OK State of Mind
OK State of Mind seeks to satisfy inquisitive minds eager to delve into the realm of mental health and overall well-being.
Join us on a journey to gain insights shared by mental health experts, draw inspiration from remarkable stories of resilience forged by those who've navigated challenging paths, and unveil the intricate science that underpins our thoughts and emotions – a sort of 'invisibilia' if you will. Through these explorations, we aim to illuminate the captivating 'whys' behind our cognitive and emotional selves, hopefully unraveling the complexities that shape our behaviors, feelings, and perspectives.
This podcast is produced by Family & Children's Services based in Tulsa, Oklahoma.
Learn more at www.fcsok.org and www.okstateofmind.com.
OK State of Mind
Show up. Be honest. Let's talk: A Real Conversation about Behavioral Health and Partnerships
Join us for a "real" conversation with two incredible leaders shaping behavioral health in Tulsa: Adam Andreassen, CEO of Family & Children’s Services, and Jim Serratt, CEO of Parkside Psychiatric Hospital.
This episode isn’t just about data and strategies; it’s about the strength of partnerships and how communities can come together to make real, lasting change for people.
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Thank you once again for accompanying us on the journey. Until next time!
One of the things I want to state about mental health there is a long history, even in an amazing country like the one we're in, of people not always being, treated and received, even by the mental health system in the best possible way.
Jim:I think I would issue a challenge.
Adam:Jim. What are you laying down?
Jim:Yeah, let's come together. Let's talk about, in real terms, in truth, let's talk about what our real needs are here. Not just what we think we need to do, but what do we really need to do? Let's forget the stereotypes of what each of us does. Let's find our lane that we're great at and make that a superhighway instead of a bunch of roads that are crossing each other.
Dee:Welcome to today's episode of OK State of Mind, a family and children's services podcast. I'm your host Dee Harris, and today I'm talking with two incredible behavioral health leaders in Tulsa, Adam Andreessen, the CEO of Family and Children's Services, and Jim Serratt, the CEO of Parkside, a psychiatric hospital that plays a pivotal role in Tulsa's mental health landscape. Today's conversation isn't just about data and strategies. It's about partnerships and the power of community coming together to make a real difference. So whether you're a mental health professional, a community leader, or simply someone who just cares deeply about the mental well being of others, this episode is for you. So welcome Adam and Jim. I'm excited to talk about this partnership, especially the Zero Suicide Academy. I mean, I know there's a lot of systems that have brought zero suicide into their environments and really has helped with the prevention piece of that. So, why was it important to bring this academy to Tulsa?
Jim:So first off, thanks for having me guys. This is really cool for all of us to get to sit down and talk about some really important stuff. Zero suicide, was fairly new to me as an organization. But the suicide aspect of it, of course, is very personal. Uh, very dear friend of mine, uh, lost his child while we were both working as CEOs of behavioral health hospitals. And so we should know this stuff, right? We should be able to. figure that out way ahead of time, but he lost his daughter very early on and so we spent a lot of time talking about it. And so it doesn't, uh, it never leaves any of us when that kind of impact happens. And so when one of our staff members came to me and said, there's, there's this idea, this is zero suicide, which sounds just the words itself. Sounds like we ought to all be heading that way, right? Right. Okay. So, she brought that in and we began to explore it and knew we needed an outstanding partner to help us pull that off. And, couldn't think of anybody I'd rather work with. So, that came about and we really appreciate the opportunity to share this adventure here in the Tulsa area.
Adam:So, I was really excited to hear about the Academy. Everywhere I've been, you know, Zero Suicide is thankfully a common thing in the United States, and I, I think it's sort of that best and worst of both worlds because on the one hand, it's got a lot of attention and on the other hand, suicide keeps going up. And so all the things that we're doing I wouldn't say they're not helping. I think they are helping, but whatever is happening more broadly, it really is, continuing to leave its mark, and of course COVID and all these things kind of added on to it, and so it's just this thing that we really need to push into more. So while I've heard about zero suicide, the academy and that next level of bringing that training into the area. That was something I was real excited about when approached about the podcast. And it was of course, uh, a great opportunity to learn a lot of what both Parkside's up to and now what we're doing together.
Jim:Yeah, I think zero suicides on everybody's mind everywhere. And they've been talking about it a long time. The academy was something new for me in that we can take a small group of people, relatively small group of people in the community and use that as the catalyst to create really strong system wide change where it comes to the forefront rather than the grief after the fact. We're going to do something proactive about it. And so to do that, you have to have the tools to do it correctly. And this academy sets us up with folks who are prepared to come in and take a small group of people, tune them up, get them ready to go, and create the kind of change that we need in the Tulsa area. Because you're right, we all know this, right? You can't pick up a newspaper, you can't listen to any radio program without hearing about this severe problem that we have in this area, and yet, it keeps growing.
Adam:Yeah, so, at Parkside, I think a lot of people know what Parkside is and does, but I don't know that most people even understand, you know, what is a psychiatric hospital in 2024. How long do people stay? What happens inside it? Because I think that for us to have this conversation, sort of that continuum of, you know, everyday life, schools, other lines of defense, and then you come with family, children's and Parkside. How does Parkside fit into this puzzle of what people go through and how, how we help? Because I think that's an important part of the conversation.
Jim:Yeah, it is Adam. Thank you. So, I even have staff members that when they come to work are not real sure exactly everything that we do. They just know that we have to take care of people, primarily keep them safe. It's evolved over the years. You know, we used to think about long term care in psychiatric hospitals. And that's not really our role anymore because all the folks like family and children's and all the area folks have Come to the table so strong, and there's been so much investment in the wraparound services and in the things that will help people stay strong, that now what our job is, I explain this to our staff this way, our job is to catch. So we're that last line of defense that catch. You probably don't think about Parkside or us. Except maybe on a Friday night at 11 o'clock when something really bad has happened or something has been said, uh, whether it's among your family or school or any other setting, a church. And so, we realize there's a problem and so there is a place that we can keep people safe. Do comprehensive assessment work, help people understand where they are, keep them safe, and get them ready to get them right back out to you guys.
Adam:And I think that's something that is a huge part of what we do as well, and I want to come back to that for a second because family and children's, you know, anybody that listens probably tired of hearing the story, but we came to exist about a hundred two years ago because women and children were often the ones falling as, you know, men at that point in the traditional home were, out and about in the oil rush, and they were being pulled off to this, that, or the other, sometimes dying, sometimes moving. And so people were, your words, falling, and we, that's how we came to be, kind of lifting them up. And that sort of lifting up the floor of people's experience, that prevention and response to crisis is still so core to everything we do. And you hope that that prevention comes into it. Now what does Parkside do that would be like, okay, you catch people, but then how does that feed into prevention? Or does Parkside do any prevention?
Jim:Yeah, so the second phase of that is we, so I said we catch. So, then we lift. And so, the job is to put as many tools in the toolbox of, especially these kids that we're working with, to help people have something when they walk out the door. From the second someone feels like they need to be safe, they need to come to an environment where they can be safe, where authorities even feel like they need to be somewhere safe, we begin to work on the idea of them not being with us. So it's a little different kind of process. We're not looking
Adam:You mean discharge, not being with us.
Jim:We're not, we're not looking for, um, you know, uh, Long-term customers, if you will. That's terrible to put it that way, but that's, that's what it is. So we catch, we lift, and then really we push, we help get people to the right place. I think that's the most important thing that we do because people don't need to stay in a psychiatric hospital. And that's why the partnerships. that we've developed with you guys especially and with others in the community becomes so important because we have to have worthy partners on the other side to be able to move people to effectively and the, the question I always get asked is, what's the average length of stay at the hospital?
Adam:What is the average length of stay?
Jim:It's seven to 10 days. And so that means it could be anything from five to a couple of weeks, depending because We've really pushed into this individualized treatment planning. And so that's not something that was always there in the past of psychiatric care. there were a lot of cookie cutters work. But now, there's no set pattern. It has to do with the patient, where they're at, where the family's at, where the support systems are at, because they've got to be released into a very safe environment. So that's
Adam:If we were to compare this to like Big Box Hospital, is what Parkside does, is it's sort of like an emergency department, patches you up, gets you back out on the road. connects you to some other level of care so that you get that follow up? Or is there a different analogy? How would, how would you describe it if you would compare it to what people are broadly familiar with in the healthcare world?
Jim:Yeah, it's very much like an emergency room for psychiatric care. we work very closely with the area emergency rooms as a matter of fact. And so, we supply that stabilizations. We're like the ICU after a surgery, you know, you go into the SICU for a little while. And so it's, we assume that's acute care. And so that's what we focus on. We'll also do some long term care if that's what's indicated, but that has to be something that's kind of agreed on by everyone. So that acute stabilization, we use the word stabilization a lot. We get folks to a better place than they are when they come in. So the most important thing we do is get them ready to be successful with you or with other outside providers because people don't initially that have to be hospitalized really want to think about the next step. They think, I'm going to be in the hospital a couple of days, my child's going to be in the hospital a couple of days, everything's going to be okay. But the fact of the matter is, we try to therapeutically introduce the idea of being involved in treatment, the idea of being involved in getting better, owning some of that, and being so ready to do that when they leave that we make that process easy so that they'll be compliant and The funny thing is most of the people to discharge that I talked to The first thing I say to them is I don't ever want to see you again, and I mean it sincerely and so that's been the 35 year career of trying to work my way out of a business, work my way out of this, and it just hasn't happened.
Adam:You continue to suffer from relevance, uh, as do we all right now. And I think that the thing that's so challenging is we all would love to work ourselves out of this job, and yet, I'm seeing some pretty startling statistics, and I've been in this field a while, and you've been in this field a while, but some of the statistics I'm seeing on suicide and other deaths of despair are pretty startling, even when I thought that I was hard to shock, and one of the ones that caught my attention, I was at a conference last week that really caught my attention, you take students, people in school right now, kiddos, students, teenagers, adolescents, middle schoolers, so on, 40% of students right now, we're not just talking about have some distress or some sadness. 40 percent of students nationwide right now have chronic sadness or hopelessness, persistent. And that just blows my mind So we're doing a lot we can do on patching people up, getting them back out there. But I really am struggling with what are we doing as a society if 40 percent of young people. who are supposed to be the most optimistic on the planet, 40 percent of them are experiencing persistent helplessness, hopelessness, sadness. How do we pull ourselves out of that? I'm sort of going a little philosophical here. What do we do? Because we can patch people up and patch people up, but if we're really just stacking up a society that is 40 percent sad and hopeless. And by the way, some of those statistics are even worse when you start breaking down people groups. The LGBTQ plus population is way higher than that. A lot of the different, ethnic and minority populations, as the terminology may go, they're way higher. So, like, What do we do when there's that much sort of stacking up from just a causing the problem?
Jim:Yeah, I think unfortunately despair has become a characteristic of this age group. And so that's just tragic I mean, that's that's something I didn't expect to see escalate quite like it has even into the lower grades and So this feeling of worthlessness of hopelessness Has to be tackled by all of us. The ability to help people understand that they are a person of value, regardless of what the world may be telling them. It's so easy to blame everything on social media. I mean, that, that seems so easy. I think what we have to do, uh, people like you and I, Adam, have to figure out how to harness that power of social media and use it to help battle some of this disparity. But, the fact that There's so much there, sometimes doesn't bring the really chronic cases to the top, they're able to slip in. We get bigger and bigger and bigger in all these systems, and sometimes we forget about the individual needs. And those kids and adults slip into the cracks. It really worries me. If we don't continue to talk to each other, and have ways that we can share information and share with each other what we're worried about, Even as providers, we're going to be at a loss on how to tackle this. It's going to take a unified effort.
Dee:Yeah, you've talked about the importance of creating cohesive systems, so that children don't slip through the cracks. And so it goes beyond just even the behavioral health care system, don't you think? It goes into the schools, it goes into prevention. And it goes into intervention and then arming kids with tools. So what's the solution here? Partnerships I think are part of that solution but what do you feel like expanding on that solution would be?
Jim:I think, something like what we're doing. We have to start a dialogue that everyone can understand fully what the problems are. We can get rid of some of those self perceived importances that we all think that we have. Let go of that perception. Understand that we have services. We're not just businesses or that kind of thing. That we're actual services. And that our primary goal, no matter if it's family and children's services or Parkside or any of the other wonderful providers we have in the area, Our goal is not self promotion. Our goal is to take care of the people we're entrusted with. And we're entrusted with this area right now. And so, when someone is entrusted to you, you care about what's going on with them, don't you? I mean, you, you have a child that's born to you and it's entrusted to you and you spend your life making sure it's okay. I'm not sure that all of our agencies understand that, but we're gonna get there. And it starts with these kind of conversations and some of the things that we're working on together as groups. I've only been here a short time. Adam and I are kind of the
Adam:When did you get here? I've been here nine months.
Dee:Yeah, both of you are from out of state, right?
Jim:Yeah, I've been here a little over two years. oddly enough, when I got here, I was told by people who aren't around much anymore that, that none of us work together in Tulsa. It just scared me to death because, can't work, you know, that's not going to be successful. And I have never moved into a community where I was so readily accepted. Especially in the mental health environment.
Adam:Same. So like, that's the thing, you know, people joke around here, they call it"smallsa" because everybody knows everything. And I found that to be true. Like, people are very connected. But there's a lot of good that comes from that. And I have felt welcomed, of course, by you, but by so many others, because I think this is a community that is very invested in its own outcomes. Now we're not as a community as a society, Oklahoma and Tulsa. We're not immune from a lot of these statistics, but I have, since I've been here, really experienced it as a community where I, I don't feel that family and children's or Parkside is out on an island. It feels like we're at some center table, working with the foundations, working with the agencies, working with the charities, working with families, working with schools, working with law enforcement and first responders. It really does feel like everybody's in this together. Is that, has that been your experience since you got here?
Jim:It's absolutely been the experience I've had. I met a little over 250 people, in environments just like you and I setting down. I think we went and had coffee or something, sat down, got to know each other. And in that first year, there were over 250 people across this area that I was able to sit down with and just kind of lay out questions to them about how can we approach this better. And I found almost to a person, everybody was ready to do something and create almost a wow factor here, that we knew we could do this in Tulsa.
Adam:And when we talk about that, you know, the number of people, whether they be young people or older, I mean like, suicide risk is going up, all these different things, I think that you know, I've talked before about social determinants of health, you know like those things like if you don't have a job, your depression is going to be hard to treat. If you don't have a meaningful connection of people that love you and care about where you are that night, If you don't feel supported and tied in, if your health isn't strong, those are all things that contribute to those deaths of despair, because they're sort of like pieces of a Jenga tower. All of us can balance if we're like, okay, my health isn't great, but I've got a supporting family, or I don't have a job, but my family loves me and I've got my health. But the more of those things we start pulling out from under, The more individuals and then collectives start to teeter, and I feel like this is an environment in an area that seems focused on, but I don't know if everybody is fully aware, all the different things we need to be doing, because the prevention of that suicide might be ten years and coming, not ten months and coming or ten days and coming.
Jim:It's exactly right. It starts very early. Sometimes The slightest thing can be the seed. And so, that's something we really have to stamp out. We really gotta help people understand their value and their worth. And I think we do that as a community. I moved here and was told about the terrible homelessness in the area. And so I don't know if any of you have lived in large cities, but I just came from the Houston market two years ago. This is nothing. And here's the really great thing. Tulsa's doing something about it. It's a conversation that's continually happening, be it negative or positive, it's still out there. We're talking about it, and it's very much like what we're trying to work with, uh, behavioral health and mental health. Adam, it's, if there's not a conversation, we can't get better.
Adam:And I've seen some people, even in this area, seem to make the faulty connection. Let's talk homelessness, that homelessness is a mental health issue. And I've seen way too much of a characterization of individuals who are without a home as in need of mental health services. Now, family and children, others, they're all trying to work together because we do know that there is a lot of what you would say comorbidity. Someone without a home may have had a cascade of things that has led them to a mental illness. But, I also think we need to be careful as a city, and as a county, and as a country, that we don't equate the things that people struggle with with the presence of mental illness.
Jim:Yeah, that's true. You know, I've been in markets before where if someone didn't Talk like us, smell like us, look like us, sound like us, they must be mentally ill. And that's just not the case. And so, it can become one more of those stigmas where people can't reach out and get the right services.
Adam:Or as a society, we can play such a game of Jenga, you know, there goes your insurance, there goes your housing, there goes your and at some point, aha, you have a mental illness. Well, of course, because look how many things as a society we fail collectively on and then we get to that point and people are suffering and they're in a mental state, but that mental state didn't come without context and background that sort of led up to that.
Jim:Yeah, exactly. And the state of mental health usually mirrors the state of other health issues throughout. And so we're not special. We're just part of the whole process. And I think as we have, again, as we're starting to have these conversations and we include people from the physical health side, I know you guys are doing some great stuff with that. I'm jealous. You guys are really way out ahead of that. Um, as we start having those kinds of conversations, we'll find that we have good common ground. I mean, the whole idea of integration of medicine is going to be an incredible, I think that's the next big wave, and I think that's going to be incredible for our whole country if we can do that. I spoke at a conference last fall about mental health and it was pediatricians and nurses and students and several came up afterwards and said, that's every patient I see, you know, this one pediatrician in particular said, I think I could talk to you about the mental health issues of almost every patient that comes to me. And these are, you know, from good families, from families that are struggling, it goes all the way across. I think if we start talking about that though, and we understand that, Hey, We can be your partner. Yeah, that makes a lot of difference.
Dee:Yeah, it's mind and body. I mean, there's been so many studies recently about the mind connecting to body and, you know, the gut and how that affects your health. And I think the world is just starting to realize the connection more deeply. But you had mentioned earlier about meeting the needs of diverse populations. You know, you may not look like me or sound like me, but We're still wanting to meet those needs. The cultural competencies of meeting the different populations. How are you going about doing that, meeting the needs of all the diverse individuals in our community?
Jim:Well, I think one of the first things you have to do is be able to have people, in your team that other people can hear, not just listen to, but can hear. And sometimes that has to do with backgrounds, it has to do with their ability to be empathetic, and that may come from life experiences. And so that whole You know, we keep talking about the workforce shortages and all that, so as we make those decisions about who we're going to bring into our team, I think we have to be aware that we need to bring people in that can reach across some of those chasms and be able to speak to the folks that are actually coming to the door. What's the old, the old saying about, you know, I just built it, I don't understand why they don't come. We have to figure out what our folks need, and that's what we need to build.
Adam:You know, these sort of conversations are ones we should always lean into, and I think we always have to lean into them. With a healthy dose of humility, because we don't look and act like everybody, we look and act like ourselves. And that makes us similar to some people out of the gate and dissimilar to others. And so when I was in school to become a psychologist, early 2000s, we had these, what you would call like, diversity seminars. And it's not that long ago, you know, just over 20 years ago, and the training was about like, here's how to work with all these people that aren't like you. And so it was sort of one offs, like, Here's how to work with the Native American population because they're not like you and here's how to work with the black population They're not like you and it was just sort of these one off Like bite sized Lunchables of how to work with people and that used to be what we talked about We talked about cultural competence and I really feel like that's important training I don't mean to demean the training, but that's not really gonna open doors And I also know that the task can't be Only get services from people like you because number one, that's nonsensical and it doesn't promote that sort of we're all in this together as well. And I think that's one of the things that is this huge opportunity, but also this huge need is what do we do as agencies, but also as a society to make sure that we honor and celebrate the differences and recognize that all of us have different needs and different people groups and different experiences and all of those things require level of competence. Lest I misunderstand something as a mental health issue that might truly just be a cultural factor or a trust factor or so many other things that where just the risk of confusion and misunderstanding with each other goes up, the more the differences are there.
Jim:I agree, I mean, I think the one thing, uh, and Dee asked this earlier, I think the one thing that shows up more often than not are the people that are coming to you, and again, we talk about the folks that, that don't look like me, they don't sound like me, but you know what they see? They are able to see empathy and compassion. It's the part of the human experience that seems to transcend that. It has to be real. Yeah. And it has to be genuine, and nowhere more so than in behavioral health and mental health. There's no, you, you can't just look at someone and diagnose them. There's no wound to see. There's no arm to set. There's no cast to put on. You have to be able to be empathetic and understanding. And most of us have been through something. Most of us that work with people have been through something. And if you can capture that in your heart for a few minutes. As you're looking at someone, I guarantee you'll find a place to connect. And that's the people we have to get into our groups and help them understand this.
Dee:Yeah, it's people that are able to be vulnerable. And people that are serving people that are vulnerable. It's that vulnerability that our human nature tends to want to go, Ooh, I can't do that.
Adam:So there's so many directions I want to go with this. And you made me think of another one. There's this, marvelous, marvelous book, and I think this is where I got it from, but it might be somewhere else, some social psychologist, but I think it was Daniel Pink, The Power of Regret. Highly recommended, but one of the things that, comes up in one of these books is, do you know what happens when people display more vulnerability? Their likability factor goes up. So while we think that vulnerability, actually exposes us, so we don't want to show it, over and over again, when people actually get vulnerable And say, hey, and either share a little bit of what's going on with them or what they're struggling with. The people that hear that vulnerability tend to, on the whole, like you more, not less. And I think it's so contrary to human nature because we're like, well, lock that crap down because then, you know, no one ever can hurt you. Unless you're Brene Brown, of course. Right, of course, Brene Brown. Um, I would love to be just like Brene Brown. But, for the rest of us, it doesn't come easy to show that vulnerability. Mm hmm. And I think that that's a really important piece in this, is that we all have to sort of go first, right? That's vulnerability. Right. Because if I reciprocate, great, I reciprocated, but you showed vulnerability. One of the things I want to state about mental health is it's not so long ago that whole people groups were on the receiving end of experiments and were on the experiments of broad categorization. Some of that persists today, hopefully the worst and most malevolent of it has been rid from our society, but there are a lot of individuals in this community and so many others who remember those things and they are gatekeepers. And they are rightfully, rightfully, as they should be, protective and cautious about engaging with large systems of care because large systems of care haven't always been careful. And I think that that's one of those things that we have to wrestle with when we talk about competence is recognizing the context of why people are suspicious of care and why people aren't always open arms when we say, here we are, let's help. Because there is a long history, even in an amazing country like the one we're in, of people not always being, treated and received, even by the mental health system in the best possible way.
Jim:Yeah, I think I would even take it a step further. I mean, I think I would issue a challenge. I mean, you and I have had this conversation several times. But, the leaders in this community, uh, especially in mental health, behavioral health, and, um, Interventions have got to display that. We've got to get over ourselves and become real. And, you know, it didn't matter whether I was wearing a coat and tie or whether I was up there in my jeans. At some of the hospitals that I've had where we've had adolescents, as long as I was real and was myself, I was just as accepted by them regardless of those kind of things that paint the picture. Instead, they're able to see Through your words and through your actions what you're doing. I think we should challenge the other leaders in the area Oh, I love to get over it get over themselves Your bottom line is going to be fine. Quit worrying about it Let's take care of some people and and if those of us that are in these leadership roles will say I'll do whatever it takes to make sure that the people that are entrusted to us get taken care of I think we're fine
Adam:What is your challenge? So you're like hey get over it. All right, we get over it. Yeah, and then What are we asking ourselves and others to do? What is that? What is the concrete, like, okay? I'm ready to buy what you're laying down, Jim. What are you laying down?
Jim:Yeah, let's come together. Let's talk about, in real terms, in truth, let's talk about what our real needs are here. Not just what we think we need to do, but what do we really need to do? Let's forget the stereotypes of what each of us does. Let's find our lane that we're great at and make that a superhighway instead of a bunch of roads that are crossing each other.
Adam:Show up.
Jim:Show up, sit down, be honest. Let's talk.
Adam:And I want to sound like I'm going to contradict myself, but I hope I'm not. I've also seen, here and everywhere else, that all these areas and people groups and gatekeepers and again, we're talking different ethnic groups, we're talking the LGBTQ population, we're talking people with developmental disabilities, I mean like, I'm talking across the gamut, so I'm not talking about just one group, but over and over, what I've seen is when, whether it's myself or someone else, when people enter space authentically and with some humility, And ears open, mouth closed, which can come harder for you and me. Uh, people are usually happier there. I, I don't find massive distrust everywhere. What I find is you stop and listen, you claim the areas, we as a system and we as an agency, we've let you down and we're gonna do better. People are pretty graceful about that sort of a thing and mostly are. I find happy that we're there to help.
Jim:Yeah, I think you're exactly right. I think we've just got to be straight up. I mean, I hate to use this as an example, but you and I were very straight up the first time we met. I mean, we talked about what our goals and ambitions were, and the things that were important, and it all came back to how are we going to be able to make a difference with the people. That again, I hate to overuse the word but they're that are entrusted to us.
Adam:I think the coffee with the Hyperverbal that stuff it really helped us go straight to the point.
Jim:Yeah, the big cookie was what did it for me?
Adam:Oh, yeah, the cookie That was the coffee shop on cherry street. Yeah, that was delicious coffee and cookies
Jim:and we're sorry We were there for hours folks, right? But that very thing is very valuable because You just didn't sit there and talk about family and children's services. I just didn't sit there and talk about Parkside. What we talked about was the things that were important to us, the life that had brought us here this far. The things that cause us to want to take care of people and to help them get to a better place. And that was what the connection was. And I think what we find is that most people in our line of work, especially, have that as a core. That's how we got into this.
Adam:Anybody who came to this line of work to get rich, I'm a little confused by your tactics. Yeah, me too. Most people come to this field for the right reasons. And we have to then return that with not just coming to the right tables, but making sure we build organizations that can be sustainable and do support careers because we don't want people to have to bounce when they can't pay their bills or can't find that sustainability. And I want to stay with this, but I also want to kind of get into some of those nuts and bolts that I think are affecting some of those things right now. Yeah. Should I go there? Yeah, let's do it. Alright. No, let's do that. I read another stat today, and it was from a conference last Thursday, and it went state by state and talked about since the unwinding, so during, during COVID, everybody raised the floor of opportunity where more and more people could be on Medicaid, right? And of course, we've expanded Medicaid this, that, or the other. What we're talking about is the mechanism. that provides that support for systems like Parkside and us because, the vast majority of clients we serve have Medicaid or no insurance. Yes. Are you similar boat? Yeah, we're very similar. And I saw the states color coded based on how far enrollment has dropped in Medicaid right now. There's been such an unwinding and Oklahoma is right up there. We're number one, tied, 25 to 30 percent reduction in people getting enrolled in Medicaid. I think there's a lot of things that go into that, certainly some of it unwinding. Eligibility is an important consideration. But we're also seeing things, you know, like the transitions with managed care and so many other things that is just sort of swirling people up. And my fear right now is that as much as we're all agreeing that we've got to do something and show up and have these conversations, we also need sustainable ways of providing support and ensuring that the agencies are all able to do the things we're tasked with doing. And for my part, I'm a little worried about some of that happening both statewide and nationwide right now.
Jim:So here's what I do know, Adam, is that most of the time we haven't done a good job of portraying our story of helping the people that can make better decisions really understand that. As an example, when I got here, like I said, a little over two years ago, one of the truths And I'm using the quotes because one of the truths I was told is that
Adam:For listeners, he used air quotes.
Jim:Yeah, I used air quotes. Um, you will never be able to get an increase in the base rates in Medicaid for psychiatric hospitalization. And I said, well, I, first off, I don't buy that. They said, no, it hasn't happened in 16 years. Let me say that again.
Adam:Was that dog years?
Jim:16 years, I wish. Um, and so You know what we did? We just took the books and laid them out about what it costs to take care of kids, specifically, the very best that we possibly can. And an amazing group of legislators worked really hard that year. And, and I couldn't even begin to list the shout outs I would have to do. And Between what was done through the state agencies and the pressure of the legislatures, we had the first increase in 16 years in Medicaid rates. Because you were real. We were real. I don't think the state's gone bankrupt. I think we're still okay. That's what I'm hearing. That increase helped us do a better job of taking care of people and taking care of the people that take care of people, which I know is very important to you as well. And so, so all that to say We gotta do a better job of getting our story out there. Of how we need support.
Adam:One of the pivots we're gonna do, um, and again, I wish I could claim that I invented all these ideas, but I'm just finding them everywhere and then, um, you know, what did I say? Creativity is knowing how to conceal your sources. That's exactly right. Uh, we're gonna, in our marketing communications and in our outreach, We're going to emphasize less and less our number of services. Because we've always been like, look, we've done this many services, but one of the ahas recently is that if people, funders, lawmakers, if they think what they're funding is our ability to provide more services, and yet suicide's going up, all these things are going up, it's not really going to feel like money well spent. And we are spending right now, nationwide, more on behavioral health than we ever have. We're making a massive investment. Um, like in the last 30 years, there's been like 15. 7 billion just in private equity pushed into behavioral health. I mean, it's, it is just amazing. But the fear is, is that too much of that is going into number of services provided. And the pivot that we're going to start doing in our outreach, and I think would be a huge aha as a community is if we really did. pivot from number of services provided to people taken care of instead of two of how are we taking care of people because these funding sources things like CCBHC enhancements and inpatient rate If we could really change that conversation to we've got to invest like this because that's how we take care of people, I think there's a lot of this would make a lot more sense.
Jim:It is a mind shift that has to happen. I mean, I've got such an amazing board that supports me at Parkside. And when I was asked about my census one day, because before I got here, many of the floors at Parkside were closed down or they didn't have enough staff to really build those up. We fixed that issue, but I had to explain to them what the census is. So the census is not how many people are in the hospital right now. To me, the census is how many people came to our door that we weren't able to help that day and why. That's the census. If we would all attack it in that manner, So that changes everything though because no one thinks that way and when you find a principle like that That feels good and you realize that no one else is doing it that way You're probably doing it right
Adam:and I don't want to artificially bring us around full circle to where we started But when you think about zero suicide and the Academy and the focusing on people I feel like one of the biggest opportunities in front of us right now is I mean like we don't have to convince Society to be against suicide, right? I think they're sort of against it, right? but How do we invite people into that conversation and equip them with the resources and awareness so that they know how to help us, but we know also how to help them? Because I think that everybody agrees, it's like, who's for world peace? Raise your hand. We're all for it. We're all for zero suicide. But back to how we engage with the community. Is there anything that we need to be doing or talking about that we're not? As it relates to suicide, zero suicide, young people, all the groups being affected by that. Is there something we need to pull back around in this conversation to make sure that we don't just talk about all this, but there are some actions or things we can lean into?
Jim:Yeah, I think it's important for us to be very inclusive of the people in our community. On the Zero Suicide Academy, I know we both have some extra seats at the academy, and so we have people coming from the Tulsa Police, I'm reading this, Tulsa Police Department, Tulsa Health Department, the city, Healthy Minds, Tulsa Girls Home, Tulsa Public Schools, Cherokee Nation. It's great.
Dee:It's all these great partnerships. It's like, a community rallying around a similar idea of prevention and how to get those tools into people's hands.
Jim:That's it. It's a compelling story. It's something that, like you said, it's hard for anyone to not be wanting to be part of that. But the mobilization, sometimes it takes those of us that aren't as scared of it, that understand it's a problem, to get out in front and help pull people with us. And I think those conversations are going to be great. We have to involve people in the work though. Yeah. And so Tulsa's prime for this right now. Shame on us if we don't take advantage of this.
Adam:A hundred percent, because at the end of the day, I've never been in a community that is as all in this together, locked arms together. I don't feel like Family and Children's Services, and I know, I know you don't feel like Parkside is out and fighting this on our own. I feel like this is a community that recognizes that we're all here to help and we definitely have some of the things. We can bring some entrees to the table, right? We're not just bringing the silverware or the, you know, the drinks like we're, we're bringing some entrees with the services we do and the ways we can engage. But it does feel like a big potluck of people, whether it is civic agencies, Healthy Minds, uh, first responders, the tribes, everybody seems to be as connected as any community I've ever, been a part of. about doing this together.
Jim:Yeah. Last Friday night, I was able to attend the Oklahoma Academy celebration, uh, policy celebration, and no less than a couple of dozen people came up to me and ask how things were going, they recognized that piece of it, that how important it is. And I'm not talking about people who are in healthcare. I'm talking about people who are in all walks of life that we've just run into, or that have heard our message, or have worked with us in some way to support us. But there's an interest and a desire to make things better and I think that's what sets Tulsa about besides the fact that everybody Here's just pretty nice.
Adam:They're pretty nice
Jim:You know what? I mean? Yeah, and then on top of that you have people who really want to leave a better world Yeah, and so Let's help.
Dee:Yeah, it's a community helping each other. And my big takeaway is Get real as a provider, your kind of call to action, but also the individuals wanting care, they have to get real about what they need too, about recognizing that it's okay to ask for help, that it's okay to get the help that they need, that there are people that are vulnerable and are out there willing to help them when they're most vulnerable.
Adam:I think that's an incredibly important point, and that's, again, one we do together because until it's cool for everybody to get mental health services, we still have work to do. And so stigma has dropped a lot, right? I mean, I've talked before, COVID made it okay to be anxious, and that actually was one of the pleasant byproducts of COVID is that it was okay to be anxious and get care, but there's still so many individuals who feel that stigma and that fear that we still have a lot of work to do, even as so much stigma has been broken down, Jim, I think you were going to say something on this.
Jim:No, I, I completely agree. Let me give you an example of how we can work together. So we were supposed to go to a meeting, people from your place, people from my place, other places in town, we were supposed to go to a big meeting and, and it got canceled. And instead, we went to a restaurant and we talked and we said, what's the biggest issue we've got trying to help our folks? And it was about access. It's so difficult, even as hard as we try. You guys do a lot of stuff. We do too, to try to make it easier for people to find us and to be able to access the system. We came up with the idea that the paperwork is so tedious, right?
Dee:That is a barrier.
Jim:So you go to your place, you fill out all the paperwork, and then And your person sees the client and says, whoops, we've got an intense problem here. We need to get you over to Parkside. They come to my house and they got to fill out all the same paperwork.
Dee:So needs to be a systemic change there.
Jim:We're talking about four or five groups in town sat down and said, let's do something about this. And over the course of time, we're working on the fact that next month, I think we're going to roll out a centralized intake process.
Dee:Oh, wow. And so exciting.
Jim:You can enter this room of care. This room of help from many different doors and you fill out the paperwork and it's going to cross over.
Adam:Interoperability, who would have thought?
Jim:Who would have thought?
Adam:Right.
Jim:And it's happening right here. And this is something I think that people that get involved with us, that work with our agencies, that work with the things we're trying to do are going to be really proud of down the road. I think Tulsa can make a difference and show folks how to do it.
Adam:This is a great conversation, Jim. I'm hoping you'll, come back and we do it again.
Jim:Absolutely. Anytime.
Dee:It's been so fun being real with both of you. Thank you for joining us today.
Jim:Thank you for the invitation. I appreciate it. Great, great stuff. Yeah, it's really good. I enjoyed that. I almost forgot there was a mic up in my face. Yeah, I did too. That was good. Very good.
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