Heart Forward Conversations from the Heart Kerry Morrison

In this episode, we visit with two representatives from Fountain House in New York.  Our primary intent was to provide a platform to share the results of a recent research report issued by Fountain House:  Beyond Treatment: How Clubhouses for People Living with Serious Mental Illness Transform Lives and Save Money.  
This first of its kind analysis not only offers a fuller accounting of the fiscal and societal costs of untreated mental illness — looking beyond health care spending to include lost wages and productivity, disability benefits, repeated emergency room visits, and criminal justice impacts — but demonstrates how clubhouses are uniquely positioned to drive down spending across the board.
  
The report finds that if clubhouses were appropriately resourced and expanded to serve even just five percent of the 15.4 million adults in the U.S. who live with serious mental illness, the net societal benefit would exceed $8.5 billion and offer a dramatic improvement in quality of life for countless individuals, their families, and their communities.
 
The report notes that the U.S. has historically spent most of its mental health care dollars on clinical treatment, such as medication and therapy, with a fraction allocated to fund the community-based social supports people also need to manage their mental illness. These are policy decisions that can and should be changed.
 
Fountain House is knitting together a national network of clubhouses to help amplify voices throughout the country to underscore the importance of the clubhouse model as a compelling mental health intervention that should be more robustly funded.
 The bios for our two guests are linked on the Fountain House website.
 Rev. Dr. Phillip Fleming wears many hats, including member, certified peer specialist and member of the Fountain House board of directors.
 Dr. Joshua Seidman is the Chief Research and Knowledge Officer.  
 Other resources and reports mentioned in this interview:
 Community as Therapy: The Theory of Social Practice. Psychiatric Rehabilitation Journal.  12/23.
   Mental Health During the Covid-19 Pandemic. National Institute of Health.
 Impact of COVID-19 pandemic on mental health in the general population: A systematic review  PubMed Central.  2020.
 Project to Evaluate the Impact of Fountain House Programs on Medicaid Utilization and Expenditures. NYU. 2017.
 UCLA loneliness scale
Quality of life measure
Brief inventory of thriving
  Clubhouse International:  Mental Illness Recovery - Clubhouse International (clubhouse-intl.org)
Dec 2020 Interview with then CEO of Fountain House, Dr. Ashwin Vasan.

In Part II of this interview with Adrian Berumen, an inmate at Calipatria State Prison,  we track his journey from serving as an inmate Mental Health Assistant (MHA) at LA County Twin Towers to being sentenced to serve a 25-year to life sentence. 
Adrian’s story resonates with Heart Forward because his peer service, under the supervision of the LA Sheriff’s Department (LASD) and the LA County Correctional Health Services in LA County jail, exemplified the radical hospitality that undergirds the mission of our organization.  
We note that Adrian spent 9 years at LA County jail awaiting his trial and in 2017 volunteered to move from Men’s Central Jail into Twin Towers to assist with the most seriously mentally ill inmates living in 141 E and F pod.  Over time, in collaboration with his partner Craigen Armstrong, who had been transferred from San Quentin’s Death Row to await a new trial, they began to flesh out their role as Mental Health Assistants.  In 2020, they collaborated on a book about their experience.
Owing to the leadership of Supervisor Hilda Solis on the LA  Board of Supervisors, there is a commitment to expand the number of MHA's  and to provide greater support to their work.  Supervisor Solis had unanimous support for a motion she introduced in June 2023 to expand the number of MHA's three-fold.  More recently, in a November 2023 motion, which was seconded by Janice Hahn,  she asked for a report back in 90 days on a number of potential supports that would acknowledge the work of the inmate MHA's.
Adrian’s story raises important questions:
·       What does rehabilitation look like with our California prison system?
·       Why can’t we consider a different model to come alongside prisoners with mental illness?  The pilot that has been successful in LA County could be replicated by CDCR.  This might be similar to the work done by the Gold Coats in San Luis Obispo County.
·       Could LA County and CDCR negotiate an agreement that inmate MHA's doing this work in LA  could see their "credits" transferred to the state prison system?
+++
Podcast interview S1 Ep 5  conducted  in 2020.
12/23  article in LA Times:  Seeking Redemption:  A death row Inmate’s journey into LA County’s largest psych ward.
Prison Levels in CA State System
Website which documents the work of the  Mental Health Assistants
To contact Adrian Berumen, BU 1415
PO Box 1415
Calipatria State Prison
Calipatria, CA 92233-5007

To support this podcast - you can donate HERE. 

 In this 2 -part interview with Adrian Berumen, an inmate at Calipatria State Prison,  we track his journey from serving as an inmate Mental Health Assistant (MHA) at LA County Twin Towers to being sentenced to serve a 25-year to life sentence. 
Adrian’s story resonates with Heart Forward because his peer service, under the supervision of the LA Sheriff’s Department (LASD) and the LA County Correctional Health Services in LA County jail, exemplified the radical hospitality that undergirds the mission of our organization.  
We note that Adrian spent nine years at LA County jail awaiting his trial and in 2017 volunteered to move from Men’s Central Jail into Twin Towers to assist with the most seriously mentally ill inmates living in 141 E and F pod.  Over the course of this time, in collaboration with his partner Craigen Armstrong, who had been transferred from San Quentin’s Death Row to await a new trial, they began to flesh out their role as Mental Health Assistants.  In 2020, they collaborated on a book about their experience.
Owing to the leadership of Supervisor Hilda Solis on the LA  Board of Supervisors, there is a commitment to expand the number of MHA's  and to provide greater support to their work.  Supervisor Solis had unanimous support for a motion she introduced in June 2023 to expand the number of MHA's three-fold.  More recently, in a November 2023 motion, which was seconded by Janice Hahn,  she asked for a report back in 90 days on a number of potential supports that would acknowledge the work of the inmate MHA's.
Adrian’s story raises important questions:
·       What does rehabilitation look like with our California prison system?
·       Why can’t we consider a different model to come alongside prisoners with mental illness?  The pilot that has been successful in LA County could be replicated by CDCR.  This might be similar to the work done by the Gold Coats in San Luis Obispo County.
·       Could LA County and CDCR negotiate an agreement that inmate MHA's doing this work in LA  could see their "credits" transferred to the state prison system?
Resources:
Podcast interview S1 Ep 5  conducted  in 2020.
12/23  article in LA Times:  Seeking Redemption:  A death row Inmate’s journey into LA County’s largest psych ward.
Prison Levels in CA State System
Website which documents the work of the  Mental Health Assistants
To contact Adrian Berumen, BU 1415
PO Box 1415
Calipatria State Prison
Calipatria, CA 92233-5007

Dr. Deborah Pitts is a Professor of Clinical Occupational Therapy at the USC Chan Division of Occupational Science and Occupational Therapy.  
Her practice expertise includes community-based mental health and psychiatric rehabilitation, particularly in the permanent supportive housing (PSH) context, and the ‘lived experience’ of recovery for persons labeled with psychiatric disorders, in particular occupational engagement and psychosis. 
 
 Her doctoral dissertation focused on practice reasoning of front-line service providers (i.e., Personal Service Coordinators) in a community-based mental health wrap-around program known as a Full-Service Partnership (FSP) serving persons labeled with psychiatric disabilities. 
 
 She took the lead for the Chan Division’s participation in the USC Homeless Initiative through her partnerships with local organizations providing services to persons experiencing homelessness to create student learning opportunities.
 In this interview, we will explore the basic framework to understand the untapped potential to fully integrate occupational therapy into residential contexts to come alongside and support people living with a serious mental illness.  We will tease out the distinction between psychosocial rehabilitation and clinical interventions.  We’ll define the terms “occupational science” and “occupational therapy" and "functional cognition."    She will underscore the importance of developing a relationship between the therapist and the client – and this takes time, something the American payment system does not reward for when reimbursing for services.
 And, most important, we will explore how occupational therapy could be additive to the service support teams in our homeless housing ecosystem – if we could find a way to pay for this.
 

 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

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