Experts of Experience - #10 Grant Riewe: Leading CX Transformation in Mental Healthcare

Episode Date: December 27, 2023

Discover how technology is transforming the field of mental health and crisis response.In this episode, host Lauren Wood talks with Grant Riewe, CTO of Vibrant Emotional Health. Grant shares his journey in innovating mental health services, particularly the 988 suicide crisis lifeline, demonstrating how technology can be a powerful tool in providing life-saving support.Learn about the challenges and successes in integrating technology into mental health services. Grant delves into the development of new platforms, the expansion of service offerings, and the importance of human connection in crisis management.Tune in for an enlightening conversation on the intersection of technology and mental health with one of the leading experts in the field.If you enjoyed this episode, please be sure to rate our show on Spotify and Apple Podcasts. Subscribe Now: https://www.youtube.com/@ExpertsofExperience?sub_confirmation=1 Imagine running your business with a trusted advisor who has your success top of mind. That’s what it’s like when you have a Salesforce Success Plan. With the right plan, Salesforce is with you through every stage of your journey — from onboarding, to realizing business outcomes, to driving efficient growth.Learn more about what’s possible on the Salesforce success plan website: http://sfdc.co/SalesforceCustomerSuccess (00:00) Introduction and Guest Introduction(01:07) Grant Riewe on Vibrant Emotional Health's Mission(03:07) The Strategic Vision of 988 Lifeline(06:20) Scaling Operations and Service Expansion(09:17) Addressing Increased Demand for Mental Health Services(11:33) Technology Stack and Service Adaptation(14:34) Personalization in Crisis Response(17:32) Measuring Success and Impact(21:43) Proactive Steps in Suicide Prevention(23:30) Role of AI in Mental Health Services(27:03) Innovation and Culture in Vibrant Emotional Health(30:12) Grant's Advice for Customer Experience Leaders

We're having a conversation around the experience of the human on the other end of the phone is potentially at the worst moment of their life. How do we improve that experience? Are you looking to get the most value from Salesforce? I highly recommend you check out the Salesforce Success Plans, which are designed to maximize ROI on your AI, data, and CRM investment. With three levels of success plans, standard, premier, and signature, you have access to the right expert guidance and support you need to achieve your business goals faster. To learn more, visit sfdc.co slash sf success plan. Hello, everyone.

Today, I'm speaking with Grant Reedy, the CTO at Vibrant Emotional Health, a nonprofit that works to improve the emotional well-being of individuals and families through a number of services, one being the 988 Suicide Crisis Lifeline. I'll let Grant fill you in on everything that Vibrant Emotional Health does, but I think it's safe to say that the experience that Vibrant provides is not only life-changing, but also life-saving. So this is super important work, and I'm so excited to hear from Grant. Grant, how are you doing today? I'm very well, thank you. I'm excited to be here. Great. So thank you for being the first CTO on our show.

Tell us a little bit more about Vibrant Emotional Health and the work that you do there. Yeah, absolutely. Vibrant is a nonprofit. We are a relatively old nonprofit. We are over 50 years old in various permutations. The thing that we're known for, as you've already called out, is the 988 Suicide and Crisis Lifeline. Before that, it was the National Suicide Prevention Lifeline, which was founded in 2005. And we were the administrator of that, along with our partners at SAMHSA, the Substance Abuse and Mental Health Services Administration. VIREN is very active in mental health here. We're based in New York City. We have our own crisis

contact center there called Here to Help, which is part of the 988 Network and then provides services to the city and state of New York, as well as some other partners. And then we're also active in the community. We do a bunch of community programs, outreach and engagement, adult and family services, child and teen services, all across the mental and behavioral health continuum. I'd love to dive into the 988 hotline and talk a little bit about how you've created a unified platform for crisis response and mental health delivery. What's been the strategic vision behind that? in July of 2022, there was a recognition between SAMHSA and Vibrant and the other entities that advocate in this space that those crisis centers, which are predominantly community funded nonprofits all across the country, don't have access to the type of technology they need to really support people at risk. And so part of the 988 legislation and launch

was to fund the building of this unified platform. The vision is for all of these contact centers, these crisis centers that are supporting people in need, provide them technology free of charge so that they can do a better job. That's not to say they're not doing a better job, but we want to give them access to more channels, more resources, more ability to understand what their crisis counselors are doing, when and where, and get more data about how they're helping people who are at risk. And how would you say, you know,

over time, how has it changed the way that mental health aid is being delivered? Well, the first is how we're expanding our services. So this past September, we launched Videophone, which is one of the first channel expansions of 98. We provide services via phone, chat or or text, SMS, or iMessage if you're on the iPhone here. But Videophone is a channel expansion. It allows people who prefer to have that video connection, predominantly the deaf community or the hard of hearing community that wants to use ASL, American Sign Language, to communicate, the video phone gives them that opportunity. We have that in one of our sister services, the Disaster Distress Helpline here, which we do in partnership with FEMA as well.

So we've used this for a while, but that's channel expansion. So that's one of the things that we get is simply access to more people to serve. Another thing that we did is this past July, we launched Spanish chat and text. So language expansion. So there can be native language integration into the platform. So help seekers don't have to translate in their head what they're speaking to kind of their core language here. When they're in that moment of need, it also allows us to present what the help seekers need in Spanish to the counselors. So the counselors don't have to translate either. So that helps us get to more people in their native language.

Overall, the Unify platform really does help us get those help seekers to counselors faster. So we're working on all the types of efficiencies we can to lower our answer, our average speed of answer, increase our average answer rate, and improve every aspect of just the mechanical operations of getting those calls answered so that we can focus on the people who are calling us. So what I'm hearing is that simultaneously, as you've been expanding your channels and expanding the service offering, you're also trying to drive efficiency in that, which I can imagine is doing a lot at once. Tell me a little bit about how you've been scaling the operation in that way while really growing what it is that you're offering. Efficiency is big.

We're growing in every conceivable direction right now because the need is massive. So if I just thought about the technology team that is under me at Vibrant, I am growing that organization from roughly 30 to roughly 125 this year. And that is about building out the platform, building out the services that are around the platform for growth. My partner organization here in the 988 operations team is growing at a similar pace. And that's about engaging with all of these centers here to deliver at speed. All of our centers in the network, of which there are currently something like 225, 226 here, they're all growing too. We have a need to train more crisis counselors across the country, and we have a need to help all shifts of the day. We're a 24-7 through 65

service. And one of the benefits of the work that we do is we have a lot of volunteer support. The challenge is that very few people want to volunteer sometime between midnight and 4 a.m. And that's the shift where we need the most help. So we're working on building that capacity as well. And then on top of that, we have a lot of work at the state level So we're working on building that capacity as well. And then on top of that, we have a lot of work at the state level that we're doing to create state awareness on what their residents and citizens need and how do we incorporate that in with the national service. I could probably go on for another hour on all the ways in which we're growing, but basically everybody has come here to build the thing because we all know that there are people in need. Yeah. I mean, I had read that in the first year after launching the 988 helpline, you received over 5 million calls, texts, and chats, which was a 35% increase compared to the 10-digit line that you

had before. Did I get that right? Yeah. Yeah. It's about that. I would share that that 5.1 million number is correct. It includes calls to one of our most important partner programs here, the Veterans Crisis Line. And so we have operated in partnership with the VA to support the VCL many years. The VA also has a partnership with SAMHSA to link that into 988. So that 5.1 does include VCL calls. But that's a huge increase compared to even just a year before. How did you really address that increase in demand so quickly? Well, we're built to have elasticity in the network. We want to answer all of the calls that come in. So actually, the call volume that we got on launch weekend, July 16,

2022, wasn't even the highest peak that we had seen in the history of the number here in terms of expansion of demand. We were getting a lot of media attention. So many of the calls and contacts that were coming in were people who were curious, we still made time for all the help seekers. And everybody knew they were very respectful as they called in to make sure that the service is up and running. Our counselor population is designed to have elasticity as well. So one of the things that Vibrant does in terms of our relationship to the network is we provide a path for any call or chat or text to get to a local crisis center. If that crisis center doesn't have capacity, we maintain relationship with a body of centers to provide national backup services. So when we do have such a huge interest here or a

huge need, we have extra demand that we can, or extra staff that we can tap into for that demand. One of the things for our service that we think about all the time is that the need increases with public awareness, particularly with public deaths by suicide. And so we watch for what is happening, what the conversation is, and we prepare ourselves for an influx into ban. We knew it was going to happen on July 16th, 17th, and 18th. We don't always know when someone might complete suicide and enter the public awareness, but we are staffed to handle spikes in capacity all the time.

That's so interesting. I know that those spikes increase once a public suicide is seen, but the fact that you're keeping a pulse on it and then you have like an army of people ready to answer those phones is really amazing to hear. I'm really curious to understand how your technology stack is structured and able to pivot from what it sounds like if someone's calling one line and they need to go somewhere else. Like, tell me a little bit about what that looks like. Well, so let's start with separating the two different types of things we do from a technology standpoint. In our role as 988 administrator, it's our responsibility to get that call. And I'll use call just the easier way to talk about it, to a counselor. Anywhere that call comes in, it needs to get to a counselor. So we are building essentially a

telephony network to connect to those calls to counselors. And we're going to make that more focused because we want to get that call to a counselor that's in the community where the caller is. And so we are doing some logic to do our best diligence to identify where that help seeker is and then route them to the nearest crisis center. Now that crisis center may or may not have capacity. So that's when we route to the national backups. We have a set of technologies that here in our partners at Mosaic in particular allow us to manage that call through here. We have an IVR, an interactive voice response system that is at the front end of 988, which allows you to choose options as well here. That's where callers would enter

the VCL. That's where callers would enter Spanish. That's where callers would go to the LGBTQ subservice as well here. And other than that, it will do the routing beyond that. So that's a partnership with Mosaics that we had for a long time. Once callers are into a contact center and they're being supported by a crisis counselor, if they're on the UP, the UP is a couple of major pieces of technology. The first is Salesforce, which is what the counselors are working on as they are supporting that interaction with that help seeker. And then we have Genesys, which is doing the interaction management, making sure that that connection goes to the counselor that is available, making sure that it's supporting. We have a number of ancillary technologies around that that provide operational reporting, that provide survey feedback, that provide other information to the counselors that need. So it's kind of, we have a lot of great partners

in this space here who are committed to the mission. Most of them have been with us for quite some time because as soon as they heard about the thing, they came, how can we support? And they're in the trenches with us every day. Are you ready to navigate your AI future with confidence? Salesforce Professional Services partners with you to design a well-architected platform built with out-of-the-box capabilities that allow you to

scale with speed and flexibility. To learn more, visit sfdc.co slash sf proservices. That's so great. When it comes to, well, I'm curious to know, like, how much does personalization play a role in, in what you do, especially if someone's like called multiple times, is that something that you're tracking? How did, what does that look like? You touched on a couple of very challenging topics there. Um let's break them apart. Let's talk about people who call more than once. Well, we say familiar voices. Others would say frequent callers. We are deliberately not tracking whether an individual calls multiple times. And 988 overall is a private and confidential service. And so we want people to feel safe and comfortable when they call that they're going to get support

and it's not about tracking them or their data. And so we don't have a general intention. That doesn't mean that a counselor might not recognize a voice, especially when they say, hey, it's Grant. I'm not feeling great again. That happens. And so people do call. And what happens here is there is some personalization that exists at the individual crisis center level where counselors will support someone that they know because they are a frequent caller. The true personalization that happens in the network really is at that counselor level. Our counselors, I don't want to say our counselors, but the counselors across the country that provide these services to people in need are just amazing individuals. They are here for the mission. What they do is listen extraordinarily well. When you're using Salesforce to tackle

your company's most important goals, failure is simply not an option. That's why their most highly skilled advisors, Salesforce CTOs, are available to help you succeed with expert guidance and implementation support at every step of the way. Learn more about Salesforce CTOs at sfdc.co slash professional services. They make the help seeker feel heard. And I can say those statements, but from a customer experience standpoint, what I'm really saying is that any person of any background and any experience in that moment calls the counselor and they feel heard and recognized. That's amazing breadth of response in our counselors. So that's where we think about personalization here in the network. The last piece that I want to touch on that I

kind of already did here in the privacy and confidentiality piece here is we really don't want to capture individual data here for the purpose of doing any sort of reporting on here, right? Nobody wants to feel like someone is tracking calls to 988, their particular calls to 988. It could be due that you can do something with that data. And so in general terms, we're not capturing individual data. We do know the number of calls and we do know what happened in those calls here, but we're never trying to tie that back to an individual. Yeah, I can imagine that's something that is so important for people who are calling you. And you mentioned tracking.

I speak to a lot of leaders about how are you tracking? What are your measures of success? I'm really curious to know what the case is for you. How are you tracking success in your efforts? Yeah. So from the top level of the network, right? And here I'm going to talk about operational tracking and then we'll talk other forms of success. But from the top level of network, answer rate is my number one. I want every call that comes in to be answered. Now, our answer rate is never going to be 100%. And that's not because of staffing. That's because many help seekers call and they hit the IVR and

then they decide that they don't want to talk to someone, or they're unable to talk to someone in that moment here. And so we do see some advantage, and that's structural in the mental health continuum. So we do expect that. But answer rate is our high one, and we're well into the 90s here on our answer rate, which is phenomenal. We have more work we can do, but we are doing very well. The next thing that we want to think about is our average speed of answer, ASA, which is a common contact center metric. And that really is an expression of how fast can we put a

human on the other end of the line with that help seeker. ASA for a live channel like phone is pretty quick here, right? I think 30, 34 seconds is around our average right now. It still feels like a long time, but that is the average here. So often it's much shorter than that. For chat and text, those interactions are a little bit less live. They're what we would call asynchronous. So that ASA is still a bit longer, but the reality there is help seekers who contact us through those challenges are okay with a little bit of a wait. A lot of time looking at, unlike most other contact center leaders or systems, we don't really care about average handle time, AHT. Many contact centers want a short AHT, help them, get them off the line. That is not our philosophy. We're on the line for the person. We need to be there as long as that person needs

us. So our handle time on interactions is usually around 20, 22 minutes, somewhere around there. There's people who need to talk. And so that's the one metric that we don't look at and we would never measure ourselves by because every minute we spend with people is beneficial. The true measure of success here, I might opportunistically say that nobody calls, right? Because there is no need. There's going to be a long time before that happens, if ever. We would love to see the end of suicide or no further suicidal ideation. That seems unrealistic as well. We are looking for more people to reach out for help. Conversely, that is an indicator that people are asking for help and receiving it here. We're very proud of our outcomes, right?

If you call and interact with any 988 counselor, we de-escalate and help those help seekers almost all of the time. We have very few situations where the individual would be at imminent risk here, and then we have other support services at play. We see an increasing need for mental health support in the country. We see an increasing use of our service. And so we are feeling good about what's happening here. People are recognizing that they need support and are getting it. So when you say that the ultimate goal, the big lofty goal is to end suicide, what types of things is Vibrant engaging in to proactively prevent that?

The biggest thing that we can do is create awareness, right? And when I say awareness, it's for everything. Awareness that mental health is health. Awareness that mental health is not something you can necessarily solve or support yourself. Awareness that there are services available to you, both services for primary care and services for emergency care, right? We are continuously communicating. This conversation is an opportunity for us to communicate here. So creating awareness that help is out there will effectively help us to end suicide. Completely. As you've been talking, you've mentioned, you know, that human connection.

We want the people calling to speak to a human as quickly as possible. And something that I speak to a lot of people on this podcast about is AI. And I'm curious to know how AI is playing a role in what you're doing, especially in the context of wanting to have more human connection instead of less, which is where AI has been used so often. Yeah, in the generic contact center sense, there's a lot of AI application, be it conversational AI or generative AI, really to engage with people who are in the service here. We kind of flipped the script on that. That's not going to work for us here, at least with the state of conversational AI as it is right now. We could talk about what would need to be true for us to think about this, but really we want to connect the human to the

human as fast as we possibly can. What we also want to do is be mindful of the fact that if we used a generative AI solution to coach the crisis counselor, we may distract them from very important and sensitive things the help seeker is sharing. So we really don't want to disrupt the crisis counselor in that moment of service too much because they are very focused on the human. That sounds like we've closed off all access points from AI, but that's not true. One of the things that we're thinking about and doing some proof of concept work on is how we can use AI to improve where we're routing calls. Calls are coming in. There is a pattern to how our calls arrive here. There are peaks and valleys throughout the day, peaks and valleys throughout the week, peaks and valleys throughout the year.

There's seasonality to when people are reaching out for care. So that means that we can do some things to balance the load, if you will, with AI solutions logistically. The other thing that we can do, and I alluded to this earlier, is when there is increased public awareness of suicide and we may get increased calls, we can use AI to do some topic modeling and some monitoring of the public discourse and help us know sooner when we might experience an increase in volume. So those are kinds of things that we're experimenting with on the AI side. Interesting. Yeah, it's, I mean, it's a whole, whole new world out there. There's so much different technology we can be adopting in on the AI front. You had mentioned earlier that

Salesforce is a platform that you use. I'm curious to understand a little bit more about where they play a role in that. And if I know they've been doing so much in the AI space as well, if that's, if that's part of what it is you're speaking of. Yeah. Salesforce for us plays a role in our 988 unified platform and the here to help unified platform that we're also building here. That's the counselor interface. Again, because it's the counselor interface, we're not bringing AI into that. Salesforce has invested heavily in that space.

One of the things that we would acknowledge is where the data exists to support our AI applications and what data could be used in AI. So if Salesforce is where the counselors are capturing their notes around that person in crisis, that's specifically not the data. I do not want to use that data for any kind of artificial intelligence. So it's nice that I've got it contained over there because I can specifically disable all AI in that space. Amazing. So, I mean, from a privacy standpoint, it sounds like it's an important tool as well. Yes. It sounds like you've been innovating a lot in this space.

And when it comes to really creating a culture of innovation amongst your team and really having people think, I don't even want to say customer centric, but it's, you know, this is your customer, right? The people calling it your caller centric, let's say, how are, how are you leading your team to really, you know, be thinking about those experiences when maybe they've never actually had that experience themselves? Yeah, you can use the term help seeker. You're free to use that term. That's what we do. We often also say human because we want to be remembered that that individual that's in distress that's calling us is a fellow human, right? And we don't know anything about them other than they are human here,

and we want to engage them in that way. I'm lucky that my team to a person is committed to the mission. So in a nonprofit, that is one of the benefits, is that I don't have to convince people that, yeah, we're going to earn an extra dollar on our stock price here. Here we're saving lives. So everybody is excited to do that. around the experience of the human on the other end of the phone, who is potentially at the worst moment of their life? How do we improve that experience? How do we also support the counselor who's helping this human through that terrible moment and give them access, right? How do we get

that human to that other human faster? Those are the conversations that we have. From there, we back out and say there are situations in which people are looking for information more than they are looking for help. And then how do we get them access to that information? 988 is, of course, for people who are in crisis. 988 is also for people who have a family member, a loved one, a friend who is in crisis who are looking for support. That's sort of an informational request more than anything. How do I handle this? Our crisis counselors are great at that. But how do I provide information to that other help seeker who's not personally experiencing

crisis? We talk about these things like how do we do this? How do we get information more accessible faster based on what the individual is experiencing without knowing anything about what that individual is? It's kind of a unique design problem that we've got. We have to assume the worst until we know something. And that's where we innovate is like we are designing for what is the most challenging scenario. And then we are trying to create breadth so people can select the path of their choice. I love that answer. And yeah, it's trying to make the worst situation better is an incredibly admirable thing to do. So thank you so much for sharing all of this. And more importantly, thank you for the work that you do. It's been such a pleasure to speak with you.

And I always ask this last question. What is one piece of points that you identify and have a relentless focus on eliminating them. Beautiful. Well, thank you so much for joining us. To everybody listening, if you enjoyed this episode, please hit subscribe wherever you listen to your podcasts. And if you'd like to find out more about Vibrant Emotional Health, where hit subscribe wherever you listen to your podcasts. And if you'd like to find out more about Vibrant Emotional Health, where can they find you? Vibrant.org is our website,

and we are active on social media, Instagram, at Vibrant and LinkedIn. Awesome. Well, thank you so much. I hope you have a beautiful day, Grant, and we'll speak to you soon. This episode is brought to you by Salesforce Success Plans. With the right success plan, every company can get more value from their Salesforce investment. To learn more, visit sfdc.co slash sf success plans. You are a business leader with vision. You've seen the future as an AI enterprise thriving with Salesforce AI and data. And it is bright. Getting there? It's a little fuzzier.

Don't worry. Salesforce CTOs are here to work side-by-side with your team and turn your AI and data vision into a reality. We're talking expert guidance and implementation support from the best of the best. To learn more, visit sfdc.co slash professional services.