NASW Social Work Talks - EP 145 - Destigmatizing and Advocating for Communities Affected by Mental Illness

Episode Date: June 5, 2026

Social Work Talks sits down with NAMI New York State to discuss the growing need for stronger mental health advocacy, policy reform, and collaboration between social workers and individuals with lived experience. This episode explores efforts to address insurance prior authorizations, mental health care access, and the movement to recognize mental health as a constitutional right in New York State. Tune in for an important conversation on reducing stigma, advancing mental health equity, and strengthening support for communities statewide.

This podcast is sponsored by Assisted Living Locators, NYC. The Power of Social Work podcast is advocating for the social work population in New York and also for individuals affected by mental illness. We're here sitting with the National Alliance of Mental Illness, or NAMI New York State, to talk about destigmatizing and advocating for communities affected by mental illness. And I'm Amanda Rodriguez, a policy coordinator here at the chapter. I'm Gideon Massa. I'm the other policy coordinator here at the National Association of Social Workers. And James Zorn, government and community affairs manager for NAMI New York State.

Thank you so much, James, for being with us here today. It is so important to stand in coalition in the mental health space because we are stronger together, especially in New York. And so for those who are listening for the first time that may not have heard of NAMI New York State, give a little rundown of who you serve, what populations you are faced with, and a little bit of history about your organization. So NAMI New York State was founded by two mothers who felt that there weren't enough services for their sons who had schizophrenia. They found the organization to represent individuals with lived experience and their families, trying to advocate for better conditions, but also to provide support and mutual aid. I often say that when I first was hired to work for NAMI, I kind of thought it was like the ACLU where you send in your membership dues and then they send you a little note in the mail that says all the great things they did with it. But like, you're not a lawyer, you're not joining their

legal team. But NAMI at the national level, obviously does a ton of advocacy work. They do a lot of research. They do a lot of community organizing. But when you join NAMI, you join the state office too, and you join your local affiliate. And the local affiliates offer everything from family to family to peer-to-peer NAMI connections there's also a host of specialized peer support groups that are NAMI home front for veterans and their families there's per ER for ER staff uh overwatch for law enforcement uh first due for EMS and fire a whole host of different uh like mutual aid programs that are all volunteer run most NAMIs actually don't have staff in New York state a couple do in some of the larger cities are New York City one obviously being the

biggest uh but really it's driven by the members and it's really the at the grassroots level uh mutual aid based nami's in so many important spaces and you know um our our membership as well we are membership driven at nesw new york we try to say no decision about you without you and so it's so important to bring you know the peer support specialists in bring individuals affected by mental illness into this advocacy work because their stories can move mountains And so we really do uplift a lot of vulnerable populations that are faced with social workers every day. So we appreciate you being here and sharing with our members, but also with your members as well. It's great to be able to share with your members and help them kind of see it from the family's perspective, the individual perspective.

Also throw in a quick plug for NAMI Provider, which is a program we do where a person with lived experience, a family member, and a mental health provider get trained to do this program. And it offers a course to teach to anyone who's in social work, mental health counseling, psychiatry, psychology. Our goal is to kind of improve that connection between the providers and the individuals, as well as our government officials and the individuals. You already brought it up, but discussing grassroots organizing in general. I feel like NAMI and NASW share a lot in common when it comes to grassroots organizing. But there are obviously struggles that occur when you're doing this grassroots organizing that you're trying to do. We're really trying to push bills. We're really trying to help social workers broadly in New York.

So from your experience, how do you think you best are able to approach that subject, best approach the challenges that come from grassroots organizing in general? When I first started, the big challenge was kind of understanding what the membership wanted. We started with a lot of surveys, trying to get a good idea. And it's been a challenge. We probably have the largest legislative priorities list currently at the Capitol. And that can be a problem when you have too wide a priority list. but so many things affect mental health you find yourself in every room absolutely i mean i just

that spoke to me too we have so many bills that we obviously work on we open it fast there's so much surrounding social work in general that we are working on it's hard to really narrow in sometimes on all those bills but we're still doing our best obviously and getting stuff done right that's the whole point of all this uh make it easier for social workers for us to exist in New York, that's us. Yeah. And we appreciate a lot of the priorities we have in common that have to do with workforce. We know that we're in a workforce crisis in the state as well as the nation when it comes to funneling more social workers and other mental health providers into the space. I did want to touch on the stigma and how it affects our work.

So as we're advocating for the workforce and for mental health populations, how does public stigma often create an obstacle as you're trying to get legislation passed, but also as you're advocating to the legislature, to the governor, but also just to get people to join the movement as well. How does public stigma become an obstacle? It really becomes an obstacle to sharing the realities of the situation, right? There's people who don't really want to share, or they don't want to share parts of their story.

Or in some cases, they are a family member, they want to share their family, but their family member and somebody who wants to share their story. It's really important that the voice is driven by individuals with lived experience, but it can be hard to really center that when the stigma is telling them to be quiet. And I often share that.

I worked in public safety, EMS, fire, for those fields specifically. It can be a really repressive force in that people fear for their jobs or they fear for their careers or livelihoods, their health insurance access their family's lives that but that is not an isolated thing there's a number of people who think like well i work in policy or i work in as a lawyer or whatever else there seems to be a even now that we're breaking the summit there's a really like

oh it's okay to talk about your mental health and then you hear someone like your surgeon talk about your their mental health you're like wait a minute uh yeah you know it's everyone means everyone And so that's the message of like trying to get all people to share their mental health stories and talk about all of their mental health, making sure everybody feels comfortable to do that. Because we talk a lot about trust in the system, but also distrust in the system. So there's a plethora of resources out there for people, but you have to create a safe space for people to want to access those resources universally. So the work that we do to constantly destigmatize accessing mental health resources first comes with education and awareness. So we know that NASW, we do a lot on the education front when it comes to hosting our CARES community engagement programs and our CEU training for social workers to help put them on their needs to serve their clients. what is something that NAMI New York State is doing to educate the public that will help reduce

stigma in that way? So every year we do an education conference. Next one's going to be this November. We try to do them every November and bring together a lot of voices there. We also do a lot of community-based presentations that we have a program that pairs high school students to go into high schools, or we do NAMI walks to build awareness. But our big one is coming up. I'm here in April, but next month is May, Mental Health Awareness Month. Timing was planned. We've been doing this every year.

And every year NAMI's done ribbons all throughout their communities. So NAMI volunteers will tie this kind of ribbon that is supposed to help bring out or highlight that mental health affects every community. So if every community puts up these ribbons, hopefully that helps drive that. That's so true because everybody understands the need for physical health services because if you break your arm, everybody understands that you need to go to the doctor or the emergency room and get surgery. However, you know, mental health, it's something that's invisible sometimes. And people sometimes don't understand that health and mental health is so correlated in the way that your health affects your mental health, but also the need for mental health services could possibly lead to a physical health problem that eventually could occur. So when people talk about overall health and public health, it's a little bit less stigmatized in the fact that everybody understands that those services are so necessary. however when we consistently combat that narrative that health and mental health go side by side then

you can begin to bring mental health into the spaces that are only discussed around physical health yeah i mean we we can talk a lot about holistic care but part of that again holistic person is their mental health yeah yeah that's absolutely something in general that uh that NAMI and NASW definitely coincide with, I'd say, just because obviously with social work, the biggest goal for social workers is getting people to actually speak about their mental health issues, the problems that they're facing. And that is why social work exists a lot of the time at least, right? I can only imagine how upsetting it can be if you're a clinical social worker, and you're hoping to help a person that's not able to really tell you how they're feeling,

right? Yeah, that must be so wildly challenging. And so, I mean, that's obviously why we're collaborating. Yeah. And we talked about public stigma and people's perception of mental health services, but also the services social workers and others provide. But let's talk a little bit about institutional. So when we're looking at systems that are meant to provide these services to individuals, what are some structural flaws in our system in New York, but also in the nation that can lead to individuals not getting the adequate services that they need or from preventing them from even going to the system in the first place? So I'll just clarify, what we have a ton of bills, we break them up into five policy categories. One is equitable access to mental

health supports. One is supporting a behavioral health workforce. One is crisis-assisted outpatient treatment and voluntary commitment. The fourth is criminal justice reform for those with mental health issues that go untreated long enough. It often falls to that category. And then one for youth and family supports. So when we talk about the institutional barriers, it's a lot of access. Is there a person who needs mental health services? Can they find a therapist who speaks but also does their health insurance cover it like a like they should and mental health parity has been obviously a big one for nami for a while it is definitely something for you all yes uh yeah we we have one bill this year around clawbacks which is something called a retrospective

denial in insurance speak i know that i know that the private practice i love this one definitely hear about that one yeah i mean it's one that a lot of patients don't really know about once be explained to them they're surprised that this even allowed but you request the service go to your doctor they said go to your insurance uh the insurance approves it with prior authorization the provider provides the care the person gets the care they go home sometimes months or years later their provider is told that actually that care wasn't necessary and we're going to withhold payment on current bills to recoup ourselves you know retrospectively deny retrospective night or claw back the funding that we have said oh actually you don't you don't need that now

uh so it's it's again it's one of those things where we can say oh well we have mental health parity but somebody can retroactively go back and say actually your arm wasn't broke no that's obviously one area and there's a couple of bills on our list uh around uh improving mental health parity and improving the the coverage rates for for reimbursements uh you know making sure that that kind of equity and pay but also the equity like reimbursement i think we hear a lot about like low pay for any all the provider groups uh but we can't just say oh we'll pay them more and then the providers are like well you're not paying me more how do i do that uh so you know it part and parcel of fixing the the workforce part is improving the reimbursement

part. And that starts more at the policy and the systemic level. Yeah, absolutely. And I think in general, it's sad, but so often you see these mental health issues along with social work coming down to money a lot of the time, at least in New York State. One thing that we're seeing, this is actually a national issue as well, but we are really pushing for social workers to get higher pay all around, which would obviously help people enter the career. So many people don't want to enter the career in general, just because there's not high enough pay. We'll go down a nursing route, et cetera. And we really hope that we are able to uplift the career and the pay for the career, hopefully, so that we can inevitably, I guess, get more social workers that can help

with this mental illness crisis that's going on right now, which is evident. Yeah, because one of the things that we've been looking at with the wages is that the mental health states can be so segregated in terms of where providers are doing the work. There are so many social workers that work for the state. And, you know, that pay, it can be pretty standard, you know, it's through the Office of Mental Health or the Office of Addiction Support and Services. And so that pay, it can be generally regulated because that's in the state. And so they understand how to control that funding. But, you know, a lot of social workers, they have private practice, so then they get their funding through insurance. And then we move on to the nonprofits where maybe the services they're providing, they don't necessarily have enough funding to pay their social workers. So I think that it's interesting the different levels to which we can look at salaries. One bill we've been looking at lately is what Assemblymember Braun said to establish a human services wage board. And then they would essentially analyze the disparities in the wages across the state and try to get some data on the issue. Because, you know, it can be hard to look at each individual sector and determine, OK, well, how much are you making? What's the starting salary here? And then is that competitive with the state? Is that competitive with other mental health providers?

So it's definitely a multi-pronged issue, but it's good to look at it first from the insurance perspective and ensure that at least social workers get funding that they are due to get, and they don't have to get an insurance clawback based on a small complication. Or just the denials that so many face before you even get to the clawback point. And yeah, that can be a huge barrier to access. Yeah. This podcast is sponsored by Assisted Living Locators NYC, your no-cost senior care advisor and concierge for seniors interested in the best assisted living, independent, and dementia care communities in the New York area. You can reach 24-7, every day, Assisted Living Locators NYC at 212-653-0152 or check the website, www.assistedlivinglocators.com slash NYC. Their team will pick you and your family up and tour a customized set of best fit assisted living communities for you or your loved one. Assisted Living Locators, a seamless transition is our mission.

So we talked a little bit about salaries and different issues affecting the workforce. Another issue that we support jointly is loan forgiveness. And I know that you support loan forgiveness for a number of different professions, as well as social workers in the mental health space. But just tell us a little bit about your advocacy journey in accepting that priority and any possible opposition you might hear from the state. but also any positives in that program as well. Yeah, we really don't hear that much opposition to it

when we talk about it. I think the only question is just like how much money is there in the budget and then prioritizing which sectors kind of need it most. I think one thing we've talked about is the need for it in rural communities as a way to kind of help draw more attention. The rural communities are facing higher rates of suicide loss.

So that's one reason that that kind of ends up towards the front. but obviously we support a number of different student loan forgiveness bills and like we're saying it's a low pay but we want to increase the pay we also want to decrease the debt

right and we have to approach it from both directions to kind of decrease the barriers increase the retention exactly because our particular bill that we're both supporting

is S1113 in the senate and that's to provide loan forgiveness for social workers but it looks specifically at rural communities and it actually looks at

populations of 250,000 or less that it's trying to incentivize social workers to go to areas like that. Because when you know, I grew up in a small town, we understand that when you're in a small town that comes with less opportunity than when you're in the city or when you're in a bigger population area. And where I grew up, you had to drive over an hour to find the nearest mental health clinic. And of course, that leads the population that's within that area to then suffer and also be less likely to access care, right? And if you have to travel far to go get care, but looking at trying to recruit those social workers

to those shortage areas, it can really benefit that population because otherwise those service providers would not be going to live there if it weren't for that incentive to go serve those populations. And what this bill would do is it essentially would require a social worker

to work in that area for at least three years in an underserved area and that would help just bolster the mental health um pipeline and care coordination system within that area to help help us so that rural communities don't fall through the cracks because often we see that with where you know there's higher rates of suicide higher rates of depression anxiety substance use in rural areas you know there's also very prominent in the city as well um but when you're isolated like that it can definitely be wounding free it's also one of the reasons we push for something that is in the budget uh it's in uh the senate one house it's in the governor's uh state of the state and her budget we're calling

it one patient one license uh it's a program that allows omh and oasis to form a joint unit and license them jointly so if you're looking to treat mental health and substance use disorder right now you have to get licensed by omh and you have to get licensed by oasis and so they would have to kind of form a unit that would license you to do both and especially for those rural communities where you there's already a shortage of social workers but that social worker is only licensed by omh and then they tell you to go 20 30 miles down the road to go to see the social worker who can do mental or can do substance use like that's also a barrier right so increasing the number of providers and just but also increasing the scope that they can serve that

community and so many people have a recurring disorder yeah no way and i come from a criminal justice background right we talk about mental health issues and justice involvement we can talk about idd involvement right the the system silos can affect those rural communities even more because if you're only licensed by one agency that's the only one population you can serve but there's all this co-occurring issues that they can't that there's these institutional barriers that stop them from doing it. And I mean, also to discuss S789, which is a bill that's right now, I think on the floor, it discusses actually finding these rural pockets that we're talking about right now. Because the other big thing that we're learning, we're bumping into at

least, is that we don't actually know where these social workers are. We are trying our best, I I guess, to make a map out of where these social workers reside. We have data from 10 years ago, but 10 years ago is 10 years ago now. We did that in collaboration with SSWAA, the School Social Workers Association of America. And the study showed that New York State in general probably has one social worker for 750 students. The goal, the intended goal as NASW and SSWAA found was 1 in 250. And I'd say New York, when it comes to mental health, is pretty good in comparison to a lot of other states. So you can only imagine if we're 1 in 750, I can't imagine what other states you're at. But on top of that, the other thing that they noticed in the

data that they found from that study is that the majority of social workers, and pretty obviously, are in New York City. They are, for the most part, all in New York City. And when it comes to social workers upstate in these rural areas there are some social workers that bounce uh from school to school every day there there might be one social worker for four schools that they go to every day uh which feels ridiculous obviously we need to be able to have set social workers for specific schools uh let alone have one social worker for 200 students yeah shout out to national for developing that recommended ratio of the one to 250 students because we understand that's how to be most effective from the youth perspective as we have social workers at schools.

And the School Social Workers of America, they also are doing some great advocacy to ensure that school social workers are doing vital work, especially with the increase in family separation, with youth being addicted to their computers, and with youth also talking to AI chatbots and having issues with that. But as we look at the shortages within schools, we have been supporting the bill as 376 to recommend the new york state department of education to analyze um the student to social worker ratios and that was you know shout out to the thomas and avalee to the new york state comptroller as well he was the one who did an audit that identified the shortage of social workers it that actually focused on new york city as well so you know the shortage you know there's

no shortage of a shortage we're gonna say right there's you know not enough social workers in rural areas there's not enough social workers in the city um you know i talked to the new york city department of education and um one of the supervisors there said that she represents a whole district and that there's only eight social workers um within that department in the whole district and when you look at a whole school district you understand that's like at least thousands of students and then you have eight social workers responsible for overseeing the needs for resources within that huge population we understand that that could definitely be out lead to social workers potentially leaving the field and also it leads students to not have

access to not only mental health services but also resources especially with the increase in instability you know that our youth are facing i know we also support that bill uh so thanks for the thanks for the plug uh it's also on our list in addition to the study you're highlighting uh It just came out this week. The Kennedy Forum put out a mental health parity index. And you can go county to county and see what your mental health worker per capita is. Oh, is that the HRSA? The Kennedy Forum.

Oh, okay. Yeah. Yeah. That's what the loan forgiveness looks at as well. It looks at the critical shortage areas of the state. Yeah. Absolutely. And I know we briefly just brushed by it, but to take us on another route,

When it comes to AI, how is NAMI dealing with this explosion in technology that is happening right now? Obviously, it will so highly affect the youth, mental health in general. How are you guys approaching something like AI? So I'd say our national organization is taking a huge look at it, right? They're paying very, very close attention. I think the one thing that they have stated that they're wholeheartedly against is just AI as a therapist, right? having AI therapy would be not great for the human-to-human connection. That is a huge part of therapy. But I think there's potentially room

in improving the billing process, especially the mental health parity issues we just talked about, or AI note-taking, but then you have questions with HIPAA. I think it's hard to look at new technology and point to it and say it's inherently bad. There's potentially

room but it can't it has to be done with intention not kind of here's the tool into the universe have fun with it uh yeah and when we look back at decreasing stigma um you know youth they're going to different tools like open ai and friend.com to discuss their emotional and social issues instead of a therapist right and so that can almost lead to more of a stigma to why youth shouldn't access services if they have this handheld device that they can go to that tells them to get up in the morning and to brush their teeth, that gives them mental health advice. And so when we look at increasing the need and access for services, it's almost like some of these unethical approaches to AI. Of course, we support ethical approaches. But when we look at

specifically the use of AI in therapy, that can almost contribute to this issue. We see where people aren't accessing services in the way that they should so i can i'll afford you this after the after a podcast session uh but there's a great report and presentation that common sense media does on this issue and it shows that the algorithms are kind of prone for engagement the same problem you kind of see with social media and some of the recent court cases the the goal is kind of retention of attention not actually finding these solutions and so that's one of the problems you have with with social media but it's also one of the problems you might have with ai where you know the engagement is the metric that they use to kind of gauge how successful a app has been we were just

at the health summit right like we have to look it's important to pay attention to what our metrics are for health uh i think somebody's example of kidney dialysis they measured their success by how many dialysis units they opened to treat people who have diabetes, and then their kidneys started to fail. And so now they've opened up more clinics for those folks, when actually the metric should have been how many people didn't go into kidney failure, right? So access is important, but you also need to make sure the metric is matching up with the best health outcome. Exactly. Because, you know, we've been trying to analyze data on the correlation between the emergency room visits that are, you know, happening with mental health, happening because of mental health crises, and then looking at, you know, the staffing of social workers and hospitals. So when we're looking at different areas that may have less mental health providers, you know, is there a correlation between that data on, you know, an increase in expenses when it comes to these emergency room visits, when it comes to people experiencing a crisis with mental health?

I mean, absolutely. And that can be just an assumption, right? But do we have that data? Someone has it. I don't particularly have it. Again, NAMI kind of more represents individuals and families, so ER data is not something I really have access to. We do have some information from our helpline that we kind of use to gauge where the holes in the system are. I always say that mutual aid flourishes

where in the holes in the system. But we do know that much like any other health condition, when you leave it alone long enough, it essentially finds its way to the ER. I say that both as somebody who is an advocate for NAMI and mental health now, but also somebody who was in the MT for six years, right, you leave a health condition alone long enough, it will find its way to the ER. Yeah, exactly. And that's why it's so important

to have open conversations about mental health. And also, you know, we talked a little bit about media and social media, but the role of media in the stigmatization of mental health definitely plays a big part. And we see a lot of the time youth is actually kind of moving more towards being more open about mental health than previous generation. And so do you see in your work with NAMI, do you see a lot of young people stepping up to advocate

for mental illness support? Well, we absolutely do. We have a NAMI NextGen program. So at our national level, there's a national NextGen program and people can open to apply. There's actually a member of our staff who was a NAMI NextGen advisor

and is currently on NAMI NextGen and they are leading our state NextGen program as the staff member. So we have 11 NAMI NextGen members who all are between the ages of 18 and 25 who volunteer to do more mental health advocacy out in the community. To that end, their NAMI NextGen Advocacy Day

is May 11th. And mark your calendars. And the week of May 11th to the 15th, they are putting on an art show, uh the capital in the concourse so we have uh youth from all over the state submitting artwork to be featured uh on our nabby mental health art show uh right right in the capital yeah and that's so true there's so many different approaches that holistic mental health approaches are helpful because you know art space therapy music therapy you know just getting creative can help people

in their mental health space so much and i know a lot of social workers try to be creative and what they provide to patients whether that be yoga or wellness seminars or um you know encouraging those different um holistic and just like you know different approaches to just traditional therapy yeah i think they're seeing it just like any other form of health where it's a holistic approach like you see a doctor you see a therapist but also are you drinking enough water are you eating enough are you are you doing things that you enjoy right those kind of more holistic parts of health yeah and i think social workers are trying to look at a whole person and environment right they're trying to look at trauma-based interventions to look at what you've been

through um how you bond to this point you know is poverty affecting your mental health is lack of access to health care affecting your mental health like i know to bring up you know the immigrant population, what they're facing right now, you know, maybe you don't have a social security number. Maybe that's why you don't have mental health care. And so having that parity and creating mental health as a human right, and really instilling that sentiment in New York is so important. And so that's why I wanted to pivot a little bit in this conversation to I know that you're working really hard over at NAMI New York State to actually change the mental, the New York state constitution and create an amendment to create more access to mental health.

So tell the social workers a little bit about the work they're doing in that. Under Article 17, Sections 3 and 4, there is a provision that states the state of New York will do things to address public health. And we want to change that to mental health and physical health. And we want to change Article 4, where the state may do things to address mental health, to a shall, which creates an affirmative duty for the state to do things in the interest of mental health. Right now, the state does do a lot for mental health. I'm not going to say that Governor Hochul, especially, being that she's one of the

governors where we actually did get cost of living increased with the target inflationary increases for the billion-dollar investment a few years ago. Same with Commissioner Sullivan. To some extent, that's all the stigma breaking and all the awareness that has happened post-COVID, post-opioid crisis around the effects of mental health. But the real goal of this is to kind of institutionalize that New York State and make a point to preserve the progress we've made. We've done a lot to kind of break stigma.

There's still obviously a lot of work to do, but creating an affirmative right to mental health and the duty of the state to act in the interest of the mental health of its citizens is something that will last going forward. We talk a lot about the systemic fixes, but this is one that's a foundation fix. Because why do we have to get to the point of a crisis to divert resources to the mental health space? And again, at this point, it's May. So what happens when mental health is no longer a topic?

Or what happens when a new person is elected to office or appointed to a different position and there's nothing saying they can't cut? we might have social workers putting in from other states outside of New York right now. So just to provide some context, you know, in 2024, Governor Kathy Hochul put out her state of the state. She put a very big focus on mental health and mental health crisis that we're in. And that is very paired with our workforce crisis that we talked at the beginning of the episode about. But with this mental health crisis, you know, we need to funnel more workers into the space

and not just talk about the crisis and what we can do. And so as we're looking at, say, the state that came out in 2024, that instilled some great programs and instilled the satellite is in schools to have providers helping youth. But it also led to a change in narrative, like you're talking about in the state where it kind of opened up an avenue for different organizations that are advocating for mental health to really begin to have a presence and to be actually listened to. Because, you know, that kind of opens the door for, okay, maybe we can actually get a bill passed around mental health, because now this is the entire narrative within the state. And, you know, even in this last state of the state, mental health was a very big part of the governor's proposals. And so that kind of opened the door, opened the doors for a lot of advocates. It really did. And again, to put this in context of outside of New York State, too, we're seeing changes in the federal administration to try to eliminate SAMHSA. So that's also kind of driving home this point that, well, we have this system. Why make it constitutional? Well, we had SAMHSA. And that's something that obviously NAMI is advocating to maintain SAMHSA. There's a lot of really good folks there who care deeply about mental health and substance use disorders.

And I've worked on several SAMHSA grants over the course of my career. I'm sure there are a number of folks, especially those who are part of the CCBHCs, who are very attuned to the status of SAMHSA right now. So at least from a New York perspective, that is part of the reason we're kind of taking up this mantle. It's the bill for the constitutional amendment changes passed the assembly twice. It just hasn't passed the Senate. It has to pass both houses, then it has to pass both houses again the next year, and then it goes to a vote to everyone in the state of New York. So, again, not to leave the folks outside of New York out of this conversation, but for the folks inside of New York, it is a way to kind of enshrine mental health as, again, a duty of the state of New York and a right that you have to have your mental health taken care of. Yeah, and I think this is a precedent for other states.

So if New York is to instill this constitution, then maybe that can inspire other states to do similar things within their constitution. Hopefully. Yeah, exactly. And so, you know, we're talking about destigmatizing here today. Another topic that we wanted to bring up was your advocacy with Jesse's law. A lot of the time, NAACP New York has been looking closely at policy that deals with involuntary commitment because, you know, we understand that when an individual is a threat to society or, you know, they are labeled as a person that could potentially threaten themselves or others, then we understand the need to potentially direct them to services. However, a concern that many social workers can look at is, is any policy being advanced anti-homeless? When you look at individuals on the street, New York City had a really big narrative around the subway dangers that were happening last year and stations and people experiencing mental health crises that may lead to more violence. However, you know, we worry about a slippery slope that could occur when it comes to profiling people based on bias. And, you know, are they actually a threat to society in themselves? And what is that line?

Yeah, it can be a really hard one to cross and one that from a patient's rights side as social workers and also as individuals advocating from the point of lived experience and family members, it is really important to try to retain as much dignity and as much rights as you can for somebody, but also recognize that they're not a place to be making decisions for themselves. I often will talk again about my EMS experience where you'd have patients who are unconscious or patients with Alzheimer's, you'd have this idea of implied consent when you start treating them that this is what somebody who, were they able to make decisions for themselves when why you act in their best interest as somewhat of a guardian. with some of the laws that your state passed it was important to try to address it from a more public health perspective a lot of the language is around feed yourself house yourself close yourself in public health there's the concept of half the battle is giving you the medication the other half is giving you the glass of water to take it with right you can't ignore that this person's mental health has affected them so severely that they can't meet basic needs and so that was one of the things that they wanted to

take into account you know involuntary commitment is a really tough one and I think a lot of people view it as a more outsized part of the mental health system if you look at say 988 numbers 80% of all 988 calls

are just phone calls no one goes out to visit the person from there 80% don't go to the hospital they just talk to the person on scene for those cases where they go in And for the majority of the cases where somebody is taken to the hospital, it's voluntarily. So you're dealing with a fraction of a fraction of a fraction of cases.

But even in that case, what we're looking to do with Jesse's Law is create a system where the individual can say which facility they want to go to, as long as it's within 50 miles of the facility or from their location, or the location that would have been taken to, and the facility says yes to receiving them. That would give that person who, even though they're not in a position to say, I don't need mental health treatment, still give them the ability to decide which facility they go to and retain some autonomy. There's also a number of folks who just avoid the mental health system altogether because they fear that that will happen again, and they don't want to go to certain facilities. But they might know a facility they want to go to. They might have had a good experience at this one, bad experience at this one. This one might be connected to the health network where they already have a psychiatrist and a mental health counselor or a social worker or whoever else that they already work with. The bill is named for a NAMI member who, that was exactly the problem. They were only taken to the mental health facility that was on the approved list in their county when in reality they wanted to go to this other facility that was the next county over where they already had this health network set up and it was closer to their family.

uh so there's a number of reasons why you might choose which hospital you go to regardless of the reason uh we still think that somebody in that event might want to be able to make that that decision and that autonomy is i mean i feel like this is we continuously bump into and even though this is this is a this is a problem that is a fraction of the case right uh i'm going to give a quick shout out to blue heron which i just watched in theaters and had the pleasure of speaking at um it goes over one of these cases where there's a child who really needs to be uh put into uh health care mental health he has a lot of mental health issues needs to be put into one of these facilities and and i i think that a huge issue that spurs and this is discussed

in the movie is that his feeling of not having any autonomy um is making him lash out a bit so giving that extra layer of at least a bit of autonomy, I think is so wildly important when it comes to these cases. And on that notion of autonomy, I know this was mentioned by the chair of mental health in the assembly, Joanne Simon, what we were talking a little bit about the psychiatric advance directive, where individuals can, you know, kind of, you know, people know their body, they know what works best for them, and they can make recommendations to what they think would be best for their care and have a little bit more autonomy in that space because to give a personal story um you know i asked for mental health services when i was in a

hospital um back when i was in college and almost immediately i was prescribed zoloft and you know i already knew going into that session like i don't want to get on zoloft i've heard you know recommendations from friends that say that you know they had negative effects on their body and their mental health actually from taking that prescription. You know, I don't want to, you know, discourage any people from accessing help if that's what they're prescribed, but that was just my own personal experience.

So, you know, I see often that, you know, people who know their body and know to speak up about what works best for them can often be not believed or not encouraged to have that advocacy for their own selves within the healthcare system. But just explain a little bit about any interfaces or stories that you have with people experiencing mental illness that may have experienced the same thing, but also what does the Psychiatric Advanced Directive aim to do? So for anybody looking for more information, you can visit the National Center for Psychiatric Advanced Directives. For the point of expediency, I'll call them a pad, GATI. When somebody gets an advanced directive, and an advanced directive is any provision of law and it's around any form of health.

If you are somebody who is going under anesthesia, for example, you can set advanced directives of what you want to happen. Some people have advanced directives like DNRs, do not resuscitate, where they don't want to have CPR done or have an AED administered. Some people say no extraordinary measures where they don't have intubation happen. But for a psychiatric advance directive specifically, it's a person who, when they're in a good place, can say, oh, these are the medications I am willing to take, or these are the steps you should follow if I enter the bad ones. It could be whatever the issue is, whether it's schizophrenia or bipolar disorder with hypomania. There's a number of different ways that somebody can kind of set these parameters before they go in. And one of the corrections I would offer to New York State is, like any other advanced directive, you can rescind it. So if you are in the hospital and you say, actually, no, I would like CPR, and then immediately flatline, they will still give you CPR. So that's often one of the things that people worry about when they get an advanced directive is like, what if I change my mind? And so it goes back to the Jesse's Law era of like, is this person in a good place to make the decision to rescind their psychiatric advance directive? That can often be a hard line to walk. But a psychiatric advance directive, regardless of that provision, is still a great thing to have ready.

if you especially if you are somebody who knows what you want knows but your body needs knows your own psychiatric history better than any person who's working in er well uh it's a way to kind of set what you want legally in advance of anything that might happen and it's not saying that oh well i plan on having a psychiatric break in a couple months uh i don't think it was planned that it's not like uh somebody who's like well i'm having surgery later better better uh put an advanced directive in yeah uh but you know it is something that somebody can set uh for themselves and it kind of also gives the the hospital and the the providers a little bit of coverage right if they're like well what do i do because there's a couple different options well this is

what they want and they've put that down to the legal document so this is something i can follow this is something that i already know the person wants yeah and part of decreasing that stigma is not expecting people experiencing crisis to be able to articulate exactly what their needs are in that moment. So, you know, when you create something like that, it creates a safety net for people that, you know, they may not know when their next mental health crisis may be.

People can't predict that. However, you can create that safety net. And it may never come, but at least it's a peace of mind that, you know, if it happens, you've got this document document that says exactly what you want. So, yeah, as you know, we talked about a lot of different policy decisions that are occurring today in New York, but also issues that affect the whole nation when it comes to mental illness. And what we're trying to leave people with today

is, first, we understand that there needs to be open conversations about mental health. And there needs to be constant advocacy, not only for yourself as you're dealing with mental health issues, but also for the entire population that is experiencing a mental health crisis. And so I want to leave the listeners today with resources on how to get involved with NAMI New York State's work. Are there resources that people can tap into and how can they get involved in what you're working? So if you go to NAMI.org, N-A-M-I.org, you can join. The individual membership is $40 a year. Family, like a household membership is $60. But for folks who are low income, there's an open door membership for just $5 a year. All of our services, like the family to family,

peer to peer, those are all free. Anybody can come. You don't have to be a member of NAMI to access those services. If you just go to the NAMI website, find an affiliate, like put in your zip code or the state you live in, you can find the affiliates near you. You go to their website, you'll be able to see when all of their sessions are. And then some of them, I'll do a special shout out to our NAMI NYC folks. They do quite a few of their sessions online. So people can still go to peer-to-peer,

family-to-family online. And quite a few folks actually go not from the NYC era just because they feel a little more anonymity going online or to an area where they don't go. But you can get involved there. And again, when you join NAMI, you join your local affiliate, you join the state affiliate,

you join the national affiliate. So you can go to our advocacy days. We're already planning one for next year, but I already mentioned our May 11th day. There's a lot of action alerts we put out to mail your legislators. But one thing I often try to highlight with the NSW folks, as well as the NAMI folks,

really anybody who's interested in government, is pay attention to your county government. If you're in New York State, and actually a majority of other states, they're called home rule states. which means your county actually makes a lot of decisions that your state is more of a provides guidance resource centers, doles out grants,

but your county and in New York state, your, your DSS is the county that the county organization that will handle a lot of those things. And there's county community services boards that are always looking for volunteers. And there's usually regional commissions that are always looking for folks. Again,

just if you want to join NAMI, you can go to our website, get connected to us and then those local affiliates and your local state office can help direct you to the best way to work in your community and our national folks will connect you there obviously anybody who's listening to this or a lot of people who listen to this are social workers

get connected with you all and be able to partner on these bills, I think we mentioned a couple times that there's some overlap, we advocate for a lot of different areas of mental health our perspective is for the individuals and families but

a lot of what we want out of the health system doesn't happen unless the folks who are social workers, mental health counselors, psychiatrists, psychologists, if those folks aren't there too. Yeah. And so many social workers say this, but a lot of social workers understand that there are flaws in the system that can lead them to not serving their clients in their best. So when clients and the people serving the clients are able to come together to discuss what those flaws are and how to better the system, then it can really lead to true advocacy and awareness and you know talking about localization of advocacy you know all advocacy is local and so true getting started with your NAMI affiliates in your local area but also with National Association

of Social Workers New York we have our divisions so we actually have a division director in each part of upstate and also in the five boroughs in New York City and that's a way to get involved in your local community at the state level when it comes to helping social workers and also the clients that they interface with um and so if you want to really do this work to destigmatize mental health join you know both of our organizations one of them we do work together as we talked about a lot today um but really we cannot do this work alone and i think that is the bottom line and so this work to destigmatize mental health it's a big flip it helps climb There are a lot of partners in this work, like the Office of Mental Health, OASIS, as you mentioned, the governor highlighting that in her state of the state.

You know, so we really need to increase that awareness at the New York state level as we serve oftentimes as a model for other states when we look at across the nation in our systems of care that we have. but it's really strong when clients and their service providers can stand together, identify what needs to be better within the system, but also bring forward that space will allow people to come forward to share their own stories. Um, because we need to share our work with people that may be scared to get involved in advocacy in the first place, because maybe sharing your story is the most intimidating thing in the world. You know, maybe you're somebody who's experienced mental illness and you have a real need and love to advocate for that. But maybe you don't want to share your story in a public forum or, you know, you can even share your story

anonymously to us. And, you know, we can have that as an outfit in our current magazine that we've had for a number of years in the city. But destigmatizing mental health, it will not happen. So we truly appreciate you being here today. Yeah. Thank you for having me on. Thank you. Thank you so much for joining us here today. If you want to get plugged in with NASW New York, go to naswny.socialworkers.org. Thank you so much for listening. Thank you.