Mental Health Matters
Todd Weatherly, Therapeutic Consultant and mental health professional hosts #MentalHealthMatters. Interviewing doctors and therapists, treatment professionals, organizational leaders, and other members of the mental health community about the importance of mental health awareness, treatment and the future of addressing mental health in the US. Discussing how to support mental health in our communities from hospitals to the dinner table and what to do when crisis arises.
Mental Health Matters
Innovative Care with Sarah Summey
What if the key to enhancing mental health care for adults lies in an integrative, person-centered approach? Join us on Mental Health Matters as we welcome Sarah Summey, Lakewood Residential Treatment Center, to unpack the secrets behind their innovative treatment model. Sarah's rich background in behavioral health care and her passionate advocacy efforts with organizations like NAMI and the American Foundation for Suicide Prevention provide a solid foundation for this enlightening discussion.
Listen as Sarah reveals Lakewood Center's unique blend of assisted living and behavioral health care, designed specifically for adults with chronic mental illness. This episode dives into the transformative power of personalized and collaborative care strategies making significant improvements in residents' quality of life through coordinating multiple service providers.
Together, we explore broader community mental health challenges and potential solutions, emphasizing open communication, the pitfalls of rigid service structures and treatment silos, and the role of peer support and nonprofits. Sarah's insights highlight the importance of grassroots movements and collaboration within the mental health sector, offering a hopeful vision for future improvements. Whether you're a mental health professional, a caregiver, or someone interested in the field, this episode is a treasure trove of valuable perspectives and actionable insights.
Welcome everybody once again to Mental Health Matters. On WPBM 1037, the Voice of Asheville, I'm Todd Weatherly, your host behavioral health professional and therapeutic consultant. I have with me today a friend and colleague I'm very excited to have on the show, sarah Summey, the chief executive officer of Lakewood Center, a therapeutic community to enhance the quality of life for adults living with chronic mental illness. Based in Greater Orlando, sarah has an impressive background that spans various pivotal roles in the behavioral health care sector, including executive officer, senior director and direct care clinical roles. Her extensive experience encompasses operational strategy, service recovery and multi-facility oversight, and leading groundbreaking initiatives in assisted living programming and forging partnerships with esteemed institutions like University of Central Florida and Rollins College. Beyond her professional achievements, sarah is a passionate advocate for mental health and is actively involved in organizations such as the National Alliance for Mental Illness, nami and the American Foundation for Suicide Prevention. With a Master of Science in Healthcare Administration and certifications that underline her expertise, sarah combines her professional knowledge with personal experiences that fuel her mission to enhance the access to mental health care for all, which is why I like her.
Speaker 1:So you know with that, ms Sarah, who, let's see. How long ago did we meet? We met? When did we meet?
Speaker 1:I mean we've known each other that long. But I feel like like I feel like we know each other, we've known each other. Like every time I look at you I'm like, oh yeah, I've known Sarah forever. We're kind of from the same place.
Speaker 2:Yeah, we are. I'm so excited because I saw Asheville's voice and I was like, literally, I sound like Asheville's voice. I could be Asheville, that's fair yeah.
Speaker 1:It's for those who know it. We've got a little, we've got a tenor to it for sure. Got a slight twang Gets washed away the further south you go. And in florida, who knows? But um, yeah, but. But up here we're small enough to have our own little special thing. I used to be able to pick out regional dialects like greensboro, winston-salem, charlotte, you know charleston. Yeah, down in South Carolina, the mountains versus the coast, they're very different. They've got their differences. You can hear the subtleties.
Speaker 2:Different barbecue, different twist. Yes, Well, I'm actually from East Tennessee, so I'm a fraud to North.
Speaker 1:Carolina, oh see.
Speaker 2:But my husband's from North Carolina, and so is my dad.
Speaker 1:I think we're just going to have to end this interview now. I'm sorry.
Speaker 2:It from North Carolina, and so is my dad. So I have to end this interview now.
Speaker 1:I'm sorry it was good, it was good while it lasted. Thanks everyone, oh, my goodness, no, I we're. You know, I've got my partners in Tennessee, um, and that is the sucker Smith Weatherly business partner Maggie Smith, you know so well. But, um, at any rate, the uh, the, the whole reason that I am excited to have you on the show today is because you kind of fill this niche that we specialize in, which is working with individuals, oftentimes a little older. Yeah, this, you know their, their history, you know hospitalizations, treatment, just time after time, and or they go into transitional environments and they fail, or they've got some, you know, complicating medical condition that nobody else is willing to touch because they don't want to have to coordinate the medical care or do the.
Speaker 1:The piece, which is what I believe Lakewood Center does really well.
Speaker 1:Having having a client with you and referred to you in the past, that drawing together kind of the best of assisted living and the best of behavioral health care and putting together into a long-term treatment model, one that can sustain somebody even for years, as they need that, lives in a special place in my heart.
Speaker 1:And there's not a lot of it. There's just not a lot of it. We don't have enough. We need a heck of a lot more, and I'm so happy about the model that you're in charge of these days, like what's been around for a little while, but I think that something that you've done is that you've brought some elements of the new clinical world that we work with. You know strategies and clinical sophistication that have to go be a part of what is long-term sustainable. You know behavioral health care, and still not forgetting that these people have clinical needs that we need to address as part of their kind of, you know, supported living health care needs. So we got to put those together in as much a, you know, collaborative way. Two ends of the field that do not necessarily work well together.
Speaker 1:Never and so how are you doing this? Please tell me.
Speaker 2:Oh gosh. Well, I think you're right. I've worked in residential treatment for a long time. I took a little break and went to the community mental health system, but I'm passionate about residential treatment. I think that it's effective and all the evidence leads. There Was just on with our medical director and one thing we were talking about was these treatment-resistant individuals. I think that's what we would call them. If we're sending them to other places and they're in this cycle, they can't break out of where it's inpatient hospital, residential program, php, iop, home, inpatient hospital, residential program, rinse and repeat. And I think one thing that we have done I'd like to start by saying is we can produce good outcomes for our individuals without the goal of discharge necessarily being essential in that good outcome. And in doing that we have to encompass all these things that you have laid out here. Right, we have people coming from all over the country, so we have to make sure that we establish dental care, primary care, kidney doctor care, endocrinology whatever that may look like, surgery for some people Surgery and recovery.
Speaker 1:Multiple surgeries.
Speaker 2:Yes, and so we have. I think, from a leadership standpoint, to just really answer you for real is I have to take a look at what types of employees. So, unlike a traditional residential program that you have like a therapist and a behavioral health tech and a nurse you know that's that's like the of your central program treatment team you know we had to add in there a behavioral analyst. We had to add in there some, a medical coordinator who is used to working with insurance referrals and getting prior authorizations and doing things like that understanding lab results to know which doctors to follow up with. And so I think it starts there. It starts with the multidisciplinary team that we've put together and then, really looking at you know what we're looking to accomplish, and really the only thing we're looking to accomplish is to make sure that our people have a good quality of life.
Speaker 2:When you're working with chronic, severe mental illness, a lot of people, I think, relate what they know back to maybe like a substance use disorder or something that is curative or that you can kind of set to the side and you might not relapse, or you might not relapse frequently With serious mental illness. It doesn't go away right. So we have to offer these opportunities for success or a positive outcome within our community, and that's what we do.
Speaker 1:Yeah, I, you know, I think that there's a. There's also a misnomer. I think that people run into at a certain stage and I'm not saying that people are not receiving treatment right, you know, that's that's not. That's not necessarily that people are receiving treatment. They have the opportunity to get better. They have the, they have the uh, the. They're given plenty of access to resources that would, that are clinical in nature, that are going to help them set goals and have a recovery plan and all the pieces that you see in a clinical program. But I'm also not putting them in the clinical pressure cooker. That's. That's aimed at these kind of, you know, fairly substantial goals in a short term model and by short term I mean anywhere from three, six months to a year. But more like, we're going to set some goals and you're welcome to try and meet them as you can, and maybe we're about reevaluate them and if you didn't achieve one, then maybe that's something that we need to look at or whatever. But like not and I I was talking to one of my interviewees recently uh, Monarch, um community Dr, chris Fowler, about this it's like not being in a hurry to get someone somewhere.
Speaker 1:Yeah, super important, because these people have done the pressure cooker thing. Yeah, they've done the aggressive goal thing. They may not be willing to be any more than what they are right now. They may be satisfied that and if they're stable and they're getting their needs met and they've got a community to be with, that that's really where the rubber meets the road, like that's where meaningful life is.
Speaker 1:And families, when they get in that model where they've done you know so many times a person's been in care and everything else, they kind of get this like where are we going? It's like, well, we're going to think of this as a journey now, not as a destination, and I think that that's something that therapeutic community models do incredibly well, that they spend more time doing a reflective model and kind of being with the person where they're at. How do you incorporate that? Because I know you're part of the ArdaUSAorg site. You guys are members of Arda, a hub organization for therapeutic communities, one of the few Southern institutions that is a member of theirs, and so how are you integrating that as a model into Lakewood Community?
Speaker 2:Yeah, yeah, good question. It might be my one of my favorite questions because I get really talking about how that we're doing that, addressing everyone that has gotten that person where they are right. So looking at the whole dynamic of the individual, that includes everybody that they came with, so the Todd Weatherly's that they came with and the moms and dads and the sisters and the family right, and so we have to have that understanding.
Speaker 2:First is looking at where has this person been and then setting a goal of, okay, where are they going to go next? But also, are we setting a goal or are we needing to adjust expectations, and in reasonable expectations right.
Speaker 2:So I think it is wonderful that little Todd has a bachelor's degree in finance. I don't know that it's reasonable to say that he's going to do much with that at this point. And so sometimes grieving that is a lot of what we do as part of a therapeutic community, and really adjusting our expectations and identifying what someone's capable of accomplishing. And then we can start to identify okay, here's the timeline that we can accomplish those things in, and I think that that's okay. And so for us that may be six months or a year, that may be three years or it may be an indefinite situation where you know if this person is doing incredibly well here, they're happy, they're healthy, they're whole, they're contributing to their families, they're contributing to their family, to their community, they have meaningful work, they have hobbies, they're well.
Speaker 2:Then they can stay here, and our residents and let's not interrupt that Right and our residents who are in that, not interrupt that Right, and our residents who are in that situation which I think would mark probably about half of what we have here are happy to be here. So they're living in their own apartment, they're getting to be someone's loved one and not someone's responsibility. They have friendships. They're part of our therapeutic work program and job clubs, so they have jobs that they enjoy. They're part of our therapeutic work program and job clubs, so they have jobs that they enjoy. They're volunteering in the community. They're going to the mall and going shopping. They're going to the theme parks I don't know why, but they like them. They may go to the beach or go on a bike ride or whatever that may look like. So I think it's before we're going on a cruise in January.
Speaker 2:We're meaning not me, but someone else doing a great soul is taking our people on a cruise in January. But I think before you can start really looking at what does your therapeutic community encompass, I think you have to look what you're setting out to accomplish first, and so we do really good at seeing the person as an individual. I know that a lot of places like you can like Google residential treatment and every single thing is going to say individualized, whole person care and like that's great for your website. I'm not accusing anyone of not doing that, but I want to when I say that.
Speaker 1:And the answer looks different every place you turn.
Speaker 2:Yes, I want to say when we say individual and I think that you can maybe back me up on this a little bit with the clients that you've placed here and also elsewhere that not everybody has an aid that comes in and helps them do their laundry or get dressed each day, but some people take a bath or a shower because that's what they need, because their post-op care needs to be taken care of, or, yeah, and finding somebody is willing to do that yes, I mean, you guys are connected, but it's like programs aren't even willing to reach out.
Speaker 1:Yeah right.
Speaker 2:Some of our residents might have that, whereas other residents may be going to college and working at the home depot up the road and coming back and being like hey, where's my dinner piece of salad, I'll see you tomorrow, and like that's their supported living, where other people may require prompting all day for every little activity and activities. We got them, we got them all.
Speaker 2:We have music therapy, art therapy, yoga therapy, um, pet therapy, um, we have um golf cart therapy golf cart therapy that todd likes um just added onto our campus a new gorgeous, beautiful coffee lounge and so I I got to.
Speaker 1:I was very happy to be one of its initial visitors.
Speaker 2:Yes, you're a founding visitor to the Elm Lounge.
Speaker 1:I don't know about founding. People put money towards that. I don't want to take credit away from them. I'm an ambassador.
Speaker 2:I thought you were sending a check, though, so okay.
Speaker 1:Oh, I see, Let me call the accounting department.
Speaker 2:Let them know not to.
Speaker 1:Have them send me a bill.
Speaker 2:Two copies. Your copy was on me that day.
Speaker 2:We have activities and spaces and you know social activities, recreational activities, therapeutic activities. But I think the part of what some places maybe don't get right or maybe they do get it right, part of what some places maybe don't get right or maybe they do get it right, but what we really get right is fundamentally understanding the person first before we start treatment, planning or identifying. You know you have to go to three activities a day. This is our activity calendar here on the wall and you'll see there's like 15 or 16 things each day that they can choose from to attend if they need to, but also, if they like, brush their teeth and take their medications, and that's all they can do that day. We're going to wait until maybe next week and try again for some of these other things.
Speaker 1:Right, well, you know, guaranteeing their safety, knowing that every day doesn't look the same, not being this kind of push, push, push, because they're not going to respond well to that. First of all, many of them, you know they've done it, or maybe their condition is not one that you know, that really is going to gravitate towards a model or do any better with a model that behaves that way.
Speaker 1:And you know Lakewood is is not for everyone, no place is. There's a certain client that belongs there and a certain client that that kind of model works well for. The problem is and Virgil and I have talked about this is that you've got a lot of the people that the private pay mental health side of the world has been working with for a while now, both hospitals and residential treatment, everything else and we've seen these people go through care and go through treatment and land in settings and doing that. They're getting older now. They're getting to be 40 and 50 and 60 and 70. You know my caseload. My caseload is at least 25% over the age of 50. Yeah, and and, and, and at 50, I promise you you're probably not going to land this kind of aggressive pressure cooker clinical model on somebody that's had a long history of mental illness and have it be, have it have any greater results than anywhere else they've been, unless they've just completely been mistreated and never gone to any place that knew how to handle it. Sometimes you can get results out of there. Sometimes you get a good assessment, know what you're dealing with. But you know, trying to move them towards a goal before they, before they're ready to be there, is like pushing a river, you know, and I had a.
Speaker 1:I had an example very early on in my time on the private pay side, working for Cooper East. We had a fourth-level care at the time where it was really a not and no one lived there, but it was a pretty heavily coach-supported house. We had one individual that was. I mean, we worked with this person pretty intensely for a year. It's like, well, you could go to Walmart and you could get a job and you could do these things. We kept, you know, just pitching ideas and throwing spaghetti at the wall which never landed. And he's like I just need to be in an assisted living where I've got a kitchen and people I can be around and activities that are scheduled and somebody to monitor my meds and a nurse I can go to, because he was a little hypochondriacal as well. And it's just like you know, by the time, by the time we wore ourselves out thinking we give him a better life and just gave him what he asked for. When he got what he asked for, he was happy as a peach.
Speaker 1:Yeah, you know it's just like this is what he needed all along and we needed to stop believing that we were the answer and that he was telling us the answer the whole time. And that was a super valuable lesson for me at the time and it's something I've carried all this time and I think that that was like what are all the different things that you guys are putting together? And it's like you're connected to community mental health, connected to university systems. You've got, you know, aspects of long-term assisted living aspects, large aspects of the therapeutic community model, care management, which is more like assisted living side, but, you know, supporting someone in an independent living setting with people that will come in provide necessary services. Care management's a big, huge service that I activate for clients all the time. And then there's like medical coordinator. So you know there's like five or six things that are being flown together, that are flown together and have to be coordinated all the time. And I've seen it, you know, in working with you firsthand, and it's like this person's called this person and this agency is involved. We've reported to the state because they've got a care entity that provides these services for this person and won't cost them anything or it's going to cost this much and we need to bill it, but we're going to be able to, you know, keep the bill down because we only need it for this much or whatever. It is Like there's five or six things that are flying in.
Speaker 1:One thing that's really hard for me to do with other programs is have them strike, you know, truly collaborative, integrative tones with other service providers, like pulling teeth sometimes, especially with, especially with TC, especially with, especially with TC. You are the you're possibly the one of two that I can think of in the country, maybe three. Give Art. Well, you know, we'll take her hat off to Art Fassman and we'll take her hat off to Monarch, you know, but like really getting somebody who integrates all those things and frankly knows how. The one advantage you have is that you're in Orlando, so you're surrounded by, you know, facilities and services and resources that you can, you can, you know, you can suddenly like play ball with the medical side of the world and the care management side of the world, notoriously sides of the world that do not play well together. How are you like making them meet in the middle and do what they do?
Speaker 2:I threaten them and I bribe them.
Speaker 2:No, I'm kidding, none of those things. You know, that's a good question. And I, you know, we I think we say this a lot in our industry, or I think it a lot. You know, we kind of stand on the shoulders of giants. That came before us, right? So I am fortunate to be coming in on the tail of a or on the. I'm coming into a 54 year old organization, so that's good. Also, I think, that prioritizing relationship building. So, to your point, you and I may not have known each other for a long, long time, but I have put priority into understanding what you do, what your needs are, how that I can meet them, how that you can meet Lakewood's needs and how that we can build that partnership.
Speaker 1:Work together yeah.
Speaker 2:Yeah, so everything's relationship. But I think it's also to your point, and maybe a little bit on your question previously is who do we have on staff to make it easy to work with these organizations? Right, like we have psychiatrists and post COVID. It's good or it's bad. It's a double edged sword. Like we have been able to access behavioral health care like never before Health care in general, like never before.
Speaker 2:I took like a doctor's appointment three days ago from my desk and it was my follow-up lab appointment. I didn't have to get in the car and go to the doctor, I was able to have a telehealth appointment. There's a pro to that. There's a con to that. Not everybody does great with telemedicine, right? The pro for me was Lakewood had never really had a medical director, like a designated medical director. We had psychiatric providers we were contracted with. We'd never really had a medical director and I wanted us to have one. I wanted to take us to that next step. Everybody that I talked to wanted to do all their services remote. So it was like, okay, if that's my option, I'm going to get the best one there is then, and I don't care if they live, as long as they're licensed in Florida and they're you know ethical and they believe the way I believe and they you know.
Speaker 1:And virtual services are appropriate for the client right.
Speaker 2:Yes, so we still have wonderful relationships with some really good psychiatric providers here in Central Florida.
Speaker 2:If someone needs in person but about 70% of our people don't so now they get access to Dr John Stevens, who, in my opinion, is the best in the field.
Speaker 2:So it's getting creative.
Speaker 2:But I think that we have done such a good job with these ancillary services and being able to offer them to people seamlessly, because we do work with okay, we know that these are the needs of that organization.
Speaker 2:So let's make sure on our end we're prepared to work collaboratively easy for me to say with them by making sure that I have a medical coordinator or a case manager or a lab technician who can make sure that labs are ready prior to that appointment.
Speaker 2:And so I think that we've done a really good job with our cohesive team on our end that it's not really so much pulling teeth with the providers when they see that a 57 year old angry male, diagnosed schizophrenia, is coming to their office for an appointment tomorrow, because, because we've done all of that hard work for them, like we have prepared them and we're ready right, and I think it's that it's relationship building and I think it's also just not taking no for an answer. Our people if you look I know for Central Florida our community needs assessment one in eight have a serious mental illness such as schizophrenia, schizoaffective disorder or bipolar disorder. So if we know that one in eight do and we know the outcomes for them, they're three times more likely to be homeless. Three times more, I think it's actually like five times more likely here in central Florida to be a victim of a crime or experience substance abuse or estranged from their family or die by suicide or put in jail.
Speaker 2:The prison system is the number one provider of mental health in this country, and it's mostly people with serious mental illness, and so these are individuals who are. And now I'm getting on my soapbox, todd, I'm getting really amped up.
Speaker 1:It was all a trap to get you to do that.
Speaker 2:Yes, and so we have this population of vulnerable adults. And then to your point, okay, now they're over the age of 50. Now they're over the age of 60. And they're forgotten about, right, like for the most part, unless they are the rare, very lucky few. And so I get real passionate about it, and so we just don't take no for an answer. We make sure that we attract the best, we retain the best, that we have infrastructures in place that we can work with the best, like yourself. So please know that I take it as the highest compliment to hear from you that we're doing a good job, because, for those listening, todd requires you to do a good job or he just won't work with you anymore, and so I mean that's a little strong, but you know, I think it's pretty close to the truth.
Speaker 2:I think you hold yourself to a high standard for the families that you serve and the people you serve, and so I hold myself to that high standard for you as well. And so, um, that's what we've done really well is just build relationships with one another, with people like you and with those ancillary providers.
Speaker 1:And you say that. I want to point out a situation with our mutual client that I think is kind of telling to what you're saying here, which is, you know, you know this individual is much older and and you know I had surgery and you know wound care and all that stuff has to go along with that, and you know one of the. It's easy for me to say, without distinguishing this person from anybody else, that these individuals, especially individuals long term with you know years and years and decades of suffering from various levels of poorly, poorly treated schizophrenia or bipolar disorder or anything Any of the thought spectrum, thought disorder, spectrum of disorders. One of the things they don't do well is hygiene, um, and I would say, in addition to that, another thing they don't always do very well is socialization. They can be rude at times, um, and so I'm not going to overcharacterize any specific individual. I'd say that that pretty much ties in a lot of them, especially ones that end up. You know they need help with socialization, they need help with, you know, just kind of talking to people and being in groups and being appropriate, being out in public and doing all that stuff. They need that guidance, um, the older they get the less willing they are to receive that guidance.
Speaker 1:And so, you know, in this particular situation we're dealing with something that's medical in nature but then has to, and this is where I think that they divide. You come in, the medical comes in, and this person gives them a dose of his poor socialization or her poor socialization. They're crusty, they're hard to deal with, they're unmanageable. They walk out of offices, they do all kinds of stuff right. They say things, awful, terrible things that they should never say and maybe they regret it later on.
Speaker 1:But you know, the truth is is that there are people coming in from the medical side or there to provide, you know, you know, bathing assistance or wound care assistance or something like that. They're not ready for that. They're they're. They're like hey, I'm just here to do the thing I'm supposed to do. Why, why are you yelling at me? Um, and so we met a little of that in this particular situation and, and you know, the team was like I don't know what to do and he's being really difficult or they're kind of. You know, there were all these things kind of going about. And then you came in. It's like look, people are not here because they're always easy to get along with, yeah.
Speaker 1:That's the road you should go work at let's remember who we are, yeah, and who our client is, and, and, and, and really kind of come off of thinking that he's going to do any different than this. So let's find a strategy. So you know, not a clinician, um, not a staff, not a like, not a tech and not a therapist, but your operations director is, the guy who walks in is like yo, can you do me a favor and just do this one thing?
Speaker 1:yeah, okay, I guess I reckon you know, and that was the solution, you know, with all the emails that go back and forth, and how are we going to manage this problem? What it was is somebody that could he, somebody had had a relationship with somebody he could talk to, maybe some golf cart therapy, some, some incentivize, incentivizing him.
Speaker 2:Yeah.
Speaker 1:And it worked.
Speaker 2:The right person for the right job at the right time. That's my motto and everybody who works here. If you're watching this podcast, I know that you're like shooting birds at the tv or listening to it or whatever. Like here she is saying that again, but that's that's how I. I operate, right? Like that's my philosophy is it's the right person, and that may not always be me. It might be me. It may not always be that person's. Like that's my philosophy is it's the right person, and that may not always be me. It might be me. It may not always be that person's therapist, and that's okay.
Speaker 2:Don't take it personally. The only people who get to take anything personally around here is our residents, because it's personal for them, and I care about these people and this person that you're talking about, by the way, it was like, oh, you're not even young enough to be off the school bus, much less run in this place. So he did not like me, this person, and so that's okay. You know what I care anyways, and I'm going to make sure that you're taken care of, and the solution that we found was again getting super creative, finding that relationship.
Speaker 2:Okay, who do? Who do they get along with? Along with Kevin the COO, we're going to send him down. And then also a little bit of just old fashioned Appalachian dignity and respect in thinking. Okay, this person is my father's age, who is a proud mountain Navy veteran, who would be horrified to think that some 20-something-year-old woman is coming into his home looking over his skin to find out if there's any wounds on his skin. However, he will go to the VA or go to his doctor's office or something like that, with plenty of dignity, just like me An environment he's comfortable with.
Speaker 2:Because he's comfortable there, because that's what you can expect in that type of room, right, and so it was okay. Well, we have a registered nurse who comes on site a couple days a week. Why don't we just bring him up to the exam room and say, hey, let's take care of your needs up here instead of in your apartment, where it's clearly not dignifying for you and not comfortable for you? We haven't had a single issue, Like the person shows up and it's like I'm here for my thing and we take care of the thing and we move on, and so it's just an example of again meeting people where they are and finding out what works.
Speaker 1:It's just an example of again meeting people where they are and finding out what works. Well, and I think what it speaks to is about how and I think we're all guilty of this to a certain extent I certainly have been in my time, but, like you, you know you get these, you get positions of task and they turn into positions of authority and the authority becomes siloed and then they're generalized to providing all the care needs when, fact, the silo is not big enough to to do that, and so it's like well, wait a minute, this is my. I need to make this call, I call the shot, I need to like be this person's everything. It's like no, actually what you want to do is get the job done.
Speaker 1:And I had a recent experience working with another organization, and it went off a little wonky because I the communication wasn't clear in the beginning, and you know I said to them and I say this to families all the time and said, hey look, I really don't care, it gets credit, I just want it to work. I'm a spear yeah, when you throw me, I want to go for, I want to go for a destination and I want to hit my target and, however it is, we got to hit that target, then let's do that, and if that, and if and if you get in credit for it, makes the most sense, then please, by all means, take the credit.
Speaker 2:It's just like if we start getting our egos involved involved it's it's like titles in an organization.
Speaker 2:I call yourself queen, I don't care what you call yourself. We just we have to do this person's laundry. Today I have, I've cleaned rooms, I've pulled weeds, I've served food, I've I don't cook the food, they don't let me, but, um, I, you know, I've cleaned the coffee machine, I've filled the copy paper like we do what we have to do to take care of these people because they're special. And you know I'm not I must have my dad on my mind, but he has this philosophy of I don't come to be served, I come to be served, and that's what we're here to do.
Speaker 2:All of us in this whole industry right Is to provide a service, that's access to care. And when we stop fussing about titles and I'm supposed to be the one to do this, or credit and things like that, then it's really amazing what we can accomplish as a community or, you know, as an organization like Lakewood, working with a partnership like yourself, when we stop worrying about it. And you know we've had to have some I don't want to say hard conversations, because we haven't. We've worked wonderfully together, but there have been conversations that were a little uncomfortable from a service.
Speaker 1:What are we going to do here? Cause we can get in trouble because instead of taking it personally.
Speaker 2:It was okay. This is the problem, okay. Well, here's what I'm thinking, todd. What are you thinking? Do you think this might work for us? Like would this be a good solution? And we respectfully talked with one another, and we do a lot of that with our residents too Like, okay, I know you don't want to take your medicine, so like, let's talk about this. Like, what's this going to look like if you don't take your medicine tonight or tomorrow, or the next day.
Speaker 2:How are you going to feel? And you know you have to be open. That openness is really important.
Speaker 1:Yeah, I think that, like the song says, hold on loosely, but don't let go Right.
Speaker 1:You know I think that roles and titles and structures and authorities and all those kinds of things. They have their place. You know, when something rises to the level of an authoritative attention, like somebody's care needs or whatever, then it's important that those entities exist and people are held to account. And when they get overplayed and they get over siloed and they stop losing connection to the variety of resources that really needed to do this job, yeah, pardon what I'm going to say next, but I'm sorry, not sorry. You get what community mental health looks like. Yeah, and that's not working.
Speaker 2:It's not working in any community. I don't know it's not working in any community.
Speaker 1:It's like it's broken. I'm like when would it? When did it ever work? What did we break it from? Like I've never known it to be functional in the first place. I don't know what this period of time you're referring to. That it was functional, that would it be broken?
Speaker 2:It was never whole to begin with.
Speaker 1:It was never whole to begin with and you know, and largely because of the medical systems, design around silos and authority and they've kind of they transplanted that model on community mental health. They, you know, short staff it, they underfund it and you know they're either respond to crisis or they have these kind of poorly managed resources for people to live in and not enough of those and everything else, and never the twain shall meet. It's like a person coming out at first they've had a first episode psychotic break and they hit the hospital for three days and send them out with meds and an IOP recommendation. It's like are you kidding me?
Speaker 2:Right Really.
Speaker 1:That's going to work. Huh yeah. How long do you think it's going to take before they come back to the emergency room door?
Speaker 2:No education for the community or for the family, no support for those caring for them.
Speaker 1:Not even communication. They won't even call you.
Speaker 2:And no even education on what this even means. To have a psychotic disorder, it's just well.
Speaker 1:you got a psychotic disorder, here's your medication, and you need to go to this place three days a week, three hours a day, and and I mean I am glad to say in North Carolina we got some funding and it went to a lot of now placed first episode resource centers which will give you a doc and meds and therapist and that sort of thing. We've got the ages center here. They're called different things in other communities. But I'm happy about that because I think it's an answer. It's not the whole answer, but it's an answer to kind of one of some of the stuff we're saying is missing. As an answer to kind of one of some of the stuff that we're saying is missing, you know.
Speaker 2:You have to start somewhere. You know you gotta allow people to um be wrong and get it right. Yeah.
Speaker 1:Yeah, cause it's not an exact science.
Speaker 2:There's going to be a time when you stumble through this a little bit. Yeah, Go North Carolina. Um, you know we have some really great community resources here in central Florida and I'm really proud to be one of the nonprofits. But it's really the nonprofit sector that is taking, that is championing this change, and I'm really excited and I won't belabor this, but I'm so excited about the peer movement movement. We peer support space here in central Florida just opened the first in Florida's overnight peer led respite to hopefully eliminate the need for inpatient hospitalization. If people just needs a place to go cool off for a few days or feel safe for a few days, because we know that the inpatient hospital is, should be the last option. Um, it serves purpose. I'm glad they exist. I worked for one of them, Um, but they're a necessary resource, for sure.
Speaker 2:They are, but not everybody needs that, and so I'm really going to turn those people out of the door anyway. Yes, I'm really hopeful to see what the peer movements doing and what the grassroots movements in these communities that are really saying I'm fed up Like we're. We're just going to do it ourselves then, and I it's.
Speaker 1:Yeah, I think we just need to get insurance companies on board a lot more than they are. That's going to be the next that we have to do. But, sarah, I I figured I could trick you into talking about your passion. I'm glad that I was right about that.
Speaker 2:I came on here. I'm like I don't know what we're doing, but I'm here.
Speaker 1:Like right, yeah, oh, I think I know what we're doing.
Speaker 2:It's so glad.
Speaker 1:Because our passions are so closely aligned, so I'm super glad to have had you on the show today. I am excited always to see you. I'll be excited to see you here soon when I head back down to Florida and pay you a visit, but until then, this has been Mental Health Matters. On WPBM 1037, the Voice of Asheville, I'm Todd Weatherly, your host. I've been here with Sarah Sumi, ceo of Lakewood Center. Sarah, great to see you.
Speaker 2:Thank you, thank you Thanks for having me. Thank you, thank you.