer symptoms, but about getting back to the parts of life that give us joy and deeper meaning.
By the time of our ten-year reunion, my high school class of just two hundred had lost two of our friends in deaths related to substance use and mental health. In college in Washington, DC I saw the stark divide between those who could access high-quality healthcare and those who couldn’t. In medical school in east Tennessee, before much of the country was even talking about an “opioid epidemic,” I saw the full fury of the opioid crisis ravaging towns too small to have a single psychiatrist. By the time I came home for psychiatry residency, people were beginning to take notice of our country’s struggles with mental health and substance use, but our system of care was failing to respond in a way that helped ordinary people.
Our clinic was founded because Middle Tennesseans simply don’t have enough access to treatment for mental health and substance use problems. Those with high-deductible insurance, TennCare, or no insurance have the most trouble accessing quality care. What treatment they can find is often overburdened, lower-quality, or fragmented. Few clinics actually provide integrated mental health and substance use treatment, and many providers don’t accept health insurance. The end result is Nashvillians losing years of life, function, and quality of life to uncontrolled symptoms, overdose, and suicide. The stakes are high.
While there’s still much we don’t know in psychiatry, we already have effective and evidence-based therapies for many of the common problems we see day-to-day. In most cases, patients can improve quickly with straightforward outpatient care. Too many simply never get adequate treatment, and never get much better. We also know that strong collaborations between disciplines like psychiatry, pharmacy, nursing, social work, psychology, and primary care lead to patients doing better for longer, while still saving money. We want to bring the kind of high-quality collaborative practice often restricted to expensive cash-only practices or elite academic settings to our community, an all-comers clinic.
From day one, our clinic will provide individual psychotherapy and medication management in a team-based model, seeing patients on a sliding-scale cash basis as we confirm agreements with TennCare and commercial insurers. As we continue to secure funding and a larger physical footprint, we plan to expand our capabilities and staff, allowing us to provide medication-assisted treatment for opioid use disorder, broader options for substance use treatment, and integrated evidence-based therapies ranging from group psychotherapy to trauma-informed yoga. Long-term goals include certification to directly provide medications for opioid use disorder in a structured setting, thus caring for the most difficult-to-treat patients and filling a particular void in the Nashville area.
When we first began talking about our clinic in 2019, we were already deeply concerned by the difficulty Nashvillians had getting connected with appropriate mental health treatment. The COVID-19 pandemic has amplified all of our concerns. Even as life returns to something like normal, many of our friends and family will continue to struggle with problems that can be managed with timely intervention. We have the evidence, the training, and the will to do things differently—right now, we only need the resources to make it happen.