How Chicago's first new medical school in nearly a century is training doctors to treat mental and physical health together

Seventy-one percent of physicians say stigma surrounds mental health and seeking mental health care in their profession, according to The Physicians Foundation's 2026 Survey of America's Physicians, released Sept. 17. Thirty-six percent said they or a colleague they know had been afraid to seek that care because of mental health questions on licensing, credentialing or insurance applications, and 55% said they often feel burned out.

At the Illinois College of Osteopathic Medicine (IllinoisCOM) at The Chicago School, students and faculty take mental health first aid training alongside the CPR and basic first aid most medical schools teach early on.

The school, Chicago's first new medical school in nearly a century, welcomed its inaugural class of 91 students in July. Its Mind and Medicine course series runs through all four years, and students complete a required psychiatry rotation and a required fourth-year behavioral health rotation.

John Lucas, D.O., the college's founding dean and chief academic officer, is a board-certified emergency physician who practiced at Carilion Clinic in Roanoke, Virginia, and was senior vice president for institutional advancement and administration at the Edward Via College of Osteopathic Medicine before joining IllinoisCOM.

Michele Nealon, Psy.D., a licensed clinical psychologist and graduate of the school's clinical psychology doctoral program, has been president of The Chicago School since 2010. The nonprofit university was founded in 1979 to focus on psychology and now offers more than 40 certificate and degree programs to more than 6,000 students.

Medical Economics spoke with Lucas and Nealon about how the school trains students to treat mental and physical health together and why they think burnout prevention has to start before residency.

Our conversation, lightly edited for length and clarity, follows.

Could each of you introduce yourself and tell us a little about your role at the school?

Michele Nealon: I'm president of The Chicago School. I've been in this position since 2010. I'm a clinical psychologist, and in my role, I oversee all of our campuses across the nation.

We have five campuses as well as a strong online presence, and I oversee our academic programs. We now have 40-plus of them at the certificate, undergraduate and graduate level, and we have just shy of 6,000 students and 20,000-plus alumni across the globe. It's a wonderful position to be in.

John Lucas: I'm an emergency physician by training, and I'm the dean of the Illinois College of Osteopathic Medicine at The Chicago School. I've been here since we started this adventure in 2023.

I'm excited to have helped bring the first new medical school in Chicago in 100 years into existence, and we're excited to have our very first class studying right now. They're actually in lab as we speak. They're really eager and excited to be launching such an inaugural effort, they're laying down a great framework, and they're looking forward to starting new things.

The Chicago School has its roots in psychology. Why open a medical school, and why is now the time to do so?

Michele Nealon: It's a great first question and one that we're asked about all the time now. We have spent decades planning and preparing for professionals to be really well educated to understand human behavior, mental health and all of the factors that shape our well-being.

Bringing medical education into that history and into that program portfolio was, in many ways, inevitable in terms of the integration of physical and mental health. This has been coming to the professions that we represent for a very long time.

Of course, being in that world, we looked at the environment that we're in. It's not that we saw an opportunity. It's that we led the training of mental and behavioral health professionals, and now we're training them alongside osteopathic physicians in training, because we want to prepare them for the future they are going to work in and for how their work is going to be. They both need to understand the connection between mental, behavioral and physical health.

That goes for our psychologists, our counselors and so on, as well as the physicians, because this integrated health perspective is going to make each of those professionals more ready for the clients and the patients they see and care for, as well as the systems they work in.

So it really was the inevitability of where these professions are going. It reflects the research that has been taking shape for a very long period of time about the connection between physical and mental health. We're a very innovative university. We're also a university that responds to what the professions we are responsible for need, and how they need to evolve in and of themselves, as well as with the other professions they work with.

The last thing I would say on this is, when you think about mental and behavioral care professionals, and when you think about physicians working in primary care, they already are America's front line for mental health. It doesn't matter which piece of this you're working in.

However, physicians in particular were not trained for that front-line mental health engagement. Primary care providers see about 60% of people, for example, who are being treated for depression in the United States.

If I'm remembering my data correctly, just shy of 80% of antidepressants are prescribed by primary care physicians, and they often have little support from specialists. Yet only about 25% to 50% of patients with depressive disorders are accurately diagnosed in primary care.

So that's a real training gap, and it's a training gap that Dr. Lucas and his leadership of IllinoisCOM are intentionally closing in on. The need is there, and we accepted the responsibility as professionals and as a university to step in and address it.

What does connecting mental and physical health look like in a student's day-to-day training?

John Lucas: I think it's important to recognize that the underpinnings of this go deeply into the history of The Chicago School and its philosophy of integrated health, but also into the core philosophy of osteopathic medicine. For those who might be watching and are unfamiliar with what exactly a DO is, or what osteopathic physicians are, it's really a difference of approach and philosophy.

It takes into consideration, in a meaningful and deliberate way, the intersection of the body, mind and spirit in a person's overall well-being.

We teach our students that it's really important to pursue wellness in all of those dimensions of a human being in order to help them achieve their best life and their optimal health.

If you neglect one, it's entirely possible to be physically healthy and mentally unwell, and then you're not a well person. So that was the foundation with which we approached this.

So what does that look like when you really emphasize it? We've had great resources through the university. A university that's been dedicated primarily to mental and behavioral health for almost 50 years just has an abundance of resources.

A lot of medical schools, at the very beginning or early in training, will teach their students CPR and basic first aid. But one of the things we took very seriously was incorporating mental health first aid training for all of our faculty and students through what we call the Naomi Ruth Cohen Institute.

We provided this intensive training to faculty and students because, in reality, if we teach them CPR, they're not very likely to use CPR in the first couple of years, or even the four years, of their training. But within their own cohort, within their student body, among their friends, the incidence of mental health challenges is enormous, and so the skill they need to help their peers and their friends and family really is mandated. It's something we really want to instill, so that students who go through a very difficult thing like medical school are able to recognize classmates who might be having some distress and help each other.

On top of that basic training, we also built a four-year curriculum called the Mind and Medicine course. That is really an integrative place where we bring together mental health specialists from many disciplines, including our own physicians, psychiatrists and social scientists, and examine how the mental and behavioral aspects of a person's life directly and measurably affect their physical well-being, and vice versa.

Everyone sort of knows inherently that those two things are related. I think most people on the street would say that. But we know it in real, quantifiable ways. We know that people who have depression also have higher rates of coronary artery disease. People going through chemotherapy who have untreated depression have worse outcomes from their cancer therapies, in ways that are very measurable.

So when we looked at this, we said, here we are with this great opportunity to partner osteopathic medicine, with its philosophy of whole-person wellness, and The Chicago School, with its dedication to integrated health, and bring together these resources to teach students: This is what you can do to be the best kind of doctor you can be for your patients.

Whether they become orthopedic surgeons or psychiatrists or, like me, an ER doctor, they will always encounter these challenges with their patients, and so I think it's incumbent upon us to really prepare them for those challenges.

I'm not looking to make everybody a psychiatrist, but they're all going to know how to look for and screen for these challenges and interface with the available mental health resources on behalf of their patients when they're done. I think that's really important for us to own here at IllinoisCOM.

In their third and fourth years, everyone has to do a required rotation in psychiatry. But in fourth year, we also have a required behavioral health rotation, which is a little different from a lot of other medical schools.

We're making them spend time not necessarily in psychiatry, but with some of our mental health and behavioral health professionals, in environments where they can see a lesser reliance on pharmacologic treatments and maybe more reliance on interventional talk therapies, group therapies and the other things that a lot of people who receive care for their psychological challenges are familiar with.

Now these students will be familiar with them, too. So when they talk to their patients someday, they can say, "You know, it would be really great. I have this great counseling group I want to refer you to because they're doing fantastic work, and I have this psychiatrist who's been helping me with my patients, and we're going to get you over there."

Historically, bringing together the medical model and the psychology model has in some cases been a challenge. We're doing that on a daily basis, bringing together the doctoral psychologists and our physician faculty to teach students and prepare them really well along those lines.

Finally, there's one other piece of the day-to-day. We have a real heavy emphasis on bringing together the disciplines of medicine, and there's a particular event we hold periodically throughout our curriculum called an IFS session, which is an integrated facilitated session.

All of the specialists, so our preclinical scientists, like the biochemists and the anatomists, and then the clinicians and behavioral health doctors, come in and collaborate around the care of a simulated patient. This is an actor. We bring them in, we present a case, and we talk about all the basic science, all the clinical science and all the mental health considerations in how to take care of that particular case.

It summarizes in a meaningful way what students are learning to that point in the curriculum. That's a day-to-day experience they have, and it's teaching them to think beyond, "Oh, yeah, that's the medical diagnosis," to, "Let's talk about what other things we have to consider to make sure we're giving them great care."

Why is it important for doctors to think about mental and physical health together?

Michele Nealon: Dr. Lucas did a great job leading into this question. As he mentioned, we just can't separate mental health from physical health.

I don't know anybody who shows up as an unintegrated human being. We're integrated people when we show up at the physician's office, and because of that, physicians need to understand the relationship between mental and physical health when they are diagnosing, referring for treatment or treating the patients for whom they're responsible.

In real life, patients do not show up separately.

Just to really emphasize some of the points Dr. Lucas made, about 68% of adults with a mental health disorder have at least one medical condition.

Think about that. That's a pretty big number, and it goes in the other direction as well: 29% of adults with a medical condition have a mental health disorder. So it really goes hand in glove.

We know that having a physical illness is one of the strongest risk factors for depression, and depression itself is a risk factor for physical illness. Dr. Lucas just listed some of those as well.

You could treat a patient and not pay attention to their psychological well-being, but the outcomes are not going to be as effective. When you also focus on psychological well-being, we know that will influence physical health. And when you focus on physical health and take in psychological well-being, we know physical well-being also improves from an outcome perspective.

So treating the two together is just best practice.

Dr. Lucas always says this when he and I are chatting, and when we're in various situations such as this: If you care about nothing else, focus on the outcome. It works better. When you look at the countless randomized controlled trials out there now on integrated, team-based care, the outcomes are better for depression, anxiety and behavioral health conditions.

And when you can improve those mental and behavioral health conditions, the physical diagnoses can also improve. So when we're training physicians who understand that care is better when you integrate both, and training mental and behavioral health experts to understand how physical symptoms interact and interplay, we're doing better for our patients, because we're looking at them and treating them through the whole-person lens.

I actually sat through Dr. Lucas's onboarding event for these remarkable students, the 91 of them who are in his educational care now. I've been a licensed clinical psychologist for too many years to even count these days. I've been very attuned to these issues, and I'm informed in many ways. I practiced, when I was practicing actively, and I've been engaged strategically and tactically in building out an integrated health care agenda for The Chicago School and the professions we represent.

But I sat in that room at a table with many other clinical psychologists who are on the faculty at The Chicago School, and the physicians were looking at the simulated patient's diagnosis through the medical lens, and light bulbs were going off in my head. I was being educated about things I had not considered before in that simulated situation.

I was thinking about the diagnosis, the potential treatment plan and the prognosis, and about the questions they were going to ask the students and the faculty members and administrators in the room, all through the lens of a clinical psychologist. And there were physicians presenting it through the lens of osteopathic medicine.

Then, in just a remarkable way, toward the end, Dr. Lucas led his team toward discussing the integration of both disciplines in the diagnosis of the client, in this case a mother with a young infant. It was so rich and so informed, even including the ethics a practicing physician would need to consider, because the question was, who's your patient?

Those are the pieces where even a psychologist like me walks out of that room going, "My goodness, right there is integrated health." At the very end, the psychiatrist on Dr. Lucas's team came in and began to put the pieces together, and what an experience. When I think about it, that is how we work in real-life settings, and yet we're not training our students, and indeed our professionals, to think that way, let alone treat that way.

So the real short answer to your question about why it's important: The outcomes are better, and isn't that what we're here for? Whether you're a physician, a psychologist or a behavioral health specialist, that's what we show up to do, and therefore that's what we've got to teach and support our students in learning as they move on to be the next generation of front-line providers.

John Lucas: In my career in the emergency department, about 17 years of it, a lot of the patients who come to mind are the ones for whom we didn't have a diagnosis.

They had a problem and we hadn't figured out what it was yet, and that's where the mental health care part of our job really comes into play. There were patients I remember vividly who would just cry because they had come in for a problem, we did a bunch of tests, and we didn't find anything wrong.

They would look at me and say, "You probably think I'm crazy." I would take the time and say, "Actually, no, I don't think that at all. I think you're legitimately uncomfortable and having a problem, and this is how we are going to approach this. I take this very seriously, and these are the next steps we're going to follow." Their reaction was relief. They would say, "It's the first time that somebody has really validated this for me."

A lot of medicine isn't like it always is on TV, where you get a great diagnosis and then somebody walks into the room. Sometimes it takes a while, and sometimes those tests are inconclusive.

The art of the thing, taking care of another human being, involves mental health care so intimately that if you don't attend to it, you can actually cause injury. When you hear somebody worried that they're losing their mind because they have a symptom nobody can find the cause of, just being able to live in that space with them as a physician and say, "No, I want to validate this. I believe you, and we're going to keep looking until we find out what's going on," does enormous good. If we can get our students ready for that, then I think we will have done great good for the future patients they'll see.

Michele Nealon: I always joke with Dr. Lucas that he really is a psychologist as well as a DO. Isn't what he said, as well as how he said it, how every one of us would want it to be when we walk into our physician's office? To know that is the person, the demeanor, the understanding and the care you're going to receive.

And [Medical Economics] just wrote about this, about burnout and loss of life to suicide. People are talking about this more and more. We recognize now, and I know we're going to talk about it later, that one in five people now have a diagnosed mental health disorder. People are struggling. They're not feeling great, regardless of what office they show up to.

A lot of people are under stress, and people listening to this will see and hear themselves in what Dr. Lucas and I are talking about. It's one thing to be seen, and it's one thing to be heard. As practitioners, we want to make sure that you are then appropriately diagnosed, appropriately treated and appropriately followed up in a way that legitimately will help you get on your feet, stay on your feet and walk toward a real quality life.

Why is it important for burnout prevention to start in medical school instead of waiting until residency or until a physician begins to practice?

John Lucas: Burnout gets a lot of press, and in order to start talking about it, you have to get a foundational understanding of what we're talking about.

I think burnout, in general, is a long-term mismatch between what your expectations of your professional life or your personal life would be and what they're actually like. We consistently see the effects of burnout in physicians in high-stress specialties like emergency medicine, but in other ones, too.

The data are showing that physicians who feel burnout, or have high scores on burnout, consistently indicate a feeling of loss of agency, meaning they don't feel like they direct their own lives. They don't feel like they have control over their practice and their decisions. They feel like they're just a cog in a wheel, if you will. Some of that has come about because of the state of modern medicine and how medicine is practiced specifically in our country, and some of the issues around the corporatization of medicine.

So to answer your question, why now? I think the answer has multiple parts.

One, the stress of medical practice starts in medical school. If we can give our students effective tools to know themselves, to manage their own stress and to find productive outlets for their anxieties and the normal parts of that which happen in a crazy environment like med school, then those patterns of behavior and those adaptive behaviors will persist through the other stressful parts of their lives. Med school is very stressful. Residency is very stressful. Practicing doesn't magically get less stressful; it all just evolves and changes. So starting early and giving them the tools they need for a long career in medicine makes sense, and medical school is where the stress starts. There's really not much like medical training in the world. We know this, and so it's a great time to start early.

The other thing occurred to me at our orientation. We had a guest speaker, a very prominent DO, who was the CEO of a big hospital organization. They were talking about different factors in medical practice these days, specifically how you avoid burnout and how we deal with the realities of a medical system that is so broken now.

There are so many things in our medical system that are broken. As this person started talking about some of the answers, it occurred to me, and I actually got up and added: One of the ways to do this is to recognize that you all are at the forefront. You are the change agents.

If you believe that something is broken, right now is when you can start positioning yourself to make a difference. So it's not just taking care of patients; it's helping fix the system.

If you start having that conversation when you're well into your practice, when your life is more fleshed out and you're worrying about all the things that come along with living a life, it's harder than if you see at the very beginning, "Wow, this thing is really broken, and I'm going to focus on that now and figure out as I go through my process how I can help fix it," because that's where the change is going to come from.

It's going to come from young, motivated, fresh-thinking people and young physicians who say, "You know what, this is broken, but I don't want to leave it broken. We're going to contribute to fixing it." So I think starting in medical school is exactly the right time, before they really get on the road and determine what path they're going to take to find their passions around the parts of the medical system that are broken and that they might want to try to fix. I think that's really, really important.

Burnout factors into medicine beyond its most prominent feature, which comes when we have the tragedy of suicidality within the profession.

In terms of numeric impact, we have an even greater issue with early retirement, emotional unavailability and physicians checking out of engagement because they're just tired of the system.

The loss of productivity from those categories surpasses it. That's not to minimize the incidence of suicidality in the physician population. It's horrible and tragic, and we absolutely have to address it. However, burnout is way broader than that and casts a much wider net, with downstream effects people will see when they go to their family doctor.

Most people have gone to a doctor who just seems burned out and not engaged, just punching the clock. That didn't happen overnight. If you go to any one of these students, they don't have that.

They have excitement and energy and enthusiasm, and our job is to try to protect that, because that's what we want when they're taking care of their patients. We want energy and enthusiasm and positivity, not cynicism and burnout. How we instill that is part of our process.

Let’s talk about the stigma in health care. Some doctors worry that seeking help for their own mental health could hurt their careers. How much can medical school do to reassure students that it's OK to seek help?

Michele Nealon: It's a great question. Again, you put something out there into the world, you start talking about it, and that is the beginning of change. When you think about a physician, their well-being is closely connected to their ability to provide compassionate, attentive and effective care.

I'll say that again, because it's really important to think about a physician and their intent, their identity and what gets them to work every day: Their well-being is closely connected to their ability to provide compassionate, attentive and effective care.

We know that medicine is an extraordinarily demanding profession. I sometimes talk now with the physicians on our campus, and I listen to what their lives have been like caring for their patients, and it's just exhausting to think about what they sometimes go through.

No matter what you hear them talking about, what they come back to all the time is their relentless focus on caring for their patients. One of the most heartbreaking things to listen to is when they talk about times they could not help a patient, what that does to their own sense of well-being, and how over time they begin, slowly but surely, to stop attending fully to their own needs, in particular their mental health needs.

The stigma is well documented, and it starts very early in a physician's career. About one in four medical students begin their educational and career journeys with depressive symptoms, and yet only about 16% of those who screened positive went on to seek treatment for their depression.

One of the big factors there was that even then, they were reluctant to come forward and talk about how they were doing, and that reluctance follows them into their practice. In one Mayo Clinic study, for example, nearly 40% of the physicians asked said they would hesitate to seek out mental health care because of concerns about their medical license.

During the COVID-19 pandemic, The Chicago School was called upon to get involved with physicians at some major hospitals across the country. It was about educating on mental health and mental health first aid, educating on all of these things we're talking about, as well as giving professional advice and direction on how to support yourself and how to seek help when that self-support is just not cutting it.

We made it possible for the physicians to participate in our trainings and webinars in a manner that would not identify them in any way. They didn't even have to show themselves on these Zoom trainings. And even then, in one of the worst moments of their lives as front-line caregivers, they felt the stigma of coming forward to talk about the strain, the stress and the mental health deterioration they were experiencing.

So look, we cannot just tell students that how they feel is OK. We can never normalize stigma. The conversations about stigma are getting bigger and bigger, and sometimes stigma actually elevates to harassment and discrimination, and people know that.

This is why Dr. Lucas and his team have really built mental health into their Mind and Medicine curriculum, in all four years. Students are trained in mental health first aid. They are trained in understanding suicidal ideation.

They are trained in not only the acknowledgment but the understanding that to be an effective health care professional, you have to take care of yourself. It's not a sign of weakness. Too often, not just physicians but society as a whole are taught, explicitly and implicitly, that mental health issues are a sign of weakness, and they're not, any more than asthma is a sign of weakness.

So for our physician students, it is essential to establish that mindset as early as possible: It's not a weakness. This is what it is.

There is some progress here as well. State medical licensure boards are beginning to look at their applications so that they no longer include intrusive, really stigmatizing mental health questions.

There is change. As a society, not just as the professions we represent, we have begun to acknowledge that mental health is actually a thing, well-being is a thing, stigma is a thing, and discrimination and harassment over mental health issues are a thing. You can see, especially in the younger generations, that they're becoming quite emboldened to have those conversations.

I even see it in my children. Well, they wouldn't like me calling them children; my adult sons are 27 and 21. They're very fluent about mental health. Their expectation of society and employers is that we're very fluent about mental health, and more and more they're able to talk about what you do to sustain positive mental well-being, as well as what you do to address mental health issues as they arise in yourself, your friends, your peer groups or your colleagues.

We're seeing that coming into medicine as well, and not a second too early, in my opinion. Not a second too early.

John Lucas: To piggyback on that, I think we as educators have to be willing to admit some of the challenges. Seeing the tragedy on a daily basis in the emergency department for that long, you don't escape that unscathed. I don't care how healthy you are mentally.

In the evolution of our brains, we're not equipped to handle that level of tragedy and stress on a daily basis without some sort of pressure valve.

One of the things I love to see nowadays, strangely enough, is in the media. All the students love the show "The Pitt," right? Everybody loves "The Pitt." It's a great show.

One of the things I love about it is that it emphasizes this duality: You have these exceptional people who have become medical professionals, but it also highlights the fact that on some level, they're actually just people. Yes, they have exceptional qualities, but they also have the same gray matter as the rest of us, the same synapses and the same reactions to stress, and these things have consequences.

It's implicit in those characters that they seek help, and some of them talk about it on the show: "Yeah, I struggled with that, and I went and got myself some help, and it really made a difference, and now I know how to walk through this day."

It's nicely reflective of this awareness, this growing acceptance, that people who become physicians are exceptional in a lot of ways, but they're OK to be human in the ways that matter for their own health.

Physicians get sick. We get depression, we get PTSD, we get those same things, and there should be no expectation that knowing about them, or taking care of patients, somehow gives you a free pass out of that category. We all get it.

I love how more shows now, and not just that particular one, highlight the humanity part of being a physician. I think that makes a difference. Honestly, every one of the students downstairs right now watches "The Pitt." They all do, and so I think it matters.