Homelessness and SMI: Transforming the American mental health system through radical hospitality.(Ep. 41)

Problem: Getting our  Homeless off the Streets and into Housing

Many of our seriously mentally ill wind up in jail, dead, or homeless.

It doesn’t have to be that way - and solutions in places like Trieste, Italy can show us the way, Heart Forward.

Meet Kerry Morrison, and discover a cost-effective, empathetic solution that lives up to “The human right to a sense of purpose.” 

Can a transformative care strategy, tested and proven in Trieste, Italy, work in Los Angeles, California?

• We hear you.
• We see you.
• You are safe here.
• Your voice matters.

Resources and links:

www.accoglienza.us.  

https://www.heartforwardla.org/podcast-season-1

https://www.heartforwardla.org/

Episode of Kerry’s podcast  with Dr. Roberto Mezzina:

https://www.buzzsprout.com/1283882/8741627 

Want us to cover a topic? comment to share?
Facebook page @Schizophrenia3Moms
@SZ3MomsTrenches -  twitter

Randye Kaye -Broadcaster, Actress, Voice Talent, Speaker, and Author (“Ben Behind his Voices”, “Happier Made Simple”)

Miriam Feldman – Artist, Mom, Author “He Came in With It”

Mindy Greiling – member of the Minnesota House of Representatives for twenty years. Activist, Legislator, Author (“Fix What You Can“)

Transcript

Copy Transcript Copied

SPEAKER_03 0:00

On many of our podcasts, we've discussed the fact that if our loved ones with serious mental illness aren't helped, they often wind up in jail or dead or homeless. Many of the homeless are suffering from serious mental illness, and today's guest, Carrie Morrison, decided to do something about it. Welcome to episode 41. Welcome to our podcast, Schizophrenia. Three Moms in the Trenches. From the place where schizophrenia and real life collide. East Coast, West Coast, Middle America. With Miriam Feldman, Mindy Gryling, and Randy Kaye. This is episode 41 of Schizophrenia, Three Moms in the Trenches. And last week we had so much fun just doing our first live podcast and answering readers' questions. And we've been asked to do it again. So probably every couple of months we will. But tonight we're going back to our standard guest format. And I'm so delighted because this is somebody that Mimi brought to the program. The question we're going to talk about tonight is why is it so hard to help the most seriously mentally ill people move from the street to a safe place? And that's a very important question. And I think we're we're going to begin right now by just bringing our guest on. And since she only knows Mimi, we'll do a brief, like one-minute intro of each of us because we have one person with snow, one person with rain, one person with heart. We can't see what's out your window. And we'll get a chance to meet each other. Um, I will just say that our guest, Carrie, we met because she was Mimi's neighbor in Los Angeles, but she's got a nonprofit advocating for mental illness, housing, and reform, and her journey to get there and her literal journeys to Italy to see a model of how we can help the homeless. Well, I'm gonna just let her tell her story. So welcome, Carrie Morrison.

SPEAKER_00 2:09

Hello, everybody. And it is warm here in Los Angeles, about 80 degrees.

SPEAKER_03 2:15

I'm so jealous.

SPEAKER_00 2:16

We have all weather, all weather spectrum represented today.

SPEAKER_03 2:21

Yep, we have um so Mimi is in Washington today, so we're kind of all over the place. Welcome so much. Just by way of introduction, I'm Randy. Um I it goes without saying I have a child with schizophrenia. That's in the name of the podcast. He is nearing 40 at the moment, always not wood, doing well in a group home and trying to rebuild his life after a relapse during COVID. And uh he has spent some time homeless. I hope that never happens again. That was not fun. And it happened to be in Idaho for about five months during the winter. And that's me. Mindy, why don't you go next? Hi, Carrie.

SPEAKER_02 3:02

I'm Mindy Gryling, and our son is in housing where he pays only a certain amount of his income for the housing. It's called bridges funding. It's kind of like section eight, but for people with mental illness in Minnesota, he's like incredibly fortunate. There's waiting lists for that, not as bad as section eight, but still bad. So the work you're doing is so important.

SPEAKER_03 3:34

Thank you. Nice to meet you, Mindy. And Mimi, even though you know her, brief.

SPEAKER_01 3:39

Okay, so I'm Mimi. We know each other from across the street for many years. Um, and you know, my son Nick, who's 36 and also has schizophrenia. And just by way of getting into it, I think this is so interesting. Carrie and I were friendly neighbors, you know, we we live in a neighborhood where everybody knows each other. And um all the years that I lived there, and all the horrible years of the 10 years that the book covers, and uh he came in with it covers, um, she had no idea what was going on across the street. And then during that time, she became this wonderful advocate and formed her nonprofit. And then I met her through somebody else altogether that she was working with in the mental health world, uh, David Israelian, who we had on the show. And he mentioned me to her, and she says, wait a minute, I think that woman lived across the street from me. So we've come full circle now, and I'm so happy to have you here, Carrie. And um, I think that the the little story about how we knew each other and didn't talk about any of this is pretty indicative of some of the problems that we deal with, and um ironic. And also, you know, one of the things I asked you when we first started talking about it is you don't have a kid with schizophrenia, you don't have this in your family. Like, why in the world? How have you gotten into doing this? Because it's a thing that if it's not in your family, you don't really know that much about. And you explained to me your whole trajectory with the homeless project in Hollywood. So can we start with you talking a little bit about that?

SPEAKER_00 5:28

Yeah, absolutely. And it's great to see you again, Mimi. And I remember when David Israelian said, Oh, I know someone you know, her name is Miriam. I'm like, Miriam, I never knew you as Miriam. I always knew you as Kenya. So I know that's your nom de pleur for your book. Um, yeah, so I this is true. I do not have lived experience in my family or in any kind of close proximity uh of people living with a mental illness. I entered this portal through my work in Hollywood. I I was managing for for 22 years the business improvement district on Hollywood Boulevard. So any of you who live near a big city will know that uh an economic development tool in the late 90s was to actually take downtowns that had really suffered from the suburbanization of America and had become a shadow of their former selves. And uh this um tool had been created where property owners would pool their money and form a business improvement district to begin to take care of their downtowns. The notion was that people would return to downtown if it was clean and safe. So I was the first executive director of a brand new business improvement district in on Hollywood Boulevard in 1996. And over the next 22 years, that business improvement district expanded and grew. These do not last forever, people have to vote on them. And as Hollywood was experiencing its return to its glory with the Academy Awards coming back and uh the theaters being restored and nightclubs opening and hotels uh coming into uh into business, as the community was being restored, but the homeless situation was becoming more challenging. And I remember it was uh right after the turn of the millennium, I I started to, I was actually kind of afraid of people who were homeless, and particularly people who had mental illness, because it seemed that there was a certain amount of unpredictability, um, hard to fathom how to engage with folks. And I had to conquer some of my fears because I wanted to understand who's here, who's homeless here on Hollywood Boulevard, where do they come from? Why are some of these people barefoot and why are why are why is no one taking care of them? And and and thus began my journey. Um, there's one gentleman, his name is Tori. He was kind of my first person that I encountered. I always tell the Tory story because I encountered him in 2008, person with serious schizophrenia, who was rocking back and forth on a bus bench for months. I mean, he barely ever left that bus bench, hadn't showered in a long time, very scary. And I finally just decided to conquer my fear and sit down next to him on the bus bench and ask him his name. And it that became kind of like the that's how the ice began to thaw. I got his name, I gave him my name and started to involve myself in his life. And kind of fast forward, Tori was the first, but then there were others, and I I was incredulous at how there was no real help for these people.

SPEAKER_03 8:58

Wait, just go back to Tori a minute. Did he ever get off the bench? Did he did you were you able to help him, or you just kind of broke the ice and began to see like there's a human being here?

SPEAKER_00 9:08

Yeah, I saw Tori a couple days ago. He's living in a board and care home. So his his trajectory was one where I engaged with people who were in social services. I was running a bid, this is not my world. And I said, How do we get this guy to take a shower? He needs to take a shower. And that became about a two-month goal to get him to trust us enough to be willing to go in a van, take a shower, as long as we would bring him back to the bench, which was heal. So it was trust building and just um being familiar and showing up every single day. And eventually the the folks who are involved with some of the social service organizations were able to get him into um into a hotel. But I will tell you, before that happened, I feel like I saw every aspect of our broken mental health system through his life. About two or three months after the shower, he disappeared. No one knew where he was for weeks. And uh it was it was a mystery. And again, a couple weeks after he had gone missing, I was walking to lunch one day and he was standing in front of the subway at Hollywood and Vine. He was, he was, his hair was um cut and his face was clean shaven, and he had on clean clothes. And I remember he had a bag, a paper bag that was stapled, and and and he had an envelope and he he recognized me and he said, Carrie, Carrie. And I said, Tori, like where have you been? He goes, I was in the hospital. I said, Oh, wow, he looked like a completely different person. And I said, What do you have in your bag? And I opened it up, and there were two like uh what I would call institutional size um containers of haloperidol and cogentin. So it's it's like the size of when you go to the pharmacy and they pour out and they put 20 in. This was like, I don't know, like a six-month supply. And I I didn't know anything about psycho psychiatric drugs. I didn't know anything about anything. I said, um, I wrote it down what these were so I can go Google it. And I took his envelope and they were discharge papers from a psychiatric hospital in the valley, and it said his name, his birth date, uh diagnosis, acute schizophrenia. Um, and then it had a drop-off point of polywood and vine. They dumped him at home.

SPEAKER_02 11:39

Oh great. That's a paper bag of way too typical. And then give him the meds. Did you see him after that? How long did it take before he didn't look like that anymore?

SPEAKER_00 11:51

Not long at all, not long at all. So he he was he was my portal into so many different um, you know, he ended up in jail, he ended up in an IMD, he ended up under a conservatorship, he ended up in a step-down facility, he ended up in aborted care, and that's where he is now. And I I just I needed to kind of, so he, I guess, would be like my my family member, right? Because if I would go to the Department of Mental Health and say, how is it that a person would be dumped homeless at the corner of Hollywood and Vine? They would say, Oh, that that never happens. Well, I have the discharge papers right here. Here's, you know, here's the evidence. So through other case studies, not just Tory, but there was a group of people that we identified as the so-called Hollywood top 14. And again, this was not just me, but a a little team of social service providers.

SPEAKER_03 12:45

We identified you just in terms of advocacy. So you had been working on downtown development, but then you got involved here. So you how did you get together this team of people? Were they just people you kind of met along the way as you were developing downtown? So it sounds like there were more social workers and things on this new team. You just called people you knew. What did you do?

SPEAKER_00 13:08

Yeah. Well, I I formed a coalition. I'm a I'm a I'm a believer in not carrying the weight on your shoulders. So in in right around that time, 2008, we formed a coalition in Hollywood called Hollywood Forward, which stands for four walls, a roof, and a door. And it was it was a grassroots coalition of faith organizations, business people, activists, service providers, local elected officials, to kind of start to meet regularly to wrap our arms around what was appearing on the streets and what what do we need to do? I mean, the homeless problem in Hollywood in 2008 is a fraction of what it is right now. This is just the beginning. So in the work of that coalition, we were finding different ways to help get people housed, get people get housing into the community. And the way we came up with the Hollywood top 14 is that after doing this work for several years, we said there's this group of people that just never move, like they never leave the alley that they're in, they never leave the bus bench, they they never leave that that corner. Uh, and they are vulnerable, they are really vulnerable. We all had a we we agreed right away um that these were people we wanted to encircle and try to advocate for to get them off the street and figure out what was holding them back.

SPEAKER_02 14:29

So that was that coalition. Did you I you said you rattled off what they were, but were there any people there from the mental health community, you know, providers, staff people, did were they asked and didn't want to, or why weren't they there?

SPEAKER_00 14:44

Uh the Department of Mental Health was a silo in and of themselves. They never came to coalition meetings, they did not participate. If we tried to sit down with people from the Department of Mental Health as we developed this list of the Hollywood top 14, they would say, we can't talk to you about these people, HIPAA, blah, blah, blah. For pity's sakes. Yeah.

SPEAKER_02 15:05

That same old bull.

SPEAKER_00 15:07

Right, right. Um, there were a couple of nonprofits who were under contract to the Department of Mental Health who came along in our team, but they were very reluctant to be fully participating because they were afraid of, you know, the hippoteflon shield was enormous. It has gotten better uh in the last 10 years or so. But I kept saying, like, okay, so if if the guy is sitting right outside the office we're sitting, he's right out there, we can all see him. Are you telling me we can't say his name? His name's Bob. Like, oh no, call him Mr. B or something like that.

SPEAKER_03 15:45

So that's all ridiculous. Yeah, I don't think we can all agree about that. You've got this coalition, you've got a homeless problem, you've got this community, if you will, of people in an alley who they formed their own kind of life. And what happened?

SPEAKER_00 16:04

So we we encircled of that original Hollywood top 14 list in the first couple of years, we were able to help about five or six of them by advocating for conservatorship. There was no other avenue we could think of. Um, so and the way we would do that is we we had some intrepid outreach workers who, if someone was picked up on a 5150, they would follow them to the hospital and camp out even all night if necessary, so that the psych this the doctor or the psychiatrist would not release them.

SPEAKER_02 16:36

And if we're not all from Minnesota or from uh California, why don't you share with the viewers what a 5150 is? I know, but I don't think everybody does.

SPEAKER_00 16:45

Yes, yeah. 5150 uh it would be a a hold uh for danger to sell for others.

SPEAKER_02 16:51

So it's like a 72-hour hold.

SPEAKER_00 16:54

Right, a 72-hour hold. And what we decided to do was to create what we called a dossier on a on a person. And what that would be would be any records that we could possibly get our hands on, including photos, including testimonials from nearby businesses, that we would show to the ER doctor to say, look, this person has a pattern and practice of living on the street for years, and you can't just release them because look, this is this is what they look like, this is where they live, this is them eating out of a trash can, this is what we have found out about them. And so we would kind of like camp alongside this person and then try to get that extended into a 5250 hold, which is the 14 day, and then follow that person into the court to seek a conservatorship.

SPEAKER_01 17:45

You know what it sounds like to me? It sounds like you became the mom for these people because that's what we do, that's what all the moms do, and these are people who didn't have the mom to keep track of everything and and you know, um be their wingman. It's pretty amazing.

SPEAKER_00 18:05

Wow, you we also would try to find the moms, so that was another thing. We inherently we would try to find that person's family. So with Tori, for example, um, and I and this will this will really relate to what I tell you about Italy, because everything we did was just human common sense. Like, let's find the family. Like Tori, where's your mother? Where's your father? And at first, when he was really delusional, he would say, Oh, my whole family was with Jim Jones and Guyana, and they all drank the Kool-Aid. I'm like, okay, well, maybe that happened. I don't know, maybe not. Could be, right? Could be our world. So after a period of of him being back into uh a treatment modality, and and a local nonprofit had put him into a hotel. We he was very lucid. And I remember we took him out for pizza, and he just started spewing names of an aunt in Long Beach and a sister in um Palmdale and a the school he went to. And I'm just I'm just writing notes. I almost feel like a detective. And I go back and I just start googling, right? And I find the aunt in Long Beach. She has a store, and I call her up and I said, Hi, this is you know, Carrie Morrison. Do you know Tori? Blah blah blah. She goes, Oh my gosh, like, where is he? We haven't seen him for years, you know. Yeah, well, he's homeless in Hollywood. And we then met his sister and later met his whole family. So that was our instinct. Find the family, you know. What tell help us connect the dots on the story of how he finally made it to Hollywood Boulevard of all places? And we would do that over and over and over again.

SPEAKER_02 19:48

Which the part the families come and help, or were they just glad to know about him, but they'd written him off, written them off?

SPEAKER_00 19:56

Both, and yeah. I remember calling his sister who lived in Palmdale, and because the aunt gave me the the number, and I said, I said, it's Carrie Morrison to Troy. She goes, I can't take care of him. I said, No, no, no, I'm not I'm not calling you to take care of him. I just want to let you know we found him, he's he's okay. I just could you tell me a little bit? And I said, Is that whole thing about Guyana true? No, because I'm alive, so clearly not, right? Yeah, it's not true. Uh, but in there's another case of a person where the family actually got involved and and this provided money to supplement this person's life in abort and care. I mean, we we've seen both the the families that are just exhausted and just have given up versus those who also will stay involved.

SPEAKER_03 20:47

Wow. Okay, so that, and I imagine there was more than one Tory with all these efforts and and many more Tories waiting to be helped. So tell us about Italy and what happened there. And so obviously, what you guys did was grassroots labor of love, labor of incredible advocacy and effort, and that perhaps let's just say could have, should have been done by the system, but let's leave that for now. And let's talk about a system that you discovered does work. How did you come across that and tell us about it? And you know, by the end of this, uh we'll we're all gonna want to know what we can do to help solve this problem here in this country. And I know you're working on that, having checked out your website. So let's just start first with your with your journey.

SPEAKER_00 21:42

Yeah. So the um fast forward to 2015, and um we've been working this Hollywood top 14 list for several years. We've seen some really interesting system dysfunctions that we're now becoming articulate about, like we can speak about it. Like the problems. And I someone sent me information about a fellowship that they said you should apply for this because this would give you some time and support to do a deeper dive into what you've been learning about the mental health system. And an organization in Los Angeles called the Durfee Foundation, they offer what they call a Stanton Fellowship to people who are, they stay, you stay in your job, nonprofit executives or government people. And they give you $100,000 to work for two years on an inquiry. They say the inquiry that if you could make inroads on this inquiry could improve the quality of life in Los Angeles. So I submitted my inquiry was why is it so hard to help the most seriously mentally ill people move from the streets to a safe place? Like, why? I don't know. I can't figure this out. And then they awarded the fellowship. I was like, oh my gosh, now what do I do? So the way it works is that they want you to spend three months away from your job over a two-year period. So ideally, they want you to go away for a couple weeks at a time. So you you you give your brain a new perspective. Half the money goes back to your organization to reimburse for your salary being gone. And then the rest you can use for travel research, etc. So I did a deep dive the first year. I read everything, I'm sure all the same books you've read, how our American system evolved into this space. I went to a NAMI convention. I went to um I went to Miami Date, I met Judge Leifman, I went to visit Fountainhouse. I did all the typical positive things in in the United States. But I was like, gosh, I don't see anything here that seems revolutionary. I was feeling a bit discouraged. So in 2017, second year of my fellowship, someone said, they said, you should go see Gill, Belgium, and you should see Trieste, Italy. I said, okay, I've got this money, I'll go to Europe. I thought Gill was going to be the gold standard because they have a foster system in Giel, which uh there's been some interesting documentaries about. But I went to Trieste first and had read about it on my way there. And Trieste, like nobody knows where Trieste is. It's 15 miles south of the Slovenian border. You know, you have to get into uh um Venice and then take a two-hour train trip up the coast. It's a city that doesn't even look Italian, it was part of the Austro-Hungarian Empire, it has been under different occupations, it's a beautiful city, but because it's off the beaten track, it kind of is like a preserved bubble in a way. And um I I spent one full day uh with a young psychiatrist on the day that I had there before I had to fly to go visit Giel. And I I followed him around, we went everywhere. So just to kind of the thing that blew me away in a city of 230,000 people, which is like the size, it's a good sized city like Merced or Modesto in California. They have a central hospital with six psych beds for the whole city in an unlocked ward, and they do not use restraints. So you just start with that. And the day I visited, it was not full. Six. That says it all. You just start with that, and we're done.

SPEAKER_03 25:33

Thank you. It was really great talking with you. In other words, they they weren't underbedded, they just didn't need that many beds because they had they had the system working the way it should work if we don't have hospital beds. Okay.

SPEAKER_01 25:45

But tell us about the system.

SPEAKER_00 25:47

Right. So they they divide the city into four quadrants, and each quadrant has what they call a community mental health center. They don't call it a clinic because they do not subscribe to a medical model. It's a more of a psychosocial human model. And in each of those four quadrants, uh, that community mental health center is open 24-7. And each of those centers have six more beds. So it is considered a failure of the system if you have to go to the central hospital. There's all sorts of intercept points to keep that from happening.

SPEAKER_02 26:19

It should be a be considered a failure of the system everywhere. Everywhere. People have to go to the hospital.

SPEAKER_00 26:27

Exactly. When you go into the community mental health center, which is where I spent a couple hours with Tommaso that day, first of all, it does not look clinical. Uh, there's uh three of them are located in these big, beautiful mansions. And then this other one was in more like a storefront location. Uh, you walk in and you don't know who are the workers and who are what they call the users, specifically users of the system. There is like a blending of there's no um demilitarized zone. Like you walk into the you walk into the Hollywood mental health clinic on Vine Street, and Nimi, I don't know if you were ever there, right next to Office Depot. First of all, it looks like a bunker. There's all there's no windows. Uh, you walk in the the door and there's two armed guards that will greet you and they will then check your briefcase or your purse, and then you walk up to bulletproof glass for your appointment. So even if you're just there to meet somebody, you're already feeling on edge, and you're not a patient. Whereas in Trieste, you're freely walking through their center. You can smell coffee, there's food, there's a lot of just joy. There's joy everywhere you look. People know each other, they can just show up to hang out. The psychiatrists don't even have offices. Their job is to be roving throughout the building and greeting people. So um in Trieste, the the the the um I visited the site of the original asylum, San Giovanni. Uh, it's up on a beautiful hill and housed, I don't know, 1500 people before it was closed down finally in 1968. And they have transformed all those grounds into repurposed them into their mental health kind of campus for social cooperatives, which are a really big feature of the Italian system. They believe that people, if they are going to be integrated into the community, have a human right to a sense of purpose. They they really focus on the United Nations Declarations of Human Rights, especially the rights of the covenant for people with disabilities, which says that you have a human right to a sense of purpose.

SPEAKER_03 28:41

Imagine that. Imagine that, like wow, oh my God. And it's so true. It's so true.

SPEAKER_00 28:49

So they have what they call social cooperatives baked into the landscape of the whole city where if you have a serious mental illness, you might just um show up and help, might help with gardening, or you might help with um, you know, some cooking or whatever. But it but if you if you're able, they will help you get an actual job. And so there's a combination of these social cooperatives that are all throughout the community, and then clubs and associations that people are, you know, it could be a taekwondo, it could be bonsai, it could be a woman's um collective. There's places for people to go in the community so that they are able to move freely throughout the community.

SPEAKER_02 29:29

What else? Who's running all these things? Are they mental health people? Are they medical people? Are they people with mental illnesses? Who is doing the organizing?

SPEAKER_00 29:39

All of the above. A lot of emphasis on peer uh involvement, people with lived experience. Uh uh now, these things are are one of the big differences between the American system and the the Italian system, the Italian mental health department in Trieste gets a budget to run it.

SPEAKER_03 29:58

So ask who pays for all this.

SPEAKER_00 30:02

So if you if you have a budget and you have X number of people that you're serving, the thing you want to do is make sure you're not paying for hospital beds because you probably could hire like six vans to take people to their social cooperative to have a purposeful day and not spend it on one person in a hospital bed.

SPEAKER_02 30:22

So, you know, I often think if we had block grants for the mental health system, it would be that would immediately make a difference, like you said. But no, we fund, you know, the hospitals, we fund the lawyers that do the civil commitment, and we fund the jails and we fund the prisons, um, but we don't fund very well the, like you said, the upstream.

SPEAKER_01 30:46

Well, there's no incentive for success. Exactly. The way our system is built, the only incentive is for subduing the problem, keeping it quiet, just getting it out of the way. And I think if money was distributed with an incentive for success of the patients, boy, it would be a different system.

SPEAKER_03 31:10

Absolutely. And, you know, FYI, we're half an hour into the podcast. And so I want to make sure that we get to, I know you have so much to say, and I wish we could talk for three hours. I want to get to your efforts to take these wonderful ideas and bring them to America. And have you had any success with that? You know, how does that translate to our, as we've agreed on many past episodes, very flawed system? Um, I have just written down on my notes a human right to a sense of purpose because that is, you know, my son is after a period of relative success where he got off social security and then COVID came and everything crashed and the whole walls came tumbling down, and he's kind of starting all over again. He's now terrified to work because we worked so hard to get his social security disability back. And now he's terrified to work, and he probably can work. He's on the same medication that um Tori was on right now, which is which is a little scary to me, but so far so good. But um you know, it it feels like it's denying him a sense of purpose to be afraid to get part-time work. So yeah, so I'm a little passionate about that. So, what happened after you went to Trieste? And did you ever go to the other place in Belgium or no?

SPEAKER_00 32:36

I did, but I felt like okay, I've I'm gonna give them the quick tour here. I think I've seen the promised land in its Trieste. Okay.

SPEAKER_03 32:42

So then how is that how is that working as you try to work to, you know, what are you doing? Tell us about your website, tell us about your work to try to translate this to our world.

SPEAKER_00 32:53

Yeah, so I I I came home from Trieste. I actually was a little bit kind of depressed because I thought, wow, I have seen the promised land, but no one's gonna listen to me. I I run a business improvement district, like no one, no one's gonna talk to me about that. So, what happened is a few months later, as my fellowship was coming to an end, they announced an international conference in Trieste in November 2017. And so I had money left in my budget, and I thought, well, I should take some people back who they will you they will listen to them, not me. And I managed to corral our new head of the department of mental health, Dr. Sharon at that time, the head of our mental health court, Judge Bianco. We we brought someone representing the LA County Jail, the mental evaluation unit for LAPD, LA Sheriff's Department, the DA Center Mental Health Deputy. We had someone from our NAMI chapter. I brought 12 people back with me to Trieste and said, Look, what do you think? And they're like, wow, yes, you're right. This is amazing. So we came back from that trip super energized, and Dr. Sharon, our DMH director, asked us to spend, you know, a good part of the early part of 2018 imagining how do you take these guiding principles that we saw operating in Trieste? How do we apply that to an American context? And we would do like whiteboard sessions, like, okay, just using you walk into the Hollywood mental health clinic, there's a guy with a gun, you know, okay, over here, there's coffee. We we were comparing the differences and we realized that one of the underpinnings was what we would call radical hospitality, which just underpinned everything about their system. Everywhere you go, you feel that sense of hospitality and welcomeness. So, fast forward, this story could go on for days, but um, LA County entered into a partnership with Trieste. We brought some of their people out to tour our systems in 2018, which was horrifically a shameful experience to take them to LA County jail to see people chained to furniture, you know, and having their eyes just their eyes just they it was I'm speechless, they were speechless. We took them to uh LA County hospital where you have restraints and you know locked rooms. We took them to see an IMD, we took them to Skid Row, we we we showed them all of these things that do not exist there. In 2019, um, LA County Department of Mental Health applied for a grant from the State Department, I mean the Mental Health Services Act, which has an innovations bucket, uh, and applied for a five-year pilot grant for $116 million to test some of these guiding principles in a pilot project in Hollywood. The state approved the grant. That was in uh May of 2019. What happened next was that LA County was um had to prepare to kind of accept that money and put a framework in place to actually create a pretty massive pilot coupled with academic partners, et cetera. And as we rounded the corner into 2020, you know, you know what happened. So yeah, so what I'm doing, I thought, okay, Carrie, you still have seen the promised land. Oh, by the way, I took another 39 people back with me in September 2019 to that same conference to just decide. That's very amazing. I hope you know that. Well, it's just like the more people who can see it viscerally and understand that this is real, we we need those voices because the most infuriating thing when people say to me, Well, why are you looking at something in Italy? You know, Italy is so different. It's like, no, the human beings are the same everywhere. If you can see what they do in Italy and you can see how remarkable it is and how kind it is, we can do that too. We just have so many structures and systems and rules and risk management that prevent us from actually being kind to people. Do they even have a HIPAA in Italy? Not the way we do. They and they involve families, uh, and they include families. So when they when they we had when our friends from Trieste came to visit us in uh 2018, um, one of our um committee members organized a brunch with a bunch of NAMI family members. And our guests from Trieste were shocked that the family members did not know where their loved ones were, and that there wouldn't be this why? Because of privacy, because of HIPAA. It they couldn't put into words, and and then you go like, yeah, I know it doesn't make sense. It doesn't make sense.

SPEAKER_03 37:50

No, it doesn't, it doesn't make sense, and there's a lot, a lot of reasons for it, but you are working so hard to make a difference. So here we are, COVID has kind of put a crimp in your plans. Where are you now? I mean, has there been any progress? Is there any money left in the budget? Uh you know, has there been a change? Tell us and tell us what we can do and how we can find out more.

SPEAKER_00 38:15

So my pandemic pivot in 2020, uh, as I called it, as I was sitting in sitting in my house going, well, gosh, everything seems to have a monkey wrench thrown into it. One, I thought, okay, well, I have seen this remarkable place and I love talking about it. And I love how people absorb the hope that this story tells. So I need to keep telling the story. I'll start a podcast. You know, everyone else got one, so I started a podcast. And the name of that is It's Heart Forward, Conversations from the Heart. And by the way, the heart forward was the hashtag that Dr. Sharon made up when we went the first time because he said in Italy they lead with their heart. They they let people lead with their heart. And the um the horse that is on the um my logo is the symbol of freedom from the asylum in in Italy. So I have a horse. It's I'm not an equestrian nonprofit. It's it's um, but anyway, so I started a podcast and I thought, okay, I am going to, I feel like my key audience is lay people because I'm a lay person in a sense, and there's so much questioning and curiosity about why are these barefoot people walking down the street? You know, what what is going on? So I try in my podcast.

SPEAKER_02 39:33

It's kind of like the emperor has no clothes, you know, it takes a child to point that out, and it takes a layperson. The mental health people seem to think what they're doing makes sense somehow and they justify it and get defensive. And if you ever tried to rip out HIPAA, they would tear out their hearts probably to protect it because they think they're righteous about the system that we have. They might admit we don't have enough of it or something, but I think they're righteous about the system we have.

SPEAKER_00 40:04

And I'm trying to create more voices to help you in what you're doing. Like I'm trying to reach out to lay people who then now have the right questions to ask and realize we could do things better. So the podcast was was a pandemic pivot. Um, I also uh decided to take this notion of radical hospitality and start to model it in a very small way. So um I did get a grant to go into permanent supportive housing communities where people who are formally homeless with mental illness are living and to begin to build a social structure, uh community engagement that's not like typical volunteers coming in. If people volunteer with me, I need them to give at least a year commitment because we want to be about building relationship and building trust. So we built a community garden at uh one of the communities in Hollywood. We started a cooking class at another one. I was just over at Path Metrovillas today. We started a writing class. And this is just um, it's more about the socialization and less about are you going to know how to make write a poem? Um, the other thing that I'm really passionate about is bringing a clubhouse to Hollywood. We have no clubhouses in Southern California, which is kind of confounding. And uh an interesting story about the clubhouse model. The folks at Fountainhouse told me, and I'm sure your listeners know what Fountainhouse is.

SPEAKER_03 41:35

We did a whole episode on it. We spoke to uh Joel Corcoran, is that his name? Uh so we spoke with him. So if you don't know what a clubhouse is, check out that episode episode, just search clubhouse on our episodes and you'll find it. So you don't have one in Southern California.

SPEAKER_00 41:50

No, and what we heard from the Fountainhouse people is that in the 70s, as the people in Trieste were building out what their city was going to do with respect to providing community care, they came to Fountainhouse to see to learn about the ethos of Fountain House and decided to take what they do at Fountainhouse and almost like it's a it's bring it back to Trieste as a clubhouse without walls.

SPEAKER_03 42:18

Wow. And I'll cool.

SPEAKER_00 42:21

I love that. And so we, I mean, you know, wouldn't Nick have loved going to a clubhouse, Nene, if we had one here.

SPEAKER_01 42:30

You know, this was the whole thing. And then when I met uh the person, like I said, that uh reintroduced us was David Israelian. And I didn't even know about painted brain. I mean, Nick could have gotten on the bus and gone there every day. There was simply no, there's nowhere in LA for people to go.

SPEAKER_03 42:48

There's this whole drop-off mentality, you know. I will say my my son is in a different group home than the one he was in when he was in his 20s. And granted, he's in his late 30s for another six weeks or so, and um before he hits 40, he's in he's accepting it more. And part of it is this sense of purpose and this radical hospitality because the person who runs his group home sometimes, like you know, for group today, let's just play taboo. And she brings out a board game and they play a board game. He's taking an art class, he is going to a recovery group, and they arrange an Uber for them to go there. And there's their social things to do, and they're going to help him get a job, and they're going to work with him on that. But they have fun sometimes. And his group home kind of sounds like a clubhouse. It sounds like the the one who runs it is doing her best to she bought them all Christmas presents. I mean, it's out of her pocket because that's not in the budget. She just happens to be this amazing person who wants to make this a home for them. And that has made all the difference. My son feels like he's in a community. Yes, he thinks he wants his own apartment. But this this concept, it's easier for me to say it's your life. Talk to your team. I'll see you on Sunday on Family Day. And of course we check in. But the he has a semblance of a life because he has people to do things with and a sense of purpose. And when my book first came out 10 years ago, I was invited to London to participate in a brainstorming about these types of it sounds like what they have in Trieste. And uh I there were people from all over Europe there, and we were just chatting about our ideal community center for people with mental health. And it sounds very much like what they have. So I'm I'm sure that came before this, but I remember the psychiatrist going, We get no respect. It's like the worst profession to go into. And I would imagine it's different where you're a psychiatrist that's part of the community and you can say hello, and you're not sitting in your office waiting for your next 15-minute appointment. It just sounds so wonderful. So, in the interest of time, because I know Mindy has to go in about five minutes. So you are trying to bring the clubhouse to Southern California, you have this podcast. Is Hollywood and Vine a little bit better at this point?

SPEAKER_02 45:25

And be and while you are answering your closing type questions, could you add in there? Have I read correctly that Trieste is actually in trouble too?

SPEAKER_00 45:34

Yeah, so uh I would say the situation in Los Angeles has not improved much. I would say the positive thing that is happening is our our candidates for mayor and for city council and county supervisor are now beginning to talk about the fact that they recognize mental health system problems are contributing to our homeless situation. There is a this kind of awareness is growing. Late to the party, but we'll take it. Late to the party. Yeah, yeah, not it's not just a housing solution. There's something else going on here. Okay, great. Um, and then yes, in Trieste, I I um have been following their events. They've had a uh a conservative government take over in that region, um, who uh was starting to threaten the 24-hour access to their clinics and um brought in somebody who had not been trained in kind of what they would call the Basalyan theory. Uh, there was like a global outcry against that. I've got some of that information on my website. And I did a podcast with Dr. Mazzina, who had recently retired as the head of that department. Um, I hear it's got improved a little bit, but it's really important that the world stay united, that this place is like a protected, it needs to be a protected bubble. Uh, it's like an ecosystem that inspires the world. So please don't mess with it.

SPEAKER_03 46:58

So, what can people do? What what you know, first of all, how can they learn more about what you're doing, your podcast, your website, and do you have a few tips for what someone could do in their own community to start a movement like this? It's a toll order, but increase awareness. What would what are you telling people that come to you and go, what can I do in Ohio?

SPEAKER_00 47:22

Yeah. So thank you. I I know you'll link to some of my resources in your episode notes. I appreciate that. I often say to people, like, especially if they're not a family member, um, go find that guy on the bus bench and go talk to him. Um, you know, uh use that experience that I had with Tori to start to inform your voice. So that if you start to hear from your local elected officials or your mental health department that everything's hunky dory, you say, like, no, um, this was my experience with uh Betty, uh, who was still out there on the street, or she was taken to the hospital and I saw her back out on the street, you know, two hours later and she still had her hospital bracelet on. The way you become an advocate is by actually um assimilating the voice of the voiceless. And for those who actually have a desire to do that and could overcome their fear and trepidation, which I highly encourage, it could be a really rewarding way to do advocacy.

SPEAKER_01 48:18

And you know, also on a very small level, uh I always tell people the same thing, and mine is about you know, nobody looks at these people, they're never acknowledged, they're never, and that's one thing since Nick got sick, and I was one of those people. Since Nick got sick, every time I see somebody on the street, I will say hello, I will catch their eye, I you know, because they're living in an invisible world, and it it it it aside from educating yourself, it also reconnects them. We see them. I want them to know that.

SPEAKER_00 48:55

Yeah, my mantra for radical hospitality is is this we see you, we hear you, you are safe here, and your voice matters. And if you can check those four boxes, that is Italian radical hospitality, and it starts to build a sense of agency and trust and um inclusion.

SPEAKER_03 49:22

That is a beautiful ending, isn't it? It's beautiful. Just just give us your again, your website, your podcast, and um and we'll close. I'm just writing down we see you, we hear you, you are safe here and your voice matters. And I'm thinking my four-year-old grandchild needs to hear.

SPEAKER_00 49:43

Yeah. Um, my website is heartforwardla.org. And I have a a blog I I write. It's called accoenza.us. That's the Italian word for hospitality. I did live there for a month and I started that blog when I was living there. There's a lot of interesting stories about what it's like to be embedded in their mental health system. So accoyenza.us, you can find you can find you can attach to it on heartforward.org as well. And then my podcast, Heartforward Conversations from the Heart, available everywhere except I took it off Spotify because Joni Mitchell left Spotify and I I stand with Joni and Neil Young.

SPEAKER_03 50:26

And Brene Brown, I believe. And Brene Brown. So well, your work is so so important, and it seems overwhelming to even begin, but we can like I know when my son was first hospitalized and he was in that room. I looked in there and I went, it's a crazy, oh, it's not a crazy, it's my son. And I thought everybody that I've seen homeless on the street is someone's son or daughter or sister or brother or husband or wife or mother or father, somebody that loves them. And so a human has a right to a sense of purpose and has a right to be loved. And that illness can cover that up. And so there's a lot of work to be done, but what you're doing is tremendously important, and it's great to start with a vision. And thank you for sharing it with us today.

SPEAKER_00 51:20

Thank you for having me, and thank you for the work you are all doing to uh educate people as well. I think we are, I think we're making a difference. I think we all are.

SPEAKER_03 51:29

Hey, thanks for joining us for this episode of Schizophrenia Three Moms in the Trenches with Randy Kay, Mindy Gryling, and Miriam Feldman. To get in touch with us or to learn more about our books, please visit our websites at MiriamHyphenfeldman.com, mindygryling.com, or randyk.com.