Cara McNulty: The Population Health Leader Who's Fierce Behind Her Why

The new CEO of Vibrant Emotional Health and former leader at CVS Health shares a  masterclass in executive decision-making.

In July, Cara McNulty became CEO of Vibrant Emotional Health after serving as President of Behavioral Health and Mental Well-Being at CVS Health. It was a big change but met all of McNulty's leadership Whys.

In recognition of National Suicide Prevention Month and following 988 Day on Sept. 8, Cara McNulty spoke with HealthLeaders about how she makes the big decisions — for publicly traded payers and nonprofits alike.

From local to nationwide crisis lines

Two years before Cara McNulty took the helm at Vibrant, the National Suicide Prevention Line transitioned from a 10-digit crisis line number to the three-digit 988 Lifeline. 988 is overseen by lead federal agency SAMHSA, which has entrusted Vibrant to be a part of the network of providers supporting 988, offering essential administrative services to those seeking help.

For more than 50 years, Vibrant Emotional Health has run multiple crisis lines — from the local NYC 988 to the NFL Life Line. Its role now includes 988, an expansion McNulty is proud of as Vibrant's new CEO.

"It took decades to develop 911. For 988's development, Vibrant used best practices plus its tremendous experience. As a broad-based organization, we had a lot to offer."

Those offerings include the infrastructure for 988's technology platforms and the more than 213 mental health centers that Vibrant contracts with across the U.S. for call routing.

"We make the experience seamless for the end user," says McNulty, adding. "Vibrant is really embedded, understanding the community so we can meet the needs of the community."

This includes those with unique needs — veterans, the LGBTQ+ population — and what is most important to meet them in moments of crisis. It's an approach McNulty describes as "Not about me without me" and one that illustrates the importance of "knowing your Why."

"What's your Why? Start with that," she advises. "If you're not fierce behind your why, you're not going to be your best."

For McNulty, this principle applies personally and professionally — and is the first of many she deploys in her executive decision-making.

Executive Playbook: How to choose the right leadership role

McNulty knew her Why when she joined Vibrant: The opportunity to be a population health leader in an entirely new way. Three of her decision factors were:

• Optimal reach: "I thought about the healthcare ecosystem, where I've been and what more I could do. I always want to have population-level impact — doing the most for people I may never meet."
• Optimal environments: "I also thought about ‘How do we create psychological safety in our work environments.'"
• Optimal place: "I asked myself: ‘Where is all this happening and most needed: A startup? A tech-forward company that supports mental health?'"

McNulty concluded: "All roads kept leading me back to an area where I haven't been, kept leading me here to Vibrant. It was a really neat process."

Executive Playbook: How to transition to nonprofit leadership

Still, leaving CVS Health wasn't an easy decision.

"I learned more there professionally and personally due to the organizational size, the infrastructure, the total impact you could have. What a powerful experience. I've never had a harder role — ever," says McNulty, noting that it began just one year before COVID.

McNulty's new role involves another big shift. CVS Health is a publicly-traded, for-profit company. Vibrant Emotional Health is a nonprofit.

"There are a ton of similarities — mainly because most people in the mental health ecosystem know their Why."

She adds, however, that many things are different: "Probably the biggest change for me is that I'm used to a lot of form and function. [At a nonprofit, y]ou don't have five financial systems to choose from; you have one, and we have to make sure we have the right things in place."

For McNulty, those right things include:

• Deep work over decks — "Another difference is that people have less time to spend on the basics, like developing decks. There's just too much work to get done. We can't fall prey to perfection and use time we could spend on strategy and innovation."
• "The muscle of fiscal accountability" — On the importance of this key skill, McNulty notes: "My past experience has brought financial rigor and understanding the importance of partners."
• "Not just good . . .  Exceptional" — McNulty prizes this in a leadership team, stressing the importance of accountability, curiosity, advance thinking and being driven by measures and outcomes.

She adds that nonprofits can "move faster and have some agility."

This is critical for McNulty's charge: to lead Vibrant through its stage of scaling and growth.

Executive Playbook: How to scale, smartly

In the coming years, Vibrant will continue to scale 988 and offer broader services beyond its crisis line and programs. This includes policy, advocacy, support, and community engagement.

"We are assessing where Vibrant is best across the mental health ecosystem and where we can leverage our skills to expand." Those skills include:

• Keeping it simple: "It's really easy in complex mental healthcare systems to make it complicated for the people who need care and support and their loved ones. There is so much noise. I don't want to create more."
• Collaborating across the industry: "I want us to collaborate and partner with the ecosystem so every organization is working at the top of its ability, not tripping over each other."
• Maintaining focus: "Where do we add the most value and why? What are our sweet spots and where should we back away because others do it better?"

McNulty notes that some of Vibrant's programs will probably remain only in New York because they are population specific. Those that will scale are relevant to many populations and scenarios (e.g., young adults, providing upstream support before someone is in crisis).

Keeping the main thing, the main thing

Cara McNulty's executive playbook ends where it began: The importance of Why.

"I know exactly why I get up every day to do this job. I don't want people to suffer in silence, to think that they're less than and not worthy. Everyone brings value."

"It takes all of us. I have learned how easy it is for us to point fingers at one or two partners. It can be easy to do that when the system is complicated. But no one can do it by themselves."

She adds: "We all play a role, and I just feel so fortunate to be here."