-It's a certain perspective of
the way that we look at people

and the lives that they live

and how to approach therapy
from a systemic perspective.

-Their access to services
has become even more limited

because only certain people
can provide the service

that they need.

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-Looking around,
you might notice

that the mental health crisis
is as prominent as ever.

Sadly, not everyone
has easy access

to supportive treatment.

How are professionals
managing it?

What community

and public services
are available for support?

Well, we're about to unpack
the answers to those questions

on this episode
of Jobs of Tomorrow.

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-It's incredible to think that
Mental Health Awareness Month

stretches as far back as 1949.

While it's important
to highlight this issue,

it's as important to recognize
that it extends

beyond the confines
of a single month.

Based on a recent
Mental Health America report,

21% of American adults

experienced mental health
illnesses in the year 2020.

That may not seem like a lot,

but that's the equivalent
of 50 million individuals.

Sadly, 55% of adults

with a mental illness
don't receive treatment.

That's 28 million people.

What should be done?

Well, licensed marriage
and family therapist

Dan Upshaw
is one of many therapists

that can help.

-I landed at this school called
Richmond Graduate University,

and they had two programs.

They had a clinical mental
health counseling program,

which is what licensed
professional counselors

typically pursue

when they're looking to become
a licensed professional counselor,

and they had a marriage
and family therapy program.

I learned more about the idea
that it's not just focused on

marriage
and couples or families,

which I really care about,

but it's a certain perspective

of the way that
we look at people

and the lives that they live
and how to approach therapy

from a systemic perspective.

-Dan,
like many other therapists,

is looking to focus

on mental health issues
from a systemic perspective.

What exactly does that mean?

-The systemic perspective,
this idea that

we all live and work
and function and communicate

within a larger system.

We don't live in bubbles,
we're individuals.

Change can be very well affected
through affecting the system

that somebody lives in.

-Now that Dan mentions it,
there are so many things

that can impact
and affect the system

that an individual lives in.

Think about it, wars, politics,

societal shifts,
and even pandemics,

these are all elements

that can significantly impede
our mental health.

These things
don't just impact adults.

According to licensed marriage

and family therapist
Erin Schaefer,

it's a growing concern
in the lives of the youth

who are struggling as well.

-It's really shifted
in some ways.

We've always had a population
who struggles,

who has mental health issues,

who will come in and out
of services throughout time.

Over the last,

I would say especially
the last three years

since the pandemic,

but even before that,
five years ago or so,

we started to see
this uptick of younger people

who really have a lot
of significant anxiety.

It's not just the,

"I'm stressed about
getting a good grade."

It's really overwhelming,
almost paralyzing anxiety

and depressive symptoms
that they are experiencing.

This is not
from the basic population

that you might expect it from.

These are from a variety
of kids across the board

who are experiencing
more and more of this.

For me, that,
I think, is the crisis

that we're seeing.

-Erin makes a valid point.

Mental Health America findings

state that 60% of youth
in the US

experiencing major depression
go without receiving treatment.

That's a glaring number
that cannot be ignored.

Access to treatment
isn't always easy to obtain.

-Another indicator
of our healthcare crisis,

as it were,

is the sheer lack
of clinicians, of providers

that we have across the nation.

In Georgia alone,
we are struggling so hard

with bringing enough providers

or having enough providers
for mental healthcare.

That's not just
licensed clinicians like MFTs,

LPCs, and social workers,
but that's also psychiatrists,

psychologists.

-2021 reports show
that in the state of Georgia,

the rate of adults
with a mental illness

who don't have
access to treatment

is a staggering 64.9%.

The main reason
why that number is so high

has to do with Georgia's lack

of affordable or accessible
mental health care services

or providers.

This isn't just
a growing concern in Georgia,

it's something
that's happening all over.

-Right now in our agency,

we have not been able
to accept any Medicare patients

because we simply
do not have enough providers

of the correct credentials

that have been required
for Medicare.

If you think about people
who are coming through the door,

that is a whole host of people
who really,

when you think about
limited services,

their access to services
has become even more limited

because only certain people
can provide the service

that they need.

-Coming up.

-Some of the skills is

understanding the different
dynamics of the individuals

we are working with.

Understanding the different
components of of one's

potential, their mental health,

or their family
system situation.

Every family is different.

[music]

-The importance of providing

accessible mental health
services for those in need.

With funding being cut
left and right,

Medicare costs are increasing,

and many individuals
are losing Medicaid coverage.

Stress and worry
are at an all-time high.

That's something
that those dealing

with mental health struggles
definitely don't need right now.

What can be done
to overcome these obstacles?

Dan Upshaw and the other MFTs

might know
where they should start.

-Across the board,
increasing trained,

licensed mental health care
professionals

into the Medicare system
is beneficial.

You can't fill a pool with water
unless you dig that pool first.

We need that capacity.

We need eligible providers
out there to provide the care.

AAMFT has done tremendous work
in creating legislation,

supporting legislation.

-Sure,

creating and supporting
legislation

can lead to positive outcomes,

but what does that look like?

-We have crossed a huge hurdle

by increasing the number

of providers
in the Medicare system.

When that takes effect in 2024,

that's going to be a great step
in the right direction.

However,

there's still quite
a bit of legislation

that needs to happen
in order to make it

just financially feasible

for these providers
to be able to provide care.

-Adding more providers
is a good start,

but there's still
the funding issue.

Thankfully,
mental health professionals

like MFTs can help step up
and lend a helping hand

with the growing demand
happening all around.

How exactly does that work?

Are there specific
qualifications

for who can be treated
and who can access treatment?

Understanding how community
mental health care works

is vital to seeing the benefits

and challenges
around the programs.

-We serve a lot of people
who are low income,

many people
who don't have other options

of other places to go.

They aren't people

who are going to be seen
in a private practice,

a lot of people who are on

perhaps government-funded
insurance programs,

and so as a result,
their options in terms of

where they can receive services
tend to be more limited.

-While working
in these programs,

MFTs often encounter

a variety of different people
with an array of circumstances.

-It's not just that
they have one issue,

it's not that they're coming
in because perhaps they have

maybe a depressive disorder.

Many times,
they have many other things

that are happening too.

Maybe they have
a depressive disorder,

but their family
is also struggling with

inadequate housing.

Maybe they don't have
good job prospects.

Maybe they are low-income,

perhaps they don't
have connections

to primary care providers.

There's all these other things

that are happening
at the same time,

while they're also having
these mental health issues.

-You know that quote,

we're all products
of our environment?

No two people are the same.

Each client comes with
their own set of experiences

that lead to their own
set of circumstances.

With that in mind,
how do MFTs approach this?

How do they go about navigating

not only an individual's
mental health,

but all of the external
environmental factors

that may be impacting them
as well?

Tanya Jacobs, founder
of a community nonprofit,

uses her training
in marriage and family therapy

to tackle these challenges.

-Some of the skills is

understanding the different
dynamics of the individuals

we're working with,

understanding
the different components

of one's potential,
their mental health,

or their family
systems situation,

every family is different.

-Part of being a successful MFT

is understanding the unique
circumstances of the communities

in which their clients live.

This is especially important
for those MFTs

who work in community
mental health agencies

or public health.

-We do have therapeutic goals,

treatment goals
that we work towards.

We also do that
within the context of the system

that they live in
because we cannot

help someone without also,

at least considering

if not also addressing
the best we can,

that system that they live in.

-Culturally, I had to understand

what it looked like to work with
someone with an Indian culture,

and understand the difference
of what was the one

from a Latino culture.

I identify
as African American myself,

even working
within my own culture,

I do not assume

that someone
will receive me all the time.

-Community mental health agencies

require more
than just the therapists

who offer services
to make them work.

There are often a wide variety
of roles that one can take on.

-I just continued to take on
different supervisory roles

and really started to oversee
different types of programs

that we had.

In doing that, just really
started to understand more

about community
behavioral health,

our role within the community,
and how we intersected,

and how we serve
the same population

that a lot of different agencies
throughout the community served.

That's what led me

to just continue
to take on different roles

and responsibilities
and to really focus on

how could we enhance what we did

and how could we
better work systemically

with the rest of the agencies

and organizations
throughout our community?

-Not only are you serving
the community,

but you serving a community
that has a need.

They sometimes have a lack of
understanding of how to serve,

or you're serving community
that says, "Not in my backyard,"

for those
that's currently unhoused.

It's the persistence
and perseverance

and have a sense of hope

to let the community know that

there is an opportunity
for change.

Over the last four years
of operating a nonprofit,

I've been able to produce change
with the community.

To do the work
from one small step

to now a bigger audience,

it is very complex.

Again, we know
the reward at the end is to see

individuals' lives changed
or impacted

with their assistance
and support.

-Coming up.

-She said,

"You save people's lives?"

I said,

"That is absolutely what we do,
we save people's lives,"

and that has been something

that has played itself out
repeatedly.

[music]

-Resistance, perseverance,
and hope,

these are all admirable traits
to possess.

That's why the standards of care
within mental health facilities

are crucial

to ensuring safe
treatment standards,

especially for
vulnerable populations

with limited access to care.

That being said,

what else goes into creating
a strong mental health center?

One way to do that is
by government agency audits.

More on that in a moment.

-Having our mental
health care centers

and any health care facility

audited and inspected

is about as important
as having a health inspector

inspect a restaurant.

If you want
to help the inspector

to make sure that your
favorite restaurant

is meeting all of the health
standards to serve you food

that has been protected,
as much as possible,

it's clean, prepared correctly,
that's just as important

for the government
or some agency

to audit and help maintain

the care standards
within healthcare facilities.

-Inspectors and auditors
are used by many industries

to ensure absolute
quality and safety.

In the case
of healthcare facilities,

they can help to ensure

that those in need
are able to access safe,

affordable,
and effective support services.

-There are so many
different appropriate

and evidence-based
treatment modalities,

treatment models
that can be employed.

Forcing a particular
treatment model

on a facility
may not be appropriate.

It really takes

some coordination
and some basic standards.

-In addition to ensuring
healthcare facilities

are suitable for clients,

there are many other barriers
that therapists

and their clients often face
in these programs.

-Barriers I am aware
of are transportation,

especially for our
aging population,

because if you can't make it
to the clinic,

you can't be a part
of the clinic services.

Also, access to devices
and technology

that allow them
to be able to connect.

When we're talking
about our aging population,

especially a population

that didn't grow up
with technology,

technology is still

on a learning curve
for a lot of them,

even if it's easy.

If something goes wrong,

it's difficult for certain
members of our population

to correct those errors.

-Technology in the therapy field

has seen real growth
in recent years,

especially in areas
like telehealth,

but it isn't always the answer
to the obstacles

that community mental
health providers

and their clients face.

Think about it this way,

what if the client doesn't have
a strong internet connection

because they live
somewhere rural?

Perhaps the client
doesn't have a smartphone

because they're facing
income challenges.

Some older generations
may not be the most tech-savvy

or up-to-date
with the latest devices.

That's why community
health providers

need to recognize that they may
only have a short amount of time

to help impact
the lives of their clients.

As a result,

they need to maximize
their efforts.

-Some of what we do
is we measure

when somebody comes in
for services,

then how long
do they stay engaged.

We know if somebody comes in
in a crisis,

then our goal is to get them
connected to services

because what we don't want is
somebody to come in in a crisis

and then not get
the services that they need

to prevent the next crisis.

Our goal really is
to engage people in treatment

so that those needs
are taken care of

and that crisis
can be fully resolved.

-That engagement
that Erin is talking about

is an integral component

of a successful therapist-client
relationship.

It can be challenged

by the circumstances
in one's life

that impact their availability
to participate in services.

Oftentimes, it means community
mental health professionals

are addressing
both mental health

and basic needs
at the same time.

-We serve about, on average,

1,500 people a week
in our food security program.

It says accessing food
can seem very simple,

but it's not simple.

It can bring on
some complexities

when we have
individuals and families

not accessing daily essentials
such as food.

Every Wednesday,

our staff was able
to serve our communities

through our food pantry.

-Marriage and family therapists

working in
community mental health

often see the positive results
of pairing together services

and programs

to address a myriad of needs.

-We have families
that come back and say,

"Since I've been accessing
the food security pantry,

now I'm able to have
more families, help my family.

I'm not worried,
I'm not stressed,

I'm not concerned about

where my next meal
is coming from."

-I feel very strongly

about working with
marginalized populations

and being able to see people

who often don't have a lot
of resources themselves

making changes
and becoming stabilized,

and seeing their mental
health symptoms improve

and then seeing
their lives improve

is by far one of the best things
that I've seen happen.

-Healthier individuals

will lead to more successful
and functional communities.

Community mental health centers

and the professionals
who work in them

are an essential part
of that process.

-I think about one time
I was talking to my daughter.

She was very young
and she was saying,

she knows what my husband does,

but she doesn't know
how to describe

what it is that I do.

We had recently been
in the big city

and I said,
"What would it be like

if you saw somebody
walking down the street

and they were talking
to themselves?"

She said, "Well, I would think
they were weird

or something was
wrong with them."

I said, "Well, these are
the people that I work with

and these are the things
that we tend to do with them.

These are the ways
that we help them."

She paused for a minute
and said,

"You save people's lives."

I said,

"That is absolutely what we do,
we save people's lives."

That has been something that has
played itself out repeatedly.

-Whether it's addressing
access to care,

introducing clients
to various support services,

or recognizing and addressing
community stressors,

marriage and family therapists

who work in
community mental health

are providing a vital foundation
for our society.

Thanks for watching.

I'm your host, Kristin Marand,

and we'll see you
on the next episode

as we explore
the jobs of tomorrow.

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