Latest / Behavioral Health Brief / Ep 3 | Mental Health In Action: Connecting People To Care, Hope, and Recovery

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Ep 3 | Mental Health In Action: Connecting People To Care, Hope, and Recovery · Behavioral Health Brief

0:06
Speaker 1: Welcome to the Behavior of Health Breed. I'm Jim Callahan,
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Speaker 1: CEO of TURN Behavioral Health Services and organization driven by
0:15
Speaker 1: one clear mission, improving lives. I often ask myself is
0:20
Speaker 1: there anything more important than that? My belief is this,
0:24
Speaker 1: When improving lives guides our decisions, stronger systems and healthier
0:29
Speaker 1: communities follow, That is the hope behind this podcast. Today's
0:35
Speaker 1: episode is about mental health awareness, what it really means,
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Speaker 1: what it doesn't, and how we move forward with greater
0:42
Speaker 1: understanding and clarity. Because while awareness has grown, misconceptions still
0:48
Speaker 1: exist that those misunderstandings can shape how people access care,
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Speaker 1: how they seek help, and how we respond as a community.
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Speaker 1: We'll explore what it takes to move beyond on awareness
1:01
Speaker 1: into action, into access, and ultimately into impact, including how
1:07
Speaker 1: models like the internationally recognized Assertive Community Treatment or ACT
1:13
Speaker 1: model help bring that care directly into the community. Joining
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Speaker 1: us today is doctor Laura Otis Miles, executive vice president
1:21
Speaker 1: at Termed Behavioral Health Services, where she spent fifteen years
1:25
Speaker 1: of her career with TURN, and she joined TURN in
1:28
Speaker 1: twenty ten. Her background is residential treatment director with the
1:33
Speaker 1: Department of Veteran Affairs, supporting veterans experiencing homelessness and complex needs. Welcome, Laura.
1:39
Speaker 1: We're really glad to have you on the Behavioral Health
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Speaker 1: Brief today. So let's talk about the journey into your work.
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Speaker 1: Your path here is both personal and professional. What led
1:52
Speaker 1: you into this field?
1:53
Speaker 2: Thank you, Jim.
1:54
Speaker 3: I'm honored to be here and participate in the Behavioral
1:57
Speaker 3: health Brief. My journey began and when I was young.
2:02
Speaker 3: I have two younger sisters and one of my sisters
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Speaker 3: has mental health and learning disabilities, and being the older sister,
2:12
Speaker 3: I was looked upon to help take care of my
2:16
Speaker 3: sisters and support them as both my parents worked. My
2:22
Speaker 3: parents did their best to take my sister to the
2:27
Speaker 3: doctor to find out what was going on. She was
2:29
Speaker 3: struggling in school, She wasn't making friends and in fact,
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Speaker 3: she was really harassed and bullied while at school, and
2:38
Speaker 3: she got misdiagnosed and bounced around different providers, and during
2:46
Speaker 3: her teenage years she became one of those kids where
2:49
Speaker 3: it was like she didn't want to go to another appointment.
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Speaker 3: She just refused to engage in treatment and move forward.
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Speaker 3: And my dad at the time really looked at me
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Speaker 3: as older sister on like what can I do. At
3:03
Speaker 3: this point, he was a law enforcement He had several
3:07
Speaker 3: positions within the San Francisco Police Department and had really
3:11
Speaker 3: instilled in me an interest in working in public service.
3:17
Speaker 3: I became really interested in psychology based on the experience
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Speaker 3: of what I saw going on with my sister and
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Speaker 3: what was happening to her and the impact that it
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Speaker 3: took by the time that she was a teenager. And
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Speaker 3: so from then I decided to go off to college
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Speaker 3: and major in psychology and social work. I went to
3:38
Speaker 3: the University of California at Berkeley, where I got my
3:40
Speaker 3: bachelor's degree, and then following that I decided to go
3:44
Speaker 3: on for my doctorate, and I learned that at the
3:46
Speaker 3: University of South Carolina, well you went all the way
3:50
Speaker 3: across country, all the way across country. University of South
3:53
Speaker 3: Carolina had a dual focus doctorate on both clinical and
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Speaker 3: communities psychology, and that really aligned with my interest in
4:04
Speaker 3: psychology and social work because the community psychology piece was
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Speaker 3: all about community mental health and working in the community
4:12
Speaker 3: and bringing services to clients and how to do work
4:16
Speaker 3: that was early intervention and prevention, which is really what
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Speaker 3: my sister didn't wind up getting by way of being
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Speaker 3: bounced around between different providers and misdiagnosed, she really didn't
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Speaker 3: get the early intervention that, in my opinion, she needed.
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Speaker 3: So following University of South Carolina, decided it was time
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Speaker 3: to come back home to California and landed at University
4:41
Speaker 3: of California, San Diego for my predoctoral internship and postdoctoral fellowship.
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Speaker 4: And.
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Speaker 3: Through the work there, I did a placement in the
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Speaker 3: Department of Veterans Affairs at the VIA Medical Center and
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Speaker 3: that began my wor leading to my residential Treatment director
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Speaker 3: position working with Vietnam era veterans, and I really found
5:08
Speaker 3: myself gravitating towards working with those veterans because they had
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Speaker 3: challenges with navigating the VA system of care, and they
5:18
Speaker 3: also experienced stigma and discrimination coming back from Vietnam that
5:25
Speaker 3: impacted their willingness to even engage and looking at how
5:30
Speaker 3: to navigate the VA system for care, even going outside
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Speaker 3: the VA system for care, and that really just resonated
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Speaker 3: with me with the experience from what my sister had
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Speaker 3: gone through and continued to motivate me to work in
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Speaker 3: community mental health and progress my career. And following my
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Speaker 3: time at the VA, I had the opportunity to come
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Speaker 3: to turn Behavior Health Services fifteen years ago. I started
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Speaker 3: as vice president and I've had a couple of different
6:02
Speaker 3: positions within the agency as you know about, and currently
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Speaker 3: I have the honor of overseeing several divisions of our
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Speaker 3: mental health and substance use treatment programs in San Diego
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Speaker 3: as well as all the way back up to the
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Speaker 3: San Francisco Bay Area, where I'm originally from and started
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Speaker 3: my journey.
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Speaker 1: Interesting, So let's go back. What comes up for me
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Speaker 1: is there's a moment in time when you were experiencing
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Speaker 1: with your family, what your sister was struggling with, that
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Speaker 1: put you on the journey all the way through your
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Speaker 1: doctorate and where you are today. What kep you motivated?
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Speaker 1: I mean, because that moment in time has brought you
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Speaker 1: to today and it's still I'm sure is something that
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Speaker 1: comes up for you when you think about it. So
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Speaker 1: describe that that feeling and that momentum and that motivation
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Speaker 1: that came from that moment in time.
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Speaker 3: Well, I would say that I found the work to
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Speaker 3: be extremely fulfilling and rewarding. So it does go back
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Speaker 3: to the people along the way, not just you know,
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Speaker 3: my coworkers and colleagues, but you know, really learning from
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Speaker 3: the clients that I've served, you know, over the course
7:19
Speaker 3: of time, and really wanting to have you know, an impact.
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Speaker 3: You know, my affiliation with the mission of Turn to
7:29
Speaker 3: improve the lives of the individuals, families, and communities.
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Speaker 2: We serve is what keeps me motivated.
7:38
Speaker 3: And by continuing to do this work, I get to
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Speaker 3: have that you know reward, you know, every day, And
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Speaker 3: as an executive VP, I'm really fulfilled by investing in
7:52
Speaker 3: our workforce, by being able to lead and you know,
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Speaker 3: create that impact at scale with our teams means that
8:05
Speaker 3: by them feeling empowered and supported, they're going to deliver
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Speaker 3: better care to our clients and families, and better care
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Speaker 3: means better outcomes.
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Speaker 1: Yeah, you know, I wanted to touch base real quick
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Speaker 1: on the veterans component. How did you feel when you
8:19
Speaker 1: watched Sheldon on our initial podcast offering when you saw
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Speaker 1: him share his story about PTSD. Was that really compelling
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Speaker 1: for you to bring back the days that you worked
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Speaker 1: at the VA when he started to share after thirty
8:33
Speaker 1: years he didn't know he had it, and one clinician, Yeah,
8:37
Speaker 1: and a primary doctor diagnosed him and changed his life,
8:40
Speaker 1: So just maybe share of some of your experiences at
8:43
Speaker 1: the VA.
8:44
Speaker 3: Yeah, that story that he told was so powerful. I'm
8:49
Speaker 3: pleased you brought that up because that was the first
8:52
Speaker 3: airing of the Behavioral Health Brief And when I was
8:57
Speaker 3: listening to the podcast, it did remind me of so
9:00
Speaker 3: many of the veterans that I had the honor to
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Speaker 3: serve at the Department of Veterans Affairs. The residential treatment
9:10
Speaker 3: program where I worked was actually based at the Indianapolis VA,
9:14
Speaker 3: So I did do a few years in the Midwest,
9:18
Speaker 3: you know, before coming back again to California to open
9:22
Speaker 3: up their residential treatment program called a domicillary and we
9:28
Speaker 3: were serving veterans returning from the Global War on Terrorism,
9:34
Speaker 3: Operation Iraqi Freedom, Operation Afghanistan Freedom.
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Speaker 2: And it really for.
9:43
Speaker 3: Me was really being aware of the differences of those
9:47
Speaker 3: returning veterans in terms of what they received. They didn't
9:51
Speaker 3: have the same stigma that the Vietnam Veteran era veterans did.
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Speaker 3: And currently our operation of the Courage to Call program,
10:04
Speaker 3: we see the similar dynamic of having younger era veterans
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Speaker 3: coming into the program as well as the older Vietnam veterans.
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Speaker 3: And Sheldon's story about how long it took him to
10:18
Speaker 3: be appropriately diagnosed and engage in treatment services is what
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Speaker 3: we see more often than not. So continuing to do,
10:29
Speaker 3: you know, outreach in a way that brings the services
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Speaker 3: to where the clients are, you know, by creating a
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Speaker 3: phone number that they can call, by staffing the program
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Speaker 3: with veterans themselves or family members of veterans also makes
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Speaker 3: a difference because it really helps sort of open up
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Speaker 3: the doors wider for them with acceptance, without stigma and
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Speaker 3: discrimination of what they may have experienced.
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Speaker 1: Some of what Sheldon said which really stuck with me,
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Speaker 1: was I didn't realize that the nightmares were PTSD, and
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Speaker 1: it took me thirty years to figure that out and
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Speaker 1: now almost, like he said, my life as whole again.
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Speaker 1: So just amazing. So that's really some great experience. What
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Speaker 1: is this industry that you're in, that we're in behavioral
11:15
Speaker 1: health mean to you?
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Speaker 2: I find the behavioral health field.
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Speaker 5: To me.
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Speaker 3: Fundamentally means restoring hope, dignity, and the possibility for people's lives.
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Speaker 3: It's about coming alongside and walking with them through their
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Speaker 3: journey of recovery and empowering them with honoring their lived experience.
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Speaker 2: As a leader.
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Speaker 3: The behavioral health field is also for me about a
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Speaker 3: call to action, which is supporting those that are the
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Speaker 3: most vulnerable, and that goes back to the need for
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Speaker 3: community based mental health and substance use co occurring disorder services.
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Speaker 3: And by investing in our workforce, we're creating environments where
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Speaker 3: both the clients that we serve and the staff that
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Speaker 3: we have on board to thrive.
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Speaker 1: What really drives your purpose at all?
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Speaker 3: This My purpose and passion are driven by my personal
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Speaker 3: and professional journey, as I shared from you know, when
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Speaker 3: I was young, you know, as a first hand witness
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Speaker 3: to the challenges presented by my sister's conditions and the
12:44
Speaker 3: impact it had on her and us as a family.
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Speaker 3: And so from a young age, that perspective shaped my
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Speaker 3: understanding and drove my path into psychology, which continues to
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Speaker 3: ground me and the work that I do to this day.
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Speaker 3: So I'm also passionate about leading in a way that
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Speaker 3: is framed within the broader responsibility of how to bring
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Speaker 3: that impact to scale by developing programs, systems and teams
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Speaker 3: that can meet the need and achieve our mission of
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Speaker 3: improving lives of the individuals, families, and communities.
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Speaker 1: We serve if you don't mind talking about your sister
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Speaker 1: and then her journey, because I know your sister. You've
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Speaker 1: talked to me about your sister, so maybe you could
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Speaker 1: share with our audience today how is she doing? What
13:40
Speaker 1: was her journey like? Why you were going through your
13:42
Speaker 1: journey and your education and stuff. How was that journey
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Speaker 1: for her?
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Speaker 3: Yeah, I am proud to say that my sister is
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Speaker 3: doing extremely well. My other sister, who's also in the
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Speaker 3: behavioral health field, followed in my footsteps. She became a
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Speaker 3: licensed professional clinical counselor, and we talk all the time
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Speaker 3: about Between her and I, we were both my other
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Speaker 3: sister's employment and job coach because one of the things
14:15
Speaker 3: that was important to my family was how to ensure
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Speaker 3: that my sister was, you know, building a life that
14:24
Speaker 3: gave her a sense of meaning and purpose and connectedness.
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Speaker 3: So even though she didn't have the peer relationships and
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Speaker 3: friendships and social network that me and my other sister have,
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Speaker 3: we had to help support her in building that and
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Speaker 3: through her obtaining some schooling, she got her associate's degree
14:50
Speaker 3: at our local community college. And then I'll give a
14:56
Speaker 3: shout out to which has been one of our community
15:00
Speaker 3: partners Safeway or Vaughn's here in San Diego has been
15:05
Speaker 3: her employer for almost twenty years.
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Speaker 2: Clerk.
15:09
Speaker 1: Wow, that's amazing. Yes, quite the journey for her as
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Speaker 1: you were doing your journey. That's terrific. Now your others
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Speaker 1: are you the oldest? Yeah? So your other sister followed you. Yes,
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Speaker 1: Well she's going to go get her psych degree that
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Speaker 1: I need to be doing. That's similar, Vein, so absolutely interesting. Interesting,
15:26
Speaker 1: that's really great. Our next area of focus today is
15:29
Speaker 1: going to be Mental Health Awareness Month. For those of
15:32
Speaker 1: you in the audience don't know, May is mental Health
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Speaker 1: Awareness Month, established more than seventy years ago, raises awareness
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Speaker 1: around reducing stigma, encouraging early support. But there's still misconceptions
15:46
Speaker 1: that are out there, and we'll talk about those myths
15:49
Speaker 1: in a few minutes. But Laura, if you could share
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Speaker 1: what Mental Health Awareness Month means to you in your
15:54
Speaker 1: role as the evp ITT term Behavioral Health Services.
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Speaker 3: Mental Health Awareness Month means to me an opportunity to
16:04
Speaker 3: highlight the importance of engaging in stigma reduction about what
16:11
Speaker 3: it means to have a mental health illness. And these
16:16
Speaker 3: days we know that there's co occurring substance use disorders
16:20
Speaker 3: as well. And one of the things that I like
16:23
Speaker 3: to take the opportunity to do when wearing my green ribbon,
16:27
Speaker 3: which is about yes, you've got yours, I got mine,
16:31
Speaker 3: which for me represents hope, growth, renewal, and really joining
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Speaker 3: with the community to support individuals with mental illness and
16:48
Speaker 3: co occurring substance use disorders in their recovery journeys, to
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Speaker 3: not be ashamed by that, to stand up and advocate
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Speaker 3: for meeting the need to the community, whether that be
17:02
Speaker 3: with advocacy for funding opportunities or individual connection with being
17:08
Speaker 3: able to help somebody in need. We know that, you know,
17:13
Speaker 3: there's a lot of people that are struggling in silence
17:16
Speaker 3: that haven't necessarily reached out for help, and so part
17:20
Speaker 3: of Mental Health Awareness Month provides that opportunity for you know,
17:24
Speaker 3: many agencies to provide outreach on numbers to call, access
17:30
Speaker 3: to services, whether it be suicide prevention or courage to
17:34
Speaker 3: call peer helpline, serving our veterans in our military families.
17:39
Speaker 1: Maybe you could also describe what we do internally for
17:42
Speaker 1: our participants in clients on Mental Health Awareness Months, because
17:46
Speaker 1: we're going to talk later about the number of programs
17:48
Speaker 1: that we operate. But what is it that we do
17:51
Speaker 1: for our participants in clients to make them aware or
17:55
Speaker 1: feel more comfortable with where they're at, especially with some
17:58
Speaker 1: of our clients who do have co disorders.
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Speaker 3: Well, you know, many of our programs operate you know,
18:04
Speaker 3: services on site at the programs and then out in
18:07
Speaker 3: the field, and we do a lot of distribution of
18:10
Speaker 3: the green ribbons to support their home and growth and renewal,
18:17
Speaker 3: to again join with them and walk alongside and be
18:21
Speaker 3: with them, to support their you know, recovery journey and
18:23
Speaker 3: honor their lived experience. Creating opportunities for our clients to
18:29
Speaker 3: share their stories, whether that be within you know, a
18:33
Speaker 3: treatment and rehabilitation group or another speaking opportunity. Looking forward
18:40
Speaker 3: to the Behavioral Health Brief, taking advantage of the connection
18:44
Speaker 3: we made with our clients to bring some of those
18:46
Speaker 3: with lived experience on who may be graduating from our programs.
18:51
Speaker 3: So we have a lot of graduations typically at this
18:54
Speaker 3: time of year as well, that align really nicely with
18:56
Speaker 3: mental health awareness.
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Speaker 5: In fact, we have a graduation tomorrow night for Turn
19:00
Speaker 5: to Recovery. Turn to Recovery is graduation and so that'll
19:04
Speaker 5: be those are always so uncompelling all the graduations that
19:07
Speaker 5: we do across our company.
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Speaker 1: When we have them, that just makes the hair on
19:12
Speaker 1: my arms and my back stand up, and it makes
19:15
Speaker 1: me so proud when we see all of those clients
19:18
Speaker 1: that graduate. So maybe what we do now is we'd
19:20
Speaker 1: love to talk about some of those myths. And I'm
19:23
Speaker 1: going to ask you a couple of the myth questions
19:25
Speaker 1: that we hear out there about mental health. What I
19:29
Speaker 1: hear often is that mental health issues are rare. From
19:32
Speaker 1: your perspective, Laura, is that accurate?
19:36
Speaker 2: That is not accurate.
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Speaker 3: I want to start by talking about why there is
19:41
Speaker 3: a myth that mental health issues or mental illness is
19:45
Speaker 3: rare that comes from the history of people with mental
19:51
Speaker 3: illness being institutionalized or being within families where there was
19:57
Speaker 3: an effort to keep those kinds of challenges grit and
20:01
Speaker 3: held back from public view. But what we know now
20:05
Speaker 3: in terms of busting that myth is that one in
20:09
Speaker 3: five adults experience mental illness within a year, and fifty
20:17
Speaker 3: percent of Americans will experience a mental illness within their lifetime.
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Speaker 1: Really mm hmm, So what population in the United States
20:27
Speaker 1: is going to experience a mental health.
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Speaker 2: Issue in their in their lifetime.
20:31
Speaker 1: Wow, and so that's a huge statistic.
20:34
Speaker 2: Yeah.
20:35
Speaker 3: Yeah, So mental illness is not not rare. What's rare
20:41
Speaker 3: is the experience of those with mental health conditions and
20:46
Speaker 3: co incurring substance use disorders feeling comfortable about speaking about
20:50
Speaker 3: their experiences publicly. That's more rare. Although with Mental Health
20:55
Speaker 3: Awareness Month and other opportunities to advocate against stigma and
21:01
Speaker 3: discrimination of those with these conditions, you're finding more and
21:05
Speaker 3: more efforts to have the rarity become publicly more you know,
21:12
Speaker 3: less rare by way of more advocacy and communication.
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Speaker 1: I think COVID really brought mental health awareness to the
21:20
Speaker 1: forefront and every.
21:22
Speaker 2: That's a terrific example absolutely.
21:25
Speaker 1: When everybody was locked up and stuff like that. And
21:30
Speaker 1: I think, you know that's what we saw, an emphasis
21:33
Speaker 1: as an essential service provider. It so really the need
21:36
Speaker 1: in our communities or mental health because maybe you could
21:39
Speaker 1: describe not so sure. I can't think of the right
21:44
Speaker 1: term to ask the question in this but how does
21:48
Speaker 1: mental health come about? Not come about? But how do
21:51
Speaker 1: you recognize it for somebody out there who may not know?
21:55
Speaker 1: Like last time I asked Sharon about getting stuck. So
22:00
Speaker 1: what's the simplest diagnosis of mental health that somebody may experience.
22:05
Speaker 1: Can you describe that well?
22:07
Speaker 3: For I would say for family members, and I think
22:11
Speaker 3: I'll target this response to families that have children and
22:16
Speaker 3: youth and teenagers in the home, because when you brought
22:19
Speaker 3: up COVID nineteen pandemic, that reminded me that probably the
22:24
Speaker 3: largest area of impact we saw in the community with
22:27
Speaker 3: communication about mental health awareness and how to intervene and
22:33
Speaker 3: prevent problems from exacerbating was in the youth community, because
22:39
Speaker 3: you know, children weren't going off to school and that
22:42
Speaker 3: impacted their ability to keep their friends and engage in
22:47
Speaker 3: social activities. That's so important for the development, you know,
22:51
Speaker 3: of our children in youth. So I would say that
22:55
Speaker 3: it's just important for observation and typically one of the
23:01
Speaker 3: things that can be noticed is just a difference in
23:05
Speaker 3: behavior and engagement. Usually folks that are struggling will withdraw
23:12
Speaker 3: and maybe isolate more, particularly youth and teenagers. And we
23:17
Speaker 3: could have probably a full podcast on the impactor screen
23:20
Speaker 3: time and social media and how that's pulled you know,
23:26
Speaker 3: children in youth from again more the pro social and
23:30
Speaker 3: active engagement in school life after school life, you know,
23:38
Speaker 3: that can really continue to support their trajectory towards you know, success.
23:43
Speaker 1: You know it's funny that you mentioned that, because it's
23:45
Speaker 1: not funny. I shouldn't say it's funny. But I was
23:47
Speaker 1: approached by a father of a son or his son,
23:51
Speaker 1: and he said, you know, going into COVID, everything was
23:55
Speaker 1: great right or before COVID, he was the star of
23:58
Speaker 1: the baseball team. He was straight in and everything. But
24:01
Speaker 1: coming out of COVID, I need help, Jim. He is
24:04
Speaker 1: no longer interested in baseball. His grades have fallen off
24:07
Speaker 1: and suffer. He's not engaging with his friends the way
24:10
Speaker 1: he was engaging. And I really need some help. Where
24:13
Speaker 1: can I go? And I was hearing that multiple times
24:16
Speaker 1: from families, and then I guide him to some of
24:19
Speaker 1: our folks in the programs to be able to help
24:22
Speaker 1: them guide them to the next step. But just you
24:26
Speaker 1: bringing that up brought back to me that whole I've
24:29
Speaker 1: had probably four or five families reach out and just say,
24:32
Speaker 1: I need help. This is what's happening. I didn't realize
24:35
Speaker 1: that that could be a form of mental health, what
24:38
Speaker 1: you just described. And then the family I described so interesting.
24:42
Speaker 1: How about myth number two, the assumption most people who
24:46
Speaker 1: need help are getting it. What's the reality there?
24:49
Speaker 3: Yeah, the reality is that about half of people with
24:56
Speaker 3: mental health condition and cocquurring substance used to disorder don't
25:02
Speaker 3: access services and get.
25:04
Speaker 2: The treatment they need.
25:05
Speaker 3: The myth is based on the perception that because there's
25:09
Speaker 3: been increased access to healthcare, like, for example, the Affordable
25:16
Speaker 3: Care Act, which created more individuals to gain access to
25:21
Speaker 3: medical benefits in the state of California, or parity laws
25:26
Speaker 3: with insurance reimbursement being equal for mental health treatment alongside
25:32
Speaker 3: physical health care treatment, created this myth that, you know,
25:37
Speaker 3: if the services are there, that people are getting the
25:40
Speaker 3: treatment that they need. But the reality is there's a
25:44
Speaker 3: gap and about half aren't getting the treatment that they need.
25:49
Speaker 3: Now there's a combination of factors as to why not.
25:51
Speaker 3: You know, it may be related to insurance and ability.
25:56
Speaker 1: To pay to access the programs.
25:58
Speaker 3: Correct right on eligibility criteria, and some services require insurance
26:05
Speaker 3: as you know, and the work that we do at
26:07
Speaker 3: turn we primarily serve individuals with either no insurance or
26:12
Speaker 3: medical So there's then.
26:15
Speaker 1: You're served in our community.
26:16
Speaker 3: Absolutely and therefore the most vulnerable and most at risk.
26:21
Speaker 3: But there also is the impact which I talked about
26:23
Speaker 3: earlier about stigma and discrimination. Some individuals and families don't
26:28
Speaker 3: access care because of the fear of that consequence. And
26:33
Speaker 3: then we also have to keep in mind that services
26:36
Speaker 3: not all services are gender responsive or culturally appropriate, So
26:42
Speaker 3: you know, we know that within different cultures and families.
26:45
Speaker 3: There's also views about what does that mean to actually
26:50
Speaker 3: access care that might withhold.
26:51
Speaker 1: You know, that kind of brings us right to myth
26:54
Speaker 1: number three. There's also a belief that treatment doesn't really work.
26:58
Speaker 3: What would you say to that, Well, there's plenty of
27:01
Speaker 3: research that shows that behavioral health treatment, especially treatment that's
27:08
Speaker 3: delivered based on the evidence based model behind that treatment,
27:14
Speaker 3: has shown effective therapy, which is like counseling services, when
27:21
Speaker 3: delivered appropriately, typically have about a seventy five to eighty
27:27
Speaker 3: percent effectiveness rate. When you combine therapy in counseling with
27:33
Speaker 3: medication treatment, so psychiatric medications prescribed by a psychiatrist or
27:40
Speaker 3: a psychiatric nurse practitioner, many of whom work in our
27:44
Speaker 3: turn programs, the combination of the medication treatment increases the
27:50
Speaker 3: effectiveness rate up to about eighty five to ninety percent
27:55
Speaker 3: for a condition like depression.
27:57
Speaker 1: Get them Housed, Get them to me with the doctor,
28:01
Speaker 1: get them as much as we can get them on
28:03
Speaker 1: their own in their living environment, and we have the
28:06
Speaker 1: making of success. Interesting, how about myth number four? Sometimes
28:11
Speaker 1: people think mental illness is a personal choice or something
28:15
Speaker 1: someone can just push through. How do you reframe that?
28:20
Speaker 3: Yeah, and the underpinnings of that one historically date back
28:26
Speaker 3: to perception of if you just pull yourself up by
28:31
Speaker 3: your bootstraps.
28:32
Speaker 1: Yeah, that old adage, right.
28:34
Speaker 2: Well, you'll be okay.
28:36
Speaker 3: And that again, with mental health conditions being kind of
28:39
Speaker 3: kept secretive in the family, then there's an expectation that,
28:44
Speaker 3: you know, someone just needs to be you know, trying
28:47
Speaker 3: harder or you know, being more self reliant, you know,
28:52
Speaker 3: push through pulling themselves up. But the myth is that,
28:58
Speaker 3: you know, for personal choice, no one chooses to have depression, PTSD, schizophrenia,
29:08
Speaker 3: as we talk a little bit more about more serious
29:11
Speaker 3: mental illness conditions, just like no one chooses to have diabetes. Yeah,
29:17
Speaker 3: so's it's that, you know, mental health conditions are medical
29:23
Speaker 3: conditions that can be treated, and there's the you know,
29:28
Speaker 3: biopsychosocial research behind that to show that treatment is effective.
29:33
Speaker 3: As I mentioned in the example regarding depression.
29:36
Speaker 1: Interesting. Before we close out today on just this portion
29:40
Speaker 1: of the program with regards to Mental Health Awareness Month,
29:44
Speaker 1: there's one last myth and it's there still stigma around
29:48
Speaker 1: substance use. It's a moral failing rather than a health condition.
29:53
Speaker 3: Right, that's another common myth, right alongside mental illness being
29:59
Speaker 3: a personal choice. The history on that goes back to
30:03
Speaker 3: the criminalization of addiction and the War on drugs and
30:10
Speaker 3: the high level of stigma and discrimination that came about
30:15
Speaker 3: in society when individuals with substance use conditions were labeled
30:20
Speaker 3: as addicts. And it's you know, related to not being
30:28
Speaker 3: a moral failing. It's countering the perception that someone with
30:32
Speaker 3: a substance use disorder has poor decision making or a
30:40
Speaker 3: difficult character making bad choices. Again, like mental illness, substance
30:46
Speaker 3: use condition is a chronic medical condition that there's effective
30:51
Speaker 3: treatment for harm reduction strategies, medication assisted treatment and what
30:59
Speaker 3: we know of out also the self help community too,
31:03
Speaker 3: and supporting individuals with engaging in care and participating in
31:07
Speaker 3: their recovery.
31:08
Speaker 1: Anything else you'd like to share our Mental Health Awareness
31:10
Speaker 1: Month Before we move on to our brief and.
31:12
Speaker 3: Break, just I hope everyone's got their green ribbons and
31:17
Speaker 3: is wearing them proudly.
31:18
Speaker 1: We're going to continue this conversation in just a moment,
31:21
Speaker 1: but before we do, it's time for the brief where
31:23
Speaker 1: we highlight a current event shaping behavioral health. And today's
31:28
Speaker 1: event that we're going to talk about is California Transformation
31:32
Speaker 1: Effort prop one and bea Chip and expanding treatment beds,
31:37
Speaker 1: housing and facilities and addressing the need for capacity gaps.
31:43
Speaker 1: We've tried to experience this ourselves that turn where we
31:46
Speaker 1: tried to apply for some Bechip funding to be able
31:49
Speaker 1: to convert one of our facilities that's a women's residential
31:53
Speaker 1: treatment into a male residential treatment using the be Chip money.
31:58
Speaker 1: But that was a very success for us because they
32:01
Speaker 1: wanted us to sign a thirty year easement on the
32:06
Speaker 1: property that only behavioral health would be served out of
32:09
Speaker 1: those buildings during the time that they loaned us the
32:12
Speaker 1: money to be able to develop. And I said, well,
32:15
Speaker 1: we can't do that as a nonprofit because at some
32:17
Speaker 1: point in time we're going to want to We're going
32:19
Speaker 1: to want to sell the building. And if we can't
32:21
Speaker 1: sell it because nobody wants to buy it, because it
32:24
Speaker 1: has to have behavioral health services. So it was kind
32:26
Speaker 1: of a self defating proposition for us, but it's been
32:30
Speaker 1: really good for counties because counties can dedicate the land,
32:33
Speaker 1: they can dedicate the building, they can remodel the building,
32:36
Speaker 1: and they can put behavioral health services in it. So
32:39
Speaker 1: the BEACHIP for the counties, especially the rural ones, has
32:43
Speaker 1: been very successful, and it's also strengthening infrastructure and access
32:48
Speaker 1: over time. But Laura, if i'd hand it off to
32:51
Speaker 1: you for a minute, how do the efforts like this
32:53
Speaker 1: impact care on the ground Through prop one in our
32:57
Speaker 1: BEACHIP process.
33:00
Speaker 3: Message a prop one is a step towards putting policy
33:07
Speaker 3: into practice by building treatment capacity and housing. What we
33:15
Speaker 3: know is is that clients with serious mental illness and
33:19
Speaker 3: co occurring substance use disorders often wind up in psychiatric
33:24
Speaker 3: hospitalization or in incarceration as a result of behavior and
33:32
Speaker 3: criminal activity associated with the mental health or substance use condition.
33:37
Speaker 3: And these individuals, when they're discharged from care back to
33:41
Speaker 3: the communities, need housing. And we talk all the time
33:48
Speaker 3: about how there's a shortage of affordable housing in our communities.
33:54
Speaker 3: And prop one in be CHIP funding is an effort
33:59
Speaker 3: towards bridging that gap putting that policy into practice. For
34:05
Speaker 3: providers like US at turn, it's also an effort at
34:10
Speaker 3: building more of a continuum of care so that there
34:14
Speaker 3: is the treatment capacity for clients to receive the inpatient
34:21
Speaker 3: care that they need and then have housing as an
34:25
Speaker 3: outpatient with community based services.
34:30
Speaker 2: The other part.
34:31
Speaker 3: Of what the impact on the ground is like for
34:35
Speaker 3: the passage of prop one is that for providers like
34:39
Speaker 3: US as well, there is an increased accountability on outcomes
34:45
Speaker 3: and data driven results that connect back to additional opportunities
34:52
Speaker 3: for funding.
34:53
Speaker 2: So it really raises the bar.
34:56
Speaker 3: On holding accountable those providers to be able to earn
35:00
Speaker 3: earn that funding and be able to continue the services
35:03
Speaker 3: moving forward.
35:04
Speaker 1: The interesting thing with prop one and beach hip, I
35:07
Speaker 1: don't know many CBOs like US that are actually investing
35:10
Speaker 1: in it. They may be taking the benefit of it
35:13
Speaker 1: by working with a county that has a facility is
35:15
Speaker 1: I think when I was at the SISAT conference this
35:19
Speaker 1: was last December. It's been a while ago, but it's
35:21
Speaker 1: the California Association of Counties. A lot of the rural
35:25
Speaker 1: counties took advantage of the beach chips so they could
35:27
Speaker 1: develop a treatment facility for them in the county to
35:31
Speaker 1: be able to have people suffering from mental health. And
35:34
Speaker 1: I was talking to the rural counties, they said, but
35:36
Speaker 1: we don't have the staff. We'd love for you guys
35:38
Speaker 1: to come up and meet with us because we might
35:41
Speaker 1: you could provide the services while we provide the building.
35:44
Speaker 1: So that was the synergy that I saw between prop
35:47
Speaker 1: One and BEACHIP. And I think the governor when this
35:51
Speaker 1: came up and Prop one passed that, I think he
35:54
Speaker 1: put twenty five billion towards it. It was a huge
35:57
Speaker 1: amount of money for the beach Chip. Some good things
36:00
Speaker 1: and there's some maybe not so good things for CBOs
36:04
Speaker 1: under Prop one and be Chip.
36:07
Speaker 2: But and you brought up workforce shortage.
36:10
Speaker 3: Yeah, that's a current challenge and that's where we as
36:17
Speaker 3: a provider community based organization CBO help fill the gap
36:22
Speaker 3: because we invest in our workforce and grow them and
36:26
Speaker 3: develop them to do this work in the interim. Because
36:29
Speaker 3: we know that building infrastructure like facilities for treatment capacity,
36:35
Speaker 3: beds available for the clients that need that highest level
36:38
Speaker 3: of care, and then housing as they come out into
36:42
Speaker 3: the community takes time.
36:43
Speaker 1: Yeah, it does. You're exactly right, and for our audience
36:47
Speaker 1: out there today. I definitely if you haven't really looked
36:51
Speaker 1: at prop one or be Chip, I encourage you to
36:54
Speaker 1: look at prop one and be Chip. There have been
36:56
Speaker 1: two rounds of funding. We haven't heard that there's going
36:59
Speaker 1: to be a third one, but if round one and
37:02
Speaker 1: round two are successful, I would bet we'd have a
37:04
Speaker 1: round three of funding because of Round one and two
37:07
Speaker 1: being so successful in the communities with also treatment and housing.
37:13
Speaker 1: So with that, we're now going to have a brief
37:15
Speaker 1: word from TURN Behavioral Health Services and we'll be right
37:18
Speaker 1: back with you or headed into our commercial break.
37:21
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38:58
Speaker 1: Okay, so, welcome back to Behavioral Health Brief. I'm Jim
39:01
Speaker 1: Callahan and we're continuing the conversation today with doctor Laura
39:05
Speaker 1: Otis Miles, executive by president with TERM Behavioral Health Services.
39:09
Speaker 1: Let's pick up where we left off and let's make
39:12
Speaker 1: our spotlight now on assertive Community Treatment designed to meet
39:17
Speaker 1: people where they are, providing on going based community based support.
39:23
Speaker 1: What is ACT and who is it designed? To serve. Laura,
39:26
Speaker 1: that's my question for you today on the ACT.
39:29
Speaker 2: Great question to get us started.
39:31
Speaker 3: Assertive Community Treatment ACT is an evidence based model that
39:40
Speaker 3: is endorsed by the federal government, which is the Substance
39:45
Speaker 3: Abuse Mental Health Services Administration SAMSA SAMSA, and it serves
39:53
Speaker 3: individuals that have serious mental illness, co occurring substance use disorders,
39:59
Speaker 3: and individuals who are at risk for homelessness, institutionalization, or incarceration.
40:10
Speaker 1: Interesting, so what sets it apart from other modalities of
40:15
Speaker 1: service that we deliver in our book of business.
40:19
Speaker 3: ACT is unique in that it is delivered in the community.
40:26
Speaker 3: Eighty percent of the services are delivered in the field.
40:30
Speaker 3: Traditional mental health services you could imagine involve clients coming
40:37
Speaker 3: in to the office for an appointment and coming in
40:42
Speaker 3: at a frequency that would be maybe at once a
40:46
Speaker 3: month or once every three months. ACT is about meeting
40:53
Speaker 3: clients where they're at in terms of the level of
40:55
Speaker 3: care that they need by an interdisciplinary team.
41:00
Speaker 1: TEA.
41:00
Speaker 3: I often describe ACT as a hospital without walls.
41:04
Speaker 1: That's right. I remember you're saying that.
41:06
Speaker 3: Rather than the client coming into the clinic for an appointment,
41:10
Speaker 3: it's designing the services to go out into the field
41:15
Speaker 3: to meet the client where they're at. And so this
41:17
Speaker 3: could be out at a homeless shelter or an encampment
41:23
Speaker 3: or if a client has housing in their home. Would
41:28
Speaker 3: that also could be on a street corner was depending
41:30
Speaker 3: on the.
41:30
Speaker 1: Situation a nurse practitioner that it would be on that
41:33
Speaker 1: team when they're out in the community absolutely so that
41:36
Speaker 1: he could immediately administer medications if he needed to, or
41:39
Speaker 1: the nurse practitioner could yes, yes.
41:41
Speaker 3: Interesting, And we have ACT psychiatric prescribers who has who
41:47
Speaker 3: have given injection right shots on the street corner right.
41:52
Speaker 1: And I think also, you know, looking at the number
41:56
Speaker 1: of services that we supply, we run a number of
41:59
Speaker 1: ACT programs, in fact one in almost each of our
42:02
Speaker 1: seven counties. In fact more how many is it? We're
42:05
Speaker 1: running four ACT programs in six ACT.
42:07
Speaker 5: Programs ACT programs, Sharrett, you're the ACT experts.
42:11
Speaker 3: Six ACT programs in San Diego, San Diego County funded
42:16
Speaker 3: by Behavior Hall Services. We have an ACT program in
42:24
Speaker 3: King's County up in the Central Valley alongside Fresno we
42:28
Speaker 3: have two ACT programs and last but not least, we
42:32
Speaker 3: have an ACT program Santa Clara County up in the
42:36
Speaker 3: San Francisco BA area.
42:37
Speaker 1: Right, and that just to take a minute to maybe
42:42
Speaker 1: guys we call it off script, But Laura and I
42:45
Speaker 1: were involved in getting that program off the ground up
42:49
Speaker 1: in Santa Clara. And the challenge with that act program
42:53
Speaker 1: was it was literally right at the beginning of COVID.
42:58
Speaker 1: And so we won this new program one hundred clients
43:01
Speaker 1: that we're going to get and it's COVID. How do
43:06
Speaker 1: we deal with COVID and clients? And launched this program
43:10
Speaker 1: and we had twenty two to twenty five brand new
43:13
Speaker 1: employees to the program, and we couldn't go see them
43:17
Speaker 1: because we couldn't get on an airplane. In fact, Laura
43:21
Speaker 1: and I the little short story here, we're up meeting
43:24
Speaker 1: with Santa Clara County and we had to get to
43:28
Speaker 1: the airport to get on our plane. We got on
43:30
Speaker 1: the plane, landed in San Diego, and that night, if
43:33
Speaker 1: it wasn't that night, the next morning, Santa Clara County
43:36
Speaker 1: went into lockdown and nobody could go anywhere. So we
43:40
Speaker 1: kind of made it out in the nick of time
43:41
Speaker 1: on that COVID, but it was extremely challenging. Maybe you
43:45
Speaker 1: could just share real quickly what some of the challenges
43:49
Speaker 1: were for that ACT program specifically and engaging clients under
43:56
Speaker 1: the ACT model because you know, COVID it took the
44:00
Speaker 1: lid off on ACT.
44:02
Speaker 2: Right right, and.
44:04
Speaker 3: We at turn brought the evidence based model of ACT
44:09
Speaker 3: to Santa Clara County as funded by our Behavioral Health
44:13
Speaker 3: Services department there, and the intention was to have clients
44:19
Speaker 3: be discharged out of long term psychiatric care into community
44:25
Speaker 3: based housing, which we were also positioned to provide with
44:30
Speaker 3: the new contract by way of doing master leasing, where
44:36
Speaker 3: we would master lease a home and then sublease to
44:39
Speaker 3: our clients coming out of in patient care. But because
44:43
Speaker 3: of the COVID nineteen pandemic, the decisions were made to
44:47
Speaker 3: keep clients hospitalized and continue on their institutionalization because these
44:53
Speaker 3: were clients that were in these treatment beds for upwards
44:57
Speaker 3: of you know, two years or war, and many of
45:01
Speaker 3: them were ready to come back ash into the community
45:06
Speaker 3: and receive our hospital without wall services, but the pandemic
45:09
Speaker 3: slowed that process. So in the meantime, we took advantage
45:12
Speaker 3: to invest in our workforce and provide a lot of
45:17
Speaker 3: education and training on the model because it is it
45:22
Speaker 3: is unique. You know, there's criteria to it that make
45:26
Speaker 3: it a specific set of interventions that we provide that
45:31
Speaker 3: all need to be you know, coordinated and managed on
45:34
Speaker 3: a daily basis.
45:35
Speaker 1: Right, And I think this is it's one of the
45:38
Speaker 1: specialties at turn behavioral health Services that were so adept
45:42
Speaker 1: at is dealing with these ACT programs and dealing with
45:45
Speaker 1: the clients and making them successful. If we talk about
45:50
Speaker 1: outcomes for a minute, what do you see when ACT
45:53
Speaker 1: is working well.
45:55
Speaker 3: When ACT is working well, we see clients that are
46:02
Speaker 3: more engaged in treatment. Because we take the services out
46:08
Speaker 3: to the clients in the field, it limits the ability
46:13
Speaker 3: of losing them along the way due to other barriers
46:16
Speaker 3: like transportation, problems with like coming into a traditional setting.
46:22
Speaker 3: And again many clients aren't comfortable coming into a traditional setting.
46:27
Speaker 3: So because of ACT providing that with the multidisciplinary team,
46:32
Speaker 3: we see them more engaged.
46:34
Speaker 2: The other part of assertive.
46:35
Speaker 3: Community treatment that I like to explain with the assertive
46:38
Speaker 3: in the name of the model is that the treatment
46:42
Speaker 3: is persistent. So it's a do whatever it takes, never
46:48
Speaker 3: give up model, and so we keep going even when
46:54
Speaker 3: clients don't want to engage with us, we keep going.
46:59
Speaker 3: And on the team, we include individuals on staff with
47:04
Speaker 3: lived experience, and these are individuals in peer support specialist
47:09
Speaker 3: or family support specialist positions, individuals that have their own personal,
47:13
Speaker 3: lived experience of having a mental health or substance use condition,
47:17
Speaker 3: or maybe even being homeless and recovering from that, and
47:21
Speaker 3: they use their lived experience to tell their story to
47:25
Speaker 3: engage clients, which we know can be so meaningful and
47:29
Speaker 3: powerful for making that connection. That increases the trust and
47:34
Speaker 3: confidence in us as a team to provide these services
47:39
Speaker 3: to the clients. And we also don't limit the timeframe
47:43
Speaker 3: of which the services need to be delivered that you
47:45
Speaker 3: might see in a traditional setting where someone might have
47:48
Speaker 3: only ten to twelve therapy or counseling sessions. This is
47:53
Speaker 3: essentially tailored to meet what does a client need. And
47:57
Speaker 3: the contact frequency is high, up to four times a
48:02
Speaker 3: week or even every day if needed, and so that
48:07
Speaker 3: increases stability and we see and this is where the
48:12
Speaker 3: research on the outcomes shows that there's less rehospitalization or
48:21
Speaker 3: incarceration back to jail by way of the intensity, frequency
48:25
Speaker 3: and longevity and the persistence of the assertive community treatment model.
48:31
Speaker 1: Very interesting. Could you just you know, there's always been
48:33
Speaker 1: this other component to the ACT program called high fidelity ACT.
48:38
Speaker 1: Can you describe that real quickly and how that fits
48:42
Speaker 1: into the overall ACT model.
48:44
Speaker 3: Yeah, high fidelity we talk about a lot amongst our teams,
48:49
Speaker 3: but for our listeners today they might not know.
48:52
Speaker 2: You know, what does that exactly mean?
48:53
Speaker 4: And why?
48:53
Speaker 2: Doesn't matter?
48:56
Speaker 3: The model has about forty years of research behind it
49:03
Speaker 3: and the research results are are very consistent in showing
49:08
Speaker 3: the effectiveness of the model reducing hospitalization and incarceration and
49:15
Speaker 3: stabilizing clients out of that cycle of relapse readmission, discharge, relapse, readmission.
49:25
Speaker 3: And the research shows that the model being delivered to
49:30
Speaker 3: the requirements of the model per the highest fidelity. So
49:35
Speaker 3: it's really prescriptive and there's a tool. Several tools have
49:40
Speaker 3: evolved over the course of time. One is from SAMSA,
49:43
Speaker 3: but we follow the tool and are evaluated. This goes
49:48
Speaker 3: back to outcomes on how well are we delivering the
49:52
Speaker 3: model according to the requirements of the fidelity tool, and
49:56
Speaker 3: it matters because operating the program at higher means better outcomes.
50:02
Speaker 1: I can remember being in some of those meetings when
50:05
Speaker 1: the annual report would be put out, like the example
50:07
Speaker 1: when we were in Contra Costa and that report was
50:10
Speaker 1: so successful for us because we were hitting all of
50:13
Speaker 1: our high fidelity markers, so that means meant we are
50:16
Speaker 1: servicing more people and there are no longer suffering, which
50:20
Speaker 1: was just great to hear onside that ACT. So where
50:24
Speaker 1: do you see You know, we'll probably take another podcast
50:28
Speaker 1: to talk about the Laura's Law tie in and that model.
50:31
Speaker 1: But where do you see ACT going in the future.
50:34
Speaker 1: What's the future of You mentioned spround forty two years
50:37
Speaker 1: that ACT model's been around. What's the future for ACT?
50:41
Speaker 3: Yeah, the future for ACT is extremely promising. The research continues,
50:47
Speaker 3: but the funding also continues, and what we're seeing at
50:53
Speaker 3: the state and county level is more funding going into
50:58
Speaker 3: the programs that are are intensive community based, have the
51:04
Speaker 3: interdisciplinary team with the multiple disciplines included, and that really
51:09
Speaker 3: operate around the clock, you know, the twenty four to
51:12
Speaker 3: seven piece of the service model and the housing that
51:18
Speaker 3: goes with it. So I foresee that the focus of
51:23
Speaker 3: ACT is actually going to continue now to be also
51:27
Speaker 3: where does ACT come in and how does it assist
51:30
Speaker 3: with the opioid epidemic and how to use the ACT
51:35
Speaker 3: teams even better than we already are for NARCAN distribution
51:42
Speaker 3: to literally help save lives out on the street because
51:45
Speaker 3: we have clients that have co occurring substance use disorders,
51:49
Speaker 3: that struggle with opioid use, access to opioids and other
51:55
Speaker 3: high risk substances on the streets.
51:58
Speaker 1: Wendy just reported up one at the last board meaning
52:01
Speaker 1: called cartom. I think it is creatim cretum and how
52:06
Speaker 1: available that is at our communities. You could buy it
52:09
Speaker 1: right at a seven to eleven store. But it's a killer, right,
52:12
Speaker 1: that's really sad. So it's really interesting on that anything
52:17
Speaker 1: else that you'd like to share about ACT and is
52:19
Speaker 1: there anything that ties in with Mental Health Awareness Month
52:22
Speaker 1: and the ACTING model or anything to share from that
52:25
Speaker 1: standpoint before we transition.
52:27
Speaker 3: Well, one of the things that I want to mention
52:30
Speaker 3: is in regards to ACT as an evidence based model,
52:35
Speaker 3: we operate at high fidelity and we have such strong
52:38
Speaker 3: results and outcomes from our programs. So shout out to
52:42
Speaker 3: all of our ACT teams working for.
52:43
Speaker 1: Us, big shout out. The yeah they're really delivering.
52:47
Speaker 3: Absolutely is that we're seeing even better outcomes when there's
52:54
Speaker 3: a co located substance use disorder treatment alongside it. So
53:01
Speaker 3: the multidisciplinary team of an ACT team includes substance use counselors,
53:07
Speaker 3: but to be able to provide even more tailored and
53:12
Speaker 3: flexible pathways for engagement of individuals into substance use treatment. Specifically,
53:18
Speaker 3: we operate two in San Diego, one in Fresno with
53:24
Speaker 3: an alongside substance use disorder treatment track, and that puts
53:31
Speaker 3: those services under the same roof, so we have sort
53:34
Speaker 3: of that one stop shop opportunity while at the same
53:39
Speaker 3: time being able to deliver services out in the community support.
53:43
Speaker 1: You mentioned that because Action Central and Action East and
53:46
Speaker 1: Dart West and Fresno Impacts and Fresno Impact all come
53:50
Speaker 1: to mind when we talk about that continuum of care
53:55
Speaker 1: under one roof, they can get services for mental health,
53:58
Speaker 1: they can get services for such since use because most
54:01
Speaker 1: of the time they might be suffering the clients may
54:03
Speaker 1: be suffering from both. So thank you for bringing that
54:06
Speaker 1: up today. But I'd really love to shift to one
54:08
Speaker 1: of my favorite parts of the behavioral health brief, and
54:12
Speaker 1: that's the community questions, Okay, and so we're going to
54:15
Speaker 1: go into that part of that process this afternoon. And
54:19
Speaker 1: I think we have our questions right Here's Laura, So
54:22
Speaker 1: go ahead, and I mean, get the cup over here.
54:25
Speaker 1: Go ahead and draw a question right out of there.
54:28
Speaker 1: Get your first question, okay, And these questions are from
54:34
Speaker 1: our employees.
54:35
Speaker 3: That's right. And shout out to Lilah for my tea.
54:40
Speaker 3: She wants to know what do you see for the
54:44
Speaker 3: future of turn over the next five years.
54:47
Speaker 1: Well, that's a big question, isn't it, Laura? What do
54:49
Speaker 1: you see?
54:50
Speaker 2: Yeah?
54:51
Speaker 3: Well, extending from our conversation about ACT and mental health awareness, I.
54:57
Speaker 2: Do see us as a.
55:00
Speaker 3: Provider CBO continuing to be impactful in providing the ACT
55:06
Speaker 3: level of care in communities moving forward. I also see
55:13
Speaker 3: that that's an alignment with where the funding is for
55:18
Speaker 3: creating that you know, treatment capacity and support of housing.
55:23
Speaker 3: There's more of a focus now on housing being a
55:27
Speaker 3: platform for stability and treatment as well as employment. Where
55:32
Speaker 3: it's like housing and employment are considered treatment. Right, because
55:37
Speaker 3: ACT isn't just about you know, treating the psychiatric diagnosis
55:43
Speaker 3: with medication management. It's also about treating and supporting success
55:49
Speaker 3: at daily life skills and all the other things that
55:54
Speaker 3: help keep somebody out at home.
55:56
Speaker 1: Makes that ACT model work so well, right, is the client.
56:00
Speaker 1: We're supporting the clients, not just on there. Like you said,
56:03
Speaker 1: psychiatric it's the housing, it's security, it's the medication, security
56:09
Speaker 1: and ability.
56:10
Speaker 3: Right and access to benefits, to benefits right may not
56:14
Speaker 3: be on the trajectory for competitive employment, but I want to.
56:18
Speaker 1: Ask you to Okay, ask away, what do.
56:21
Speaker 2: You see for the future of turn.
56:23
Speaker 1: Well, that's a big open ended question. We're right now
56:28
Speaker 1: developing our strategic plan, but we're really only looking out
56:31
Speaker 1: twenty four months because so much is changing, both at
56:34
Speaker 1: the federal level here at the state level with what's
56:38
Speaker 1: happening at SAMSO, what's happening at HHSA and Washington d
56:42
Speaker 1: C and trying to rework funding and some cuts of
56:46
Speaker 1: funding and stuff. I think this next year is going
56:48
Speaker 1: to be another transition year for us, this fiscal year
56:51
Speaker 1: coming up, but I'd like to see our growth and
56:53
Speaker 1: what we're focusing on is more criminal justice through CDCR
56:58
Speaker 1: and DRP. I think we're really good at that. We've
57:02
Speaker 1: heard about that earlier today. But we have our men's
57:04
Speaker 1: program and we have our women's program of them coming
57:08
Speaker 1: out of incarceration, finishing their term in incarceration, and then
57:12
Speaker 1: being transitioned into the community. I think there's a big
57:15
Speaker 1: opportunity there for us because we do that really well,
57:19
Speaker 1: and I think almost all of the programs we're in.
57:21
Speaker 1: I think one of the things that's unique for TURN
57:25
Speaker 1: is that we're not just one modality. We're not just
57:27
Speaker 1: children or adult and older adults. We're not just criminal justice.
57:31
Speaker 1: We're mental health, substance use, criminal justice veterans. And so
57:36
Speaker 1: that gives us the ability and flexibility to EBB and
57:40
Speaker 1: flow as funding ebbs and flows. But I think all
57:43
Speaker 1: of those categories are still growth categories for us, and
57:47
Speaker 1: we're going to have to pick and choose the opportunities
57:50
Speaker 1: that best suit and best fit inside our wheelhouse over
57:53
Speaker 1: the next twenty four to thirty six months. So that's
57:56
Speaker 1: how I would answer that question for Elilah from IT
58:00
Speaker 1: all Right, how about question number two?
58:08
Speaker 3: Okay, also from it RJ asks what's the most unexpected
58:14
Speaker 3: thing you've learned during your time at TURN?
58:19
Speaker 1: The most unexpected thing? What was that question again?
58:23
Speaker 3: What's the most unexpected thing you've learned during your time
58:27
Speaker 3: at TURN? For me, I would say that the most
58:32
Speaker 3: unexpected thing that I've learned is how providing the right
58:39
Speaker 3: treatment model at the right time can support does support
58:46
Speaker 3: clients rehabilitation and recovery. Early in my career when I
58:52
Speaker 3: was doing residential treatment.
58:53
Speaker 1: At the VA where we talked earlier today.
58:55
Speaker 3: Yeah, at the Department of Veterans Affairs of VA. I
58:59
Speaker 3: don't think I saw the pathway of success for clients
59:06
Speaker 3: coming out of residential treatment back then like I do now.
59:11
Speaker 3: And I really do think that that's because my purpose
59:16
Speaker 3: and passion and motivation for doing community mental health work
59:20
Speaker 3: and mental health awareness is from being able to implement
59:25
Speaker 3: through the opportunity to TURN high fidelity ACT model and
59:30
Speaker 3: really increasing our expertise in doing that successfully with essentially
59:37
Speaker 3: saving the lives of so many of our clients.
59:40
Speaker 1: And I think the key to that is we did
59:43
Speaker 1: it successfully miles from our headquarters at home. We did it,
59:47
Speaker 1: and we're still doing it in Santa Clara, Fresno Kings
59:52
Speaker 1: and delivering it because it's a challenge to deliver in
59:55
Speaker 1: each community and each community is different with their own culture,
1:00:00
Speaker 1: owned demographics and geographics. We're getting to the clients so
1:00:06
Speaker 1: really interesting.
1:00:07
Speaker 3: Is there anything unexpected for you that.
1:00:09
Speaker 1: Well you've had how what was that question? Again, it's
1:00:12
Speaker 1: the most unexpected thing you learned during your time at TURN.
1:00:17
Speaker 1: I think the most unexpected thing for me was when
1:00:20
Speaker 1: I first came to turn ten years ago. Ten years ago,
1:00:24
Speaker 1: but about halfway through that we were really trying to
1:00:28
Speaker 1: develop our housing program and really do master leasing. And
1:00:33
Speaker 1: what was unexpected for me in that challenge because of
1:00:37
Speaker 1: a real estate background. We're leasing, We're putting clients in
1:00:40
Speaker 1: a building. Right, how hard that can? How hard could
1:00:44
Speaker 1: that be? What I didn't realize is how the clients
1:00:48
Speaker 1: were really suffering with their mental illness and substance use
1:00:52
Speaker 1: and stuff. And for example, the you know, the heat.
1:00:55
Speaker 1: Some client may tear a ceiling fan out of the
1:00:58
Speaker 1: roof of the of the unit because he thinks it's
1:01:01
Speaker 1: a spaceship. And so I underestimated the need of the clients,
1:01:07
Speaker 1: thinking that just housing them was going to help. And
1:01:10
Speaker 1: so that was unexpected for me. Housing and combination, combination
1:01:17
Speaker 1: with the treatment.
1:01:17
Speaker 2: To treat the psychotics.
1:01:19
Speaker 1: Right, because he knew I could treat the psychotic and
1:01:22
Speaker 1: we were getting him housed and getting him fed and
1:01:25
Speaker 1: and back on medications, they'd be successful. But I underestimated
1:01:31
Speaker 1: how some of these clients could really be suffering from
1:01:35
Speaker 1: mental illness or co occurring disorders. And so that was
1:01:38
Speaker 1: probably one of the one of the biggest unexpected things
1:01:41
Speaker 1: that I've learned during my time at Turn. We had
1:01:44
Speaker 1: to shift and I think we shifted well. Anyhow, So
1:01:49
Speaker 1: question number.
1:01:49
Speaker 2: Three, all right, there we go, got it?
1:01:53
Speaker 1: You got it?
1:01:53
Speaker 3: Okay, Angelo from Accounting asks as an EVP, what keeps
1:02:00
Speaker 3: you at Turn and what positive changes.
1:02:03
Speaker 2: Have you seen over the years.
1:02:07
Speaker 3: What keeps me at Turn after fifteen years is I'm
1:02:13
Speaker 3: passionate about our mission and the impact that we make.
1:02:18
Speaker 2: I'm also.
1:02:21
Speaker 3: Deeply rewarded by working alongside such a mission driven workforce
1:02:30
Speaker 3: as well. It's a pleasure and an honor to work
1:02:35
Speaker 3: with our staff, all our teams.
1:02:39
Speaker 2: We have rock.
1:02:39
Speaker 1: Stars, we do, and sometimes we forget that, you know,
1:02:44
Speaker 1: But that's why I love getting out to the programs
1:02:47
Speaker 1: and really meeting the boots on the ground people that
1:02:50
Speaker 1: are doing the services. And you do an excellent that's
1:02:54
Speaker 1: so rewarding.
1:02:56
Speaker 3: Absolutely, and I think the positive changes over the years, yeah,
1:03:00
Speaker 3: are are evidenced by the work that you've done, that
1:03:04
Speaker 3: we've done together in the last you know, decade or so, and.
1:03:10
Speaker 2: You know the.
1:03:13
Speaker 3: Pride and investment we have and really acknowledging where there's
1:03:17
Speaker 3: you know, success to be celebrated. And I think we're
1:03:21
Speaker 3: doing such an excellent job at that. I mean, I
1:03:25
Speaker 3: think back to during the COVID nineteen pandemic when we
1:03:30
Speaker 3: got a lot of positive feedback about those services we
1:03:35
Speaker 3: operated at the San Diego Convention Center.
1:03:37
Speaker 1: Yeah, I'd forgotten all about it, right.
1:03:39
Speaker 3: The counseling corner that was a group of us, and
1:03:43
Speaker 3: we won some healthcare Hero awards the San Diego Business
1:03:48
Speaker 3: Journal during that time. And I think that, you know,
1:03:52
Speaker 3: coming out of the other side of the pandemic and
1:03:55
Speaker 3: then being able to successfully grow Santa Clara Action, which
1:04:00
Speaker 3: started and struggled.
1:04:01
Speaker 1: In the pandemic.
1:04:03
Speaker 3: Right, we have such terrific outcomes and support from our funders.
1:04:10
Speaker 2: To this day that program.
1:04:12
Speaker 3: And so the positive changes over the years are how
1:04:14
Speaker 3: we acknowledge success, how we celebrate it, and invest in
1:04:20
Speaker 3: our workforce to continue to commit to, you know, the
1:04:24
Speaker 3: mission of improving lives.
1:04:26
Speaker 1: Yeah, And I think the big success over the ten
1:04:30
Speaker 1: years that I've been here and seeing is we continue
1:04:33
Speaker 1: to deliver top not services for all of the underserved
1:04:37
Speaker 1: in our community, and we get acknowledged for that and
1:04:40
Speaker 1: every one of our counties. I think we're really well
1:04:43
Speaker 1: respected for the level of service that we deliver to
1:04:46
Speaker 1: all of them. But as we begin to wrap up
1:04:49
Speaker 1: this conversation today, Laura, I really want to thank you
1:04:52
Speaker 1: for being here today. This has been really another great
1:04:55
Speaker 1: learning session. Great to be back with you. And because
1:04:58
Speaker 1: we opened up some of these regions, that had to
1:05:01
Speaker 1: close some of these regions together, which was sad, but
1:05:04
Speaker 1: we've really pushed behavioral health to a new level in
1:05:08
Speaker 1: a lot of the communities that we've worked in. But
1:05:10
Speaker 1: before we close, is there anything you'd like to leave
1:05:14
Speaker 1: with the listeners today as a takeaway for them?
1:05:19
Speaker 2: Absolutely.
1:05:20
Speaker 3: In honor of Mental Health Awareness Month, I would like
1:05:24
Speaker 3: a call to action for our listeners, encouraging folks to
1:05:31
Speaker 3: you know, start a conversation or check in on someone,
1:05:36
Speaker 3: or for someone that may be struggling with mental health
1:05:38
Speaker 3: or substance use issue, you know, to reach out and
1:05:42
Speaker 3: ask for help because help is available.
1:05:44
Speaker 2: Yeah.
1:05:45
Speaker 3: And for community members and stakeholders, I encourage folks to
1:05:52
Speaker 3: learn about turn learn about the services in their communities,
1:05:58
Speaker 3: advocate for ongoing funding, and continue to be of help
1:06:04
Speaker 3: and support and contribute to the effort.
1:06:07
Speaker 1: Yeah, that's great, because that's why we're doing the Behavioral
1:06:09
Speaker 1: Health brief. I want our community and we're advocating so
1:06:14
Speaker 1: they know about the great level of services that we
1:06:16
Speaker 1: supply out there, but Laura, thank you so much, really
1:06:20
Speaker 1: appreciate it. Now we're going to transition into the gratitude
1:06:24
Speaker 1: portion and close out today's behavioral health brief, So thank
1:06:27
Speaker 1: you for joining us. Laura, sincerely appreciated, and your fifteen
1:06:31
Speaker 1: years of service have been tremendous.
1:06:34
Speaker 2: Thank you, Thank you very much.
1:06:37
Speaker 1: As I close today's episode, I want to pause and
1:06:40
Speaker 1: practice something essential to well being and perspective, and that's gratitude.
1:06:45
Speaker 1: It's something I practice every day through a gratitude journal,
1:06:48
Speaker 1: and I encourage you to find a practice that works
1:06:52
Speaker 1: for you my journal that I use every day and
1:06:54
Speaker 1: give thanks to everything in my life that i'm grateful for.
1:07:00
Speaker 1: To start by thanking the incredible staff at turn Your
1:07:03
Speaker 1: compassion and commitment makes this work possible every single day.
1:07:08
Speaker 1: I also want to thank our community partners. This work
1:07:11
Speaker 1: doesn't happen in isolation. It takes collaboration, trust, and shared commitment.
1:07:17
Speaker 1: We're grateful to work alongside you and strengthening the health
1:07:21
Speaker 1: and well being of our communities and to our funders
1:07:24
Speaker 1: at the federal, state, city, and county levels. Your support
1:07:28
Speaker 1: allows us to expand access and continue reaching those who
1:07:32
Speaker 1: need care most. To our listeners, thank you for spending
1:07:36
Speaker 1: time with us today. Please like, share, and subscribe. As
1:07:41
Speaker 1: I close, I'll answer the question I open with. There's
1:07:45
Speaker 1: nothing more important than improving lives, and together we are
1:07:50
Speaker 1: improving lives. I'm Jim Callahan. This has been the Behavioral
1:07:54
Speaker 1: Health Brief. See you next time. I