Share Public Health podcast transcript, Mental Health: No Wrong Door

Season 1 Episode 4

Laurie Walkner Welcome to Share Public Health the Midwestern Public Health Training Center’s podcast connecting you to public health topics, issues, and colleagues throughout our region and the country, highlighting that we all share in public health. Thank you for tuning in to the series focusing on mental health. In this series we will explore mental health through the lenses of schools, public safety, and the business community. Be sure to check the notes to get links to resources mentioned in the podcast.

Maya Chilese Well good morning everyone this is Maya joining from the Midwestern Public Health Training Center, and we’re delighted to have a wonderful group of people with us today to have another fascinating conversation about collective work that community partners are doing to help address mental health in their communities. Today we’re talking with the team in Washington County, Iowa that has come together to address mental health specific in their community. They’ve built a really strong coalition, which includes the Sheriff’s Department, a crisis intervention training, public health, and more. Today we’re going to learn a little bit from them about how the group came together and what they’re working on now. To get started, I’d like to ask each of you to introduce yourselves and maybe just a little bit about what you do. Let’s get started with Danielle. If you would, please.

Danielle Pettit-Majewski Sure. Hi Maya. Thanks so much for that introduction. My name is Danielle Pettit-Majewski and I am the administrator for Washington County Public Health. In my role I do a lot of different things. I have my hands in a lot of different pots. I work on outreach like this from our Community Health Needs Assessment, emergency preparedness, grant oversight, just a number of things to keep our department running smoothly on the day-to-day basis.

Maya Chilese Thanks Danielle. Lynn would you share a little bit, please?

Lynn Fisher Yes. I’m the public health nurse for Washington County Public Health and I work with several different programs. I work with the immunization program. I’m the vaccines for children coordinator. I work with communicable disease and TB program. I work with the Community Health Needs Assessment and the health improvement plan.

Maya Chilese Thanks Lynn. Bobby?

Bobbie Wulf Bobbie Wulf, and I work with the Southeast Iowa Link region. I work for Washington and Louisa counties. I’m the coordinator of disability services.

Maya Chilese Thanks Bobbie. Is Sarah on? Could you introduce yourself?

Sarah Berndt Yes. I am Sarah Berndt and I also am a Henry County coordinator of disability services for Southeast Iowa Link region. I’m also the program director for our position Link Jail Diversion Program that serves six jails in our eight-county region.

Maya Chilese Welcome Sarah. Thank you. Alan share a little bit about yourself, please.

Alan Brady My name is Alan Brady. I am the jail resiliency coordinator for Washington in Keokuk County. I actually work underneath Sarah. She directs the program. I’m also the crisis intervention team coordinator. This training is a 40-hour training for officers that trains them in mental illness awareness and how to interact with those individuals.

Maya Chilese Thank you Alan. What a great group. I’m really excited to learn a little bit more about what you’ve been working on together. So maybe just to kick us off, I’m curious, how did this group come together? How did you get started? How has it evolved over time? Who would like to start?

Danielle Pettit-Majewski I’ll jump in Maya. This group came together after our 2015 Community Health Needs Assessment. One of the things that we chose as a community to work on was mental health and access to mental health. At that time, if you recall, the governor had decided that he was going to shut down the mental health facilities in the state. There was a lot of concern about having access to mental health services. We reached out to a number of our community members who work in mental health, social services, in law enforcement, all of the cross-jurisdictional organizations that come face-to-face with mental health. The impact that has on health on a daily basis. We started meeting in November of 2015 and we have really grown from there.

Maya Chilese In 2015, you said? Wow. You guys have been at this for a little while.

Danielle Pettit-Majewski We have been. It has been a consistent robust group that continues to grow. I think we have approximately 31 members on our coalition that meet on a monthly basis. Obviously it depends on everybody’s schedules, but we have had a very engaged group. And a lot of different conversations over the years about how we can increase access to mental health services through our community.

Maya Chilese Thank you. I’m curious about when the group first got together. I imagine that you had quite a bit of conversation around things that your community could do together to address this issue. How did you land on working around crisis intervention or some of the other things that you’ve been working on together?

Sarah Berndt Well crisis intervention really has evolved. When we first started and the coalition first began, we really were thinking that we’re going to work on assisting health care providers with accessing mental health services and stigma. Those were a couple of the top two objectives we thought we would be working on. We did indeed work with getting resources and referral information into healthcare providers hands, but then we’ve also started now on several different new paths. It has been very exciting.

Danielle Pettit-Majewski I think we realized once we all came to the table that we, as partners, didn’t even necessarily know what all the resources in our community were. We first had to learn what everybody around the table had to offer. We wanted to make sure that we shared that with the community, so we put together a resource guide and a referral for our providers. We did this so that they could ensure they knew who to refer to in the community. We had a lot of conversations about where we should start because we’re kind of looking at this from two different directions. Were we going to respond to the crisis that we saw in the law enforcement side? With people who are already dealing with mental health? Or are we going to take more of a public health approach in prevention and focus on screening kids and ensuring that they were getting their needs met? We really felt that there was not a lot of resources sufficient enough to go after both. It took us a while to wrap our hands around the problem and look at it from multiple different angles.

Bobbie Wulf As part of the group in the Mental Health Coalition the Southeast Iowa Link region representative was myself. We brought in our partners with the transition Link and began discussing the crisis intervention programming and what we were doing inside of the jails. We dealt more with the adult aspect of mental health services versus public health dealing with the children’s side. We decided to develop a partnership amongst all of us so that we were addressing all of those issues. Sarah could probably speak about when the southeast family region began doing some planning with that type of programming.

Sarah Berndt We started this around March of 2015. That is when the National Association of Counties started partnering up and offering a program that is called the Stepping Up Initiative, which is an initiative to help those folks who are booked into jail. Also, those folks with mental illness who are having an interface with law enforcement. We are trying to divert them from going to jail. If they do make it into jail we want to help them reduce the length of stay that they are staying in jail. Of course, while they’re in jail we want to connect them to treatment opportunities so that when they are discharged from jail they’re going into an array of services that will hopefully help reduce recidivism and have them not return to jail.

Maya Chilese Yeah. Sarah, thank you for that. I know across the nation as mental health has progressed the interest in community-based services and helping to serve people in their own area where their home is has really been the best practice, instead of keeping people in some sort of facility or infrastructure. I’m curious about two things. One, whether or not law enforcement was a part of your coalition at the start, or whether or not you had reached out to them once you started thinking a little bit more around crisis. My second question is if you have consumer representatives involved? In other words, people who have perhaps experienced these services who may have experienced challenges with mental health and can serve in sort of an advocacy role.

Sarah Berndt We do have some consumer involvement. In the crisis intervention training one of the pieces of that, and Alan can talk to that more, is to have people present in the 40-hour training. People who have lived experience. That helps law enforcement officers see the faces in a different environment. To help when they’re going out on their routine patrols and that kind of thing. Then as far as the Stepping Up Initiative, I believe that all of the counties in our eight-county region did a resolution. What that was is the elected officials, law enforcement, mental health providers, and all of the stakeholders in the mental health system were at a meeting. We discussed the resolution and then the county signed onto that resolution to enter into the Stepping Up Program to help address the mental health needs of the men and women who are booked into jails that have mental health issues. They saw the need to address law enforcement.

Lynn Fisher Both county law enforcement and city law enforcement have been really involved in the Washington County Mental Health Coalition. They routinely attend our meetings and are very active in that. As far as for the Mental Health Coalition, we do have a school subcommittee. On that school subcommittee we have persons with mental health experiences participating.

Maya Chilese I’m so excited to hear that.

Bobbie WulfThe law enforcement agencies in Washington County have been participating. As Lynn said, not only the meetings that we’ve been having with the schools, but also with our Mental Health Coalition. They’re also on the committees that we have at the region level with the eight counties who have been an important part of developing that training. As well as for the crisis intervention.

Maya Chilese Wow. This coalition has really taken some great strides in the years that you’ve been together. I’m curious, in probably many communities across the nation there are similar sorts of coalitions. I know that there has been some similar type of crisis intervention teams that often partner with law enforcement. I’m wondering whether or not you have partnered or have had any contact or communicated with similar coalition’s in different areas. If so, if that has been a value to you or to them in learning together about how you would address these issues?

Bobbie Wulf I would say most recently we have begun to share and gather information from a coalition that’s adjacent to us. We began a new project with learning how adversity and toxic stress affects us biologically. We have started those connections with another coalition, but up to this point we have not included other coalitions. Would that be a fair statement, Danielle?

Danielle Pettit-Majewski I do think that would be a fair statement. I think it would be excellent if we could find other coalitions that are working on similar goals, but at this point we haven’t necessarily found those. We do have a NAMI support group that has started, so there have been conversations between leadership and this committee. Also, in that coalition as well. I do think that there’s room for that work to happen.

Bobbie Wulf At this point our Mental Health Coalition has pulled in the other members of the community to address mental health, which includes our NAMI group. This also includes our providers of service and also includes the Southeast Iowa Link mental health and disability services region. We’ve pulled the partners into our coalition and developed some of the services that are available to us and shared those resources with the team members that are involved in that coalition.

Maya Chilese This is fantastic. One of the things that I think is so interesting is just recognizing that collaborative work takes a lot of respect of each other’s roles. Also, recognizing that there’s sort of this collective organism that is the community that everybody has a role together to play. I’m wondering, what would you say have been some of the things that have really helped this particular coalition function well? Not only together as a group of trusted partners and colleagues, but that has also ended up being effective in your specific community.

Bobbie Wulf I believe that some of the previous services that we had were able to develope those relationships amongst a lot of the members of the coalition. We all had a common goal. The coalition was a natural place for all of us to come together and talk about some of the gaps in services that we saw. Prior to doing some crisis intervention training, we had established mental health professionals in our emergency room for crisis intervention. We had already developed some of those relationships with our magistrate, law enforcement officers, hospital, and mental health professionals. We had been sitting at the table years prior to the coalition. I think that having some of those established relationships just made it stronger when we developed the coalition. As we moved forward we already had that respect with one another, and when we brought people in they really learned about a lot of the things we were doing. We’re excited about that. Moving forward was something that we all wanted to do, and develop the best service array for our community.

Danielle Pettit-Majewski I would have to agree with Bobbie. I think that sometimes you look at a smaller, rural community and think that we’re going to have fewer resources. I do think that we are a smaller, rural community. A lot of the people sitting around the table have those relationships already built, like Bobbie said. We work on a number of other projects together, so there is that trust. We can go full steam ahead without that introductory phase, if you will.

Maya Chilese Yeah that’s very true. What I heard you saying, is a bit of a reflection of the culture of the community and how that contributed to your ability to really to come together. I think it’s really interesting to hear how public health fits into that. I think, at least my experience has been, that sometimes in smaller communities the likelihood of that strong partnership or preexisting relationships is really valuable and allows everybody to come together. Run a problem as opposed to sometimes in bigger communities you tend to see a bit more siloing where there are so many providers or partners around mental health that those folks have a coalition tackling that issue. Therefore public health might remain a little bit more on the prevention side, instead of beginning to dabble a little bit into what some might consider on the treatment end of the spectrum. It’s exciting to hear how you all have been together. I know that we have talked quite a bit around a variety of things, or we’ve heard a variety of things so far that your coalition has worked on. I just wanted to make sure before we moved into hearing more about crisis intervention, what have really been any of the other main priorities? I heard about a school subcommittee and a couple other things. Would somebody name off the priorities that you’ve been working on together?

Lynn FisherOne of the priorities now for the coalition is we’ve started to learn about ACEs, Adverse Childhood Experiences and connections. We’re learning about how important connections are in the community, and many of us have attended training with Connections Matter. That has become a major emphasis now for the coalition, to build these relationships with other members of the community as well as educating the rest of the community about the importance of relationships with people. That is one aspect that we’re starting to move it into a little bit newer direction. I think it’s a very exciting time for the coalition with ACEs and the topic of ACEs.

Danielle Pettit-Majewski I will say, just to reiterate our first priority. When we met we realized that we didn’t know, as providers and partners, what everybody else around the table was able to provide to the community. One of our first priorities was to ensure that we put together some information so we could share that information with the community. We realized if we don’t know something then somebody who doesn’t work with this every day is certainly going to have a more difficult time. Oftentimes people don’t seek out resources until they’re in crisis or until their family members are in crisis. We really wanted to put that information out in an easy-to-understand packet. We have put it all over the county in places where there’s going to be zero stigma. These include hair salons, the courthouse, the library, restaurants, and then the regular places that you would think of, including providers offices and things like that. We really wanted to make sure that we spread the word about what resources are in the county. Also, to have a “no wrong door.” This is essentially referring to everybody back to Bobbie. If they felt that there wasn’t their exact resource listed in there or they weren’t sure which direction to go we really wanted to make it a priority that people knew where they could get access to services when either they or a family member were in crisis.

Bobbie Wulf I think as we bring awareness to our community and start educating our members, then it brings about good conversation amongst everyone. Then we feel more comfortable talking about mental health.

Maya Chilese That’s beautiful. I just would make an observation. One of the things that I have seen in a variety of communities is this really powerful shift from the objective of safety over to a priority about resiliency. This shifts the way we have conversations around people, and even about children engaged in a child welfare system. Or because of certain issues in the family or whatever. I just am really excited to hear this group talk about such powerful things and their role inside of that. That’s wonderful. Alan, I would love to hear a little bit more from you. Lets move into thinking a little bit more about some of the other work that this coalition partners have done. Alan, would you please say a little bit more about what you do?

Alan Brady Okay. I coordinate a 40-hour training for law enforcement. We are going to move into offering it to dispatchers as well. The training itself is also open to first responders, jailers, and emergency medical staff. We’re trying to make a complete and fluid transaction when it comes to crisis intervention. The training for officers is held in Mount Pleasant, which is a central location to all of our counties officers. They’re there for the week and they train on different aspects of mental illness. They work with different signs and symptoms with different mental illnesses and disorders. Also, how to interact with those people and how to visually understand when people are escalating. They get this training in their boot camp anyway, but this allows them a little bit deeper look as well. They also get those lived experiences and access to resources that come in during the week from all over the area. Those resources are able to interact with the officers and tell them what they’re capable of and what they offer to the community.

Maya Chilese Alan, is that training required for law enforcement?

Alan Brady Depending on how you look at it, yes. It is not required by any kind of policy code or anything like that, but it is something we’re aiming for in our region and have all of our officers trained in CIT. Most of the law enforcement departments in our area are on board with that, and they’re behind sending their officers and getting everyone trained. It is for the community outcome and how well officers interact with individuals after the training.

Maya Chilese Yeah. Alan, are you guys using a specific curricula that you’ve found, or is there something that you guys developed?

Alan Brady We have had the lovely abilities from our region to be able to send people the different trainings around the nation. Crisis intervention and most notably St. Louis and San Antonio. We have also taken notes from Johnson County. They’re a little bit bigger area so we were able to play off some of the stuff that they were working on. One of the people that were big in starting this role is actually up there now. The developing of our program has been based on several others, and we’re just taking the good out of each one of them to put them into our program.

Maya Chilese That’s great. Alan, what have you seen in terms of some shifts in how participants of that training have viewed or thought more about their work and relationships? Also, working with community members who might be experiencing mental health challenges.

Alan Brady One of the things we do in crisis intervention during the 40-hour training is role-play. During those role-plays we will have actors come in and act out scenarios where somebody is demonstrating a symptom of mental illness. As the week goes on the role-plays get longer and symptoms tend to get a little bit more severe. The officers interaction with individuals is completely handsoff. There’s no hands-on. During this interaction all officers lock their guns in their car. It’s completely safe and it allows officers to get almost real-life usage of the skills that they’re learning during CIT from those role-plays and into the real world. The reports that we have gotten back is that officers have been able to interact with people and build relationships and rapport with these individuals that they interact with on a frequent basis. This has led to better relationships and an increase in their knowledge of being able to recommend the amount of resources that allow these individuals to seek out the help they need, without future interaction with law enforcement.

Maya Chilese That’s fantastic. I think the use of role-play in your training setting is brilliant, and I think that it helps individuals be able to take what they hear in a training, in terms of some real-life practice. Especially as law enforcement, who we all know potentially put their own lives and safety at risk in their work everyday. They possibly running into situations where they’re not sure what to expect, and yet we want to ensure that they’re caring for people in a way that preserves their human dignity and provides the best for them. I think that’s really exciting to hear that as well. I think I heard someone else in our conversation this morning reference people with lived experience. We might consider them as consumers of mental health services or peers, and they also participate in the training in some way. Could you say a little bit more, Alan, about how that happens?

Alan Brady Yeah. Our lived experience pieces are one of the most important pieces of CIT. They get to not only see how these individuals interact and behave in their their normal setting, but also they get to see recovery, which is very important. That ability for hope and moving on from their mental illness. For instance, a couple individuals, one of which is Aaron Liken. He comes and speaks of the St. Louis area. Aaron Liken is an Autism ambassador out of St. Louis, and he has spoken at FBI Academy. He has done all kinds of stuff all over the nation. He is a great guy. He himself is on the autism spectrum and he comes to speak to the officers to tell them about what to expect on the street if they interact with somebody with Autism. Also, he talks more on a situation and how they should handle it. He mentions their behaviors and whether or not they’re actually being aggressive or if it’s just something that is from their Autistic behavior. Then at the end of the week we like to bring an individual, who is not too far away from our home site, who has battled with Schizophrenia his entire life. He’s actually a very successful realtor out of Des Moines and gives the image of hope and recovery. He’s also a very funny guy and a great presenter. We like to bring those people in so that the individuals that cops interact with most of the time that shed a bad stigma on mental illness. Now we bring those people in to show them the good behind the scenes, which really does help.

Maya Chilese Yeah. I agree. That’s why I think I was sharing the observation that I’ve seen that as more of us become aware of that, it allows us to shift past that immediate concern for safety alone and being able to move towards how can I be an ambassador for their recovery and supporting their resiliency. I have huge praise for your management of that training and to your community partners for considering that of utmost importance. I want to ask some of our other participants today if there’s things that you might want to add on to what Alan was sharing about the training, and how that might have changed your interaction with some of our law enforcement folks in your area?

Bobbie Wulf I think an important part of that crisis intervention training to law enforcement also is one of the days we bring in our resource fair. We have our providers of service there to meet face-to-face with our officers. This gives them an opportunity to not only learn about the resources that we have, but also puts a face to that service and just build some more relationships.

Maya Chilese Yeah. That’s fantastic. To your point about putting together the resource and referral guide earlier, that’s a step beyond just having the sheet of paper. Then a community officer can say, well Sharon down the street would be a good fit for this person and can provide that connectivity in a little bit more powerful way. That’s fantastic. I’m wondering how you guys might have measured your success? Surely you have captured some stories of success, so if you wanted to share some of those also. I’m curious, how you might be measuring the success? Sometimes those things come in those really tangible ways. I think, Sarah, I heard you mentioned earlier some of the things that the behavioral health community often might track in terms of length of stay, connectivity to treatment, or the avoidance of having to enter into higher levels of care. Even performance measures are indicators around that. I’m really curious about some of the success stories that you’ve seen that might be a bit more qualitative if you will or things that you really would have identified as demonstrative that at some point in time made you say this is working and we’re doing a great thing for our community.

Lynn Fisher I think one of the things that is important in how we work through our program as jail diversion coordinators is the focus on ACEs and resiliency. We do try and let the detainees we work with that have exposure to ACEs and to help them understand their own resiliency. Then, probably a recent story, it’s not necessarily from the Washington County area, but in a couple of our other counties we have a Substance Abuse Court and my staff while training a new hire that we have attended the Substance Abuse Court and there were seven individuals there and of those seven individuals five had been through our jail diversion program. They strongly identified how important the connection was that they had with our jail diversion folks while they were in jail helped them become successful once they got out of jail. Even one of those individuals is what we call a frequent flyer and of those five individuals they all had employment and were working on getting into their own apartments and very grateful to my staff that they were able to talk to and say thank you, that helped me stop this cycle. One of the individuals even told the judge at drug court how important our program was to them at helping them become stable and be able to have a different path that they’re walking now that they’re out of jail and have had some supports from that program. They had somebody help them do a warm handoff to those community service options that are out there that they may be comfortable reaching out to on their own.

The Mental Health Coalition’s Subcommittee, the school subcommittee, has had a lot of success this past year and they were successful in obtaining a grant. They are now able to provide some mental health supports and at the school, on-site, which is a huge improvement. They are now are able to launch even further because of that initial grant funding, so they’re building on that program. That’s been a real success with the Mental Health Coalition. The fact that the Mental Health Coalition is still alive four years later, we haven’t disintegrated, we’re all very passionate we still want to move forward, we’re working on this awareness campaign, and we have new goals show that the coalition is still very functional and alive at this point. This, I think is, a real success because so many times you see committees form and then after a year or so they disintegrate.

Maya Chilese Yeah very good point Lynn. Another question I had is since you’ve been successful together and have worked collaboratively really well for quite some time, I’m curious, within your work has there been some things pop up that were unexpected, perhaps a direction that you went that you didn’t see coming or that you didn’t anticipate was going to be successful? Now you’ve seen a lot of passion around, what are some of the things that you did not expect when you started this work together?

Lynn Fisher Well, I don’t think we really expected the emphasis at the school. There is a new mandate now for schools to be conducting Adverse Childhood Experience training and resiliency training. That really was not on our radar when we started four years ago, so that’s been a change with new mandates for the school. Then, we had access to a national speaker, John Richardson Lauve, at a regional training. We were so excited to meet him that we invited him to come to Washington, Iowa and he did. He came and spent an entire day in Washington, partly with the school system and then also with our Mental Health Coalition. So, we had access to him to learn that we were right on track with a lot of other coalitions. He was able to give us advice on future direction, so that was new. We were not planning on having any access to a national expert or to be able to spend a day with us here in Washington County. We were not expecting for the schools to have this emphasis and required trainings on Adverse Childhood Experiences and resiliency, so that’s been a new direction for us.

Danielle Pettit-Majewski I think one thing that we weren’t expecting is just as the time has gone on how many different ways we were able to loop in other opportunities to what we were doing with the Mental Health Coalition. This has become such a hot topic of interest and that I think has really helped us expand our coalition. We were not 31 members when we started in November of 2015. We have really realized how many people are impacted by mental health and how many organizations are dealing with it. What is exciting to me as as Lynn talked about with the ACEs and with the Connections Matter is getting out into the business community, talking to workforce, helping them to realize how they can engage with their employees to help with recruitment and retention, and how broad this topic is and how it touches so many aspects of our lives. I think that has been really exciting and really surprising to help people realize that in overcoming the stigma we can really impact a lot of change.

Bobbie Wulf To expand on that we have brought in some unconventional, if you will, providers such as our local YMCA and our Iowa State Extension Office. People who are really working towards building resiliency in a way in which we had never thought of it before. Now with some additional training, we are really trying to broaden our array of services, connections, and supports in our community to bring that all together to develop that resiliency. I think we’re really excited to build those relationships that we’ve never had between public health, mental health, and now with some of those other providers who have typically not been involved in our system before. I think that the development of NAMI has come up just recently in Washington County as well. We are starting to think about them as a partner in education and peer groups which also will be a great asset for us and we’ll build our coalition stronger.

Maya Chilese Yeah thanks everyone for sharing. This is a really powerful example of people working together. I just keep hearing in my head this is public health. This is fantastic and I just really love hearing about people that are so passionate for individual and community resiliency. To echo a lot of what I’m hearing is just how meaningful that is to a variety of people. Not just a variety of people that you work with, but to note that everyone knows someone that experiences mental health challenges at some point or another in their life. We recognize that there is no health without behavioral health. To have this work happening in your community makes me feel proud to be a part of this work somewhere else in the nation and to know that there’s good people like you working on this stuff together. I’m wondering, as we’re coming a little bit closer to the end of our time together, are there some other notes of things that folks wanted to share today? If you were making a recommendation to another community that is where you were in 2015 and they’re just getting started, what would you say to that group?

Bobbie WulfI think that it’s important for people to understand that partnerships take time. A lot of us try to rush into a coalition and the relationship building piece of it is very important. That does take time, like you said, just to build that respect with one another and understand where each of us come from in our professions and in our lives, in order for it to be successful. So be patient.

Maya Chilese Yeah very true.

Danielle Pettit-Majewski Looking for a quick win is always what you want. As a public healther, I’m always thinking everything takes longer than you think it should. Especially as we’re thinking about doing our community health needs assessment again in 2020, I think like we’ve barely tapped the surface of what we should be working on with mental health. Just go in knowing that it takes longer than you think it should. It is a big issue to wrap your hands around and there’s multiple perspectives to look at it from. So do not get discouraged if you’re not seeing immediate results.

Maya Chilese Yeah that’s a good point Danielle. Lynn, I think you were going along the same thread there, did you want to come back to that comment and add a little bit more?

Lynn FisherI think that Danielle captured it really well. So many times I think community members or coalition members are looking for that quick win and sometimes that just isn’t possible in the first year to have some major event be accomplished. Like we all have mentioned, we’re still working on building our relationships and learning what each other does. It does take a lot of patience, persistence, and diligence. Coalition work requires a lot of those elements from the leadership and from the membership as well- from everyone on the coalition. It’s really important to have those elements present.

Maya Chilese Very good point Lynn. I think that’s true. Most of us recognize that we don’t see necessarily changes and health indicators for a good five years. You’re not going to see an outcome related to perhaps prevalence rates or things like that for a very long time, if that’s what we were using to measure some success. We might have been on the wrong boat, so being able to identify other things. Sometimes just community connectedness and the strength of a coalition can really reflect those positive outcomes. Did anybody have anything else that you wanted to share about a recommendation to another community who might be at the start? Alan, perhaps a little bit around getting a training program going? What might you recommend to another community?

Alan Brady I was not necessarily the one that initially started the full program. I came in towards the beginning of its inception for crisis intervention. A lot of it was very established. However we are moving forward with an advanced CIT course and we have been trying to get started on a dispatcher course. I would say another thing to get involved is to reach out to the communities around you that have these programs started. A lot of communities are very willing to help out and give you information on how they got stuff connected, how they got the resources connected, and how they got people involved in the training. I still reach out to the individuals from San Antonio and St. Louis when I have questions on things. I have actually offered to other communities to help them out and try to get the CIT program started in their own community, so they can be selfsufficient. Some communities are willing and some aren’t, but that’s the big thing – judy teaching out and getting help. There’s no reason to reinvent the wheel per se on this training.

Maya Chilese Great thank you. As you wonderful people have been talking this morning, I’ve been capturing some of the things that I think might be reflective for our listeners. Keeping in mind, of course, that most of the folks that this podcast is directed towards are those working in public health. Let’s just kind of go around and I’ll go down our little list here and call on you by name. Think of something that you might recommend that the listener could consider after they’re listening to this podcast. What might be one thing that you would recommend for them to think about next or take action on next? Danielle, I’m going to put you on the spot. You can say pass if nothing comes to mind. Danielle, would there be something that you might recommend that our listeners could do next?

Danielle Pettit-Majewski Yeah, I think one of the most important things when you’re thinking about mental health is just realizing how many people in your life are dealing with mental health issues. By finding ways to start those conversations, start reducing the stigma, start looking at it as the second leading cause of disability following heart disease. There’s a lot of people who consider mental illness as different or other, but really it is incredibly prevalent. If we start looking at it as just another chronic condition, I think it helps to reduce some of the stigma. It helps open up more conversations when we normalize it. We recognize and talk about it in a way that doesn’t seem scary or different, but just as another chronic health condition that we want to look at and we want to help improve.

Maya Chilese Yeah that’s great. Thanks Danielle. Lynn might you have a thought for our listeners?

Lynn Fisher Yes I think it’s really important if you’re thinking about forming a group or forming a coalition to listen to all the partners and get a lot of input. You may not know everything that you think you know. This really affects a lot of lives, so it’s really important to get information, ideas, and input from all of your community members, community partners, and the citizens of your community.

Maya Chilese Great, thanks Lynn. Bobbie would you have a word of wisdom to share with our partners?

Bobbie Wulf With the coalition it’s always important to not only, like Lynn said, to listen to all of your partners but always be thinking of the next step, to never be satisfied, and to always want to improve our communities as much as we can. So when you finish one project and you’re moving forward, just remember that there’s so much more out there that we could be doing to continue to improve the relationships of our community and the resiliency.

Maya Chilese Yeah, caring for other humans is neverending work. Good, that’s great. Sarah, what would you recommend to listeners?

Sarah Berndt I would say that mental illness has a huge impact on the entire family. So when you’re providing services really try and look at the family needs because that’s so important. It affects the adults. It affects the children. It affects everybody in that unit and everybody needs help healing.

Maya Chilese Good. That was a powerful statement. Everybody needs help healing. Thank you. Alan, any last thought that you’d share with our listeners?

Alan Brady I would say the big thing, especially with trying to establish a coalition like this, is the ability for all these resources and partners to come together and kind of put their own agendas aside. Being able to work for one common goal is very important. Being able to reach out and get help when you need it and not being afraid to do so. The other aspect is that we are integrating every portion of our region. So, even officers are engaged in the conversation. It’s very important because when officers get called out, it’s not because somebody was sleeping in their house. It’s because they were out in public, on the scene, which creates more stigma around mental illness. That’s something that we’re trying to diminish. Bringing all those partners together, setting aside agendas, and working towards a common goal.

Maya Chilese Good summary, Alan, thank you. Wow this has been such rich conversation and I’m so grateful for everyone’s time this morning. I was jotting down a few really powerful things that I heard folks say throughout this conversation. I was just going to provide a bit of a summary on those, and please feel free to all of our very talented and compassionate podcast guests today. I heard a couple things that I would even like to note that our listeners could keep in mind, starting with the recognition that we want there to be no wrong door. Wherever you are in terms of your place of employment or the program that you’re in, you may not have anything to do with the service arena or this group of people, but just begin to think about yourself and about no wrong door and what would that mean if you came across someone who needed assistance. Where would you refer them to? I heard this group mention today things that, for me as a listener, I would want to make sure that I’m increasing my own self awareness about resources or partners in our community. I would want to consider my role in that partnership group, similar to how this group has described what it meant to work together. Alan did a great job summarizing. While we all have respectful roles that we bring together and our own expertise, minimizing our individual agenda for the common good is important. I heard a lot about using recovery language. For listeners today leaving this podcast, think about what that means to change our language towards words of recovery, hope, and resiliency. I also heard some suggestions for folks to become more aware of ACEs and traumainformed care, and how you might integrate that into the work that you’re doing. Perhaps the last one might be to connect to peer advocacy organizations like NAMI. NAMI has chapters all over the nation. You might not have one in your community, but there are likely other peer support organizations and surrounding communities that might be interested in partnering with you as well. A lot of stuff came out of this last hour and I’m so grateful for Danielle, Lynn, Bobbie, Sarah, and Alan for your time today. Kudos to you guys for sticking together and creating a strong coalition. Thank you so much for being willing to share with us today about how you got started, how you identified priorities together and a little bit about what those are, and how those have been impactful to your community. Specifically more about crisis intervention training and how working with a broad base of partners across the community has helped to shift the language to thinking about I’m supporting resiliency, hope, and recovery for people. This has been another podcast series from the Midwestern Public Health Training Center and we’re so grateful for your time today. Thank you so much everyone.

Laurie Walkner Thank you for joining us today. Special thanks to our guests and members of our planning committee Sonja Armbruster, Katie Brandert, Stacy Coleman, Brandon Grimm, Suzanne Hawley, Abigail Menke, Melissa Richland, Hannah Shultz, Laurie Walkner, and Kristen Wilson for guidance in creating this series and To Maya Chilese for guidance as well as hosting this series. Theme music was composed and produced by Dave Hoing and Roger Hileman. Funding for this webinar is provided by the health resources and services administration. Please see the podcast notes for an evaluation and transcript.

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