Watching Mental Health Episode 8 | Robin Reedy

This is a transcript of Watching Mental Health Episode 8 with Robin Reedy which you can watch and listen to here:

Katie Waechter: Hi everyone, and welcome to another episode of Watching Mental Health. And I am really excited because today we are going to be talking with Robin Reedy, who has been the executive director of NAMI Nevada since 2017. After volunteering with the organization for seven years and since joining NAMI Nevada, Robin has spearheaded initiatives that have driven significant growth across the state, and I've personally seen that and it's been resulting in expansion of programs and services from the north to the south and everywhere in between.

And it's also led to an increase in our funding, which has been incredibly important for our state in particular. And so NAMI's mission is really to improve the lives of individuals and families affected by mental illness, through education and support and advocacy. And this is a testament to Robin's passion for the cause and her service to NAMI and to the state really in bringing more mental health access across the state. On this episode, we are going to be talking more about that mental health access and advocacy as well in the state of Nevada, which unfortunately has some of the worst rankings for mental health access. And Robin is really spearheading initiatives to make a difference with NAMI Nevada. And so we're going to talk more about that. And so without further ado, I'd love to please welcome Robin Rey.

Robin Reedy: Hi everyone. Thank you for having me.

Katie: Thank you so much for being here again. I'm really excited to have you. I've seen your work firsthand and it's really important. And so I want you to kind of tell us a little bit more in your own words about who you are and why mental health matters to you.

Robin: Well, I'll tell you who am I after retiring from the state and I worked for the state of Nevada for over 20 years, and I ended my tenure there as chief of staff to a governor. And when I left and retired from the state, I really wanted to do something in mental health and homelessness primarily because I grew up with a mother who was diagnosed back then. It was diagnosed with manic depression, with schizophrenic tendency. Now it would be called schizoaffective disorder. And as you can imagine, because I am older, back then they didn't really have much in the way of medications, much in the way of services. They pretty much threw away people back then when mental health condition. And certainly I grew up thinking I was an expert on mental health because I had lived it. But what I realized when I got involved with NAMI is I knew very, very little and mental health and the services had changed so drastically over that time.

And then I also that Nevada was number 51, dead lack, and you can take dead quite literally in this state. People are dying from mental health conditions because of the lack of services in this state. So I've made it my mission and my retirement to do more with nami. That's when I volunteered with nami. We started the western Nevada affiliate that has been going gangbusters, serving the rurals of Nevada. I helped Southern Nevada grow. I then worked in the advocacy area because of my legislative experience. And then when this position opened up, I said, well, this is the position I want to be in. This is where we're going to make the most difference. So I took the job of executive director because I want people to understand that there is recovery in mental health arena and that every voice makes such a difference in this state, maybe not in another state, but in Nevada, one voice can make a huge difference. And all of those voices together can actually get us off of number 51. We need to remove the stigma. We need to give hope to families who are helping their loved ones, and we need to make significant differences in policies and treatment of those people living with a mental health condition.

Katie: Yeah, we definitely do. That's a great segue because I was really going to ask in your opinion, what is the problem with Nevada with our access, why it's so hard for us to get out of 51, is it come down to funding? Does it come down to stigma? Does it come down to a little bit of everything? What have you seen?

Robin: Well, it certainly comes down to it. There's never any one solution, but I will tell you, I come from the finance area of government. I did government finance, so I understand, and we've always had to have a balanced budget. So we can't overspend like the federal government or California or anything like that. And we also are a state that really wants to keep government very tight, very small. But I will tell you the advances that we have made so far are pretty much all the advances we can do without spending more money. So now it's got to be a commitment and a political will to put more money into resolving these issues and access of services. But the good news is when you put more money into this at the front end, you save significant money at the backend. So as we're trying someone's homeless and they have to go to an ER when they're in crisis or they go through criminal justice and intention facilities and correctional facilities, those are an incredibly high cost of services. But if we get them the right meds at the beginning or we get them in a wraparound treatment so that everything is working, then you don't have the emergency rooms and the crisis centers and all of those things costing us money. So we save money when we put money in the front end and try to do prevention.

Katie: Yeah, we do. We do. And it feels like in this last legislative session, we tried to talk a little bit about mental health. Some things were passed. Do you think that, I don't think, well, obviously enough, it wasn't done. But what was done was that impactful? Will that make a difference? And I'm thinking about there could be others, but I'm thinking about the bill that really incentivizes people to stay in the states when they practice or through school, after school with payback programs, with, I don't know what it is, but it feels like there are some things that they tried to do. What have you seen?

Robin: Well, I'll tell you, we are number 51 because of several reasons, because we have a lack of people to provide the services, psychiatric nurses, psychiatrists, psychologists, especially in the pediatric area. So getting policies and laws that create an incentive to have people stay in this state and treat people, that's a great piece and that's incredibly important. We're also dead last because of the amount of money that the state puts into services. And that's improved over time. I mean, don't be wrong. There's been improvement, but it's still not where it needs to be. In the last two sessions, we, two sessions ago, we started the nine eight eight call in line. Now what's important about that is yes, it's 9, 8, 8 people can remember it specifically for mental health. It will guide them to crisis services. But the biggest part of that bill was the fact that they added a revenue stream.

And that stream is coming from our cell phones. It's a tax on our cell phones, but it's going to provide the crisis services so that when nine, eight, eight call gets it, they have somewhere to send you. So that's particularly important. So again, getting revenue, ongoing revenue to treat this is great and like a miracle in the state to have that pass. In this last session, not only did we have the incentive bill to keep people in the state and to forgive loans and to reach into high schools to try to get people excited about going into human resource jobs, but we also had SB 1 67 and SB 1 77, and these were medication barriers. These were laws that in Medicaid, which is our largest funder of people who need mental health services, and even in our regular insurance, it's basically getting rid of the insurance's ability to stop you from taking a drug.

So if the doctor prescribes a drug that is on the insurance formulary, the formulary is basically drugs that are allowed on that insurance. And if that drug doesn't work, then they have to go to the next drug, whether it's on the formulary or not. That's important because drugs, especially when it comes to psychiatric drugs, affect everyone's brain differently. More important is if you take a drug and it doesn't work for you, it can remap your brain where another drug might not work for you. So you really want to narrow down what works and not go through eight or 10 drugs to get one that works and be bogged down by only the cheapest drugs that that insurance company decides. So again, medication barriers and not getting enough medication out there is a reason we're dead last, and then the homeless population that we have trying to find housing for those people who can't support themselves because of a mental health condition.

Here we're talking about severe mental health problems so that we want supportive housing and we've been pushing that. The good news is as well, we did get some money for housing and homelessness. We didn't get an ongoing revenue stream. And that's what you really need to do to maintain a house. Just like the bank, when you go to buy a house, they want to make sure you have an ongoing revenue stream to maintain the house, keep the house up. So not everyone gets the loan, right? Well, this is thing for us to build a building or renovate a building and turn it into housing. The rules say you have to have an ongoing revenue stream to be able to maintain it. And that's what we're pushing and planning on pushing for in our next session as well.

Katie: Well, yeah, that's really important. I know here in Southern Nevada, we get phone calls all the time about housing. That's when I was manning the helpline phones, that was the majority of our calls was where to put people who are struggling with SMI into housing. And it is a continuous problem. I think you're right. Until we do get that funding, and I think that's really powerful that 9 8 8, we were able to get that funding, that continuous stream of funding. You're saying through the cell phone tax talk more on nine, eight, eight because some people, it feels like there's maybe some stigmas or some myths going around that 9 8 8 first off isn't good, which I think is obviously it can be better, but nine eight is a great place to start and I think what we were able to get done was valuable, but people will say that perhaps access is a problem. Is that still a problem? Are people still experiencing long wait lines? Do you know anything about that?

Robin: I don't know an incredible amount of detail about it, but I will tell you any program that starts, it's always going to go off slowly. But when you're starting a program like that, 9, 8, 8 and getting that in, if you don't have somewhere to send them, if you don't have the psychiatrist, the psychologist, the crisis centers, I will tell you those things are being built up and it's moving forward. But I do know of people who have had issues with 9, 8, 8, but no more issues than not having a 9, 8, 8. I mean when you call 9 1 1 and all they can send you is a cop, how is that helpful either? So it is a growing pain type of situation with this particular program, but we'd be going through that growing pain no matter what. The pain is deeper because we're number 51 and we have so much to make up for.

Katie: Yeah, definitely. No, I fully agree

Robin: In the coming year is going to be working with sheriff's offices and just different crisis centers to try to make sure that everyone is understanding 9, 8, 8 and that it's getting out into the rural and that we can arrange to have the appropriate crisis services as close as possible to where it needs to be.

Katie: Yes, absolutely. Yeah. We want to keep that training up for CIT get our law enforcement to be trained for these kinds of situations. But I think you're absolutely right. 9 88, it was never going to launch perfectly, but the fact that it launched and that we do have some income from that I think is really powerful. But then it leads into our deeper problem here, which is this issues of access. And so you touched on medication a little bit. Now some people will say that NAMI really pouts medication and medication medication, but from my experience, NAMI has really been less about shoving medication down your throat and more about making sure that we have access to whatever it is that ours and ourselves and our providers would want to do together. And so just talk a little bit more about that, about access and medication.

Robin: We want whatever works for the individual. So indeed we do not just push medication, we push whatever works. If it's yoga, if it's CBD or DBT therapies where you're eating right, you're sleeping right, you're paying attention to everything. But there are those for some medication is the solution. And for us, what we say is we want that decision to be between the doctor and the patient, not between a bureaucrat sitting at a desk who knows nothing about anything other than what's on their formulary. We want the decision to be an educated one between the patient and the doctor, and if the patient can lead a happy and what they perceive to be a life that they want, that's what we want. But when insurance gets involved to change meds or you change insurance, and let's face it now, everyone changes insurance every year and then the acceptable formularies change and the family gets this letter saying, oh, you need to go on this. Instead of that. That period of time of changing medication is the most dangerous time for someone living with health condition, but especially if they've been stable on the medicines that they've been given.

I don't have a thyroid, so I have to take a thyroid medication. And the only thyroid medication for me that works is Synthroid. Quite simply, Synthroid has been around or flippant ever. I pay something like 40 or $80 for my prescription of Synthroid because it's not on the formulary. I know how upset I get when I get a note from the new insurance saying, okay, did you know there's a cheaper way to do this? Yes, I do. I'm 66 years old, I've been on Synthroid medication for 20 years. I would love to pay for cheaper medication. It does not work for me. So if I get that frustrated over something like Synthroid, I can imagine what an individual or a family goes through after they've take four or five different changes of meds and found something that worked and then to be told they have to change it. So any company should not be allowed to change a med for a non-medical reason and something else we're going to be pushing. But we're there for whatever works, pet therapy, yoga, Zen, doing whatever, meditation, whatever works for you. I know someone that as long as they can get up at the same time, go to bed at the same time, do their workout in their gym and do things, they're great without meds.

Katie: Yeah, I love that about NAMI Nevada. I have never felt like that kind of pushing of medication, and I only recently learned that other people do, and it was a surprise to me that people kind of have that aggression against nami because I think that here in the state we've been great. And I love that even the NAMI Nevada conference that we just had, we talked, there was a whole panel on psychedelics and kind of what the research researches around that. And it's just like you said, it's about finding what works and then encouraging that and encouraging access to that. And so tell me more about NAMI Nevada, all the amazing things that we've done, that you've done. I know that since you've come on board, you've really rocked it and made it come to life. And so I'm just really excited to have you here, the ed. And so tell me more about NAMI Nevada.

Robin: Well, I am just a mess. I mean, I go out and I talk about my experiences. I tell stories about things that have gone on in the state, but mainly I think it's because I just talk. I mean, I really believe that stigma is basically prejudice, it's bias, it's racist. It's saying that somehow someone's not good enough because they have a mental health condition and that's just not the case. If we would all have advocate and express our views to decision makers, this would be a no-brainer. I mean, it really would make the biggest difference in this state. So we have expanded our education programs. So we have family to family education program that you can come for a couple hours each weeks for six to eight weeks. People can take that. The families and caretakers of someone can learn about the diagnosis and can learn about medications, can learn about side effects of those medications, can learn how to deescalate a situation, how to better express themselves, how to advocate for, they're caring for.

We have our support groups both for family members and for people who live with a mental health condition. And they can go in there and they can learn from other people what psychiatrist is good, who's taking new patients, where to go here, where to go there, what worked in some cases, especially for those that are severely have A SMI, severe mental illness families can learn about guardianships and what lawyers can help them with that and how to go about it. The biggest part of it is really in support groups is people with that lived experience can tell other people who are coming in, what they did, how they did it, and people aren't feeling alone. I mean, that's huge. We now have the teen text line out of nami, Western Nevada where teens can text in. And the biggest piece about that is if you're a parent or a teacher or you just know someone who may need help, you can send that cell number to the teen text line and they will reach out and talk to the individual.

And I thought being 66 years old, I'm like, who would do that? Who would reply to something like that? Guess what they do? Almost to a percent. They do. And it helps. And teens and young adults are feeling better because of it. We have the NAMI Western Nevada warm line where people just call in to talk again and they're talking to people with a lived experience, who've been through what they've been through, and it has reduced the number of calls to 9 1 1 for people with mental health conditions. Wow. We're also using that to work with youth peer recovery support specialists and other peer recovery support specialists so that if someone is hospitalized and they have left the hospitalization in their discharge, we can work with the hospital and reach out to them and make sure that they're going to their doctor or make sure that they're picking up their meds or help them.

If there's a barrier to any of that through the warm line, they actually reach out and talk to people. I mean, a lot of the things that we're doing are just practical, helpful things, and there's certainly a million other things we want to be doing, but all the services that we provide as we provide at no cost to the recipient. But again, everything this office costs money, our telephone line, the cell phone, the Zoom service, everything that we have costs money. So at least our 5 0 1 C3 and I got to put that plug in. So we'll certainly take donations, but more importantly, we'll take voices. We'll take, if you want to say something but you're afraid to save it, say it. I will help you phrase it. I will help you get a letter to the editor. I will help you send something to your elected official.

I will put you on our advocacy list so that you can see the changes that are going on and we'll put in where to go, what to say, how to say it, why we are for and or against something, and we will give you the links that you can send it off to the people that make those decisions. When I was in finance, in government, anytime I had to go to the legislature and I saw that the university was on the agenda, I had to get there early to get a seat because the university system knows how to get their bills passed, and they filled that room with people to be for whatever or against whatever they're testifying on. And then as soon as they're done, they all stand up and they all walk out and every elected official sees how many votes are walking out that door for that ida. And that's what we need to do as a mental health advocacy group. We need to make sure that people are calling in, writing in, or just sitting there with a nanny t-shirt on, and when our stuff is done, we get up and we walk out so they can see the votes walking out of that meeting.

Katie: Yeah, that's amazing. And that's exactly, I think you're absolutely right, and I love that you have this advocacy push in this passion and this background, frankly, because it helps guide us as part of the affiliates to really be doing this. So I started doing NAMI Smarts this last year, and I love it. I got to go to Carson City. That was amazing. So it's really inspiring. So what are the kinds of things that, and you mentioned one of them, but what are the kinds of things that NAMI Nevada is wanting to get these voices together for? What issues are we wanting to push forward in the next legislative session?

Robin: So our number one is always housing because as you've said helpline, it's the number one call. It's the number one call to all of NAMI and all of our helplines is housing, so we want supportive housing. When my mother was much older, she finally got into a county that had a housing facility, they had taken over a hotel, made them into little studios, and that was the only time in her life she was stable, was in the supportive housing facility. So many empty buildings around the state. So we need to turn them into housing facilities, not just for mental health, but for any disability that supportive housing would be workable for. We want to remove medication barriers, we want parity. We want someone who walks into an ER to have the same attention that someone like me, 66-year-old, if I walked in and said, oh, I have pain in my chest.

They would take care of me. They need to do that with someone who's going through a mental health crisis as well. They need to pay attention to that and they need to be trained to pay attention to that. We need it in our schools so that people growing up, we need to reach them earlier so that the school systems have help for the youth in doing that. Gosh, so many things. And again, just access to services, having the services there, the state is working to get crisis services across the state where even law enforcement could run into an issue that is supposedly mental health. They could drop it off at the crisis center, have them deal with it, not drop them off in a jail. So all of those things are things that are going to make a difference in the state and certainly,

Katie: Yeah, most definitely. And I think just like you said, what we need in order to really get improved mental health access, mental health care is for us to come together to be that unified voice and to show our policymakers that we're serious by telling them our stories, by showing up for these committee hearings and showing up when we can and sending in the emails. So I think it's really valuable. I think your leadership is super important here. And so I'm excited to see what the next year and couple years bring as we go into our next legislative session, and hopefully we will have a much more unified voice and I'm excited to be a part of that process. We're excited

Robin: To have you. Thank you, Katie.

Katie: Well, thank you. Thank you so much. I love my NAMIs here in Nevada. I'm a huge N NAMI fan, so I'm just really grateful to be connected with you with Trend the ED down here in NAMI Southern Nevada, and with our community, our NAMI family, and I think we're growing here in the state and the state needs that, and so I am excited to be a part of it.

Robin: Alright, thank you.

Katie: Well, with that, we are all done. That went by really fast. I learned so much. And so that was just really powerful to just sit here and listen to that and to just get your insights. And so I'm just really grateful again. And tune in next time. If you are interested in all of these conversations around mental health, stigma, access, how to make it better. We are live every first and third Wednesday. And then you can, of course donate to NAMI nevada.org. Go check out nami nevada.org is the website. And like Robin said, they are a nonprofit and we survive off of donations. And so thank you so much for being here and we will see you next time.

Robin: Thank you so much, Katie.