 And at this time I'd like to welcome back Don Mordecai to the stage, as well as Tony Beretta, our Senior Vice President. So as they're coming up, I'll just read you a little bit more about Tony. Again, Senior Vice President of Government Relations for Kaiser Foundation Health Plan in Oakland, California. He oversees development of Kaiser Permanente's public policy positions in collaboration with senior leadership. Are they fighting over there throughout the organization to ensure that Kaiser Permanente maintains a common voice in support of the interests of the organization, our members, and the communities we serve? So Don and Tony, I'll hand it over to you. Well, thank you, Sesse. So I have the, well, Tony and I have the unenviable task of trying to distill a pretty amazing day. These days always go by really fast for me, and it's like there's so much good stuff coming at us. So first of all, let me thank all of you for joining us here today and for being actively involved like I asked at the beginning of the day. I appreciate that. I want to thank the amazing group of speakers that we had that brought so many diverse perspectives and ideas, which was terrific. And I want to thank the IHP staff and the staff at the Center for Total Health for hosting us, welcoming us, making it move smoothly. Just terrific work, everybody. So thank you. So I sort of spent the day like scribbling things down on little pieces of paper. And then I sort of distilled those things and I just want to share with you my thoughts, basically, that came out of that. One was we started the day acknowledging that we have inadequate capacity, right? But that was too broad and we very quickly got down to a lot of nuances about that. And one couple that struck me is that we have inadequate capacity, but it's also poorly distributed. So it's a double problem. And I want to thank Dr. Muta for bringing that to our attention. I love the idea that we need to be thinking in terms of being driven by what people need, right? Not what our traditions are or what we want to give to them or what we were trained to give to them, but who people need. And that not everybody needs the same thing. We definitely need to train more people, but we need to train them in new ways to do different things in different settings. So evidence-based care came up a lot and I certainly appreciate Brad bringing that perspective and Brad's work with us at Kaiser Permanente to think differently about how to bring evidence-based care to our members and patients. I was very thankful that it was mentioned a couple of times what we're doing around measurement-based care, what we call feedback-informed care. And we are doing that across our program. That is a national initiative for us to bring measurement-based care to the field of mental health and addiction care, because we believe it's crucially important that we understand what are we doing, how is it working for people. I think it was Glenda who said, you know, it's really useful for when you're working with an individual to understand whether that individual is getting better. This is their symptoms going down, by the way. That's what that signal means. I think in terms of the graphs that we generate through doing this kind of thing. But we also use it in aggregate to help us understand how our systems are working and to identify bright spots where, you know, which of our regions is doing best at helping people with depression get better in the most efficient way possible, because that's what people want. They want to get better fast. They don't want to linger in care that they don't need. We talked about care in primary care and other non-traditional settings, and I think one theme that came through is how do we move care closer to where people are, right? That's what people want. Of course, we work, the 48% of us in the healthcare system work in this system, where traditionally it's like we build these wonderful temples and they're called hospitals, and you come to us because you love coming to us so much, you know? That's gone. People are living different kinds of lives now, and if we can get them care on the phone, email, you know, all the other ways, they appreciate that, because that allows them to live their lives in their communities instead of coming into our lives. We need culturally competent care, and we need to respect the fundamental dignity of people, as Dr. Ren said, which I appreciated. The panel on community and faith-based approaches talked about this idea of, can we focus on mental health, not mental illness, not mental disorders, but mental health, and the idea that mental health really resides not in hospitals or clinics but in communities. And what we're thinking, when I think about Kaiser Permanente's community health approach, we're thinking about how do we move upstream, right? And not just, oh, can we get people who are in our system but they're sort of preclinical, and that's an important group, but can we really move upstream? Can we look at what's going on in communities that drive adverse childhood experiences, which we know contribute to adverse health and mental health outcomes much later in life, right? That's the real upstream, right? How do we make our communities into places that are supportive and healing places and not traumatizing places, which too many of our communities are at this point? And I love the idea that we need each other to make this happen. And then I guess, and I'll wind up with this, which is a lot of what I got was a real sense of expanding the field of opportunities and solutions that we have. And that this was not just a, oh, yeah, we got it. We really got a pipeline problem. We really got to deal with it, but really thinking way beyond the traditional, right? So what can we do with peers? How can they contribute to mental health? What can we do with our faith-based communities and how can they contribute to mental health such that it's not just, oh, well, peers could really help the mental health, the mental health, mental illness care system in this way and they could fill in in this way. They can actually transform this, right, to be thinking again about mental health because we all have mental health. So I think finally I want to point to the next generations because as Linda alluded to, what I see in younger generations is much more openness about this conversation, much more expectation of like, hey, I need some help, so let's figure out how to get me help. Instead of a, well, I'm going to live in silence, I'm going to suffer, I'm going to blame myself, all those old notions that should be discarded. I have a chance every once in a while to speak to high school groups of kids in underprivileged areas around San Jose who are interested in the healthcare field. So that's great. I don't talk about psychiatry and thinking about how fun it would be to work in fields that think about the brain and things like that. But I'm struck at the kids who will stand up and say, well, Dr. Mordecai, I have OCD and I'm working with my doctor on it and I'm wondering about this, this and that. They're in front of 50 of their peers just right out with it and it just kind of warms my heart. So I think there's huge potential there. So I will wrap up with that and hand it over to Tony. You absolutely should. So thanks, Don. First, I want to thank all of you for giving us a full day and just extraordinary to be able to be part of these conversations. I do want to thank the Institute for Health Policy team, Sessie, Megan, Sam, Becky, Monique, Joy, whoever else I'm forgetting. I think that's most of the team who put this together. These forums that we've been having, we've had a couple of forums that have focused on mental health and they're really reflecting what we believe as a public policy and government relations team at Kaiser Permanente reflect the concerns of the organization as we look at the types of issues that need to be considered and particularly in the mental health space, trying to raise attention within our organization and with those with whom we work generally to try to see where we can go, because I think the last conversation helpfully touched on this. For many years this was a conversation about mental health parity. It was about lack of access to coverage and while there is still work to do in those spaces, absolutely, actually meeting the mental health needs of our population extends beyond that and involves developing new models of care, finding new resources, changing the types of resources that we have and I think that's what we've been talking about largely today. America, I have to thank you for changing the metaphor of going upstream to swimming in a lake with boulders coming down on it. I'm going to work that into my upstream dialogue from now on. Right now I will say the last couple of hours of listening to the solutions, which I was charged with trying to pull themes out of and some of my colleagues helped me with this, felt a little bit like drinking out of a fire hose and then having somebody throw rocks at you. So that was a little bit how it was. But I do think there are a few things that really come through very clear that help us with our next steps as we step away and frankly, a part of our purpose in holding this meeting is to help my colleagues and me, Julie Stoss, others on the government relations team figure out what do we need to take out of this meeting in order to synthesize policy internally to try to find ways that we can convert that into an actionable policy agenda in the states where we work, in the communities where we work and at the federal level so that we can bring Kaiser Permanente's voice more effectively to places where we haven't been as present as we want to be in the future. And it is the work of our colleagues who are actually, you know, those of you who are actually on the ground addressing mental health needs in our system, we're learning a lot there, and we learn an enormous amount from all of you when you come to meet with us in these sessions. So very, very briefly, I would point to a couple of things. It was loud and clear the lack of good data to inform the policy debate that exists. There's an old saw among budget policy people in Washington in particular, but everywhere, which is to say, in God we trust, all others must bring data. And particularly if your concern is, can we get appropriate financing to make things sustainable? Can we draw on other stakeholders in the community in a laying out the reasons why there should be a reallocation of resources? Without data, nothing will ever change. And so getting good data, the team at UCSF is really to be congratulated for stepping into this. The team at the University of Michigan, God bless them for starting to do this. And yet the data are incomplete. It's still very embryonic. And I think as a foundational point, we really need to work on that. It's out of that that I think we will be able to start executing on the financing questions. And then a piece of that, and this came out in the conversation, how much of it is to pay for the types of things that we're doing now? What type of payment flows are needed to help transformation in terms of training new models of delivery? I thought that presentation around integration and coordinated care and the fundamental disconnect between traditional payment models and what's necessary to enable that. We have seen very challenging effort in the medical care space to do very much the same thing. Clearly that road is still in front of us in the behavioral health space. And yet that is where we will create new capacity. That is where we'll be more effective in terms of models of care and telling the story of how that's working. And I thought that was wonderfully done today too from an advocacy standpoint, absolutely critical. Standardization of licensure across the country. I thought that was a very important point that is actionable at a national and state level. Just to point out, not only do we have the problems of non-state-cross-state licensure, you have different certificates and licenses from state to state. That really impairs the ability to leverage the entire national workforce in appropriate ways. And so that's something that I think I wouldn't have thought of, but had to come forward. There was an enormous theme today around rural access. Touch on telehealth around that. And I do think that, and this is something that state legislators we deal with or attuned to, is the problem of broadband access. And that needs to be characterized as a health problem, and health resources need to be available to help lean into that problem because it's not going to happen magically in some other way. There's been lots of efforts to do that. I think we heard in a number of different dimensions the need for better measurement, whether it's at the government level and how performance is happening. We've heard models of care and measurement and driving satisfaction for providers. So I think there's a policy conversation to be had around supporting how measurement should be happening and can we get to more common measures. And I have a long list of others. Probably the biggest one that I think came through here as well, which is a political problem as much as it's a policy problem, is virtually every speaker today reflected on the problem of silos, of the problem of the guilds, and the desire of people even practicing within those guilds to transcend the current definition to help people identify themselves as professionals, how they identify their systems and what they're providing, and everybody knows that somehow we have to move beyond that. And that's going to require flexibility and creativity. And policymakers can help in that regard. They can help to create a demand at a policy level to push on the stakeholders who typically are coming to them with the narrower concerns that they have around the traditions. Nobody wants to have their cheese moved in a policy discussion, but the current cheese isn't tasting very good and it's in the wrong places. So we need to be able to figure out how to come together as a community to be able to tell a better and different story to the policymakers. So, Ceci, I know that's more than enough and I do want to thank you all again. We will keep this conversation going in a variety of ways. You may say a little bit about that. And again, we really look forward to the continued engagement and continued input. So thank you.