Heart Forward Conversations from the Heart
Kerry Morrison
The American mental health system is broken beyond repair. Rather than trying to tweak a system which fails everyone, it is time to commit to a bold vision for a better way forward. This podcast explores the American system against the plumb line of an international best practice, recognized by the World Health Organization (WHO), in Trieste, Italy. The 40-year old Trieste model demonstrates how a community-based treatment system upholds the human rights of the people served. The Trieste story is anti-institutional and models the therapeutic value of social connection. Topics will address contemporary challenges in the American failed mental health system as contrasted with the Italian approach toward accoglienza – or radical hospitality – as the underpinning of their remarkable culture of caring for people. Interviews will touch upon how the guiding principles of the Italian system – social recovery, whole person care, system accountability, and the human right to a purposeful life – are non-negotiable aspects if we are to have any hope of forging a new way forward in our American mental health system. This podcast is curated and hosted by Kerry Morrison, founder and project director of Heart Forward LA (https://www.heartforwardla.org/). Heart Forward is collaborating with Aaron Stern at Verdugo Sound as the technical partner in producing this podcast (https://www.verdugosound.com). Kerry Morrison is also the author of the blog www.accoglienza.us.
All episodes
Best episodes
Seasons
Top 10 Heart Forward Conversations from the Heart Episodes
Goodpods has curated a list of the 10 best Heart Forward Conversations from the Heart episodes, ranked by the number of listens and likes each episode have garnered from our listeners. If you are listening to Heart Forward Conversations from the Heart for the first time, there's no better place to start than with one of these standout episodes. If you are a fan of the show, vote for your favorite Heart Forward Conversations from the Heart episode by adding your comments to the episode page.
Long-awaited research findings signal need to pay attention to our fragile system of licensed facilities serving people with mental illness: A conversation with The Future Organization (Part One)
Heart Forward Conversations from the Heart
10/19/23 • 62 min
This is Part One of a two-part podcast interview.
A long-awaited research study and report prepared by The Future Organization (TFO) helps to shine a light on an important, but fragile segment of our housing continuum for people with mental health conditions, many formerly homeless. Colloquially referred to as “board & care homes,” they are officially referred to as Adult Residential Facilities (ARFs) and Residential Care Facilities for the Elderly (RCFEs).
Sponsored by Brilliant Corners and funded by the California Community Foundation and Cedars Sinai, the study was part of an initiative involving the participation of the LA County Department of Mental Health, the LA County Department of Health Services, and Genesis LA, with intention to draw attention to the issues affecting licensed residential facilities that care for people with serious mental illness in our communities.
In this interview with the study’s authors, Aimery Thomas and Leila Towry of The Future Organization, we will learn about the scope of their research, the intent of the study, and explore some of the findings and insights from their year of research:
- The “Market” in Los Angeles County, which consists of over 750 licensed facilities serving people with mental illness and elderly residents;
- “Market Users,” or the range of agencies, service providers, government partners and others who are connected with, or place clients into, licensed facilities;
- The Market’s residents: their demographics, perceptions, and unmet needs; and,
- The owners and operators and their challenges, needs and perceptions.
This promises to be an eye-opening interview for anyone involved in the homeless housing sector as the importance of this housing resource in serving people with experience of homelessness is not often acknowledged or understood. In fact, as the study reports, owners and operators of these facilities feel invisible and disconnected from the policy and agency connections who could provide vital aid to sustain them in the important work they do in caring for the most vulnerable in our communities across Los Angeles County.
Part Two of this conversation will largely focus upon the recommendations of the study report.
Here are some links to help you navigate this issue:
Summary of study findings from Brilliant Corners website re/ this study.
Full report, Serving our Vulnerable Populations: Los Angeles County Adult Residential Facilities and Residential Care Facilities for the Elderly, August 2023.
August 26, 2023 article in LA Times about the release of the TFO report.
July 12, 2022 article in LA Times about continuing closure of board & care homes
Blog at Accoglienza.us
Peer-assisted Mental Health Care Inside the Country's Largest Jail: A panel conversation
Heart Forward Conversations from the Heart
05/28/21 • 77 min
The power of Zoom – captured as an audio file for this podcast – presented an opportunity to hear about the origins and outcomes of a collaboration between the L.A. County Sheriff’s Department and Correctional Health Services nursing and mental health clinicians which began in 2016. You will hear from officials involved in conceptualizing the pilot and two inmates who have lived embedded in these pods for four years and wrote a book about their role as “mental health assistants.”
Our academic panelists provide a broad overview of the tragedy of incarceration of mentally ill inmates in the U.S. and why policymakers must make community-based treatment a priority to end the endless cycle of homelessness and incarceration of people with serious mental illness.
PANELISTS INCLUDE:
Craigen Armstrong, Mental Health Assistant
Adrian Berumen, Mental Health Assistant
Dr. Philippe Bourgois, Distinguished Professor of Anthropology and Director of Center for Social Medicine, UCLA
Bruce Chase, Assistant Sheriff, Custody Operations, LA County Sheriff’s Department
Joan Hubbell, Mental Health Program Manager, Twin Towers Correctional Facility
Jeremy Levenson, PhD Candidate UCLA Anthropology, Center for Social Medicine; Medical Student Mount Sinai School of Medicine
Moderator: Kerry Morrison, Founder & Project Director, Heart Forward LA
Ten (10) recommendations to shore up fragile LA County licensed residential facilities. Part Two of our conversation with The Future Organization
Heart Forward Conversations from the Heart
10/27/23 • 53 min
This is Part Two of a conversation with Leila Towry and Aimery Thomas of The Future Organization (TFO) about their recent year-long research study into Los Angeles County ARFs and RCFEs. These are commonly referred to as “board and care” homes, but the researchers make a case that the community and regulators should intentionally move away from that labelling as we attempt to forge new policy in this space.
The study was supported by an Initiative, involving the participation of Brilliant Corners, the LA County Department of Mental Health, the LA County Department of Health Services, and Genesis LA, funded by the California Community Foundation and Cedars Sinai.
In this interview, we discuss TFO’s findings relative to the connections between this segment of the housing market in LA County and our crisis of homelessness. We will explore how licensed facilities are not seen as part of the continuum of housing options in the “homeless services” sector, and, in fact, the federal department of Housing and Urban Development does not recognize licensed facilities as housing according to federal regulations which require individual leases.
As the study authors will assert, not recognizing the market of ARFs and RCFEs and the vulnerable populations they serve represents a blind spot in public policy discourse on ending structural homelessness.
We will also focus on just ten of the more than 50 recommendations offered in this report, across the domains of key players affecting outcomes for this Market – municipalities, Los Angeles County, the State’s Community Care Licensing Division that licenses and regulates facilities, and the facilities operators themselves. Los Angeles County owners and operators have been collectively advocating for change and improvement through a newly-formed organization, the Licensed Adult Residential Care Association, or LARCA.
Resources associated with this episode:
Here are some links to help you navigate this issue:
Summary of study findings from Brilliant Corners website re/ this study.
Full report, Serving our Vulnerable Populations: Los Angeles County Adult Residential Facilities and Residential Care Facilities for the Elderly, August 2023.
August 26, 2023 article in LA Times summarizing key finding of TFO report.
July 12, 2022 article in LA Times about continuing closure of board & care homes
Blog at Accoglienza.us
The Power and Promise of Community Inclusion: What we can learn from Trieste. A conversation with Dr. Dave Pilon
Heart Forward Conversations from the Heart
11/06/20 • 45 min
Dr. Dave Pilon talks with Kerry about his journey through the world of community-based mental health. In talking with him, one gets a sense of how our life experiences, over decades, can come full circle to tie everything together. Most recently, Dr. Pilon was the author of the proposal outlining a bold five-year mental health pilot, submitted to the state of CA in 2019, inspired by the WHO-recognized community-based mental health system in Trieste, Italy and adapted to an American context. Not only was he inspired by Trieste, but his vision was also informed by his seminal work at The Village in Long Beach, the site of a fascinating study in the early 90s. That state-funded study documented how an integrated service system, geared to whole person care with a per-capita budget, led to noteworthy recovery outcomes for the participants. Topics to explore will include psychosocial rehabilitation, the elements of recovery, and how we all benefit by helping people with mental illnesses to find belonging, purpose and true inclusion in our community.
Biography:
Dave Pilon received his doctorate in Social Psychology from Harvard University in 1981. From 1989 until his retirement, he served in various roles at Mental Health America of Los Angeles, including as its CEO from 2009 until 2017. For over 35 years he has consulted in the design and transformation of mental health programs and systems throughout the United States, New Zealand and Japan. Most recently he has served as the lead consultant to the L.A. County Department of Mental Health for the TRIESTE Pilot.
Dave has presented numerous workshops on ethics and leadership issues in psychosocial rehabilitation as well as on the development of performance measures for social rehabilitation programs. He is passionate about creating better ways to serve the most vulnerable among us, particularly people with serious mental illnesses.
Resource guide:
Chandler, D., Meisel, J., Hu, T.-w., McGowen, M., & Madison, K. (1996). Client outcomes in a three-year controlled study of an integrated service agency model. Psychiatric Services, 47(12), 1337–1343. https://doi.org/10.1176/ps.47.12.1337
Chandler D, Hu TW, Meisel J, McGowen M, Madison K. Mental health costs, other public costs, and family burden among mental health clients in capitated integrated service agencies. J Ment Health Adm. 1997;24(2):178–88. Crossref, Medline, Google Scholar
Los Angeles County Department of Mental Health. The TRIESTE* project: *true recovery innovation embraces systems that empower [Internet]. Sacramento (CA): Mental Health Services Oversight and Accountability Commission; [updated 2019 Apr 30; cited 2020 Jan 29]. Available from: https://mhsoac.ca.gov/sites/default/files/documents/2019-05/1054552_TriesteConceptPaper-4-18-2019FINAL.pdf
What is CAHOOTS and why are more and more people talking about this? A Conversation with Ben Adam Climer
Heart Forward Conversations from the Heart
05/21/21 • 53 min
2020 will go down in history for many things, including the significant push for a diversion of mental health related calls from law enforcement to a different model. The CAHOOTS program, initiated in Eugene, Oregon, has captured the imagination of many throughout the country who are looking for a tested approach which shifts the burden to a peer-led team.
CAHOOTS stands for Crisis Assistance Helping out on the Streets and was started in Eugene, Oregon in 1989. It originated as a collaboration between a local nonprofit clinic and the city and has grown into a 24/7 service. Multiple vans serve the city and offer an alternative to the traditional reliance upon first responders of police or paramedics which can often be a traumatic experience for all involved.
Ben Adam Climer, who started his career working in homeless outreach in Los Angeles, moved to Oregon in 2014 and worked on the CAHOOTS team for five years, first as a crisis worker and then as a trained Emergency Medical Technician (EMT).
Climer is now consulting with a number of local jurisdictions who are looking to shift crisis calls away from the traditional law enforcement response to specialized teams with clinical workers, trained crisis workers and/or peer responders. Climer walks us through how CAHOOTS is dispatched in Oregon and describes the types of calls they are uniquely equipped to handle. He also shares data about the positive outcomes, both financial and human in scale. Most noteworthy is the importance of de-escalating situations by not resorting to forceful interventions and avoiding costly hospital and jail interventions.
To contact Ben-Adam Climer
Ben Adam Climer | LinkedIn
Articles:
CAHOOTS: A Model for Prehospital Mental Health Crisis Intervention (psychiatrictimes.com)
Huntington Beach latest to create non-police team to handle mental health, homeless issues – Orange County Register (ocregister.com)
You Tube:
(153) Los Angeles CAHOOTS Presentation - YouTube
Unglamourous expertise: Recovery from acute psychosis to reflections on system change. A conversation with Lee Davis, Alameda County Mental Health Advisory Board
Heart Forward Conversations from the Heart
03/12/22 • 53 min
Lee Davis is currently the chair of the Alameda County Mental Health Advisory Board. In her official bio, she indicates that she is a Civil Engineer and Journeyman Electrician by profession. She comes to her work on the Advisory Board as a woman with lived experience of a mood disorder.
In this interview, we explore three themes about which Lee is passionate:
1. The case for involuntary treatment
2. The lack of capacity in our so-called continuum of care
3. Her assertion that the failure to invest in the requisite infrastructure to treat people and promote their recovery is morally wrong and socially debilitating
In addition, we explore Lee’s extraordinary life journey, about which she writes with remarkable vulnerability in her blogs.
Being Bipolar. Maybe it is my unisex name. Maybe it is... | by Lee Andrea Davis | Medium
Other organizations she references in this interview:
Alameda County Families Advocating for the Seriously Mentally Ill
Articles about the February 2022 sleep-in organized by FASMI with which Lee was involved.
Oakland: Protesters sleep on sidewalk, demand mental health care (mercurynews.com)
Link to the annual report for the Alameda County Mental Health Advisory Board
Whispering at Ground Level: How to build trust with people suffering on the street. A Conversation with Anthony Ruffin.
Heart Forward Conversations from the Heart
06/04/21 • 57 min
Anthony Ruffin is a gifted and compassionate crisis worker who relentlessly seeks to establish trust with the most vulnerable people living on the streets. His career spans working with both nonprofit organizations and the Los Angeles County Department of Mental Health. He gives homage to a mentor who many were privileged to know during her amazing and courageous life of caring and service, Mollie Lowery of Housing Works
In this interview, we are going to gain vicarious insight into Anthony’s approach and see the realities of this human crisis through his eyes.
Anthony has visited Trieste twice and he will compare and contrast how people with mental illness are cared for in that community in comparison with the U.S.
Articles that have shined a light on Anthony's compassionate approach:
A true L.A. hero: For people dying on L.A. streets, he offers help, and he won't take no for an answer - Los Angeles Times (latimes.com)
The Fight to House Hollywood's Sickest Homeless - The Atlantic
'It's almost like a death watch': Severely ill homeless people are at risk of dying on the streets of Hollywood - Los Angeles Times (latimes.com)
Homelessness: A walk along Skid Row in L.A.—block by bleak block (calmatters.org)
Should California expand what it means to be 'gravely disabled'? - Los Angeles Times (latimes.com)
Lessons learned from the mid-90's Village Integrated Services Pilot and why they're even more relevant today: A history lesson with Dr. Mark Ragins and Dr. Dave Pilon
Heart Forward Conversations from the Heart
05/14/22 • 82 min
This interview will regale the history of a mental health pilot from the early 90’s that remains as relevant today as the day it was started. Back in the day, the Wright-Bronzan-McCorquodale Act of 1988 (known as AB 3777) funded – from the state’s general fund -- three Integrated Service Agency programs for mentally ill consumers. The most well-known of these was MHA’s The Village in Long Beach (Mental Health America) which became a model for the Mental Health Services Act (Prop 63) which would follow about ten years later.
This pilot featured two study groups. The Village coordinated and supported the 24/7 whole-person life needs of 120 consumers, randomly picked by the independent evaluator. The budget was based upon a per-capita allocation of $15,000 per person per year, paid quarterly in advance. Within this budget, Village staff (think “community integration managers” as opposed to case managers) had to cover all costs associated with inpatient care, outpatient care, vocational support, community engagement, whatever was required. By contrast, the control group was serviced through the usual and customary public mental health system; a clinical model.
Ragins and Pilon will talk about the remarkable staff culture that evolved and the stunning outcomes associated with the pilot. Higher levels of employment, lower levels of hospitalization and the like. The evaluation report is summarized here.
True payment reform is required if the public mental health system is going to make a difference in the lives of the people it services. Recovery is possible, but people need to be supported in all aspects of their life, not just with medication and clinical interventions.
The Guests:
Dave Pilon received his doctorate in Social Psychology from Harvard University in 1981. From 1989 until his retirement, he served in various roles at Mental Health America of Los Angeles (MHALA), including as its CEO from 2009 until 2017. For over 35 years he has consulted in the design and transformation of mental health programs and systems throughout the United States, New Zealand and Japan. Most recently he has served as the lead consultant to the L.A. County Department of Mental Health for the TRIESTE Pilot.
He is passionate about creating better ways to serve the most vulnerable among us, particularly people with serious mental illnesses.
Mark Ragins calls himself a recovery-based psychiatrist. He worked for 27 years as the medical director at the MHALA Village in Long Beach. Most recently, he’s been serving on campus as the only psychiatrist at CSU Long Beach
Dr. Ragins website features a number of resources and writings from the recovery mindset about which he is so passionate. He has recently published a new book, Journeys Beyond the Frontier: A Rebellious Guide to Psychosis and Other Extraordinary Experiences.
Italian psychiatrist Franco Basaglia: his life, his impact, his legacy. A conversation with Professor John Foot.
Heart Forward Conversations from the Heart
04/18/22 • 50 min
John Foot is a professor of Modern Italian History at the University of Bristol in the U.K. He is an expert on the life of Dr. Franco Basaglia, the visionary psychiatrist whose lasting impact on the Italian mental health system continues to inspire the world.
We will explore Professor Foot’s journey into this avocation, which was sparked by the chance viewing the film San Clemente (1982) while on a trip to Trieste.
Professor Foot is author of Franco Basaglia: the Man who Closed the Asylums. He is a co-editor of compendium of essays about the impact of Trieste in other counties that emanated from a symposium held in Oxford in 2018. It is titled Basaglia’s International Legacy: From Asylum to Community.
We also explore in this interview the plan to translate into English a book that was originally published in 1968, L’istituzione negata (The Negated Institution), which had seminal impact on advancing the Basaglian revolutionary school of thought in Europe and South America.
That one man could have such profound impact on advancing a human-centered, community-based system of care for people living with mental illness is astounding. This interview will provide some insights into Basaglia, who is relatively unknown in the English-speaking world.
Other resources associated with the interview:
Documentary (1968) I giardini di Abele
Book (1969) Morire di classe
Documentary (2013) Dentro le proprie mura
Making Sense of California’s Conservatorship System. Part One. A Conversation with Dr. Alex Barnard
Heart Forward Conversations from the Heart
05/07/21 • 52 min
Alex Barnard is an assistant professor of sociology at New York University, and received his PhD in sociology from the University of California, Berkeley in 2019. He is writing a book, tentatively entitled "Mental States," that examines why people with similar illnesses have very different trajectories between institutions of care and control in France and the United States. His work uses interviews, on-the-ground observations, and archives to examine why these countries developed very different mental health systems starting in the 1960s and the consequences of these choices in clinics, social service agencies, courts, and in the lives of service users themselves.
Since 2018, he has been working on a parallel project focused on analyzing the evolution and functioning of California's conservatorship system, which provides intensive, legally-mandated services to people with severe mental illness deemed as unable to meet their basic needs.
He has written a report, "Absent Authority, Absent Accountability" aimed at helping to identify how to get professionals the resources, information, and coordination to make conservatorship a positive tool of transformation for vulnerable Californians.
Update 10/5/23
Part Two of this conversation with Professor Barnard is available here.
The conversation focuses upon the publication of his September 2023 book Conservatorship: Inside California’s System of Coercion and Care for Mental Illness .
Links for this episode
Professor Barnard’s website
From the “Magna Carta” to “Dying in the Streets”: Media Framings of Mental Health Law in California
Contact information:
Show more best episodes
Show more best episodes
FAQ
How many episodes does Heart Forward Conversations from the Heart have?
Heart Forward Conversations from the Heart currently has 43 episodes available.
What topics does Heart Forward Conversations from the Heart cover?
The podcast is about Health & Fitness, Mental Health, Podcasts and Mental Illness.
What is the most popular episode on Heart Forward Conversations from the Heart?
The episode title 'Does the American mental health system stand the test of a human rights framework? A Conversation with Dr. Soumitra Pathare' is the most popular.
What is the average episode length on Heart Forward Conversations from the Heart?
The average episode length on Heart Forward Conversations from the Heart is 53 minutes.
How often are episodes of Heart Forward Conversations from the Heart released?
Episodes of Heart Forward Conversations from the Heart are typically released every 8 days, 23 hours.
When was the first episode of Heart Forward Conversations from the Heart?
The first episode of Heart Forward Conversations from the Heart was released on Sep 25, 2020.
Show more FAQ
Show more FAQ