Mental Health Case Management and Care: Helping Those in Crisis (ep. 65) -guest, Kat Thompson

Social worker by heart, therapist by trade, Kat Thompson earned her MSW in 2022. She’s a mental health professional specializing in helping those in crisis. She also is a founder of Cascadia Cares ,”:building a world where it’s normal to help others.” 

1. Tell us what a case manager's scope of work and responsibilities are.

2. What made you want to pursue this line of work?

3. What do you believe are the most challenging aspects of dealing with people who have SMI?

4. What changes would you most like to see in the system?

5. What is the hardest thing about your work?

6. How do you find the job as crisis line counselor as compared to case manager?

7. Tell us what else you are doing (ie. your non-profit and political work) and how it fits in to the big  picture.

8. If there was one message you'd like to get across about mental health/illness and the system, what would it be?

9. what kind of training you received before each of your positions?

Links:

https://cascadiacares.org/

Hope for Troubled Minds: https://delightindisorder.org/hftm-call-for-submissions/

Mindy and her book: https://mindygreiling.com/

Randye and her book: https://benbehindhisvoices.com/

Miriam and her book: https://www.miriam-feldman.com/

Hosts:

 Randye Kaye - was a morning Radio Personality bringing humor to CT families when her own son was diagnosed with schizophrenia. Now she is still a Broadcaster, Actress, Voice Talent, Speaker, and Author (Ben Behind his Voices, Happier Made Simple)

Miriam Feldman -  is an artist, writer, and the mother of an adult son with schizophrenia. Her book, He Came in With It chronicles her family's story and was released to rave reviews on July 21st, 2020.

Mindy Greiling - Mindy Greiling was a member of the Minnesota House of Representatives for twenty years. She helped found the nation's first state mental health caucus, which successfully lobbied for a significant increase in Minnesota's mental health funding Her acclaimed memoir is Fix What You Can.

Transcript

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SPEAKER_00 0:00

I am a big fan of offering to call when I'm with the client. Hey, you know, bud, your mom called. She's really worried about you. Can we call your mom? And you know what? I've never had someone say, No, I don't want to call. Yeah, they want to call their mom. They're just mentally disorganized. They're dealing with other stuff. They have the negative symptoms of abolition, not wanting to do anything. And so sometimes it just doesn't occur to them, hey, we should call your mom and check in. You want to call your mom? Okay. And so I'll just partner with them and include the parents.

SPEAKER_04 0:28

Our guest today describes herself as a social worker by heart, therapist by trade. She's a mental health professional specializing in helping those in crisis, and the founder of a nonprofit whose mission is to build a world where it's normal to help others. 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 Feltman, Mindy Gryling, and Randy Kaye. Case managers in mental health. How do they do what they do? Why do they do what they do? We are so excited because tonight we're going to interview a wonderful case manager who's going to tell us everything. So in a moment, we will get to Kat Thompson, who's going to tell us all about her work, all about her background, and also about her wonderful website, Cascadia Cares. But before we get into that, hi Mimi. Hi, Mindy. It is mental health awareness month. And I believe there's also a mental illness awareness week later in the year. But this is mental health awareness month. And I wanted to just share two things with you and with our listeners. And more and more I'm hearing from people who have just discovered us. And oh, I'm listening to all your podcasts from the beginning. So this is episode 65. And we're just, if you've just discovered us, we are so delighted. We're three moms with three sons. Each of our sons has schizophrenia. We've each written a book about it. And we're here to do this podcast to continue the work. So I wanted to follow up on something I mentioned last week. We had a wonderful guest with a workbook for teens who are uh dealing with psychosis. And so you can check out episode 64. But I did mention that I had read this book, Tell Me I'm Here, by Ann Devison, one of the earliest memoirs, which was turned into a very uh affecting play that was produced in Australia. And they used our podcast as their research, and you can check out an episode on that. But I mentioned that she had what I thought was a really good description of schizophrenia for people who don't know what it is. So I found it. I just want to read it very quickly in case you're new to what schizophrenia is. Anne Devison, by the way, is an Australian documentary filmmaker, very famous. And so her book got a lot of traction, it was beautifully written. So she just puts it this way: with schizophrenia, fundamental processes in the brain are disturbed, distorting the way a person thinks and experiences the world. Messages are channeled to the wrong responses, like an old-fashioned telephone switchboard making faulty connections. Information floods in and overwhelms the brain. And I just thought that was a simple but effective way to put it. When each of our sons are symptomatic, it's hard to reach them. And I think that's the reason. I also wanted to share a quick story, if it's okay, because it is Mental Health Awareness Month. So there is a project called Hope for Troubled Minds. And it is a collection of letters that people write to loved ones who have mental health issues. And it's going to be published like in November. I'm going to look it up here. Um, Tony Roberts is the man that is creating it. And the book is going to be, and if you're watching on YouTube, I'll post a picture of the cover, Tony Roberts and contributors. It's tributes to those with brain illnesses and their loved ones. So a while ago, I submitted a letter to my son, who I call Ben, for public purposes, and it was accepted. And then locally, some playwrights wanted to do a Mental Health Awareness Month play reading with some short plays, and they accepted my letter, which I turned into a monologue. And uh I went to it on Saturday, and another actor performed it. And there was this a series of beautiful one-act scenes dealing with postpartum depression and uh SIDS. And uh there was one with a case manager. Hmm, hello, Kat. You're coming in in a second. There once gid about a case manager who had a client with schizophrenia who was homeless, and she'd gotten her finally housing after a long, long wait. And the client turned down the housing because she preferred, I'm giving it away, but I don't know when you'll ever see the play. So it's okay. She preferred to um spend her money to buy her son a violin. She was at a point in her life where she was only allowed to see her son once a month because of her illness and her homelessness. And he was accepted to a music program and he needed a violin. And she decided to spend her housing money to do that. And the closing line just blew me away. She said, actually, the caseworker had just gotten through a miscarriage. So she was really thinking about motherhood. And I said, and the caseworker said, I guess she wanted her one chance to be a mother more than she wanted housing. And it was just like, oh my God, break my heart. So after this series of plays, one of the actors, actresses who did um a different skit that involved her eating lunch on a park bench, she wrote us all a letter. And she said that she went outside of the library, which is where this took place, and outside of a library, and you know, libraries are often havens for homeless to come and get some shelter, get some, get out of the cold. And there was a man who was the way she described it, like screaming at garbage bags, like just trying to get the garbage, and everybody would have avoided him, but you know, she turned to her fiancé and and said, Maybe he's hungry. And the guy had like walked away by that point. And because she had done this scene where she was on a park bench with a lunch, she happened to have a lunch with her. Like it was a half a tuna sandwich and two bags of chips. And her fiance actually followed this man who was uh talking to himself and deep in his psychosis to offer him the sandwich. And suddenly this man just brightened up and just said, Thank you for noticing me. Thank you for the food. I appreciate it so much. This person who five minutes before had been looking frightening. And she said, Not only doing these plays, but I learned a lesson about stigma about seeing the person underneath the symptoms. And that so I told her I might share the story on the podcast. And it's just a moment to see I used to see homeless people on the streets and go, oh well, you know, they just need to get a job. Like I didn't know until any of us have relatives with schizophrenia. We don't know. And in this mental health awareness month, if any of us can see the humanity, see the person underneath and understand that it's not their fault, they didn't do anything wrong, and just see the human being, and that's my story.

SPEAKER_03 7:58

Sounds good.

SPEAKER_04 8:00

So thank you. Nice you guys, you guys are okay. Should we bring on our guest? Sure. Anything to report? Everything okay?

SPEAKER_03 8:08

Well, I'm doing one interesting thing. I'm going to DC on the 23rd to lobby with Rachel and Angela and all the other angry moms.

SPEAKER_02 8:19

It's the 2024th, though.

SPEAKER_03 8:22

I'm going on the 23rd. Oh, I see. Okay. That's very exciting for me, Ms.

SPEAKER_04 8:27

Tell us about that. Tell what are you lobbying for? Very specific.

SPEAKER_03 8:31

We're lobbying around the REMS requirement for clozapine. So it's a specific issue. Those are all the blood tests that you have to have in order to get the clozapine, and it's really making it unnecessarily difficult, if not impossible, for people to be on clazepine. So we're that's a very specific thing that for some reason has gotten a lot of traction recently. And so we're going to go there and yell about it. So I will post, keep keep everyone posted as we go.

SPEAKER_04 9:00

Please do, and we can uh we definitely do an update on that. On how to do that.

SPEAKER_03 9:05

Well, I have an introduction to Kat, so I'll read you guys that and then we'll get talking with her. Um, Kat Thompson completed her undergraduate degree at the Evergreen State College in 2017 before continuing on to earn a Master of Social Work degree in 2022. Kat has a passion for social justice and helping others. Currently, she's employed as a mental health professional and works assisting individuals who are experiencing crisis. She formed a nonprofit in 2015 as part of her undergraduate program. The nonprofit Cascadia Cares sponsors two barrier-free food pantries and three barrier-free hot meals a week. Kat can be found on Saturday mornings baking pizza for the free hot pizza project that serves unsheltered individuals in downtown Centralia. She loves animals, nature, music, and spending time with her family and best friend, a 65-pound flat coat retriever. So welcome, Kat. Welcome. We are really um you know, the first thing I'd like to ask, and I'm sure that our um listeners would be interested in, is can you tell us what a case manager's scope of work and responsibilities are, especially in relation to a social worker? Because we're all kind of confused about that distinction.

SPEAKER_00 10:35

So a lot of times people confuse case managers with counselors, and quite frequently, if you show up to a mental health organization and request counseling, you'll actually end up receiving a case manager. And uh for the benefit of the audience, I'll explain Maslow's hierarchy. I'm sure that the three of you understand Maslow's hierarchy, but Maslow hypothesized that people are not able to reach their full potential when they're hungry, when they're tired, when they're feeling ill, when their physical needs, needs are not met. And so a case manager kind of comes in and they do offer some counseling in the form of maybe empathetic listening and reflection. But a lot of what a case manager does is start to get those things on board that maybe have slipped through the cracks when somebody's uh experiencing the symptoms of mental illness. And so a case manager can help somebody figure out how to use public transportation, they could help somebody make a doctor's appointment, they could help somebody to uh make sure that they're in housing or to apply for housing or to navigate the systems of Social Security or DSHS. Uh, those systems are hard for me, and I have a master's degree. So imagine hearing voices in your head and being very mentally disorganized and trying to navigate those systems. And one thing that we found is that once people start to have the stability in their pyramid, that it's easier for them to obtain uh the satisfaction of achieving like the mental parts of the therapy. And so we do offer where I work, we offer therapists, but generally a person will see a case manager first to be able to get stabilized, to get ready to uh approach that self-actualization stage.

SPEAKER_03 12:11

Interesting. Well, I had never heard of Maslow's hierarchy, so I'll be the first to admit it, but I'll be looking it up after the show. But that's that's interesting. So then, and then so how does that contrast with a social worker? Social worker is more therapy.

SPEAKER_00 12:27

So a social worker does do therapy, they also do case management. I would think where a social worker differs from case management or mental health therapist, is that part of our code of ethics is that we are also advocating for marginalized classes. We're advocating for social justice and we're doing that macro work out in the community. So, in addition to meeting with clients, I also do things in the community to help further uh society and social justice. And um, that's kind of the difference in a social worker. We want to see the best in society because that will benefit our clients. So we are helping our clients by helping society.

SPEAKER_03 13:04

I see.

SPEAKER_04 13:05

Is there a difference in the in the training and in the pay scale?

SPEAKER_00 13:10

And I think the pay scale is probably a little bit lower for social workers because many of us uh are happy to work for nonprofits where we can serve Medicaid funded clients. And so that always comes with a bit of a pay cut. Uh as far as training, it's actually longer. I could have gotten a master's in counseling in just two years, but a social work degree actually requires three years. And so there is three full year or two full years plus a year's worth of internship internships mixed in there. So it's a little bit more, and the difference and the reason why I pursued a social work degree is that there are some things such as like Medicare or the VA that you need to actually have that social work degree in order to build.

SPEAKER_02 13:51

So I I you know must be quite different in Washington because here in Minnesota, social workers are paid, they're trained, a lot more trained than case managers. They often work for counties, so they get the government benefits, the government contracts, and and um, you know, all of that pensions, whereas case managers are kind of you know working for the nonprofits, and they don't often don't get very much training at all. They have in-service, they have people above them that they can ask about, but um, but they don't get paid anywhere near what social workers do. So that's um it's unusual, I guess, with uh in your situation. What I'm interested in is um because all of us being the mothers that we are and the ages we are, we have worked with a lot of case managers and social workers so forth. And sometimes I have to say I have not always been um the probably the one that they want to see coming in the door or calling all the time, because I just have such high expectations for the mental health system and for my the services my son gets and how I think he can do, because he can do really well or not really well, and some of it you know depends upon the help he's getting because he needs help. He has schizophrenia. So, um, what are the most challenging parts of the job for you? And do you have any tips for how family members can better work with people like you so everything is productive and not uh combative?

SPEAKER_00 15:33

Uh to touch a little bit on the first part of what you said about the pay scale for social workers and counselors, a social worker can go be a therapist at any organization. We're fully trained and qualified to be a therapist. It's just many of us choose to work for those lower paying organizations because our heart is in service. And um, I've never had a parent that I haven't been excited about.

SPEAKER_02 15:54

Before you go on, I should say I wasn't talking about counselors, I was talking about case managers versus social workers. So I have no idea where counselors fit in there, except I think they're above the other two, at least with the training and you know, sitting in their offices and counseling.

SPEAKER_00 16:10

But anyway, counseling's kind of an interesting term because you can be a counselor and a case manager, and you can also be a case manager and a social worker. And so for quite a while, I was my position was a case manager on an assertive community team for adults who experience severe and persistent mental illness, such as schizophrenia or bipolar with psychotic features. Uh, but I was still a social worker. So a social worker is an identity, it's it's who I am at my heart. And so there's, I could be a social worker and be a janitor, but I'd still be a social worker. And so, and you had asked a question about uh relating with the case managers. And I think one thing to realize when you are working with case managers or social workers or uh counselors is that the pay scale is so completely different, and uh the people's motivations for being there are equally different. And so some people will accept the jobs at the nonprofit organizations because it is the first job they've had, they don't have many other opportunities. Um, some people take the job just because they could get the job and it seems easy. And then there's some people whose hearts are really in it, and I think that's really the difference. So I never applied to work at the agency where I'm currently employed, but I was doing social work. I wasn't a social worker, I didn't have a degree, but I was working within society. I was already out in the community on the weekends, delivering hot coffee and donuts and just companionship to people who were on the streets and didn't have anybody else. And one of the managers of my current agency saw me out there and saw me um posting on Facebook, and people were talking about people who were receiving services and um really making derogatory comments. And I was on there saying, hey, you know, I'm out there every week and I know these people. You know, this one guy was a teacher, he had a bachelor's degree and he was a teacher for years. He had an apartment, his landlord uh decided to sell the apartment and he lost his apartment and now he's homeless. And so I was out there advocating for people in different uh marginalized communities, and I was actually recruited. And I think that's a big difference, is there is such a huge spectrum of people who are in love with this, whose uh heart is in this and their soul is in this. And then there's people that show up for their job and their paycheck, and it's really, I don't think that whatever their education or their job title, like it can go either way for all of those. I think it just really depends on that purpose person and finding the person who's really just passionate about helping. And I think I love that statement.

SPEAKER_03 18:42

That's really wise. Yes, and I think I can say for all of us as mothers, you know, we light up when we find that person whose heart and soul is in the work because it's evident and it makes a huge difference right away. What made you decide to go into this kind of work?

SPEAKER_00 19:01

Um, I touched on it a little bit before. Uh, so I've never been able to just look at people in pain and think, oh, that's them. And maybe it's because I was bullied so terribly as a kid. I didn't gender conform, I looked very much like a little fat, freckled-faced boy. And so I really knew what it was like to be mistreated, to be on the outside, to be marginalized. And um, one of my first memories was going on a train with my family and seeing homeless people underneath, I must have been about seven, underneath a bridge in Portland. And we had come from Pocatello, Idaho. So I didn't really have any experience seeking seeing people with homelessness. Uh, when we got off the train, we stopped at a grocery store and some woman was outside and she was holding, I don't know, it could have been a baby, it could have been a doll. I to me, as a little kid, it was a real baby, and a sign that said, hungry need food. And I was old enough to read, and I read that sign, and my mom didn't want to give her food. She's like, No, honey, she's homeless. You just do that. And I cried until my mom went back and gave her some food. And so I think as a child, being bullied so terribly, I had such a feeling of powerlessness and such a feeling of being set aside and unheard, and I couldn't do anything about it. But now as an adult, I can't fix everything, but I can stand up and I can make my voice heard, and I can make people important who are normally shoved to the sides of society.

SPEAKER_04 20:22

Well, can I can we clone you and bring a few of you into every state and that would be so amazing. I just wanted to circle back to something Mindy asked you before because you started to answer it, and then we we went in another direction. You started to say something like, I can't remember when I wasn't excited to meet a family member or something like that. Was that about to we were asking about how you feel about meeting family members?

SPEAKER_00 20:49

And interesting. Yeah. The reason why I said that there's never been a time that I haven't been completely delighted, even a cranky family member that's mad at the agency, I would still rather meet because you three are angels in my eyes. So many people, their moms, their best friends, their fiancés, their sisters, everyone in their life abandons them when these symptoms of mental illness come out. Now, if they had cancer, if they had kidney disease, if they had Parkinson's, their families would rally around them, but people abandon people who are experiencing the symptoms of mental illness. So I've never not been just delighted to work with a parent in whatever capacity is helpful for them and their child or their offspring.

SPEAKER_02 21:35

Boy, I wish everyone had that attitude. But I sound wonderful.

SPEAKER_03 21:42

Well, let me ask you something. So I think we can see very clearly your altruistic and compassionate drive to improve the world. At the same time, you're doing it dealing with people with serious mental illness. Illness. That is a very challenging area of the marginalized people. What do you find most challenging about that? And, you know, how did you end up doing that as opposed to just having a soup kitchen or doing the other things you're doing anyway? What pulled you towards mental illness?

SPEAKER_00 22:20

Well, one of the things that's challenging about working with people with mental illness, it would be surprising. It's a stigma against me, is I have so many people. I don't know how you could do that. I would never do that. Are you safe? Uh, people really believe that if somebody's experiencing psychosis, that they're automatically dangerous. And I have worked for I've worked seven years in this field, six and a half full-time. I have knocked on wood, never been assaulted. And I have been with individuals who were in the worst psychosis that you can imagine. And so I think that that's one of the worst parts is kind of alleving the fears of like my parents and my close friends that just because I'm meeting with somebody and we meet one-on-one, I'll take people. If you know, if they're stable and I feel safe, I'll take them in my car and we'll drive and we'll go out for coffee or we'll go to a park, we'll go hiking, and I'm alone with them. And yeah, it is a vulnerable position. But if you know your clients and you have that good rapport and you are doing the case management to make sure that they're, you know, up to date on their meds and that they are doing the things that they need to do to stay stable, it is safe. And so that's probably one of the biggest challenges is actually managing the stigma from other people around the job.

unknown 23:32

Interesting.

SPEAKER_02 23:32

How do you handle to get back, circle back one more time to the parent um provider uh dynamic? How do you handle HIPAA? You know, so many of us have been told we can't talk to you, your family member didn't sign a release of information. And we have, you know, been around long enough to know that the HIPAA law doesn't require that strict of a divide and you can't communicate at all. But since you're obviously wonderful, how do you handle it? The client hasn't signed a release and the family member is desperate to communicate.

SPEAKER_00 24:14

I am a big fan of offering to call when I'm with the client. Hey, you know, bud, your mom called. She's really worried about you. Can we call your mom? And you know what? I've never had someone say, No, I don't want to call. Yeah, they want to call their mom. They're just mentally disorganized, they're dealing with other stuff. They have the negative symptoms of abolition, not wanting to do anything. And so sometimes it just doesn't occur to them, hey, we should call your mom and check in. You want to call your mom? And so, and then when we're on the phone, the client's sitting there, I can say, Hey, is it okay if I talk with your mom a little bit about what's going on? Okay. And so I'll just partner with them and include the parents.

SPEAKER_03 24:50

We really do need to clone her. We need more of more uh people like Kat out there helping our kids.

SPEAKER_00 24:57

It's uh I guarantee there's people that would disagree.

SPEAKER_04 25:02

That may be true, but it brings up an interesting question in my head about your training. So obviously, you've studied a lot, and there are many different programs around the country, but I know in medical school there's a lot of like, oh, we never learn bedside manner, and they're trying to do some things. Is there anything in your training as a as a counselor, as a social worker, as a case manager to help you give, to help you have the kind of attitude that you have? Is there is there to the training an empathy piece?

SPEAKER_00 25:43

So there is, there is uh, as far as social workers go, there is some training around um empathetic listening and our code of ethics and how we relate to people. But really, there's I'm gonna say no, for the most part, there's not really any training in that. And that really has to go back to the agency and the people that are selecting people. And so I think my ability to work with lots of different people comes from working retail. I was a retail manager for 10 years before I came to mental health. And so you learn to work with everyone, you learn that people are not always reasonable and that they're not always just because they were just horrible one time, doesn't mean they're gonna be horrible the next. And so you learn how to give a thousand second chances and really just believe the best in people. Um, I find it helps me to uh instead of saying, oh, that person was so rude or that person was so abrupt or they were so angry to say, hey, they were really dysregulated. I bet there's something that happened in their past that this kind of triggered something about. And you know, we all have things and we're all uncomfortably rude at some time if we are pushed in just the right way. And we need to recognize that none of us are perfect and give people second chances.

SPEAKER_02 26:52

I love that too. And so as long as you answered that one so well, I'll try one more. And I have a feeling you'll be able to answer this one too. But um, but the question is before what kind of training have you had in anasygnosia? And then how often do you run into that and how do you cope with it?

SPEAKER_00 27:14

Um so we do, I was on a PAC team, uh, which is like I said, works with adults with severe and persistent mental illness, including schizophrenia. And we did do a training, we we've we did several official conversations with University of Washington about anasygnosia. Um, one of the trainings that we did, uh it's really interesting, and I I put some of it to work, you know. Um, first of all, like, and it's a little bit different working with people with schizophrenia because if I meet someone with depression and I'm like, hey, bud, you want to go out for a coffee? And they're like, no, well, that's kind of a face value thing, right? And we need to really respect their ability to make decisions for themselves. And I still want to honor client self-determination with my clients who have schizophrenia, but I also need to recognize that they are living with an asynchrosia. And so sometimes it may be like, hey, bud, you want to go get a coffee? I don't know. You know what? I'm so thirsty and I really need this coffee. Will you just come with me? I don't like to go alone. Oh, okay. You know, and I've had I've had several clients that their only engagement with me is I do a free food outreach, and I would go to this free food warehouse, and their only engagement with me would be they would come and volunteer. They're volunteering. Um, but when we're volunteering, we also know that that's a dialectical behavioral therapy concept that accepts concept in DBT that talks about the ability of contribution to grow resilience. So it's actually therapy and action. And so um, I've told Mimi before, I'm not above begging. Uh, I will take a hard no, and I do accept that no sometimes. And I think that's really big that we're not forcing people into things, but when they have an asynchnosia to recognize that and maybe not take the first no like we would with a client that doesn't have that symptom.

SPEAKER_04 29:01

That is so I just want to repeat that the value of contribution to to reduce or to increase resilience, to increase resilience.

SPEAKER_00 29:13

That's beautiful. People that are plugging in feel better, you know.

SPEAKER_04 29:16

Oh, so so true. I mean, I always when I talk about the elements of recovery, it is treatment, whatever that means, whatever that means, um, purpose, structure, and community. So community can come from your family, it can come from doing volunteer work, and and I know with my son and also with my young grandchildren. If you say, I need your help with something, or to a toddler, would you be a helper and put the placemats on the table? Everybody wants to be a helper. And I think one of the hardest things about schizophrenia is it steals many things from you, but it steals your role in the world to be needed for something. And so when you say, Oh, I don't want to drink alone, there's a good, kind person underneath most of the people, the psychosis that we see. And I I just love the way you phrased that. Thank you. Can you tell us a little bit now about Cascadia Cares? I know it's been around eight years or so, so this is not a new thing for you, but tell us about your organization and the website and how people can help.

SPEAKER_00 30:27

So, Cascadia Cares was a happy accident as my working at the current agency where I'm at. My whole life seems to be a series of happy accidents, and I just kind of followed the vibe and ended up where I'm meant to be. So uh when I was going to Evergreen State College um in 2015, I was taking a class and it was called Making Changes, Doing Social Justice. And an element of that class was that we needed to volunteer, and it had to be with an established nonprofit. And so I had before I'm a retired roller derby girl, I loved skating roller derby, but in my altruistic nature, I know I'm such a character. Uh in my altruistic nature, when I was skating roller derby, I had a teacher, I was going to Centralia College, um, and I had a teacher and an advisor there, Alicia Wicks, who served on the board of the Hope Alliance, that used to be Human Response Network at that time. And so I had approached them and I said, Hey, can we do a fundraiser for you? And they were like, Yeah, you know, and because I knew this board member, um, it worked out really well. We did actually two fundraisers where we did some roller derby bouts uh and did these themed roller derby bouts and donated the money to the um domestic violence organization. And so that was what I intended to do when I was taking this class. I was like, oh, well, I'll just contact them and see if I can't just do another fundraiser for them. Well, in the year or so since the previous one I had done, um, my teacher, I don't know if she was still on the board or not, but she went to Africa. She has a house in Africa and she goes there and does social work in Africa. So she wasn't in town for me to be like, hey, vouch for me. And uh I kept contacting that organization and they just didn't get back to me, didn't get back to me. And um I was really kind of in a panic because it was 15 hours a week that we needed to volunteer. And this is like week three, and I'm thinking, holy moly, what am I gonna do? And so at the time, my very best friend, his name was Charles Nesmith. He passed away in 2019. Um, but he was a huge part of who I am and how I got to where I am, and he had his master's in business administration. And I said, Chuck, we hope we start a nonprofit. And he said, Yeah. And so I asked my teacher, and Evergreen is so low-key. Like I think maybe he thought I wasn't gonna do it, but he was like, Yeah, go ahead. So we and so we just started this nonprofit. And I had thought that I would that I would stop it when I got done with the class, and then it became I would stop it at the end of that year. Then it came I would stop it when I got my bachelor's degree. And now it's like I've got my master's degree, and I'm excited to have the free time to be able to do things like writing grants and plugging in more to the nonprofit than I've been able to for the past three years. So, what is what does Cascadia Cares do? So I kept our mission statement purposely vague so that we could encompass uh as many ways to help society as possible. And so, really, what we want to do is help people. Our mission statement is we connect needs and resources in the Pacific Northwest. Um, what we do mainly is focused on food sovereignty. Uh, we do uh three barrier-fillment barrier-free meals in uh one in Lewis County and two in Cowlitz County uh each week. And then we sponsor two food pantries that are barrier-free. They're put up on the street. One is at Nature Nurture Pharmacy in Shahalas, and that's a homeopathic doctor in Shahalas that's let us use their space outside of their office. And then the other is at the Phoenix Clubhouse uh in Centralia. And I actually helped write a grant to start that Phoenix Clubhouse, and I love the clubhouse program. So uh they're they're more than happy. I share the food with them. They put out the barrier-free pantry, and then they also have a little kitchen that they just got put in there as part of their clubhouse, so they're able to access the free food and create meals um for the people there. Um, in addition, we we're really big on plants and uh gardening and food sovereignty in that way. And so I have a friend that has an organic farm in Centralia, and we've partnered with her for the past few years to do a plant giveaway. And so this last Sunday we were at two different locations. Uh, we started in the morning at Shahalas, then moved to Centralia, and we gave away very close to 1,000 tomato plants. We still have a few left that are finding homes for them, and so they were all organically grown in heirloom. And for me, it had a dual benefit. Um, I want to give food to people, I want them to learn how to grow food and learn where food really comes from, besides a grocery store, but it also helped to support this organic farming and help keep farms active and thriving in our community. Um, additionally, we've done some other things as far as mental health. We've done some events. Uh, we did an event that was a paint and sip during the Gay Pride month last year, and it was to benefit the Johanna Henry Scholarship Fund. And Joanna died as a result of mental health complications. And so uh we're we're literally just kind of out there all over in whatever way. Um, one other cool thing we did, I think we gave about $4,000 worth of free books away last year. And so, but we didn't just give books away, we went to local independently owned bookstores. Uh shout out to Shakespeare and Company and Shahalas were fabulous. Uh, we went to independently owned bookstores and we purchased the gift cards. And so we did a competition that you could nominate an A plus teacher. And so students, other teachers, community members could nominate a teacher to receive these gift cards to put books in their classrooms. Uh, when we saw that was going so well and fall had already come and it was getting kind of dark, we decided that, you know, people's mental health is kind of tanking. You know, I work in mental health, so I know like the vibe of the community. And I said, I asked the board, I said, you know, can we do an approval to, you know, just do like $500 worth of youth books and people could just go to the bookstore and pick one out? And they said yes. So we did another event where people just showed up to the bookstore and said, Hey, I'm here for a free book from Cascadia Cares. And they were able to access that. And so reading and the connection between reading and reducing poverty is huge for me. I wouldn't be where I am today if my mom wasn't an avid reader and if I didn't spend so many years as a kid with my nose in a book.

SPEAKER_04 36:21

I just love them the mission on your website, you know, building a world where it's normal to help others. I mean, that that is that is so beautiful. If there was one message or more than one that you'd like to get across about mental health or illness and the system, got any messages in that category?

SPEAKER_00 36:40

Yeah, a message I'd like to get across against about mental health is that we're all the same. I people don't realize is that the normal brain under the right circumstances, lack of sleep, medications, drug-induced, high stress can experience delusions and hallucination. And we're all more the same than than what we are different. And so when we have the opportunity to vote to fund mental health care and to support the people who work in this field and the people receiving services, I really hope that people vote affirmative to those policies.

SPEAKER_03 37:15

Let me ask you something. So now you're not working as a case manager, you um transitioned to doing crisis counseling. How's the how'd that come about and how's that going?

SPEAKER_00 37:29

Um so it came about, I I absolutely loved my job on the ACT team. And um, like I said, unfortunately, uh social workers do tend to work for nonprofit organizations that are not paid very much. And the starting wage for somebody off the street that had never even been with the company was actually $2 an hour higher to work for the crisis team. And I approached my agency and I asked because I wanted to stay with my clients and I wanted to keep my caseload, but I'm also a single woman homeowner. So I pay all my own bills, my house bills, my medical bills. Um, and surviving when uh it's time to start paying my student loans was not looking possible unless I was gonna get a fair pay for my education. So I was really torn to have to leave the act team that I was on, but I had already done an internship with uh a crisis team and I was already had really great rapport with the managers. And so I asked for a transfer to that team, knowing that if my clients did have their mental health symptoms just really become overwhelming, that I would most likely be able to help them still, anyways, because I'd be the one called out.

SPEAKER_02 38:41

And how do you find that? Unfortunately, the farther away or the closer workers are to the actual clients, it seems like the less they get paid. And in order to get paid more, you have to work away from the clients, which is very when it's somebody like you, who's obviously, you know, spins gold with clients. Um, one thing I want to, I hope someday you're head of the Department of Human Services in Washington State, if not the country. And you've done so many things, you've had your fingers in so many pies. What challenges, if you could be somebody that was the head of one of the agencies, either in the state or the country, what would be one or two things that you would like to change? You clearly worked around all the things that are problems that we've asked you about, but if something you could just plain change, what would that be?

SPEAKER_00 39:36

I would change the availability of housing. Uh many people are experiencing homelessness and it exasperates their symptoms and they want housing. There are people who are choosing to spend their money on drugs or other recreational activities and not seek housing, but that for the most part, it's the people that I'm meeting, and I'm out there every week talking to people, they want housing. In fact, they've gone through all of the appointments and all of the rigmarole to get the HUD funding, and nobody will take the HUD funding. And so uh I would like to see some legislation to make. Um, ideally, I would love to see that if there are these large corporate landlords that instead of having these separate places where we other people into some other category and you're gonna be in these low-income or these disabled apartments. I would like to see some sort of requirement that for every hundred units you have, a certain percentage of them would have to be allocated for low-income special needs so that there's more of an opportunity for housing because people aren't going to get better while they're out in the streets.

SPEAKER_02 40:40

Thank you. We've been working on that in Minnesota. We have had a huge problem in that area, but all of a sudden, in the last four or five years, we've been paying attention to it. We still have a lot of ways to go, but we're putting tons of money into it. Lots of places are being built, and still there's there's a big void.

SPEAKER_04 40:59

And they need services as well as housing sometimes. I know for a while my son had an apartment, but the services he had to walk to it, and they did not come to him, and he crashed very quickly. So it's a it's a delicate balance. Uh, Mimi, you were about to say something before. Do you remember what that was?

SPEAKER_03 41:18

Or no, I think I lost it.

SPEAKER_02 41:22

Okay. While you're thinking about it, um, I chaired a study for the League of Women Voters on Affordable Housing in my area, and I'm working on a housing project right now. Again, one thing we recently found out, speaking of that apartment, Randy, without services, that's the cheapest way. The cheapest way is if somehow families will take their family member in, and then the person is left high and dry when the family gets too old or dies. But the next cheapest is the apartment without services, or even if there are occasional services, that's cheaper than real supportive housing where there's you know staff more often, or there's a community, there's working on purpose. So always follow the money.

SPEAKER_03 42:10

Yep, that's how it generally breaks down.

SPEAKER_04 42:14

Um we have we have a few minutes left, so I want to get in any last questions or anything, Kat, we haven't asked you that you would like to mention or talk about.

SPEAKER_00 42:24

I would just like to maybe put some energy towards manifesting my ultimate goal. And um, I knew about this goal, I wasn't sure how it would pan out or any because I didn't know about funding or anything. I was in fifth grade and we were reading about hippies in social studies, and here I am, and I see these hippies holding hands on a hill. And I was like, those are my people, those are my people. And so all I've known since I was 11 years old was that I needed to get to that community, holding hands and connecting on the hill. And so my end goal, and the reason why I got my master's in social work is so that when I get licensure, uh the other one of one of the other board members who's the other main person of Cascadia Cares is Amy Joe Brassfield, and she has her substance use disorder professional license. And our main goal is we want to eventually have a large piece of property where we have both transitional and permanent housing, both for people who experience infinite health symptoms and people who just want to come for healing, and we would offer holistic modalities of care in in uh addition to offering uh you know regular therapy, like I learned in school, we'd also like to offer massage therapy, gardening, cooking, those life skills and that psych rehab aspect and community. And so I I really see myself in 10 years sitting around the fire in a drum circle with people that are all on my land to come and heal. So I'd like to maybe put that energy out into the world. If you have any mojo to send my way, I'll take it.

SPEAKER_04 43:56

Well, we have your first three people who would come there. Each of our sons, this is like be right up my son's app.

SPEAKER_02 44:04

I thought you meant us, Randy. I want to go.

SPEAKER_00 44:06

Oh, that's true too. We'll come with them. We'll I don't want to segregate people and be like, okay, you have mental illness or you have drug. I want us all to come together because that's that I think that's where healing is.

SPEAKER_03 44:19

You know, one of the things, Kat, that I go back to over and over again when I talk is this idea of a place in the world. And this idea that we've taken this section and rather large section of society, and we've said, you have no place here. Go away or go to jail or go under a bridge, but you don't get to be part of our world. And I think in no small part that perpetuates the problem. And we all see our own sons, you see your clients and the people around you, how everybody thrives when it's more integrated, and and the people who are doing well tend to pull the people who are not doing as well up as opposed to the other, which is, you know, the opposite, which is what everybody always is afraid of, but it doesn't really work out that way most of the time. So I I applaud you. I think that that's a great idea.

SPEAKER_00 45:17

You know, I'm childless by choice, and I think that the these are kind of my kids, and I just want to bring them all home.

SPEAKER_04 45:25

There are many ways to mentor and many ways to parent, and giving birth to someone is only one way to do it. That's that's how I feel. So um I just want to say uh what an absolute delight it has been to chat with you and learn about what you do and may your passion spread everywhere for P. I'm sure there are others like you who feel the way you do. We've all, you know, it's uh we need to highlight those. We do a lot of talking here about what's wrong with the system, but there are people like you are about what's right with the system. So, or or right in spite of the system? I don't know, but there are there are workers with a heart of gold. Each of our books has certainly its fair of gripe, its share of griping, but also success stories of people who have helped people that we love. I had one social worker who took the time and when I said, How do you do your job? She said, I I'll tell you why I do my job. I like to see people get better, and I think your son will. And that remark kept me going for another year, you know, just for anyone who could see the value in my son. Oh, he's so well behaved. When he refuses his meds, he says, No, thank you, ma'am. I can tell you're a good mother. Like just these moments of bringing the family up, seeing the person underneath the illness, and may your attitude spread with your with your enthusiasm. I'm sure it will.

SPEAKER_00 46:55

You guys have said a couple of times in this uh sorry, you guys have said a couple of times in this interview that you'd like to clone me. And looking at you three, I would love to clone all three of you and give them to the clients that have been abandoned because um, you know, I know that your sons are not probably able to recognize what a benefit you are to their lives and and just that they're angels. And I've seen I've seen how important that that family that doesn't give up is. And so I would like to clone the three of you and give them to people that have been abandoned.

SPEAKER_03 47:27

There you go. We've solved the whole problem.

SPEAKER_04 47:30

That is it. Well, thank you so much so so much for coming on the podcast and keep us posted how everything's doing. Thank you. Have a good night, ladies. Hey, thanks for joining us for this episode of Schizophrenia Three Moms in the Trenches with Randy K, Mindy Gryling, and Miriam Feldman. To get in touch with us or to learn more about our books, please visit our websites at MiriamHyfenfeldman.com, mindygryling.com, or randyk.com.