 My name is Cecilia Cheverria, I'm the executive director with the Institute for Health Policy and I'll be your emcee for the day today. Welcome to our fifth IHP forum. We've been thrilled to be able to host these over the past year and a half and they've been a really great place for people to connect and to learn about important issues that we're facing not just Kaiser Permanente but our country as a whole and we've been thrilled to be able to convene smart people to discuss these issues. So before we get started I want to go over a few housekeeping items. So you'll note that you have a folder in front of you and that has some helpful information for the day. So it has a copy of the agenda which includes the Wi-Fi password. So please take a look at the agenda for the Wi-Fi password. We have a one page overview of the issue. We have a registered attendee list and we have an evaluation form and I'll get back to the evaluation form in a little bit. If you have to take a call today we ask that you please do so outside or that you see one of our staff members. Staff are wearing a blue pin. You've seen some of the folks at the back registration table. Ask anyone with a blue pin if there's a space available for you to take a call. We're happy to try to accommodate you if we can. If there's an emergency please use the back exit where you entered. That'll be our emergency exit for the day. And as part of our day today we will be covering a lot of information and we're hoping that the conversation takes place in the room but also on social media. So you'll note on the table that there is information about hashtags that we'll be using to carry on the conversation on Twitter. So please feel free to tweet today during the event as well as after the event with your thoughts. So those surveys, those evaluation surveys in the back of your packet, we do need them. We do listen to your feedback and your guidance. That's one of the reasons why you have a list of the registered attendees today as we heard from you and we knew that people were interested in that. So please continue to give us the feedback and we'll continue to try and incorporate your suggestions as best we can. We will be breaking for lunch at 12.30 for those of you that really need to plan your next meal. So at 12.30 we'll be breaking for lunch. So now that we've got that out of the way I'll transition us to the official start of our program so I'd like to ask Dr. Mordechai to come up and I'll read his bio. Dr. Mordechai is the Kaiser Permanente national leader for mental health and wellness. He's been with Kaiser Permanente since 2003. He trained at Stanford University School of Medicine in child and adolescent as well as adult psychiatry. His clinical work is with patients with developmental disorders, ADHD and the range of general psychiatry issues. While he sees patients of all ages he's particularly interested in working with adolescents and young adults. Dr. Mordechai also serves as adjunct clinical associate professor of psychiatry at Stanford University School of Medicine. So thank you, Don. Thanks, Ceci. Good morning, everybody. It was a little tepid. Good morning, everybody. All right. I am one of those people who likes to plan my next meal. And the snacks are sort of in between now and my next meal. But anyway, welcome to our nation's capital. Welcome to our Kaiser Permanente Center for Total Health, which is a terrific space to do things like what we're doing today, which is gathering together. We've got a problem in our country, and I don't think this is going to be news to anybody here, about one in five. Some people say one in four Americans all the way from adolescence on up through adulthood at any given time are dealing with a mental health condition. This goes up to about a half at some point in our lifetime. So these are incredibly common conditions that people are dealing with. And yet, if there's one fact that always gets me, it's less than a half of people are getting any kind of treatment for those conditions. And you hear that over and over again, but let that sink in for a second. Less than half of people with these chronic and sometimes deadly conditions are getting any care at all, let alone evidence-based care. So the percentage getting evidence-based treatment for mental health conditions is much smaller than that. We could spend many forums talking about all the different reasons that these things might be. One reason that I think we just have to look square in the face is we've got a pipeline problem. We have a staffing problem right now. We don't have enough people to meet the needs of all the Americans who have mental health conditions right now by a long shot. And we know that our cadre of people who are trained to do these things are getting older and older and older. I was thinking this morning like, oh, I'm one of those psychiatrists over 50, right? Like, here it's me, right? So we need to think about the pipeline, and we will certainly think about the pipeline today. So we need to do better, right? It's not just a pipeline problem, but there is a pipeline problem. When we think about what else we can do, it's how do we bring these evidence-based solutions, which by the way are often far more efficient in their use of mental health professionals in terms of delivering care. So for instance, collaborative care. How many people have heard of collaborative care? That's pretty good. Okay, good. So collaborative care is an evidence-based program to bring mental health care for depression, anxiety, which by the way are the most common presenting mental health conditions in primary care, to bring evidence-based care into primary care, right? And you might say, well, aren't you just trying to protect specialty care? No, right? We know that when you do that in primary care, what you're doing is serving a population that may not have gotten care at all otherwise, either because specialty care is not available or they don't have any interest in walking through doors marked psychiatry or mental health or specialty care. So we have to do that. And it doubles the outcomes of usual care in primary care. I like to think like, oh, if Namer Pharmaceutical Company came out with a medication that could do that, you can bet we'd be paying for it, right? And yet, collaborative care is really having trouble finding footing even 15, 16 years after the evidence came out that proves it. So we need to think about how to do things better. We need to think about the pipeline. For our part, we are working on breaking down stigma. It's the right thing to do. But of course, if we're successful, we generate more demand. We're still going to do it, right? We're coming out with our third year of the Find Your Words campaign. I wonder, I'm going to venture to ask, how many people have seen anything about Find Your Words, any of our videos, any of, OK, that's pretty good too. Find Your Words is a public health awareness program that we designed not to trumpet Kaiser Permanente, but instead to say stigma is a problem in our country, and we dedicate ourselves to breaking it down. It includes videos and resources. You can go to findyourwords.org to check it out. We've focused it on people who are dealing with a mental health condition, people who care about somebody dealing with a mental health condition. How do you have difficult conversations about depression? We're even moving towards how do you have difficult conversations about things like suicide? How do you ask about that? Is it OK to ask about that? And the answer is yes, it is OK. So we're going to keep doing that for our part. We're working hard on our training programs. We have Dr. Catherine Wetzler here today who's going to talk about what we're doing within our Northern California region to train what I hear today is over 160 mental health professionals every year, and that's separate from the training that we're doing for physicians. So those are psychologists and master's level trainees. We have connections with top level universities to train psychiatric residents. We're actually starting our own residency programs in Northern California. So that's another piece that we're doing to say, OK, we get it. There's a pipeline problem, and we need to feed that pipeline. So throughout this day, we're going to talk about other successful strategies that we can look at to solve this problem. And how do we bring our existing providers up to the evidence base that exists today? That's another thing we need to do. How do we leverage them? We want to keep an eye on public policy solutions. And we're going to hear more about that throughout the day. What should we be getting behind to help us solve this problem, right? Own forgiveness, opening up more slots. There are lots of policy ways that we can make mental health a more attractive career for people, because it's a great career. And I think lots of people would think about doing it if they knew that they could, if they knew that they'd be supported in it, if they knew that they go into it, that they can support a family, have a place to live, have a decent life. So those are things that we want to make possible through public policy. So please, be an active participant today, ask questions, challenge the status quo, make connections, meet people. That's what we're here for, to raise our collective understanding and to make a difference if we can. So I am going to turn it back to Sassy to start us off. Thank you. Thanks, Don. So that sort of activity and engagement starts right now. We will be starting today with a poll. And we'll have a few others during the rest of the day as well. So there are instructions at your table on how to participate at the poll. It is on the little stand in the center of the tables. But basically, to use the poll, you text KPIHP to 37607. And there's instructions as well for how to do that from a laptop. So I will let folks get that going. But one of the questions we want to kick off so that we know who's in the room is if you could tell us what sector you work in. So please select the sector that best fits the organization that you're affiliated with. So we have a few different types, professional and member association, healthcare system, government. We may have the government people distracted today. But research and academia or non-profit community organizations. So take a minute to please complete the survey. So great. So it looks like a healthcare system by a long shot. Right, oh, we do have some government people. Thank you for coming. Great. Wonderful. Thank you. So it looks like about half the folks in the room are with healthcare, a healthcare system. We have 20% of folks with professional membership association affiliation, almost 20% from government. We have good representation from nonprofit community organizations and some academia as well. So thank you for participating in that poll and sharing that a little bit about yourselves.