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Transcript of It's Okay If You're Not Okay podcast Episode 3 09/30/2019

Keith: I'm not thinking about Chinese food anymore. I'm thinking about Medicaid expansion.

Kate: I so appreciate you here and think about Chinese food and ice cream.

Keith: Welcome friends. Thanks for joining us for another episode. I'm Keith.

Kate: I'm Kate.

Renee: I'm Renee. And It's Okay If You're Not Okay.

Keith: Next week is national mental illness awareness week and NAMI puts together the theme each year. And this year's theme is, "Why Care?" So let's just take a couple minutes to talk about why we care about mental health real short, and then let's move into what are some barriers for people accessing services and mental health that they really need?

Kate: Sounds like a great plan.

Renee: You know what? I'm actually gonna invite you to start this episode for us, Keith.

Keith: Oh, gladly. So why care? So really my transition into the, into the mental health world was more of a career choice. But as I've been learning more about that world I have seen and been more mindful of the ways in which mental illness has had an immediate impact in my family. In my family's history and how not receiving care. Or taking advantage of, of resources has made some of my some of my history challenging with my immediate family and extended family. And so I have desire beyond that and you know, even just friends and families who have had difficult family situations because of mental illness, I care because I know that if those folks would have received services earlier on an earlier intervention that their lives would've been really different.

Kate: Ah, thank you for sharing that.

Renee: That's powerful. Yeah. And I, and I appreciate your perspective. I work in the field as a behavioral health clinician. And, and, and you don't, and that's awesome that you have such a profound perspective. I really appreciate that and thank you for doing what you do. Thanks.

Keith: What about you? You, you two. Kate, what's your, what's your, why?

Renee: Why care? Why do I care? I care. Because as a young high school student, I had an amazing experience that just partnered me with students who were quote unquote different than I was and I learned so much from them. So I think the anticipated outcome of that partnership was that some of these students that were different would learn from some of their peers, right? The reality is it was such a reciprocal relationship. And so in that moment I just feel really grateful that in my self-absorbed 18 year old self brain, I was able to recognize that just because somebody is different doesn't mean they're like missing something or lacking something.

Keith: Or incomplete in some way.

Renee: They've got something different to offer and that maybe I can be a part of somebody's journey in a helpful way. Not that I don't have ever have all the answers, but maybe I have an answer that that person needs. And so coming into the behavioral health, the mental health care field and I, I have worked in foster care and in acute settings a lot with children and families and sort of find myself here at the community mental health center with just this really broad spectrum of life experience and age and circumstances that we work with. I just feel really equipped for that. And I love starting where folks are at. Recognizing how I can help them. Maybe maybe some of my own skill or getting them connected to somebody who can.

Keith: Yeah. So they can learn, change and grow.

Kate: Thank you for all that you do. That's an ongoing journey and that's important to recognize. Yeah.

Renee: And making sure that I am always learning from the person sitting across from me. All right. I, it doesn't matter who you are. That is what started my journey here and I've got to keep my finger on that. I'll never lose that. Or I will be healthy enough to step away from the career and go to culinary school.

Keith: We might all benefit from that too.

Kate: Make some good Chinese food.

Keith: All right, Kate, why do you care?

Kate: Well...so in addition to just personal impact, as many people can, you know, come to realize and agree with. I also care because you matter. And I hope that everyone listening can hear that and understand that and that you matter, not just when you're healthy, you matter when things are hard and you're not feeling like you're at your best. And because it's so hard when people are in the dark place to believe and truly believe, not because they don't want to, but to believe that you matter and you're worthy and you deserve the help that you need. I mean, that's, you do. And that's why I care. Because I want to be that voice for someone who can't find their voice in that moment until they can find it again. That's really for me what it comes down to. And knowing kind of like what Renee said, it also feeds my journey. It helps me learn and grow on what I can do differently and what I can do to help support my own mental wellness. And while getting the opportunity and the honor to really walk in with someone else cause I feel honored and grateful and blessed to have the opportunity to have someone trust me, to walk it with them because that's a vulnerable time. And so I'm going to get off my soapbox, but for all kinds of reasons I care, but especially because every single person listening matters no matter where you're at.

Keith: I want to move on to that next segment about barriers before. Do that. Want to give our a disclaimer for the podcast, the views and opinions expressed in this podcast do not necessarily represent those of Johnson County Mental Health Center or Johnson County government. So now let's transition to barriers because we know on the national statistics as one in five adults in America have a diagnosable mental illness, we also know that a great percentage of those are not seeking or receiving care that they might need. What are, what are some of the biggest barriers for people accessing care that they might need?

Renee: Yeah, I would, I would love to take a stab at that if I could. I also just want to say thanks for kind of intertwining these two maybe seemingly non-related questions of why care and then what are the barriers. But I think it's so our listeners know it's because we care because we've really chosen this path in this field, in this time of our lives that we also want to recognize, Hey, how can we get our listeners motivated and engaged along with ourselves to go, how, how can we impact change out there? What are some of the things that we're seeing? If folks aren't in our world and they don't necessarily know what those barriers are, they could have an answer for us. And that would be, that would be amazing. So I will, I will start off in, in the wise words of, of our director Tim DeWeese, I really love that he, he kind of narrowed it down to two really broad scope topics, if you will. Right. So money and, and workforce. So I just want to maybe invite us for the rest of the time to kind of talk about those two, maybe large those broad scope items and kind of narrow them down and describe to our listeners a little more about what those mean to us. So maybe start with our, here's, start with the finance, the money world. What are some Barriers?

Keith: Yeah, let's do this. I also want to add a third category that may be significant.

Renee: I'm sorry, I have not approved this.

Kate: Stigma?

Keith: Well, yeah, stigma, but there's a stigma along with cultural considerations that is maybe a third tier of that?

Renee: OK, so money, workforce culture, cultural...

Kate: Stigma can play into that.

Keith: Yeah, yeah. So money, money, I think, I think one of the biggest issues is the fear of not being able to pay for services. And we have a interesting role in our community as a community mental health center that we tend to provide services for uninsured and under insured in addition to other folks who have severe mental illness and substance abuse issues, but we see that here. So every year we provide about $7 million worth of charitable care for residents of Johnson County.

Kate: Which is amazing to think about.

Keith: Yeah, right now if the Kansas legislature were to expand Medicaid, about 3.5 million of that would be, would be funded for us. But even a step before that, for residents who maybe don't have insurance, but know that they have some concerns about their own mental health, the fact that they might not know that we provide charitable care. Right. They just know that they don't have insurance and so they don't feel like they're likely able to pay for pay for it. And so they just don't seek it out cause they don't know that we even have that option of charitable care.

Renee: So the barrier could be, I don't know how I'm going to pay for this or I don't even know that someone could offer me assistance to pay for this. Right. Yeah. Yeah. I think another, another thing that, just from my limited perspective here, the community mental health center the, the folks that we serve, guys, we, we talk a lot about severe and persistent mental illness. We talk a lot about psychiatric rehabilitation. A lot of, a lot of those services that we're providing man, they're really walk alongside someone with, with, with our client leading the way, right? Going, Hey, what are your goals? How do we help you get there? What are some tasks we can really walk alongside you and do? And guys that's not covered by any commercial insurance. Right? And if it really is tough, cause that, again, I know we're gonna talk about culture, we're gonna talk about stigma, but man, what a dividing line. Hey, if you have commercial insurance, you're not going to have any severe persistent mental illness. Right? Okay. That's sarcasm, right? That's absolutely not true. Right? That's not a dividing factor of any way, shape or form. Again, going back to that, back to the statistic that you mentioned earlier Keith, that one in five adults have a diagnosable mental illness. And that's a, that's a, a wide spectrum of functional impairment, right?

Keith: Right. And socioeconomic class.

Kate: And you've mentioned severe and persistent mental illness several times. Do you want to share a little bit of what severe and persistent mental illness means or what that?

Renee: Sure. So the one thing that I would say is that probably, you know the state can define it in a nice probably clear sentence. What I want to say is if you have any sort of question, come connect with us. Come ask us or come tell us truthfully, here's what I'm experiencing and let us give you some feedback. Hey, awesome. We've got some great providers to connect you with or let's look at some services that Johnson County provides because really, truthfully for the, for, for listeners, and thanks Kate for, for pointing me out or kind of holding me to that, pointing it out, holding me to the, to the carpet here, that folks that we're serving here have a significant chronic mental illness but are also struggling with some functional impairment. So we're going to talk housing, hygiene, employment, family or social relationships. And having a mental illness that's impacting a lot of domains of functioning, that's an intensive service regimen. And to not have that funded, I mean I, I would be extremely discouraged

Keith: At the federal level, likely the state level. There are definitely conversations around what's called mental health parity, which is legislation that would provide for private insurance companies to provide mental health services. So that's something that's out there and being talked about. But that is definitely a barrier, a barrier for accessing services. Anything else you need to jump in on this?

Renee: I just want to speak a little bit more about that and just so that it took me a little while to wrap my head around what, what does parity mean? I don't get that right. And it's just spending equal amount of dollars on something. Okay. It's like if we spend $100 on physical health. We should be spending $100 on mental health, right? We're talking billions of dollars here and in big picture stuff, but just right. Just spending the same dollar amount given the same amount of credence too. So that's what parity references. And it took me awhile to kind of figure that out. But it makes sense though, right? Should we not our, our, our mental health should we just as invested in as our physical health. So yeah, we got, we got some work to do there.

Kate: Yeah. And I was like, I've, I haven't said a whole bunch cause I remember. So my background I have my masters in public health administration and this is something we talked about in public health. Generally speaking. It used to be more based on the physical wellbeing of an individual. And we're starting to see that shift some. And we, I did a paper on mental health parity that was not selected. It was kind of given to us and I struggled significantly with that paper. And the reason is because I couldn't even figure out why. This is a conversation that we're having. And I'm going to try not to get on a soapbox, but I was like, how can we not justify the fact that our whole body, not just the physical ailments but the mind as well as one of the major parts in our body that's controlling the functions of so many things not getting equal? And that just comes back to stigma, lack of understanding in my mind. But I struggled writing that paper cause I mean, I'll just be honest, I don't, I don't know why we can't get there. Knowing how many people we say, we'll talk about the one in five have a diagnosable mental illness. And then you think about how many loved ones are also surrounding that individual

Keith: Who are impacted by it directly.

Kate: And so, so many people are impacted by mental illness to some degree, but we're sitting here having the conversation about why they shouldn't be, you know, treated equally. And it's just, it's heartbreaking. But I, I do want to say, as I'm standing on my soapbox, I think we're starting to make progress. And the conversations are happening more. So I do want to give the shout out to that. We still have a long way to go.

Keith: I think what's really interesting about this perspective and then I'll come back and play a little bit of a devil's advocate just for conversation's sake. I know it's my job. Thinking about zero reasons why campaign and the the teen council around zero reasons why. So in this last year they developed what needed to be the strategic plan of that campaign and they rolled that out. So it's you know, teen student driven and then rolled that out to our community. And one of the things that, that was on the forefront of their three priorities is, is giving mental health basically the same amount of time in schools as a physical health. And so, yeah, so there's, there's just a, there's a push from it. It's very grass roots, that desire. It's coming from the youngest generation because they're experiencing it in their schools and talking about mental illness, more suicide prevention, more in their schools. And so there's more of a desire for that. Now just to play the devil's advocate pieces, it's really easy at anytime and all these things that we're talking about to say we really need this to change to, to remove this barrier. Yep. But we know that every bill is a part of a broader system and so absolutely everything has to get paid for by something. And so how does that, how does that budget all work? We recognize that. So just wanted to say for our own set, our own sake and for our listeners that we're talking here specifically about what are the barriers, what might be a possible solution for those for accessing mental health services. But we don't have a full on like federal budget that we're proposing to make that happen

Kate: Thank you for saying that.

Renee: We just get to sit in a small, cozy room here and talk about all of our opinions and save the world.

Kate: And our wishlist.

Renee: Exactly. I want to so for, for our listeners and I, this just came to me right now. So if Keith doesn't agree with what I'm going to say, he has all power and can edit this out.

Keith: Yup sure can.

Renee: One of, so I'll get here. Thanks for bringing up Zero Reasons Why I want to highlight something that we're doing that we're doing a darn good job of is recognizing that barrier. Simply that barrier of just money, the dollar and in when part of my team. So I am a proud mama of it. Okay. With the clinicians on my team, we house the student clinic? All right. So we have students pursuing their masters degree in a licensed behavioral health field and we want to say, listen, we're going to carve out this time for these students to see folks that aren't insured, that don't have just again that...coverage. Okay. And I know it's not helping everything. I know that's not the end all be all. But what I will tell you is that because we've done that, people have come out of the other providers, guys have come out of the woodworks to say they'll do something like that. So that is again, just the...yay. So just us talking about how we are providing no to low cost services for folks who are uninsured or under insured. It really has this kind of wildfire effect on providers and I am really proud of that and to be a part of it. So it just goes to show that talking about this stuff really does things.

Keith: Yeah, I think that it's really interesting because that also plays into the workforce problem as a barrier too. Right? So let's jump in there.

Renee: Look at that. Look at that transition. Good job.

Keith: We here at Johnson County Mental Health Center, we offer tele-psychiatry. And that came about because when we had an open position in the past for a psychiatrist, we had a hard time filling that position with anybody local. And so we had to expand that search nationally to find someone who would be able to provide these services so we could still take care of our clients with licensed individuals to do that -- qualified individuals. And so we're seeing that across Kansas with just a workforce problem. What are some of the things that play into that?

Renee: Yeah, I guess I can speak being a licensed clinician in the workforce of the mental health field. I will use Kate's term, but I got on my soapbox and was just having a casual conversation with someone. I don't know if any casual, any conversation's casual with me, but I got, I got a little heated and I am I am a sports lover. All right. So I love sports analysis I love going...football is my favorite sport. I love going to football games, watching football. And I was having kind of an, an existential crisis of my love for sports and watching professional athletes get paid a lot of money. Again, disclaimer, just my opinion. Okay. Just my opinion and I spouted out to somebody. I save lives, not score points. So I think I get to make a tee shirt that says that. But getting down to it is right. Is, is wage. Okay. We've got a lot of folks. I hope a lot of folks that want to come into this field and I only speak to myself, I went to college. You do need to get a master's degree and then license all of that has a thousands of dollars price tag attached to them, the continuing education and all of that for ever. And I will tell you, I'll chip away at student loans and time when my fifties. And so again, money's not going to solve everything. Money's not going to solve our, our barrier, money's not gonna solve a workforce issue. But one of the, we'll talk about the tele-psychiatry. We, we'd, we don't have some of the resources financially to bring in the folks that have the expertise in child psychiatry, the expertise in community mental health psychiatry. It, it's also mean you've got some people got to work two jobs coming into the behavioral health world because it is not the most lucrative career endeavor. So again, I, I think you find a lot of us folks that land in here like we do in this room of we're not here for the price tag. It's not what it's about. But I also wanna make sure that I can put a roof over my head, food on my table and pay my bills.

Keith: Yeah. I mean, when somebody completes their degree, has experiences in the job market, if they have two different job offers and one is paying considerably more than another...guess where I'm going...

Renee: Absolutely. Yeah. And so then it's, I mean, you got burnout, retention, turnover, burnout. Oh my goodness. So I think all of that when we talk about workforce, how do you attain a strong workforce and how do you maintain and retain? Yeah, it's tough and it's a large investment. And so smaller agencies might have some difficulty with that. Yeah.

Kate: Well, and I think too, it goes back when you mentioned burnout, it kind of goes back to my thought of, we don't have enough mental health providers because back to what you make and all of that verse an increasing need in the community, right? So you have providers then trying to figure out how to have that worklife, homelife balance so they don't get burnt out, but yet you want to provide and meet the need of the community and then you just go back and forth, which can cause some more of that tension. And when it comes to making sure we have the workforce who can be retained and be retained in a way that's healthy and supported and

Renee: Healthy workforce.

Keith: And so I want to come back to the original question to loop this back around to the way that this serves...we live in this and we know that this is a significant issue for mental health centers in Kansas and probably nationally, but specifically the way this plays out as a barrier to service for people in the community is that there's not always enough providers for the level of need that exists.

Kate: Yeah. You hear all the time. Oh, the wait time is three months to get in or two months, you know, and I, I'll never forget when I first started working in the mental health field and I was working with a college student because that was my previous job. And I was talking to the provider and I said, they really need to get linked with community mental health care like ASAP. And the provider said, well, that four week turnaround is actually really good. And I remember just saying, thinking to myself, you've gotta be kidding me. Four weeks is considered a good turnaround in terms of...it was psychiatry. But I remember just being mind blown by that. And now that I work in the field, you can see, I mean, it's not that people are sitting around having long lunches. I mean, they're, yeah, I mean it's, they're trying to make sure everyone's getting supported and there's just not enough workforce to make sure everyone can get that quick turnaround that is oftentimes needed. But that mental health providers are really doing, and this is a non-clinician mental health providers really are doing the best they can to meet that need is an issue. Yeah.

Keith: Yeah. And it's, I mean, it's a complex issue, right? And so there's, there is that immediate as far as for the workforce in the community mental health sector. So more of a, a service, a service perspective in that way. Like there's, there's, you know, state funding and other funding they could increase. So this year the Kansas state legislature increased the amount of money's going to community mental health centers in Kansas. They increased it to match where it was 10 years prior, not including inflation. So it's good, right? It's positive. They're in a, in a difficult time where they're trying to go out where money goes. We are really thankful for, for that respect. Absolutely. Also acknowledging that we are just back to a level where we were 10 years ago with, not including inflation, and we are having this more significant workforce issue as far as finding qualified candidates to apply for our positions. And being able to maintain as an employee leaves to go do something else. Being able to maintain our level of service for our clients as we're trying to find people to fill those roles. Yeah. I mean, we're all here because we love our jobs and the reason that we're talking about this is because we care. We know we're talking about why care, why care, because we care and we want it to be possible for other people to be working in this field because we do care. We want folks to receive the services that they need. And so there's other, you know, people could look at the higher ed system. People could look at all kinds of other reasons that contribute to the difficulty in finding qualified candidates. There's need for improved and increased technology to make some of that remote therapy possible. And yeah, so it's, there's a lots of pieces there, but a workforce availability is a second barrier. The third one we mentioned was the, the cultural cultural components and stigma. Kind of marrying those two ideas together.

Kate, you wanna jump this, jump in with us there?

Kate: Oh man. Got to figure out which way to go with that because there's just so much in my head going right now. I think there's two separate things and I actually kind of look at, I kind of pull the two apart even though they naturally flow together. But when I think about stigma, I first start with just the general lack of awareness and understanding of what mental health and mental illness are. Cause I do feel, not everyone, but I feel like a chunk of the individuals who even unintentionally express concerns, for lack of a better word about mental health or mental illness that come across as stigmatizing is often because they just don't understand. And until we can address that and help people become more educated and understand, for example, that mental illness is not a choice but an illness and a disorder just as any other physical one, then we start to make some change. But I also think as we talk about cultural beliefs, we have to also under understand when we're working with someone, whether it's clinically or not, that we understand what the beliefs are of their home culture and that ethnicity or that religion and that we are meeting them where they're at in supporting them in a way that aligns with those beliefs and can start breaking down the stigma within that aspect as well. And that can happen in a home that can happen in a clinical setting, that can happen anywhere in the community, which is why we talk about the importance of why we care is because at any point in your day, you're going to interact with someone who has their own beliefs about mental health and mental illness, good or bad. We all have our perspective.

Keith: Well, I just a couple weeks ago I was on my way home from work and was picking up some pizza for my family on the way home and I was in line to pick up pizza and I happened to get in line behind...

Kate: Now I want pizza...

Kate: I ended up in line behind a guy who's been connected to both me and my wife for some 18 years. And and know him through my church connection. So my background, I used to be a pastor and so it's really interesting to have, now, this conversation. It had been a while since I've talked to him. He wanted to catch up about, Oh, now I work in the mental health center. And we started talking about the ways that sometimes even the religious perspectives together with cultural traditions and, and caveats can shape the way people perceive mental health in very significant ways. And that's, and you know, I'm, I was talking about that through one particular lens of one, one faith tradition. But I think that you know, every faith tradition has some way that they view mental illness, whether that is explicit or implicit. It shapes the way that we understand it. And sometimes, depending on what that perspective is, can make people feel at least cautious, if not afraid to talk about symptoms that they're having. That could be related to mental illness.

Kate: I always say religion can be a protective factor or a risk factor when we talk about things like mental illness or suicide or any of that cause I mean it depends really on the approach and how that's looked at. And I think the faith community is wonderful and they play a strong role in helping their loved ones around them get linked and have the conversation.

Keith: We've had a real, a lot of really great chances here with the mental health center to engage with several different faith communities in our, in our county, we have representation from various faith communities in like the Johnson County Suicide Prevention Coalition. We have different places of worship that provide space for us to do different meetings and events. There's a lot of positive things happening in a wide variety of faith communities who are wanting to talk about it more because they're realizing that mental health as a whole community issue in every player has to be a part of that. And that's really positive.

Renee: So the, the clinician in me takes it probably two or just to a smaller scale. If I can just for a minute and I talk and all that. So if you're talking about culture, ethnicity, religion, all of that comes together and is manifested in the family, right? And so we can be a part of the same ethnicity and we can be a part of the same religion, but in our family unit, here is how we teach it. Here is how we model it. Here is how it manifests itself. And so I go back to, and again, I'm just a big kind of family systems. I look through that lens a lot or a systems theory. So that's where I come from when I talk about this as a, as a barrier to access is that if we so I gotta another tangent here. Sorry guys. In the child development world, we know that children will begin developing, right? Their moral compass in elementary school. Yeah. Okay. It's, it's, and, and they still got a lot of growing and maturing to do around that, but they are forming already pretty concrete beliefs, moral beliefs, right? What do I believe, good, bad? What, what do I believe about people? And, and so knowing that the family I wouldn't even say family of origin, right? Because man, I think the family is just so dynamic that we all know that families look so different. But imagine a child who is in the foster care system, right? And doesn't have any of that consistency or again, a family who was involved in a religious community, cultural community, but has a very narrow scope of thinking. Okay. Hey, right, we all have opinions. We all bring this to the table. We all raise our families in that space that we have. It is really going to be a generational change. It's gotta be a movement because I recognize, man, my parents grew up maybe thinking something different than I would like them to think or experience now. And it's okay to have bring those dialogues to the table and it's okay to talk about it. But it's also really difficult for someone who that is their family belief or dynamic to then step outside of that belief and seek help when you might not be able to come back to your family and feel supported. And I just recognize that that feels so alone. Right? That just is so lonely.

Keith: And that can be such a, I mean, as far as all the barriers we talked about, that could be feel insurmountable because you can, you know, you can figure out maybe through payment plans. You can wait four weeks to get in because there's not enough employees. I don't know how my family is going to respond.

Renee: Or, I know how my family is going to respond. Yeah. And I will be ostracized or shunned or not taken seriously. Right. That's tough. Right?

Kate: Or maybe even in that internal family unit, it's not, you're not looked down upon for expressing or verbalizing that you're struggling with mental illness. But don't you dare say anything to any of the other family where they kept secret just within your four walls. And you know, I have to say sometimes, sometimes that individual might not want to share. So I have to honor that. But sometimes they might say, I want people to know, I want people to understand that this is part of me and to then not be able to vocalize it because of some of those beliefs can be very difficult.

Keith: So thinking of some of our listeners who may be in that exact situation at this moment, what words of hope and encouragement do you have for them who may be personally experiencing that barrier to receiving help?

Renee: Yeah, I'll, I'll go back to the message that I shared in a previous episode in our suicide prevention episode is that you're not alone, which is episode two. Go back. Listen, my message of you are not alone and it can sound so cliche and so, Oh man, just not very personal, but what I hope to...what I hope comes across in my message of you're not alone, is that there are somebody else in your position feeling something similar, experiencing something similar, and you might not be able to reach out and grab their hand right then, but they are there and there are folks to receive that message from you. We have crisis lines, right? We've got something 24 hours a day that you can reach out just to get you through that moment until you can go. Cool. I take a deep breath. Yeah, I can do this. I can get through tomorrow. Maybe they can come to Johnson County Mental Health Center. Maybe I can call someone or you know what? Maybe I'm, I'm okay today doing what I'm doing.

Keith: And I want to also just say that mental health services are confidential. And so even if you just need to take that first step for yourself, reach out for help. Some of that conversation can be how do I talk about this with my family? And how do I navigate that?

Kate: Yup, absolutely. And I would just add, I mean I was trying to, I was like, again, I can't think of just one thing. I don't know why you can't ever just narrow it down, but I know I just like, I have all of these feelings right now. I'm just like, if you're listening, you're loved, you're not broken, you're not damaged. There's nothing wrong with you. You have a mental illness just as other people have physical illness and this is your story. And if you feel that what is best for you is to share that story, then share that story because there is nothing, absolutely nothing wrong with you for saying that. My name is Becky and I have depression and then I say it's so nice to meet you and I'm so proud of you and I just, whatever journey you're on, just own it and love it. Give yourself grace its going to have ups and downs and you're loved. You're here so loved.

Keith: I think. So important. I think. I think this has been fantastic. One piece I think is a major component of this section as far as barriers that we would just really, it we can't miss it is being able to access mental health care in your, in your native language. That's definitely that, that language barrier is definitely challenging whether that's...including in that our deaf community and being able to access care through ASL. That's definitely a barrier and that, and that plays into some of the workforce and financial pieces too and having resources available to provide that care. But I just wanted to make sure that we identified that as a barrier.

Renee: We are, we're identifying barriers, maybe large scale, small scale, just going, hey because we think about this stuff. We want to be better, we want to go out there and we want to invite more people. So I really want this to be an invitation to folks. If you've got a barrier I want to say, Hey, we've thought of it. It's cool. Come in. And we just want to normalize that for you. And if it's something that is just, man seems insurmountable, come on in. And we're just going to, we're going to try to help tackle that one, one small piece at a time if we can.

Keith: Yeah, let's wrap up with sharing those crisis lines. So people have that.

Renee: Yeah, absolutely. So our, our personal our Johnson County Mental Health Center crisis line is (913) 268-0156 and that is available 365 days a year, 24 hours a day. Please reach out. We have mental health center staff manning those phones around the clock just for you.

Keith: And the national text line, you can text 741741 and that's also a 24/7 line. And the national suicide prevention lifeline is 1-800-273-TALK. That's 1-800-273-8255.

Kate: And they also have an online chat available. So if you don't have access to a phone, don't let that discourage you from reaching out. You can still do that by computer and go to the national suicide prevention lifeline website. And on the top right hand side corner, it says chat here. You click on it and clinician or someone going to be on the other line to help you out.

Keith: Do you want to get engaged in that? The mental illness awareness week? Next week you can search for mental illness awareness online or NAMI, N-A-M-I, and they have a lot of social media graphics that you can share to raise awareness about mental illness in your own community, on your own social media platforms. You can use #whycare and tell your story, tell why you care. Thanks for joining us for another episode.

Kate: I'm Keith.

Kate: I'm Kate.

Renee: I'm Renee. And It's Okay If You're Not Okay.