WMH Season 3 Ep 3: Making Systemic Change to Improve Mental Health

This is a transcript of Watching Mental Health Season 3, Episode 3 which you can watch and listen to here:

Katie Waechter: Hi everyone, and welcome to another episode of Watching Mental Health. And I'm really excited because today I'm bringing on somebody who I've been working really closely with over the last year. And together I think that we've been making some really great moves and I know that independently he has been doing some amazing things in mental health. So I'm going to talk a little bit more about Matt Cox and then we'll bring him on. And he is a seasoned mental health leader with over 20 years of experience driving systemic improvements across inpatient, outpatient, and community-based services. He has spearheaded initiatives that enhance provider networks, improve access to care and foster community partnerships with so many different areas of the community. He is dedicated to building a healthy mental health system that includes all voices, especially the providers because he used to be one to prevent the depletion of quality professionals and ensure sustainable care for our communities, which is so important here in Nevada because of the struggles that we've had on a mental health systemic level for a long time. So today we're going to talk about some of those initiatives that Matt is spearheading to improve mental health services right here in the state. So without further ado, let's bring on Matt Cox to the show.

Matt Cox: Hey, welcome. Thank you, Katie!

Katie: Thank You so much for being here.

Matt: Yeah, thanks for the kind introduction. It was humbling to hear all that. So it's been a journey and it's been, I loved your intro by the way. That was cool. The music.

Katie: Yeah. Yeah. No, I mean PR connection is great and I've been with them since I started this show. But yeah, I'm really excited to have you on board because like I said, you have been doing a lot and to hear it all in one bundle can feel overwhelming, can feel like a lot, but I think it's because you care. And so with that, I want you to tell me a little bit more about who you are and why you care about this stuff.

Matt: Well, thank you. Yeah. Before I jump in, that just a big shout out to you, just working along with you for the last year, just seeing your passion. It's always fun to be next to passionate people, really where we get movement in society because if we can be idea people, but to be doers, I think somebody said to be a visionary, but to be a doer, visionary is a very unique thing. And you're one of those and I really am honored to be around you and just to be a part of your podcast. This is awesome.

Katie: Thank you so much.

Matt: Yeah, so I'll tell you a backstory then I'll tell you a little about me. I always thought somebody needs to do a really good mental health podcast and here you are. So you've done it. I tried. And years ago I have to share those. It wasn't as advanced as it is now. Now we have yard stream, we have, it's so easy. But little bit of my background is I've been in mental health since forever. I actually got introduced, I think it goes back to my childhood growing up as a youth that had intellectual disability, I struggled. I hated school. I didn't like school. I read at a fourth grade level today. You probably didn't know that. I never shared that.

And so I was that short bus kid and I say that fondly because I was that kid that I would rather not be in school. I'd rather be playing sports. And I grew in love with soccer. So I loved that game. I ended up playing for college and then I ended up coaching Dixie College men's team eventually.

And through that world of, and my history of my intellectual discipline, I flunked out of school. It's in my TED Talk, I talk about it a lot. And one of the things I learned is I had a passion of going through that mental health struggle and having anxiety every day. And part of being a kid with a learning disability, I learned I had to a DD. And a lot of people don't realize with a DHD, I didn't have the H, but I had the a, d, D. So I was the kid that would be in the back focusing somewhere else, and it affected my executive part of the brain. So I struggled with reading and this all leads up to why I got into mental health. And I struggled. I hated school, I flunked everything. I actually flunked out of high school. And then I went to homeschool and I did better in that kind of setting. It was self-paced.

Then in my senior year, I started my first business. I was mowing lawns and I realized I love entrepreneuring. And so I got introduced to mental health when I started working with foster kids. And that was around 2000, or actually in 97 or 98 and then around 2000. And then I actually joined a company and became a foster parent and did a lot of things. And I found a lot of kids felt the way I did when I struggled with my learning disability. So I went into it because of passion. And this is why I tell mental health workers, you have to be called to work. It can't be because you want, it's not an industry that you're not passionate about it, it'll burn you out very quickly. Does that make sense?

And then it led me to Nevada, which then led me up to Nevada where I came in oh nine and I entered into the Wild West back in oh nine. That is way behind in things. I'm not being negative, it's just way behind. And then I became a provider till about 2021, I sold everything. And that leads me up to where I'm at now advocating. And I started a company acceleration due to what I saw as a provider. I just saw providers don't have anybody helping them. They don't have a voice. And I went through that noticing how dysfunctional the system, and I know we'll get into that. And that led me up to where me and you met.

Katie: Yeah, absolutely. And we met still talking about the provider not having a voice. We teamed up together to start the Mental Health Coalition, which has been going for a year now, where a year old. So happy birthday to us. Oh yeah, that's true. Oh wow. But yeah, I mean we are all about giving the voice back to the provider, but also to the community to really go in and make some changes instead of just complaining about it, which I know is something typical here in I think in southern Nevada. And I think it's a lot of people feel stuck. It's so much we are so behind. So talk a little bit more about where you're at with that and your thoughts there

Matt: On the coalition and where we're at. Yeah, I think it was fun because when I got approached to do the coalition, I was like, yeah, heck, let's do it. And then that's when I was introduced to this Katie person and then Katie came in and we were just really clicked on it. And it's been a year. That's crazy.

And so I think the idea behind it was we need to challenge change. We need to be change makers. We always, I think in the industry when it comes to where we're at, and the reason I really pushed hard in it is everybody just settles and says, that's for the way. And it sounds like you hear that. I just hate that. I'm like, why are we letting it be that way? Because it's our system and we vote these people in and we tell them to be stewards for us, but then it flips and turns the other way, if that makes sense. And so if we don't be active and we don't have a voice and share our experience, and I think that's where me and you got together. And I loved your vision. I didn't want to do a mental health coalition that was the same,

Katie: Right? Me neither.

Matt: And that's where I think we get along a lot. We don't want to just get into a room and bitch, I don't know how else to say it. So we designed it and I loved how it just kind of naturally, and we're still working it out and we're still figuring our pulse on it, but we wanted to run it like a business and have smaller objectives every quarter instead of, we can't change Medicaid rates. That's not what we want to be a part of. Yes, we can influence it, we can go lobby for it. But in our coalition, we wanted to make sure, hey, what can we do? And let's start small, get some big wins, but let's get big voices. And I think, am I right? That's where we went towards it. So I'm excited. I mean, I really look back now that you say it's a year, man, that goes fast. And I think now we're getting a consistent attendance of 15 to 20 people and they're quality people. That's what, I dunno if you see that.

Katie: Yeah, absolutely. And they're across the space, which is something that I love. I love that we have a hospital voice there,

Provider voice there. We have M people who work in the state. We have MCO, and we are trying to encourage the voices to come together. So some of the things that initiatives that we've been working on include resource database that is right there. We're just looking for, we're working on funding around that. And we have a mental health career slash resource fair coming up, which is pretty exciting. And we're just trying to tackle these problems one at a time. And I know that that's something that you're doing as well. So you're doing some amazing things out in the rural, and I wanted to touch on that a little bit because you're not just doing initiatives around the mental health coalition. So talk to me a little bit more about some of the other mental health things that you're doing, especially out in the rural. I know you're doing some really great stuff there.

Matt: So we partnered with a whole bunch of individuals out in Iser County. So Judge Johnson, she was the initiator along with Kim and Diana, Kim Riggs and Diana Starter Stater, I said it wrong. And then Ed and Bill Till. So we all got together, we said they've been trying to do this for 25 years, get this done. And so in a matter of four months, maybe a little longer, but around there, we came together and figured out what Judge Johnson's vision was and she needed housing. She needed a transitional program even though way out there. And then we all got together and brainstormed how we could do it. And so Ed had connections here, everybody had their connections. And Katie, we did this with zero money. And so we actually brought some private money to get the box bowls done. So we bought and we, well, we didn't, but the individuals came in with some money, bought three box bowls. So we went in front of the city, commissioners out there, got to pitch it. I think they were just so surprised that Company Acceleration came in with all those individuals. And we didn't have a hidden agenda. We didn't, because I think the rural areas are always used to people having hidden agendas. What is it for me? And we're like, yeah, we just want to, we're not providers. We don't bill, we're consultants. We'll help in the long term if you need our services. But on this project we're donating our time and we want to get it off the ground. And it's been beautiful to see. I mean, judge Johnson's excited. She gets these, have you ever seen the box bowls?

Katie: I don't think so.

Matt: No, no. These are the cool ones. They're over in north Las Vegas. They have a huge warehouse.

Katie: Okay, yeah, I think so

Matt: It's the houses they prefab and they, they're about 50, 60,000. So we got three of those purchased for out there. And then as you know, that area is going to be a very big thing for Nevada. They're going to have the mines there. They're going to have, what is it, the lithium mine and the gold mines out there. So eventually they're coming in. So we're trying to really build out, and that's just one area. And so we're going to take the same concept and push it across to Peram. To me, Mesquite needs a lot of assistance for that. So that's our rural area project. And then I just help a lot of facilities, my experience, so I have a lot of consulting. So we do a lot of that. And then just individual providers, we put together a really good mental health or healthcare coaching packages to where we help them come in and scale, see all those things. Because Kim and all of our team, we have a lot of years of experience. And that's what me and you talked about with the coalition is that they need the business. So our whole idea of our coalition is we're trying to become the business center for the mental health. Is that fair to say? I dunno.

Katie: Right, right. Yeah, exactly. Touching back on the coalition, we have these ideas to have these different committees that are really going to be focused in on either the business portion or on funding or on very specific items that are just a large struggle. So maybe youth was probably a good one, a committee dedicated to youth. And so we've talked about all of that. And yeah, we definitely want that to grow. I'm glad that you brought up your firm more that you brought up all of, because it's not just consulting and it's not just consulting on just business stuff. It's consulting on broadly across the board, what happens if me as a provider, if I'm getting in trouble for something that I didn't do, if I'm getting knocked, if I'm raising my voice and all of a sudden next month I'm getting investigated for something that seems eerily suspicious. I think that's amazing stuff. And you guys are doing that. We're doing that, right?

Matt: Yeah. I think one of the things through my experience when I exited and sold, I watched the, I'm going to be just straightforward. I watched the dysfunction as the oversight of the human services. And what I saw is that these agencies don't talk and they're very unhealthy and dysfunctional. And so what I was really frustrated with is, and then through one of the experiences, I made a really good connection with Andrew and Matt, which is over a certain unit and I shot some documentary with them. We started Brain, we've worked with them. And it's been fun because I think there's a feeling if you're a good provider, they should be your best friends. And then you should always run things by them and say, Hey, I'd like you to come out and speak to my staff, or I'd like you to come, Hey, I'm thinking this. Or Hey, I saw this. What should we do? How we make change? Because 50 billion in fraud is in that world and that's how much is going on. And so that's part of the consulting. So when you call, there's a lot of just experiences also knowing what can be done if you're being supervised by somebody.

That's what I think we're doing for the coalition and also the oversight committee is that you can call and ask questions to make sure, Hey, is this legit? Well, let us find out and we'll get back with you because providers don't have anywhere to turn to. And when they get into that, does that make sense? So that was part of the vision.

Katie: Yeah, absolutely. And I do think that that's so key. And it's cool because it seems like we were doing this on the side, not the consulting work, but really this looking at these problems and these experiences that are this dysfunction essentially this total dysfunction in our state. And from that, or you've helped to establish through our mental health coalition, this watchdog committee. So talk to me a little bit more about that.

Matt: Yeah, I think it came out in one of our meetings,

Katie: I think. So

Matt: We can't take all credit. It was cool because the group, we put up the issue and then we do a term we use in our group, IDS, it's issue discuss or solve or opportunities and obstacles. So when we did all and we were going through the discussion part, it was fun to see how it was born. They were like, well, we need oversight then. And I think what came out of that is an oversight committee. I know you've said on some, I've said on some, and the problem with the oversight committees I've been on, they're all stacked, is that the right word to use? Stack means that special interests are on there, people in certain

Katie: Already in there taking over, making sure the voices that need to be heard. Yeah,

Matt: No, and it's about money and people doing back handshakes and all that stuff. And so those oversight committees are not really effective. And if you're a good politician, you're listening to this. That's true. So what it was cool in this is that the group said, no, it needs to be non-providers, no political, more bipartisan political view, and that we're trying to make sure we create transparency and accountability. And they all did it. We just kind of guided them. And I know me and you are on the advisory board,

Katie: But they took it up, they're passionate and already some things have been coming through. So

Matt: Yeah, we've had complaints.

Katie: Yeah, it's cool to see that it's already up and running in some ways. And so I think what we want to do next is share these valid complaints and stories with the community. It feels like the public really doesn't know about a lot of what's going on.

Matt: And I think in my career over the years, it's ignorance and it's also misleading information. You got so many lack. Well, and then let's talk about that. You have limited venues and you're a media person, you write articles and you're a wonderful reporter. You write good stuff. And that it's all about controlling the narrative, which they do. And so yes, and I think that's where the oversight committee is needed. And so if we can tell the story and just say, here's the facts, and they might target a provider, but then the duty of the oversight committee is to show both sides of the facts. Does that make sense? So then that way, because right now it's a very unhealthy environment for providers. So when Nevada says we're open for business, they do not want outside providers coming in. Very So over the last five years, Nevada's probably lost millions and millions of dollars of potential providers coming in, but we don't have enough in to do the work.

Katie: Right. So yeah, I was just going to say, that's so interesting because we're at the bottom of all of these healthcare lists. We don't have the providers that we need. We have a few, but we don't have nearly enough that we need. And there is a lot of systemic problems blocking these providers from coming in. So I know just from what I've seen problems with getting licensed, there are certain licensing boards that are like the mob, they don't want outsiders in. There's also problems with our schools. We can educate, but we don't have those programs afterwards that keep providers here in the state. So there's I think quite a few problems. What are some that you have noticed that you think that we can make a difference in?

Matt: I think some of the things we can make the quick change in is just our systemic issue is getting everybody to stop, have silos in kingdoms. We have a lot of silos where certain providers will be given the contracts all the time.

It's the same people with the same grants, with the same money, and they don't perform well. I'm just going to say that the same ones that are getting the money are not performing. That needs to stop. I think that's the first change that needs to occur is it needs to be, Hey, if you can't perform, let's spread that. Let's get some more individuals. But I think also what we're doing, Katie, is bringing people together in the industry and having those crucial conversations. I know there's other groups that say they're doing it, but it ends up becoming clickish eventually. And so if we can really keep, and that's hopefully our goal is keep it very open. And we're not always going to agree.

We have to have healthy conversations, not combative conversations and healthy means, what about this or what about that? So I think that's the first step. Second step is we got to address the workforce. Now, mental health workforce is becoming nursing shortage. And we're doing this a lot where we're like, oh no, we're okay. And the state can't take care of everything. They're the worst and I'm not being hear me, it should be the individuals helping and the state shouldn't run services. They're the worst ones to run 'em facilities or being in charge of things. How do you oversight yourself? And I've seen it, it's not, it's very unethical because the

Katie: State run hospitals can have historically been some of the worst.

Matt: And then they go audit themselves and then they pass with flying colors. That doesn't make sense. We don't see any problems we monkeys see monkey do. And so the thing is also, I think, so that's one thing is systemic is taking the silos down and then making sure that we come in and we have those crucial conversations and not being in special pockets. So if we come together and we say, Hey, this is what we need, and it's hard. I know this sounds so hopeful, but taking the ego out of it and saying, Hey, what states, because I know here they hate it. If you talk about this, state's doing really good. Well, we're not them.

Katie: We're not them.

Matt: Yeah. Well,

Katie: They're different from Nevada, so it'll never work here. Yeah,

Matt: I know. And that brings it to the third thing. We need new leadership. Unfortunately, that mindset of what you just said needs to go away. It needs,

Katie: So that's a great point. And that segues well into my next question, which is I thought it was interesting in the governor's most recent state of the state where he's talking about splitting up the health and human services department, and he very specifically mentioned that mental health is no longer going to be there, mental health will now fall under Stacey Lee who heads Medicaid. So I thought that was interesting. We've been talking about this all of last year of these problems. So tell me your thoughts on that.

Matt: Yeah, I have thoughts and my opinions. I think it's his way of taking care of a certain issue that nobody wants to talk about. And I think me and one of our colleagues that we talk to all the time knows that issue and it's a leadership and a stigma issue we're talking about. And I think what he's trying to do without disrupting the train of the kind of belief system, that's hard. It's hard. My heart goes out to Governor Lombardo in a pool and trying to swim, and he probably has alligators and poor guy.

It's a tough job, tough job. And I've met with some of his representatives and they express that. So I think what this is is an attempt to deal with the drama that's going on in the Department of Human Services and without disrupting it, it's pretty degen and it'll see, I'm interested to see how it pans out. I think it's legislation wise, I'll be surprised. I mean, he does have the majority, but what he's doing is trying to say, and I'm trying to be diplomatic in this, but I'm just going to say he says, and we've been sanctioned, Nevada's been sanctioned for youth services.

Katie: We've gotten in trouble. You're not just saying nothing here. We've gotten in serious trouble with the federal government,

Matt: And this is what sad Katie, people won't talk about it because they're worried about retaliation. They're worried about if I'm a provider, and I say most people if I say, did you know that the state was sanctioned for youth services? And also they have a grade F for wanting to work in the state. They got an F for satisfaction because of all that. So I think that's what he's addressing at the driving the bus is failing. That's the best way I can put it without throwing names out there. So what he's doing is I think he's separating it and saying, Hey Stacey, good luck. I'm putting this in your hands. Hopefully you can take it on. My heart goes out to Stacy because now she has to take on Medicaid. Plus now she has to take on oversight of big job, big job. That I don't know where budget wise, I mean it makes sense, but budgeter, I think you should just start over here and just clean house. But I don't know why they're so scared to clean house, but that's me. I dunno what your thoughts are on it. I think,

Katie: Yeah, I mean definitely drama behind the scenes, and I think you're right. It's his kind of tactful way of just trying to keep the bus moving forward. And I was hopeful at the end of his state, of the state that he really does want to work together to make some change. We haven't seen a lot of the change on the healthcare side, so I'm hoping that it'll come through in some ways. The legislative session did just start. So tell me your thoughts on that. I know it just began, and so we don't really know what's going to happen, but there is one bill that we're going to be kind of working on, so you can touch on that. But yeah, talk to me a little bit about what you think slash hope will come out of the 83rd legislative session for our state.

Matt: It's going to be a tough session because everything that's going on in the world in our new administration that came in for the us, so this legislation is going to be heated, going to be, I was watching on YouTube because I always try to stay up to it, and they even said that it's going to be a tough one and we'll see because he does want to pass some things in education. And then it trickled down to some in the one we just talked about for healthcare. I think he has a huge uphill battle because the powers that have been are not going to let go of control. And so it's going to be a fight. I'm optimistic. I hope that they can get into what's called a bipartisan setting, come in the middle and do what's best for all.

Katie: I hope so too.

Matt: Yeah, that's my hope. And I sit more in that. I think me and you agree, we sit more there. I'm more of a conservative in the middle, bipartisan, and so I'm not extreme on either side, but I just want us to get things done and so like, Hey, come together because the next four years for Nevada is going to really shape it because we have a hard time. Hopefully this new administration settles in because it's been a shock value for everybody. And it'll be interesting when everything settles. I think for this legislation, that's what I would take from it. There's going to be a lot of fighting and arguing. Everybody has their agenda and I'm hoping for that. They do it for the greater good for all of us. That's all.

Katie: Yeah, no, that's a great point. It's a heated climate, and so Nevada can't just avoid that. That's the climate that we're in. But I do you have hope that will come out the other side that the governor has said he really wants some bipartisan things to come forward. And so hopefully we will work together as a state and we'll see. I

Matt: Think too on this legislation, I hope legislators, if any catch this is that it's hard too, Katie, and I think you see this, they'll make these laws and these legislation rules, but they've never been, let's take just healthcare or mental health. Let's take mental health. Never been boots on the ground.

So then I see a lot of times legislators and not all I'm saying most, they don't really connect. Once they get voted in, they lose the connection with their constituents. So ones that voted them in and they're not meeting with him, you see that a lot on the state level, the city level, the county, and some try to act like it, but at the end of the day, do they know what Katie does? Do they really understand the hard lift for a hospital worker? Do they really understand what it meant to go through covid? As a nurse, you got to learn the empathetic. I see a lot of times it's like I'm going to take out and I see it in Nevada, there's a lot of, I'm going to put the hammer down before looking at, if that make sense. There's a lot of hammering before digging in and seeing what the root cause is?

Katie: Well, I think we've seen that with other bills that have come out where they're like, yeah, this sounds like a good idea. Let's do it. And then afterwards, everyone's scratching their heads, right? It's like, well, wait a minute, how are we supposed to do this? Some bills happened in the healthcare space last time that have to be readdressed this time because there was so much confusion. But I like what you said there because that leads me to, and we're at time here. So that leads me to, I think, a good way to end, which is to say that our legislators are not experts, they're not subject matter experts, they are just people who got voted in. And it is up to us as the people, as their constituents, as their community to keep reaching out, to keep telling our stories, to learn how to tell them effectively. So we're not crying for 15 minutes on a two minute elevator ride and they got nothing out of it. But to really learn what our issues are and how to tell them. And so then that way, at least they're educated. I think one of the cool things about our state is that our legislatures, our policymakers are so accessible.

And so Nevada is a small state. It is hard to steer the ship. We only have the session every other year, and that's our con, but our pro is that hey, we can talk to them, we can talk. And so it's up to us, I think as the community to talk to them. And I think it's up to us, maybe Matt, you and I, to show the community how to communicate with our policy makers. I know nami, Southern Nevada, they have a NAMI Smarts program that teaches you how to talk to your legislatures. There are ways to get involved and hey, if you don't know where to start with our mental health coalition, it's free. It's open to the public. It meets every fourth Friday of the month. And so we would love to have anybody who's passionate about this, who wants to get involved to please get involved because the more people who are passionate who care, that's what we need. And that's what we said at the top of the show. And so I think that's where we need to be. And I just appreciate all of your work, all of your passion, because yeah, when you start to feel burnt out, you need to have people by you who are feeling it and who are there to help Keep it going.

Matt: Yeah, you do. And I'll end on this. I think the one powerful thing we've done is documentaries and I'm going to be doing a lot more of those. And so I've shot two and we got a really big one. We're going to be pushing out for mental health and the history of mental health here because stories are key and that you're a storyteller. So that's something I...

Katie: I'm so excited for those. They're going to be so good. I didn't want to mention them, I wasn't sure where you were at, but I'm very excited for those documentaries to come out. I've seen some clips, but with that, tell people who are interested how to get involved, how to reach you if they would like to get in touch and learn a little bit more.

Matt: So you can get ahold of our consulting group at Excel team. So it's just like it says down there X team, we just kind of play words on there, taking your company to Excel, expand, and then you can just go onto my Facebook, it's at Matthew Leland Cox or Matthew Leland Cox on, that's all you have to put in on any of the platforms. Reach out to us. You can get ahold of us either way, or just Matthew at Excel team. You can reach me that way. So I'm excited we can do anything. I can take an hour with you and just kind of see what you're trying to do and give you some guidance either way, or we can jump in there and do a lot of good work with you.

Katie: Yeah, absolutely. I've seen some of the good work both on a business side as well as on just having somebody who's in your corner to help you navigate these difficult moments that come being a mental health provider. And so I've seen the work. I think it's amazing. And for anyone who wants to keep watching, tune in every first and third Wednesday of the month at 3:00 PM Pacific Time, right here on PR Connections. And then you can see all of our episodes afterwards at my website katierosewaechter.com. So thank you so much everyone. Have a great one!