Brian Kenny:
Oscar-winning star of stage and screen, Robin McLaurin Williams, is regarded quite simply as one of the greatest comedians of all time, which makes it all the more tragic that someone who spent his life finding ways to make people laugh, would ultimately succumb to the mental health ailments and addictions that tormented him from a young age. Later in life, he worked bits about his mental health struggles into his standup routine to shine a light on the challenges he and millions of others face each day. Known for being a kind and gentle person, he would never have wanted anyone, most especially his children, to endure what he did.
Today on Cold Call, we welcome Professor Lauren Cohen to discuss the case, Weapons of Self-Destruction: Zak Pym Williams and the Cultivation of Mental Wellness. I'm your host Brian Kenny, and you're listening to Cold Call on the HBR Podcast Network.
Lauren Cohen is the L.E. Simmons Professor in the Finance & Entrepreneurial Management units at Harvard Business School, and Research Associate at the National Bureau of Economic Research. He's a first timer here on Cold Call.
Lauren, welcome.
Lauren Cohen:
Thanks so much for having me, Brian.
Brian Kenny:
We're doing this case as part of Mental Health Awareness Month, so it's a very poignant case. I'm really curious to hear about why you decided to write it, and we'll get to that in a minute. But I think the more that we can do to raise awareness about mental health, particularly around this time of year, is really critical. So thanks for writing it and thanks for being here to talk about it. Why don't we just start the way we usually do. I'm going to ask you to tell me what the central issue is in the case and what your cold call is to start the discussion in class.
Lauren Cohen:
Absolutely. That's a great question, Brian. I think mental health awareness is a wonderful thing, but it's not enough. It's not enough. And especially when it comes to this topic of families. So I help to run family programs here at the Harvard Business School, and these are issues that certainly pop their heads up in every organization, but families in particular. This is one issue that even when we get to the awareness level, that's a great thing. But this case is about moving beyond that, and how you do that and, how you do it right and how you do it wrong. So that gets into my first cold call. So the way that I cold call this case is I ask students, because from the beginning, I want this to be an open conversation, and if we can't get rid of the stigma when we are talking about mental health, then look, we’ve got no chance in doing it when they leave the classroom. So I ask the students, what on earth Zak is screwing up. What is he just totally messing up? How is he just totally, like, train wreck, total complete disaster of how Zak is handling this? So when I start that way, it just opens student and jars students into thinking, "Oh my gosh..." not how wonderful is it then, and we'll get to this, that Zak confronted these, that he had this year-long struggle. And then not only is he confronting in his family but starting a company around it, using his MBA and using other skills he has to really address this and help others address it.
Brian Kenny:
I should just say, if our listeners haven't already figured it out, Zak Pym Williams is the son of Robin Williams, and the case is really about how he is helping to confront his own struggles with mental health. How did you hear about this? What led you to write the case?
Lauren Cohen:
So Robin Williams is a central figure and I think someone that people might be familiar with and less familiar with his son. So as we started to think through this from a family perspective and how to jump into this case, Zak's name came up actually as someone who was doing this and as an entrepreneur in this space and who was kind of turning this negative into a positive. And we're so interested and intrigued by that, that we started to dig more into his background. As we dug into his background, we said, gosh, this is a great case where we can show both the negative, the positive, and potentially have a neat decision point that our students can really both, I would say not step into the shoes of, but really understand and then put their shoes into those shoes, which sounds a little weird, but that's what we want them to do. And then take it from there and think about how it applies to their own family, and then see how one person took this beyond. Not that we would want all of our students to take this and then start their own mental health companies, but to understand that it doesn't have to end with just how you deal with it in your family.
Brian Kenny:
Yeah, that's great. What did you learn about the sort of landscape of mental health in the United States as you did research for the case?
Lauren Cohen:
There's a lot that we don't know, and more importantly, there's a lot that we think we know that we don't know. Let me explain what I mean by that. Many of the statistics, they seem like they differ and change from year to year. And the truth of the matter is, they do. They not only change from year to year, but they change from surveyor to surveyor. That's because, especially with questions around mental health, you'll get this thing that in academics is called the framing effect, the survey framing effect, which is to say that your answer to a question really matters or is really kind of dependent upon how I ask you that question. And how I ask that question can elicit very different responses. In fact, what they've shown is that I can get you to switch from yes to no on something depending on how you ask the question. So that's where you get very differing rates of mental health issues depending on how we ask people about it, when we ask them, how we ask them. So it's really hard, and especially without hard, I would say thresholds for diagnoses, then it gets really tricky to interpret these types of pieces of data. And then the thinking about the data over time and understanding what it looks like gets even harder.
Brian Kenny:
So we know it's hugely prevalent. You mentioned a little bit earlier that Zak had an MBA, that he was putting to work here. Can you tell us a little bit about his background and his upbringing?
Lauren Cohen:
Yeah, let me do that. So Zak, his father was Robin Williams. So he had this kind of larger than life father, but that father was a part of his life for only part of it. So at some point that Robin Williams then, he and Zak's mother, they broke up, and then Zak saw much less of his father. So to say that his father was a huge part of his life throughout, he wasn't. But he certainly had an impact on Zak's life, which is to say that he certainly kept in touch with Zak, and he was an important figure in leading Zak throughout much of what Zak did in his adolescence. Not the only one, but an important one. So he very much felt both that wind behind him, but the shadow over him of his father. I think seeing how his father dealt with just the stresses of being in the limelight all the time, that impacted Zak in a big way. So he saw how his father both used substances to help to deal with that, and then some other kinds of methods that he used, and he mimicked that, as many children do. So Zak, in part of his life, he had many, many kind of dark years and dark experiences that I think were really painted by his father, Robin Williams. You see this pattern. So what happened to Zak is that the pattern kind of repeated itself and repeated itself until Zak said, "Okay, now I need to do something about it." I think what's so interesting about Zak's case is that he said, "Now I need to do something about it." He went to the frontier of what he thought he should be doing, went to doctors, got medicated, and it turns out that didn't work. That didn't work. I think that put him in the situation that so many of the listeners will be in as well, which is, "Hey, gosh, I'm really doing my best. I'm going to the medical profession. That's not working. What do I do now? I seem like I'm out of options."
Brian Kenny:
And so what did he do?
Lauren Cohen:
This is the great question and part of the case, that's when he turns to alternative options. That's when he said, "Gosh, well, if traditional and Western medicine can't help me, then maybe I can move to..." I would say, really, it's still part of Western medicine but a part of Western medicine we don't have enough data on and so is not as well-structured. And that is thinking through other modes and mechanisms that might impact mental health. How do diet, how do micronutrients, how do all these other aspects of things that we intake and the way our body works, how does that impact our mental health? The truth of matter is, well, there are some hypotheses about how this might work and whether there's some anecdotal evidence. There's not as much good peer-reviewed evidence on these types of things. But that didn't stop Zak from exploring them. It turns out that that was the solution for him, that when he turned over this other stone, that really kind of opened up what his life is today.
Brian Kenny:
Yeah, but he kept working at it, and I think that was the key. The case does describe the way the medication affected him. I know there's a lot of experimentation in this. I've known people that have tried different medications. Some have worked, some have not, some have made them feel worse. In Zak's case, the medications seemed to be doing the opposite of what it was intended to do. Can you talk a little bit about the kinds of medications that are prescribed usually?
Lauren Cohen :
Yeah. The tricky part about Zak's case and many of these cases around mental health is that hormones play a big role in regulating mood and regulating lots of things in our body, and including mental health. So the drugs that are now prescribed and that work for many people, they alter hormones. I would say it's less of a kind of heat-seeking missile that only hits its target, and more of a kind of grenade that you throw at the thing, you hope it hits the target, but it often has a lot of collateral damage. So in Zak's case, and this is true for many people, it had that collateral damage. It far outstripped any help it had in terms of the mental health wellbeing. Now look, is that saying that these drugs aren't having their intended purpose? No, they are, and maybe they're having it for 45 percent of people. And you know what? Forty-five percent is a heck of a lot better than zero, and so that's a lot of people that you can help.
Brian Kenny:
I think he also, a lot of people say, "Oh, you need to exercise more. You need to sleep better." Zak tried exercising more.
Lauren Cohen:
Yes, he did.
Brian Kenny:
That didn't quite do it for him either.
Lauren Cohen:
That's when he had to turn to a support system. That's when he turned to his now wife. That's when he turned to others and just really opened up his entire deck and said, "Look, this is what I'm going through. You might have thought I was going through one or two of these cards. Nah, no, no, no. I got the whole deck. I dropped the whole deck and now I don't know what to do." And only then, when he could open up and be transparent about that, that he got the full level of support that he needed.
Brian Kenny:
So that's a huge step forward for him. It's being vulnerable in a way that a lot of people don't want to be vulnerable. But for him, it turned out to be the sort of key turning point that allowed him to get involved with Bring Change to Mind. Can you talk a little bit about that organization?
Lauren Cohen:
Yes, absolutely. So Bring Change to Mind is a wonderful organization. It's trying to de-stigmatize talking about mental health and bringing it into the conversation. I think we need to do that. I think there still is a stigma around it, thank goodness less than there used to be, and I think that can be signified by the podcast we're having right now. But I think that's what it tries to do. It was started by Glenn Close, is one of the people who started it, and it's because she had this experience in her life. So she had family members who were going through mental health struggles, and that really prompted her to start this in 2010. So it's this organization that has been able to galvanize I think a lot of wonderful programs around bringing people who otherwise might have a little bit of a sticking point around this. It brings them people who they're familiar with that say, "Hey, gosh..." like a Zak Williams, that say, "Hey, I have problems with this too, and if I can come out and talk about it, then others can as well."
Brian Kenny:
Yeah. What do they do exactly? What's their approach to helping people?
Lauren Cohen:
Look, they use varied approaches, and I think you need to in cases like this. But I think one of the great parts of what Bring Change To Mind does, and this is what I would say is one of their unique features and comparative advantages, is that they go to places where other organizations shy away from. They will go into high schools, they go into prisons, they go into other places where these things often aren't talked about and not enough people go. And yet they go with many of these high profile people that people really do look up to and kind of recognize. In that sense, they look up to the kinds of openness and transparency they bring.
Brian Kenny:
One of the key insights that Zak had as he started to do this was that really the best medicine for him was helping other people. Is that fair to say?
Lauren Cohen:
Yes. Yeah. I think in his case, that's true.
Brian Kenny:
Yeah.
Lauren Cohen:
I'm a little reticent to prescribe that as a panacea because that's not going to work for everyone. In his case, he really did get in that sense, I'm happy with the life that I'm leading, what I'm doing every day, and I wake up and I'm proud of the work I do, and I can step back and be happy with this." This is one thing that really drives him and to this day drives him. So I think that's wonderful. And that may work for some people, and it may not work for others. But yeah, it really has for him.
Brian Kenny:
I think he even pointed out that knowing that other people are relying on him, it kind of motivates him to do what he needs to do. So for him, that's a great motivator.
Lauren Cohen:
That's right.
Brian Kenny:
The case does allude to his relationship with his father later in life, I gather, as Robin really started to come to grips with what his own issues were. Was he able to glean any insights from his father? Did they have a relationship where they could talk about those things?
Lauren Cohen:
They did. They did. As both of them matured, and certainly as they both got older, they got closer. So that relationship did help. I think he saw, in some ways, he saw and started to understand better, as did Robin, paths that didn't work. So Robin was much more open about things that he had tried which didn't work.
Brian Kenny:
Yeah. And Zak makes no secret of the fact that what he really wants to do here is break the cycle, the familial cycle, the genetic cycle, whatever it is. But there's clearly a cycle that goes from generation to generation. He has children of his own. What are some of the things that he's grappling with as he thinks about how to do that?
Lauren Cohen:
That's really one of that central, I think, tensions in the case, central tension in the sense that every family faces this tension. Every family faces this tension that, gosh, mental health, in the same way as physical health, financial health, lots of the aspects of families that we much more openly will talk about, it's a thing. And it's a thing that, yeah, we can pretend it's not there, or we can only deal with it once it happens or once there's problems with it. But oftentimes, once these cracks develop, they're hard to tape back up, right? They're hard to put back together. Once those cracks start, you'll find that the whole structure is much less strong than it would've been had you started to address it earlier on.
So that's one thing that Zak is trying to do but trying to do in a way that he understands that he can't do this unilaterally, which is to say, look, he has a family, he has kids, but he also has cousins. He also has other people within that family ecosystem. So if you can just have that conversation and start to broach it and start to come with a plan to address it in some dynamic sense. Addressing this is not just talking about it today. Addressing this is not a, "Hey, how you doing today?" Or coming up with a mental health checklist that you then ask about every once in a while. But coming up with a much deeper plan in thinking about how to deal with issues maybe before they start, or how to address, like you said, these kind of genetic factors, the extent we see patterns developing, then saying, "Gosh, what can we do to try to stave that off beforehand?"
So he's got to try to do that in a way that, and this is going to happen in every family, where he might have some agents that he has more control over, so his immediate family, or even can have that conversation a little more frankly with, but others, he doesn't. Others that he only sees once a year, others that he might see only a few times a year. And even if he tries to broach this, they're just going to say, "Yeah, forget about it. We don't want to talk about it with you," or, "We don't want to talk about it at all."
Brian Kenny:
Right. Or sort of gloss it over like it's not a big deal.
Lauren Cohen:
Yes. Yeah, yeah, yeah. Or push it off. "Oh yeah, we should definitely talk about that but now let's get back to this."
Brian Kenny:
Yeah. So it's really reckoning with it as a family, an extended family. Really, everybody has to reckon with it.
Lauren Cohen:
Yes.
Brian Kenny:
Yeah. So I'm curious, you're a finance professor. You wrote this in a business school setting. Why should business people care about this? This is a family problem. Why should business leaders have to worry about this?
Lauren Cohen:
If we think about it from a business context, what are the factors of production of a business? So in our traditional production function models, there are two factors of production, and they are capital and labor. And if you have a technology component, that kind of supercharges both of those. What's been happening in the last 40 years is that every firm has been moving more toward the labor side, which is to say labor has been becoming a more important part of every production function. Not only that, but every economy around the world has been shifting more toward labor intensive industries, which is, think healthcare, think finance, think... and essentially everything. That's more of GDP is coming from that, which is just to say that labor, humans, are becoming more important parts of production. It's not like in 1970 where you could say, "Okay, what's the value of Ford?" Well, look over there at that plant. Let's count up the number of plants. Count up the number of machines, and that's the value of Ford. No, no, no, no. It's not like that anymore. It's the people. And the people's value is going to be dictated and it's going to be mediated by everything that can impact their ups and downs. And this is a big one. Their mental health and their wellbeing is a big one.
Brian Kenny:
So that information at the leadership level is critically important, but we know that there's a huge cost, a huge economic cost to firms, for people that are suffering from mental health issues that for one reason or another can't make it to work. I'm sure that Covid probably exacerbated some of those issues and brought things to the surface that weren't there before. So I guess my question there is, should businesses, are they obligated? No. But should they? Is it good for business to do something about this and to pay attention to it and to maybe programmatically think about ways to help employees deal with these things?
Lauren Cohen:
There's an easy answer and there's a hard answer. The easy answer is just say, "Yes, of course, it'd be great for your firm to address mental health." Then the response of any firm justifiably would be like, "Great, what the heck do we do?" "Oh, we want to address it. Great. We'll address it." What does that mean? Does that mean setting up a program? Does that mean having someone on staff that we say, "Okay, you can come talk to this person," or that we will put it in our healthcare plan that we'll cover these things. Look, those are all different responses, and they have all very different take-up rates.
So I can tell you this, just giving access is not enough, is not enough, and we see that across every type of benefit that firms will put into place. We see this in retirement benefits, we see it in education benefits. We see firms put these things into place, and they say, "Oh, you have access to this wonderful treasure trove of things." You know how many employees take advantage of it? Remarkably few. Remarkably few. So in that sense, I think we can go one step further in saying that, Brian, it's not enough to just have a program that offers access to these services, but we need to take a more proactive stance in that we need to make it a part of the vernacular, and we need to make it a part somehow of their jobs.
Brian Kenny:
So they really have to assert themselves with their employees to get them to take advantage of these kind of things?
Lauren Cohen:
Yeah, absolutely.
Brian Kenny:
Yeah.
Lauren Cohen:
In particular, I think along those lines, they need to do more than just say, "Oh, we're going to hire this expert. Brian's going to come in and yeah, he's the expert in this, and then he's going to do it." Now let's us, CEO, let's go take an extended long lunch break." Right? I mean, that's not enough. No, I think leaders of firms, boards and management, need to take time and ideally commission a little bit more of a rigorous analysis around what types of mental health issues are likely to impact their employees.
That's going to be different in a hospital, in a setting where perhaps you have many healthcare professionals, especially given these recent shocks, that are under-slept, that are overworked, that are dealing with life and death situations. It'll be different than that as opposed to a financial firm, as opposed to a manufacturing firm, as opposed to a pilot and many other situations. Situations where you deal with people all day, situations where you don't, where maybe you're coding, but you have these, you're dealing with these frustrating problems that you just seem to be entering the same thing all day and getting back the same negative responses.
So all these types of things might elicit or might be riper areas for different kinds of mental issues. So understanding what is likely to impact your employees and using the right treatment for that, or potential treatment for that. Are you always going to get it right? No, of course not, but at least a little more thought than, "Yeah, we're just hiring this person to come in."
Brian Kenny:
We know for a fact that this generation of workers that are coming up really care a lot about what their employers believe and the values that they have. I've got to think it would be a brand enhancer from an employment standpoint if you were able to figure out how to provide the right kinds of services and really help people avail themselves of them.
This has been a great conversation, Lauren, and so appropriate for Mental Health Month. I've got one more question for you before we go, and that's just, if there's one thing you'd like people to remember about the Zak Williams case, what would it be?
Lauren Cohen:
This would be something that would be wonderful if our business community would take up the yoke of and try to push forward, but it will always start and end in the family. It will start and end in the family. What that means is that these conversations, which are always easy to prescribe but never easy to have, they need to be had, and they're really great to have tomorrow, but you got to have them today.
Brian Kenny:
Yeah. Lauren, thanks for joining me on Cold Call.
Lauren Cohen:
Yeah, it's my pleasure. Thanks so much for having me, Brian.
Brian Kenny:
If you enjoy Cold Call, you might like our other podcasts, After Hours, Climate Rising, Deep Purpose, Idea Cast, Managing the Future of Work, Skydeck, and Women at Work. Find them on Apple, Spotify, or wherever you listen. And if you could take a minute to rate and review us, we'd be grateful. If you have any suggestions or just want to say hello, we want to hear from you. Email us at coldcall@hbs.edu. Thanks again for joining us. I'm your host, Brian Kenny, and you've been listening to Cold Call, an official podcast of Harvard Business School and part of the HBR podcast network.