 I'm not saying that everybody in the ceremony is about to begin. I think I just said that. So, what we'll do to start, and welcome everybody. Thank you for being here in this exciting news and the beginning. I mean, we're going to open with Inbo and Michaelis. And so if you want to see if you've got it. Welcome, everyone. I feel like my heart is like, wow. This is all of you here. The county, the agencies, community members. If I could welcome anyone. You're just welcome. You're just really amazing. Thank you so much for being here. We have a transition into this presentation. We are in Congress, and at second store, we've been integrating more and more mindfulness awareness practices to support us to do a better job in everything we do. In the way we are with ourselves and the way we manage our own stress. In the way we are with the people we serve. In the way we are with the people we partner with. It's very simple. So, if you have any anxiety about it, please let it go. So we're just making a transition in order to be able to be here from this present, to open our mind and hearts to the experience ahead and to support each other in this wonderful journey that I have across. So the invitation right now is just to find a comfortable way to be on the chair. Each chair has their own, you know, to make peace with it. And this episode, and actually hopefully in the next couple of hours, if you can put your device on the most disturbing... Thank you. On the least disturbing capacity, that would be great. And if you can turn it off all the way, it would be wonderful benefit. On the chair, if you are comfortable for the next two minutes, closing your eyes, you know, just find a way to bring your gaze inward. Just to allow yourself to check in with how are you doing right now at this moment. Taking a moment, ask yourself, how are we doing physically? Noticing your physical body. If there is any tension, you are aware of, that you can let go. Checking in about what is on your mind right now. You might already have been very busy this morning. Just noticing what is there. Just for just checking in, how are you doing? How is your heart doing right now? Emotionally. Taking a moment for taking your own internal weather report. Physically, mentally, emotionally. Recognizing, welcoming, the whole of who you are. Then gradually bringing the awareness to your breath. Hopefully you are breathing this hot line. Just noticing the very natural rhythm of inhalation and exhalation. Just no need to change. Just noticing the exhale, the inhale. And recognizing for this moment how the breath and as we pay attention to it can be just a wonderful resource to support your well-being. Transition into this presentation. We just like to set the intention of being, listening, of community building, of hope and inspiration. And again, expressing such deep gratitude for each one of you for being here and for this wonderful community of support. So as you hold this intention, gradually opening the eyes, back to the room, wriggling toes, fingers. Taking a moment, kind of looking around. And just with your eyes, welcoming another person that you don't know. Seeing if there is someone around which you haven't seen. With your eyes and heart, expanding the well-being. So with it being said, I'd like to turn it over to Edwin. And so we begin again. Does everybody know what second story is? So our program is a... I was thinking of the greatest one language that could be perfect for trying not to make it apply to the greatest degree as possible. But as I could think about it, the one thing that I say second story is and does is, second story brings sanity back to mental health, right? It brings sanity to kind of the insane dimension. And so we try to find a balance in what it means to be peers going through this and to be able to connect with each other. Everybody that works at second story has gone through their own psychological upheaval. And myself have been hospitalized quite a number of times, depending on how you find quite a number. And so we all have a lived experience. And please, for the people that work at house, if I leave something out to the significant, please set up and say it at some point later as we go into the discussion. So we were funded by a SAMHSA grant, and the grant is now hanging, and now we're going to be looking into funding with the county. And so we work with all kinds of folks, people that are coming from the hospital, people that are coming from places that are going to come to this and which is also part of what we work with in slideshows. Kind of there's part of the team once we work. And so we're at the forefront of the peer respite movement, I guess, or at least part of the forefront as much as everybody works together. And so we kind of are working in innovative ways of creating new ways of approaching each other in communication and connection and finding the meaning of what it is that we're going through and be able to articulate intensities and be able to receive the same intensity back and be able to find, you know, argumentally that we are people that believe in it. And some of the research will show just how impactful we've been on the community in Santa Cruz Pears. And there's enough people here today from within the county and from the campus itself that have also seen and been a part of this process of our own transformation. And it's kind of redefining what it is that we're looking for as a community of health, of mental health. And so here we are. And we're all in this group together. And it's not even about mental health peer movement. It's about a movement towards greater wellness. All those great words, but even a health movement. Because ultimately we're all here for each other in some way and we're doing our best to keep taking steps that create greater and broader visions. So I think that I've left out probably about 99.957% of what I could say. But I also am mindful of time is better than me rambling and proudly knowing about how great the program is. I think all that people describe it themselves. And so I want to bring Eric Riera up here who is the mental health director at Santa Cruz County. He's good forward. And he'll say a few words about the program. And then we'll hand it to Involve Next and then to Bevin. And then what Bevin's done after about 45 minutes of research will then move into just a general connection with the rest of us about how the program has impacted each of us. Well, thank you, Adrian. And I guess I have to begin by first saying congratulations to Second Story. I've been with the county for about 18 months now. This program has been really critically important to the community. And I think what you'll hear today is a lot of the evidence of the impact that this program has made in the community. And I'm very excited to see it moving forward and looking for some opportunities to expand it as well. You know, it's one of the themes that you'll be hearing from the county over the next year is the theme of community impact and how we can work together with all of our organizations and stakeholders, consumers, family members in the community to make the biggest impact for the population that we're serving. And Second Story has really exemplified that community collaboration. One of the big challenges that we've faced as Adrian mentioned, the program was established through a SAMHSA grant which is actually expiring. And we had to figure out a way, what are we going to do now? Funding ends. We have a critical program to the community and we want to sustain it. And fortunately, we were able to work out a long-term sustainability plan for the program. That was just finalized last week. And we are able to successfully move this thing forward. And that was a big word for all of us. And bottles of chuckling in the corner. Perhaps a few sleepless nights. But we're in a great position now where we don't have to be concerned about the funding and we can look at opportunities to really make a bigger impact in the community. So again, congratulations to Second Story. Lots of opportunities ahead of us, I think. On a state level, for the first time, the state's committed to expanding a peer certification process which for the first time will bring in medical revenues to support programs just like Second Story. And what does that mean for us? We can look to expand to other parts of our community. Watsonville, for example, loved to have a program done in Watsonville similar to what we have here in Santa Cruz. And so we finally have some opportunities to think beyond what we have today and very, very excited to work with everyone here to make that a reality. So I hope you enjoy your day here today and I'm very proud of all of you who have accomplished. Thank you. This is the case of what Second Story is because we haven't really defined it. A two-week residential care facility, mental health facility of sorts, and it's a place that people can stand for two weeks and recover or get through any kind of crisis before it turns into a crisis. That's as overview as I think. We can highlight a community-based organization in Congress to have a peer respite part of our very wide group of programs. And I had the opportunity for almost the last three years to be the person in the Compass that worked directly with Second Story. And before me, it was Betsy. So glad that you're here. And it's been an amazing journey. And if you're not familiar, which took me some time to really immerse myself in the language and the framework of the peer respite program around the country and where do they fit? Because many, so just kind of went with around it and all the experts are seeing right here. They can say, well, there are some similar programs that operate independently. They're just their own program. They're not associated with another big non-profit or small non-profit. They're just on their own. And then when Second Story was envisioned, as Jona will tell us later on, for many reasons, mostly logistics and really to make it happen, it seemed like a good idea to have Second Story attached to an existing community-based organization just to support its day to day. So this is how it started, which is unusual in some ways and there were many conversations about does it need to be independent? What does it mean for it to be part of the traditional existing community mental health? So when I came on board, I was very curious about that and it's been an amazing learning opportunity to really to understand what it means and more than anything to... really in some ways I was reflecting on this. Every day this relationship with Second Story, this amazing team that works at Second Story requires me to question, where am I coming from? How am I... What guides my beliefs about the people we work with? What guides my decision-making processes? How am I in the world as part of a community mental health organization? So I'm just so grateful for this push to look at that because as we know, many of us looking around the room just from the color of our hair, we've been around for quite some time, have done this work for some time and we have our habitual patterns about that and our beliefs that we've developed over time and what guides our work and we are all very enlightened and we keep learning and changing our habits and our some habits are supposed to stay the same. So again with the Interaction with Second Story the questions that are being asked from a peer perspective has been so enlightened to me and listen to what I like. A few of them have been a great opportunity. The whole concept of collaboration and what it really means to collaborate with each other has been, oh, I can look at it very differently. How am I being... How is it like for me to sit in the room and really listen to the other person? Am I really taking their world view into consideration? And keep learning. So that's been a great point about that. When it comes to trauma-informed care I really actually want to express my deep gratitude to Second Story Program because in some way it's through Second Story that I made the big leap into saying absolutely we have to be trauma-informed and there's no way around that and the way that the peer movement talks about trauma-informed care the way they define safety which is so much... It's different because again as provider we have all our guidelines around safety and protocols and then talking to the Stafford Second Story it's about, oh, just a second it's about how it's defined by the person you want this. It's not my definition it's this person's definition just as an example. When it comes to empowerment and collaboration in some way it's very subtle differences but they're so deep in terms of how we are with each other so it's been an amazing journey and so what I want to really promote since we are on TV if you haven't known that and this is more a message to the rest of the country that he's been watching Second Story very closely because it's been a very pioneering program that is doing things very differently so there's a lot of learning that you'll learn very soon from that and that is being based on the experience of Second Story that there is an amazing benefit from having a pre-run program embedded in a community mental health organization because I believe that as a result of this collaboration there's so much amazing learning that if it was separated it would never happen so I just want to have it being on record that this is I think a really great successful model just for this reason so with it being said I'd like to turn it back to everyone Thank you and so now we've had a four year research component as well and so it's been Bevin Croft that has been kind of the person that we've given all of our data to and anyway I think I'm just going to give it to you right now Bevin Croft I'm a research associate at Human Services Research Institute I hail from Cambridge, Massachusetts I'm here visiting for the week Human Services Research Institute is a non-profit organization, research organization we have been working with policymakers, providers stakeholders on local state and national levels to do program planning evaluation and research to improve human services systems for close to 30 years I work on the mental health team at HSRI and I've been very lucky to have to be the central person focusing on this evaluation since it began in 2011 Also here's my colleague Lisa Oskra who started at HSRI with me and now is a California and she and I have collaborated on a lot of work on this evaluation in particular and on studying, understanding and documenting best practices for peer respite programs nationwide So today I thought I'd give you just a few slides on national context to understand where Second Story sits in the movement as some people have been talking about that includes peer respites exploring community-based alternatives to support people who are experiencing or are heading towards crisis I'll say a bit about Second Story but a few people have already offered some definitions maybe all for my own and then spend the bulk of the time describing the evaluation which is really a work in progress So it began in 2011 we have been just wrapped up data collection and now a few interviews with some of you along here this week and then we'll be running a bit data collection and still really synthesizing a large volume of information that we've collected over the years but I do have some selective results I'll describe some work that we did more recently that's completed looking at the first phase completed looking at the program's impact on inpatient and emergency services provide some fresh results from our survey and interview particularly focusing on the experience of this program of free guests for the people who stay there So peer respites in general are short term voluntary home life environments for people who are experiencing or are experiencing some kind of psychological upheaval with this intense experience really the self defined part is important as it is throughout this program and the premise is offering support by people with lived experience to people with lived experience to either prevent or overcome crisis and also with a focus on creating connections within the community rather than taking the person out of the community to deal with whatever's happening peer respites in the context of a larger movement towards health and behavioral health systems change so if we look at in the 90s the Olmstead Bollywood Supreme Court and this focus really really led a human mandate to state and county governments to provide services in the least restricted environment for people with all different types of disabilities and challenges so really since then we've been able to stop locking people away and containing people and to support them in the community and that's been hard and we're still working on it but we can see this as the beginning of the movement. The substance abuse and mental health services administration the federal entity part of the health and behavioral services department that funded the first few years of the program has really made a lot of positions that support these ideas of serving people in the community an emphasis on the value of people with good experience working within the system at all levels and the good and modern being the whole system is a paper that we really like in Tesserae that just sort of lays out a real broad array of services in the community that are needed if we're really going to support people with their diverse challenges and lives and in general in health care we can look at the Affordable Care Act and health reform and movements in the health field and understand a shift moving away from a focus on illness and disability to a focus on a whole person and recognizing that people are not just you know disembodied heads and arms and medical problems really everything is interrelated and if we really want to support people from the perspective from a holistic perspective so you see patient-centered medical homes you see person-centeredness being an aim of major federal agencies across health care and then you see integration and then move towards treating a person or the whole person and that includes mental health challenges behavioral health challenges and physical health challenges starting to blur the lines between those so I think we can really understand the context of a movement thinking more holistically about health and wellness in general in the past few years POS has been popping up all over the country there are currently three in California including Santa Cruz are there more yet? Just three there will be more coming and others and four more I believe concretely plan but it's important to understand that POS is one of the first and all of these programs know about Second Story and know about what's happening here in your community and are watching to see what happens okay so I keep on going quickly past this slide Second Story was funded by SAMHSA now it's going to be funded through county funds is a ministry through this community-based organization in Congress and really evaluators alright so the evaluation was a condition of the SAMHSA grant and we were hired on through that grant process and it's a pretty broad evaluation it uses a mix of quantitative and qualitative research methods and it has a focus on outcomes as well as process so the outcome questions that we sought to answer back in 2011 when this program started was to what extent has this program met its objectives that were stated in the grant and those objectives were to reduce emergency hospitalizations their virus and cost of services to foster recovery we can tease apart what that means and increase meaningful choices for people in the community on the process side we wanted to understand how the program was implemented so that we can capture best practices, lessons learned things to do, things not to do for future programs since there are more coming every day we also have been seeking to understand the relationship between second story and the rest of the community and that means the provider community in this room, it means the larger community it means all different stakeholders it means for Santa Cruz to have resources in the community as part of the community we used a number of data sources for the evaluation today I'll focus on the first three but Lesha and I have been working on a measure to capture fidelity to the pure respite model so basically if we're thinking about a pure respite as an evidence based practice or becoming an evidence based practice what we need to understand in order to do that we're starting to try to lay the groundwork to that I've also attended a number of meetings virtually and in person visit every year looking for documents but primarily I've been working with an excellent team data collectors headed by Linda here who've been all of whom have identified having lived experience themselves who surveyed guests all guests are invited to take a survey at the beginning of the end of their stay second story to be part of the research study and then every six months or so we collected if we sat down with people talking to people on the phone and had conversations started with more qualitative open-ended conversations to understand the different links to questions and those have been with guests, providers many of you, team members, etc and finally we analyzed some of the data I have here at the counter that just captures service utilization and some basic demographics we'll go through the survey the source is a little bit the surveys as I mentioned were administered by people with experience who were specially trained in research ethics and how to do survey administration and the survey was collected at baseline so within 24 hours of entering the program so ideally sort of before people were exposed to the second story environment or just a few hours of exposure within two days of leaving the program and then for folks who didn't come back to the program within six months they were also surveyed six months out to see if there were any longer terms in the past the surveys that we used focused on these areas there were a number of questions it was a fairly lengthy survey that was done and the data that I'll be presenting today constitute the first ever baseline survey and the last ever discharge survey for 101 of the guests we used the second story in this time period the stakeholder interview as I mentioned we ask people a lot of questions but the central question that I'll be presenting on today is just what is the impact of the program the lives of the people who use it we ended up doing over the course of the past four years 23 interviews with 19 guests so some folks ended up being interviewed more than once and the way that we identified people for these interviews we used different methods each time but we didn't want to just get like the happiest customers of the program we wanted to get more of a diverse perspective on the program so we sampled we tried to over represent people who were dissatisfied on the survey for the program and we also when we did the services analysis we identified some folks who had higher levels of inpatient emergency use and second story who used second story a lot to talk with them and we also focused on people who were younger so 18 to 30 range and tried to focus on that group as well because as you all know that's a good fit is that a particular critical point in their involvement with the system in the second story may have particular benefits for these individuals we've also spoken with providers before this week conducted 6 interviews with 9 providers and I've been speaking with some of you in this room this week so that number will go up we've done individual interviews with team members over the years and then also as I mentioned a number of group interviews with the team members all of these interviews lasted 3 minutes to an hour and they were audio recorded and transcribed and then we used qualitative research methods content analysis framework analysis to organize the material which ended up being a lot into themes sort of ideas and clusters and we're still in the process of that and then the service utilization data the third part that I'll be presenting today is the county service use data so we collected all data on everybody in the system of care every single person in the system of care from May 2001 to June 2013 and we used, we identified the second story group and for the rest of the people in that data set we used a statistical method called propensity for matching which I can explain to you later if you're interested to create a comparison group and the idea is the comparison group are people who are similar to the people who used second story along the characteristics that we could measure so demographics, diagnosis and service use history and the idea there is to try to compare outcomes to apples try to compare a population of people who are similar and see if there was a difference in the outcome and in this case the outcome was total hours of inpatient or emergency service use so everything more acute than the second story after the date of first respite stay and for the comparison group we had the first respite stay matched for the others so if we write into the results of those then I'll just say a little bit about who we're talking about so between and these slides are a little different, the samples are a little different depending on the data source a total of 209 unique individuals used the respite in the three and a half years that it's been open and this is awesome it's December but a lot of those people used the respite more than once actually a minority only 40% used the respite only one time people see an average of three times so they went back we had some interviews where people are saying I come back to the second story because it works funny just keeping that in mind is interesting a small number of people use the respite over 10 times over the three and a half years and those are the folks that we were trying to understand more about and we tried to interview some of those folks like to stay also varied typically like to say it is two weeks the average like to stay was 10 days some people for various reasons there were exceptions made and the range was from 1 to 52 days in order to be part of the studying we had to stay for more than 24 hours if a person stayed for less than 24 hours they weren't included in this study the average age of respite users and this is from the county information so it's a little fewer because this is what we had in the time period that folks is due last year the average was 44 the majority were non-Hispanic and white only a small number were married or employed more people were employed part time but only 5% were employed in the county and we didn't see any significant differences between that comparison group that I mentioned and the second story yes so like I said we seem to do a good job creating a comparison group and of the people who used the respite for the services data 42% used emergency or inpatient services after using the respite so by and large this was pretty frequently used emergency services let's see a little more about who used the respite these are from the surveys where we were able to capture the more detailed information 72% lives independently of that includes the supported housing the major living sources of housing that was connected to treatment in some way 13% reported that they were homeless one or more nights in the past 30 days there's fairly large libraries 83% had completed high school or G.C. there's 60 in the surveys more people reported employment in the county data I think a lot of that is probably making more informal employment and this is very interesting to me 96.7% of people who did a second story reported that they had ever experienced violence or trauma so when Inbal talks about the importance of trauma and poor care I just want to second that it's being critical critical so getting to the analysis of the county data look at the math out of the way we took that comparison group that I mentioned and then we looked at the people who used their story and we looked at the likelihood of using inpatient emergency services after going to the rest it and we did a logistic regression model for those of you who care that controlled for all the covariates that we could control for so sort of holding demographics age service use history constant we found that respite guests were 70% less likely than non-respite guests who were similar to use inpatient emergency services after they went to second story and then going a little further down we did also find that the likelihood of subsequent inpatient emergency service use increased with each additional day of respite stay so there was something about the folks staying longer interested that sort of reduced this finding but still by and large at a statistically significant level so we can say with 95% certainty that this is not re-readable to chance people are quite less likely to use inpatient emergency services when they have used for respite then we took out the people who did use inpatient emergency services as for respite and we said well are they using the services but using them less so are they falling down and needing to get that extra support but are they able to pick themselves back up again more quickly and the answer to that is by and large yes those people who did use inpatient emergency services the ones who had stayed at the respite used significantly fewer hours of those services than the people who didn't and again going a little below the longer the stay at the respite there seemed to be diminishing returns to those longer states so we saw that this sort of wore off the longer people used the respite so interesting finding is that I'll discuss a little more and we'll be happy to discuss later I think we're hoping to explore some of these questions further but the takeaways here are people who use inpatient emergency services less and when they do use them they use less of them so the next slides are some newer results that I recently put together just sort of compiling information from the in-depth interviews and the survey because we care about more we care about other outcomes than just inpatient emergency services so for these findings in the green arrows these are the from the guest surveys I guess they feel like houses too they're from the guest surveys and there are the percentage of people the guests were asked if they agreed or disagree with a whole number of statements and these are the percentage of ratings, guests whose ratings increased so they're they went from strongly disagree to agree or disagree to undecided so their ratings increased they were more likely to endorse these different statements and anything that's presented here is statistically significant at the 95% level so again we're comparing the four people I've reused the respite to after they've used the respite for any length of time that they use the respite for changes that we wouldn't see if just a trivial change so and then the title of the slides are the themes that seem to emerge out of the conversations that we've had over the years with guests, providers, team members etc. what we're wondering about the impact of these programs on people's lives so the first thing that emerged is a pretty intuitive one respites refer to rest and a lot of people spoke about how this program was a way for them to take rest so ten guests and four providers really talked about this concept of describing Second Story as a place to get a break from stressful or toxic life situations so one guest said Second Story is my safe place I come here and I can breathe I come here and I have people who love me it's my safe place I love here, I don't know why I would use any other place but here and that quote was really indicative of what a lot of people said of Second Story just being a sort of a sanctuary for them and in this sense a few people kind of went further and talked about how being able to stay at Second Story and get that break and they had used the hospital for that break they had needed to go away to the hospital which one person described as more dramatic and moralizing than something like Second Story which really enabled this person to get back on their feet more quickly attend to her life responsibilities that she had while she was resting as opposed to having to be taken out of all of them another theme I mentioned was recovery earlier and as a construct recovery didn't really come up that much but what did come up was this idea of living the life that you want so we think of recovery as something that's self-defined and I think people at Second Story really just thought of it being a place for them to that supported them to live the life that they wanted so really I think getting to one of the fundamental promises of recovery so this looked different for every guest some guests described having the freedom and flexibility to explore what it was that they really wanted and make improvements in those areas one person said you were all there for to discover who you are I think Freud said to working to love and that really is what it is and we saw this in the data as well and it was so good data just some general assertions here I have a decent quality of life significantly more people endorse that statement having more good days than bad and this one overall house studies was interesting because we were early and stuck again it's a smaller percentage but statistically significant when we asked to rate their overall health people rated it higher after staying at Second Story that sort of connection mind-body connection piece yes oh good, thank you that's so good I won't be that much longer so I would say probably the most pronounced theme that came out of the interviews was this one connecting to a peer community it jumped out of the computer at me as I was living through the interviews people described Second Story as a support network community-based, this free-loving second family, like a commune a warm-loving place, communal comfortable welcoming and community-loving containers the theme was presenting data interviews with 14 of the guests out of 19, 5 providers and definitely with numbers of the staff team the guests go up with a positive sense of belonging they hadn't had before Second Story one person said it gave you a sense of identity it gave you a sense of belonging it showed me that there are people whose minds work the way my mind does who are in control of their minds don't let their minds control them who are hugely intelligent and really work around lives and this sentiment, this idea of being inspired or feeling more hopeful by seeing people who are sort of living examples of having living the life that you want in spite of serious mental health challenges really resonated with a lot of the guests and as you can see we saw very high ratings of belongingness and community finding this community that they didn't connect to before having a sense of belonging and even contributing to that community so another related theme was very strong is around developing one-to-one relationships which are obviously supported by that community feeling so several guests and staff spoke about developing one-to-one friendships through the program and those relationships included connections between guests so one guest said Second Story made me feel comfortable enough to go up to people and talk to people not just staff but clients too it wasn't alone. There was other people there quiet too like me and so it just helped me out a lot I took baby steps and it's easier for me to talk to people now because I've got Second Story and here we see very high ratings in the 80s of increased endorsement of I'm happy with the friendships I have I have people I could do enjoyable things with and this is pretty important having the support from other people in a crisis which might explain some of the reductions that we saw in the emergency service use another big piece of the developing relationships was developing relationships with staff a lot of interviewees the majority spoke about developing one-on-one connections with particular staff members during their states and I think these particular findings speak to the intentional peer support model that's used at the program which really focuses on mutual relationships as being the base of where the team members are coming from is really about establishing mutual relationships and connections before doing anything else so like I said I really like that we can have a real serious conversation between each other and exchange information from each other it's not like a one-way talking two-way relationship in communication and it's really genuine we're just really real with each other and they tell them when something's not working for them they're real it's like a friendship instead of the very close cold-hearted professional support there's connection there's real connection at second store and as you can see people are more likely to agree that they have at least one close mutual relationship and have trust in people to turn to a number of people spoke about being treated as an equal this was also referred to as having more dignity and having more of a sense of humanity through a second story being treated as a person of living illness several guests sort of compared this to past experiences they've had in the health system where they felt the opposite of that so disempowered treated as an illness one person said I don't feel less van in this environment I feel like across the table we're all equals even though I'm not pure staff still in provisional crisis services I may have come out of this feeling somehow I'm defective if this wasn't around and it was just the hospital crisis house I would feel in those environments very mentally ill like these are mentally ill patients and I'm not a patient I'm a person and I get treated like a full human being this could be related to people endorsing the idea of control and following important decisions in their lives about finding direction through second story in different ways half the guests sort of said the program helped them to work towards specific goals and sometimes the goals were concrete like going down to school or improving their physical health which is interesting because the program doesn't really explicitly push that into all of the guests but a lot of guests spoke more interesting generally about changing their old patterns and habits to work towards the wellness and personal growth things that they wanted to work towards so one person said without second story I wouldn't have as much direction in my life for a sense of hope that I could recover it's hard to say exactly where I'd be but I can see how it has changed me or how it changed patterns in my life I think if I didn't have that I'd just be stuck in the same old cycle doing the same thing over and over again and having the exact same thing happen to me really being mindful is the word being able to see that there is a way to be able to change and I'm starting to do that and I've accomplished a lot of goals that I didn't think I could accomplish just coming to the second story again I enjoy seeing the concept of growing as a person and importantly hope being hopeful about the future and finally a very strong theme that I struggle with how to conceptualize I call this flexibility and freedom at one point as well but now I'm calling it gaining independence it was about how the program is open and self-directed people can really make their own choices and the impact that that had on catalyzing change and pushing motivating people to work towards their own goals so one person said when talking about how it's not locked how you can do it everywhere you don't have to eat at specified times you don't have to get up at a certain time this person said I remember when I first started coming here I was like a kid I was like oh my god people aren't saying I have to do this and always reminding me about it it was really a joy but I matured a lot so I'm pretty much used to it now I guess I'll also spoke about how the freedom and flexibility led to them taking more responsibility depending on what it was that they had to act to change that themselves another person said second story feels like we make our own decisions and people don't take full control of your lives until you do and eat door screens both ways and here we saw people endorsing just a sense of agency personal autonomy believing in positive changes and using personal skills strengths and talents unique to that person the public flexibility wasn't perfect for all guests too I should mention some some guests voices desire for more structured activities more structured policies not everybody likes doors bringing both ways all the time and others complained that the program plays too many expectations on them so I think that's indicative of the program changing over time how it approached this flexibility piece and also just people getting different but by and actually we saw some clear gains so summing up what we have now and this is really selective like I said there are more and we can and will do more pulling out these themes and really finding them and understanding them but we saw we observed both quantitatively in the surveys qualitatively in the conversations that we had significant improvements and things that are important like quality of life and hope wellness self-determination independence and critically these personal relationships and community connections for the guests and for the staff too I think I would add and then the administrative data side we saw these significantly significant reductions in the emergency service use which has implications for cost for the system and the whole in the future we have more planned doing more work to understand the program's implementation and really starting to develop resources for other programs around the country and this program to grow on best practices and guidance for how programs like this can have the same kind of impact the second story has had across the country and then also the the question of the organizational structure how the leadership was structured in the house was something that the team has really wrestled with over the years and it's quite fascinating from an organizational studies perspective so we hope to do some work to understand that in the context of the peer movements and social movements in general in terms of the outcomes evaluation digging down further into the survey and county data that I described linking the survey data and the county data to really understand what are the characteristics that we're seeing in the surveys that may be indicative of the reductions in inpatient and emergency service use so who's reducing service use and why and we also will be doing a round 2 of the services analysis with a larger sample size so that will happen this year before or after my return to leave I promise anything but we'll have a larger sample size so we'll be able to detect results with more sensitivity and get at this question what's going on with those folks who are using a higher amount of services what's the story looking more sort of characteristics and understanding that and maybe informing how the peer can respond and maybe meet some needs what is meeting needs et cetera we'll see and then this question of what the impact is on the system as a whole I think is really salient second story's mission I think is certainly to be a space of community for people and to support people but I think it goes beyond that and it's about system change and about social justice and so what does it mean for programs like these to be situated within a mental health system how does it change the world view of folks like you who have been working in this system a long time so maybe do things differently in your processes in your life have some references here there are a few copies of the sizes that you'd like them and then they'll be available I don't know how much time I have do you want to contend or pick up any questions yeah if folks have questions about the evaluation or any of the findings now or later I'm happy to answer them it just solidifies what we are doing with a little love second story so it's great to see you today my question was in the length of state the longer they stay the diminishing return is that based upon the baseline average length of stay of 13 days and was there any type of metric for days state longer than the state and the the regression back to three seconds for a step and is there analysis on why is that I'll answer the first part of your question and I may have to ask the interpretation of the second so in the in a regression model you have an outcome and an intervention so in this case inpatient emergency service use and stay at second story or just stay at second story and then put other things into the model so you can talk to them and the one thing that we can talk to them was total days of stay and rest day we also put number of respite states to see if there was a difference and there wasn't so we used total days of respite so these findings are based on that so we found that around I'll have to look it up but it was on nine or ten days we started to see the diminishing returns kicking so that's really the finding for now what was the second part of your question do we know why that is? no we don't know why we we tried to find out with some quality interviews and we talked about we have some ideas one issue might be related to housing so we did have measures of housing stability in this just kind of rough measures from the county so like were they homeless or not but I don't know how accurate that information is in housing is a complicated issue so one issue might be are there people who are using both of these kinds of programs as de facto house which given the circumstances of a lot of folks that you work with I think might be possible other things too might be lack of social connections in the community just more challenges that even second story we got to make a dent in those are ideas but hopefully we'll figure out we'll understand that more about the time system when kids are young I'm going to say in their early 20s they're more in denial with a mental illness unless somebody calls the police or feels like their life's in danger they get taken to the mental place so is second story an alternative to these kids where they can go into second story instead of getting a job in the mental ward I think a lot of people on this room have ideas about this question I'll offer one observation that we've seen from several different folks for younger folks one issue might be coming to terms with what's happening and not wanting to be labeled not wanting to be somebody who's in the system for years and years and years we've understood serious mental illness is a chronic disease that you never recover from you're never going to work you're never going to get married you're never going to get the money and the sentence to receive second story is very powerful and offers an alternative to that and folks come to second story and see all kinds of great adults grownups of all different ages who are living very full and meaningful lives who've been labeled with serious mental illnesses who have been through the system as opposed to maybe going to a lot facility and seeing the folks You know, have really been through the system and taken and are in pretty bad shape from being in the system for years and years and years and it can really be scarier or hard for folks. That's one observation. Yeah, but is it an alternative? Because they get taken away, they get put in the facility for 24 hours or a couple days, they joke up with the, like, you know, a generic or a general, oh, we're going to do this, and everybody gets the same thing or whatever, then they come out, they're coming off of all of those drugs, and you're about to square one in a month or two. So, second story, do they offer an alternative to going into the psych ward because they are having an episode? Yes. Okay. I think so. So, we don't offer, like, cures, right? There's no such thing as a cure in all of medical health practices. There's no cure, but what we do offer, especially with young people with this, is extended time that they're connected with the county and they're part of the TAG transition stages program and we offer extended stays with them so that we can kind of bring through some of that, some of the mental illness model type of existence. So we definitely, and we've had incredible success. So we don't, with people that come in that are young, they're saying, I have schizophrenia, well, where is it? And so it just becomes a conversation about the human and the person that is expressing a very difficult time in their lives and being able to, and from our framework, it's not illness, and as a result of, like, really speaking to it and finding strength and sympathy as a community with each other and providing a different way of being so alternative, yes, we can use our words alternative, but it's, it doesn't solve everything with young people and turn to the program that will reap the rewards and no longer seem themselves as ill or broken, but they still have to explore those kind of equal spaces anyway. So that's kind of how it works. We've had a lot of these kids, you know, they have poor eating habits and it just, it's a little over adults. I'm talking about the younger kids, like, you know, our children, some of our children, that, you know, they're going to become adults, so why not live it in the bud? And so we've been doing a lot of research on this and realizing how important nutrition is. So I'm just wondering, I don't, can everybody hear me? So I'm just wondering, like, when they get into this second story, are there some, you know, better habits also offered with, you know, with nutrition and not just pills? Well, I'm sitting right next to you, can answer that question. Yeah, yeah, yeah, yeah. You know, yesterday I was at NHK and then I threw as a young man in that HQ who came up to me and, ma'am, ma'am, I just want to tell you something. Well, you say hello to everybody at Second Story. He said, I just want you to know that I'm at this program for drugs and alcohol and do a guide post. This kid has come to us several times. He is psychotic, drug addict, meth user, you know, and so he comes and then he leaves and then he comes and then he leaves and he says, I just want you to know that this time, I'm really going to do it for 90 days. I know, and he looks so good and so clear. And so, you know, I don't know if he will or not, but it's just, it's that feeling of community, a feeling of belief. You know, we listen to his story about why he uses drugs and why he, and how that helps him with his magic. So, that's an example. And yes, it's continual conversations about nutrition and exercise and, you know, sleep and just the basics of self-care basically. So, it's different than going to the psych board. Yes. I just want to highlight something that is related to this and I think just, I really hope everyone comes away with this concept. The idea of flexibility and freedom, the idea of self-determining the program experience is critical in Second Story. Is eating well important? Yes, especially for young people? Probably yes. But Second Story team members are never going to tell anybody what they shouldn't eat because the program is about creating support that goes deeper and setting the stage for people to develop their own independence and their own sense of self-worth and their own intrinsic motivation to be well in ways that they define for themselves. And I just want to highlight that as what I see as a critical ingredient that makes this program unique among any other program I've experienced and seen in the mental health system. There's a crisis situation and the police are called and immediately here they take up to telecare. Now, that's not much of a choice. I'm wondering whether or not there could be a choice already situated to where they can say, I want to go to Second Story because it's just going to be a cycle going into telecare if something isn't set up to where there's a choice. And a lot of times it doesn't need to be hospitalized something, the crisis isn't that critical and avoid the trauma of going into hospitalization that stays with a child for life. So we can be that. It's a matter of coordination. It's a matter of the person if they want to be there. It's really their choice if they want to be there. If they say I want to go to Second Story then that's realistic or plausible once we get kind of hooked into the whether it's accordion or whether it's somebody in the system the grappling looks right now and we're trying to figure out what to do next. If somebody is saying I want to go to Second Story it's probably before going to the hospital or something it's going to be a decision that it gets difficult to make but if we're a part of that process and we're able to be a part of it we won't be a part of a decision as much as receptive, offering maybe a good fit for us we're open to talking about it. And that said once a person gets into a hospital there's also people that the hospital PHF now is working with us the telecare is now working with us to send people to us and again they feel it's appropriate and part of our model is mutual like we want it to be on the equal terms and so trying to break sort of those barriers well of how do we communicate with each other in ways that we know we're both fulfilling the needs of society and our expectations and so yes, yes and then once we get people from telecare then it becomes another conversation of breaking people out of the dogmatic of the abilities and so that's kind of where we're after us there but it's complicated how to get people into the new networks but I just want to really quickly I just want to say we've got 45 minutes left and I want to make sure that we have time for story time just because it's I'm seeing heads nodding so we do want to move in that direction so really quickly do you want to start Rich? No I just feel like this gal here I still feel like her question was entirely answered because when you have a child, a young person he's not an adult or an adult and has not assisted care and wants to come to the house and this is the first time crisis for them how do you bridge that gap to allow them to come to the house it seems like it seems like they're going to have to go to the pub they're going to have to do all the things you were mentioning until they can get into the system and how can we have something for people who are just having their first crisis or having their whether or not all into the system yet we get calls from parents or to directors did you better answer that so now that we know that the funding for the program is sustainable for the next few years this is actually one of the areas that Eric and Pam and Cali Mental Health's leadership with collaboration with Freckenstoy and us at the Compass are looking at how we can expand services is there a way to have peer support with the sheriff as they go to the house is there a way to really intervene in the first contact so it's in the work coming soon so now if we can we do want to start the story right? so who wants to start and who's been impacted by Second Story and who wants to say what it's been for them and why do providers think of questions that have been okay my name is Michelle and I was around before Second Story was started and I went through like three different levels around Second Story I began with Second Story as part of the process of putting it all together making a house and furniture and all that good stuff and then I went through I was also a data person for the Second Story and I really enjoyed doing that and I was a client as Second Story more than once and I think I also actually extended stay once and the thing is is that I had never had been in the mental health system ever with my life and I was robbed at gunpoint at my work and everything changed from that day on and I spent a lot of time in the Cyborg here the older one and I saw the effects of the reoccurring door showing into the Cycords and I observed I'm a good observer, I'm a pretty intelligent person so and then the third phase was I became a volunteer there and I did a lot of art stuff, art watercolor things like that and I really enjoyed it some days nobody was there and some days everybody was there and then sometimes a staff member had a few minutes they would sit down and do some work with me I also encouraged that as far as what it's done for me Second Story first of all it has given me a community that I can relate to and I said I had never been in the system so I didn't know I was a worker but after being evaluated by several doctors I was diagnosed with work line personality disorder which was a result of being a child in a very abusive family on top of having ADHD and whatever else and as I worked through staying at Second Story I became I trusted everybody, I started trusting and I think that was the most important thing for me because when I was in the psych ward I couldn't trust anybody I almost got beat up in my room in bed one night so Second Story is that kind of place where you go you walk in and you feel like you're at home if you've never been there it's a regular house there's no doctors running around there's no toilet pressure cuffs hanging out there's nothing like that and the great part about for me was two things one I could manage my own medications and nobody was telling me one hand take them and all that and if I needed help around that I'm sure I would have gotten it and it also allowed me to have the freedom to continue on with my life while I was there there was times when I was in the psych ward where I was frantically going crazy how to get people to come to my house and take care of my animals and pay my bills and nine times out of ten when I walked out of that psych ward I felt like a deer in the head place at the front door like okay now what do I do whereas with Second Story I was able to go to my house and feed my cat maybe take a nap in my own bed if I wanted to go to the beach Second Story had some tricks that they would take walking trips and things like that so the bottom line is that if I had a choice as a peer I would never go back to the psych ward again I would never I would call Second Story before I would do anything else because I have a community of friends now that I trust you know and growing up in an untrustling family this makes it's like my family and I feel like I go wrong anybody else like to say something or some things or some words some thoughts first experience with a microphone my name is Asha Christie and I'm really happy to see everybody here be with you this morning thanks for coming I wrote a couple things for the last minute which was that I have been diagnosed with post-traumatic stress disorder and major depression and I believe that I have saved my life at least a couple of times by staying at Second Story Second Story has been wonderful for me not always easy because I've had to and wanted to navigate some very difficult states of mind at times Second Story really provided the mutual support for me to learn about grow and more thoroughly and move through my own process which was a wonderful let's see I have been involved since the beginning I was among the first 20 house guests I resumed involvement a couple of years ago as a house guest visitor and volunteer I feel that this has been and is a very positive impact on my life and a positive impact on my family and friends practicing intentional peer support and having had the opportunity to receive the IPS training which was a wonderful experience and healing in itself and putting it into practice to the best of my ability at any given time this has greatly improved my quality of life in all my relationships whether it be in and around respite house to friends and family into peers also adding very valuable skills to the hospice care I have enjoyed doing anything in my future will be greatly impacted and of course my practice of peer counseling was both to come to me I look forward to receiving a living doing this as well I think it's extremely beneficial to have peer support if you do go into the pack for one thing for some people probably for a lot of people I believe the house is very exciting and cutting edge we keep learning I experience it as a vital and living organism thanks again for being here today and for receiving my sharing my nation is awesome okay, so I just I just wanted to read something it's a quote from Tick-N-Ha all the wonderful things that you are looking for happiness peace and joy can be found inside of you you do not need to look anywhere else and I love second story I have been participating and a very thankful resident of the second story home I came in feeling disconnected scattered and hoax while there I have gained hope focus, direction most importantly second story has given me a loving safe environment to call home even for a moment in time volunteering at second story gives me a purpose and an opportunity to do service and make our community beautiful I had a stroke last year so I can read a little slow actually I don't know how to read all they helped me so much as a second story also I mean giving me a lot of support during the time that I really needed it and didn't have anywhere else to get that that kind of support right there with me every day just a really really great place anyway I'd like to also express my deepest heartfelt gratitude for the second story home the county supervisors also that have helped that historian become a very important part of our community and and for the people who keep it growing the second story is a of course safe warm and inspiring home where those of us who are on the fringes of society or are in a crisis situation we can have a warm bed nutrition, nurturing and camaraderie in order to gain stability to be stability to be grounded and have a place to focus in order to get strength to to be able to stand strong again to stand strong again to see I also thank the supervisors also for helping us to create a place for the children to play in the the park in the cover bridge park and that's an important place for my child space and yeah I thank you very much for coming and second story is just a really wonderful home and I love it so much thanks I'm seeing fingers pointing in different directions I'm trying to get Dr. Seuss a little bit this way that way did somebody want to speak, is it Jamie? Hello everybody my name is Jamie and I work a second story and as a peer counselor I'm trying not to say how much when I talk about collaboration I think that's a really really big thing I was reminded and collaboration came right here the day that my mother said hey I saw you on the internet I saw you and there was there was a show and it was second story and the whole probation department saw it and I'm thinking to myself well how did you see it that was my question and then I thought to myself that means that the county saw it that means that a lot of people that are trying to it seems that we all have the same objective I know that I would not have known that if I did not experience second story I think of second story as a liaison organization of a county-wide thing we have things such as the housing such as going in and into the hospital and what the effect is on people that are trying to provide services as well as people that are receiving those services and that's across the board and the county on a really basic level it's really magical and it's really really cool to be a part of that and it's really really cool to see my peers come up here and know that I'm a peer and I'm a part of something and I'm also a part of a bigger community of peers and so I just wanted to thank everybody for showing up here because that's what we need second story respite my twice born story when I was hired to work with my beloved peer group at Second Story Respite in 2014 it was a new birth into the mindscape of attentional peer support I had been present at the planning group for the creation of a peer operated respite house while I was attending the Mariposa Wellness Center in Watsonville, California during the early years of 2000 it wasn't until 2014 when Molly at the Rose Acres Board and Care suggested that I apply for the peer counselor position open at the Second Story Respite House in Santa Cruz, California I had been working for Molly at my traveling barber service as a hair helper I did apply, I was very happy to be hired I began to learn the practice principles of intentional peer support and there began my birth into the knowledge of the very greatly comprehensive method of peer counseling after working a few months I set way into their new management team and before long was enrolled in the required IPS training this classroom experience is the greatest and most fun I've had in school now I am a permanent part-time employee working one night shift a week and as an on-call counselor I'm expected to work two additional shifts a week of called on one of the very special components of our rest of house is that it has a two-story building its name second story is found throughout the how-to manual workbook created by an author Sherry Mead in it we are taught how to write our second story as an alternative to traditional mental health methods peer support has the intention of discovering the story obscured by talking about what is wrong with me rather than what happened to me and instead of moving away from the problem or its symptom its moving towards what it is we want to choose to create for ourselves and those in the world around us peer support is about creating mental health but mental health isn't the opposite of mental illness trauma informed peer support start with the question what happened to you rather than what's wrong with you we are looking at the root cause rather than trying to treat the resulting symptom with archaic methods like lobotomies insulin shock or heavy medications with devastating side and after effects so now we have peer support when we learn how to hear not only how to listen the untold account important to the peer appears and we hear what's happened by empathetically validating the speaker repeating back the so what happened moving towards where the person wanted to go in life a personal focus plan can start to grow into an improved way of being IPS teaches a wide range view of looking at many factors looking at what they are present in the whole person when someone is having a hard time functioning well in the world we share not everyone shares the same world view of how things are holding multiple truths is another one of the four basic tasks of IPS what is true for me may not be true for someone else after many years of study of language, religion and philosophy that is in the childhood bedtime lullaby row, row, row your boat gently down the stream merrily, merrily, merrily life is but a dream for me is true and as in the fairy tales they all get happily enraptured is also an archetype of the true someone else might believe differently that life is real life is hard and that when our bodies die that is their final end the purpose of IPS is to connect with create a relationship and reconnect with the peer we are in a relationship when there is a lack of understanding or an opposing view it is a skill we practice so to go on to a discovery of how our lives can come to an improved state of understanding and fulfill goals we may only dream of a wise man once told me if you don't have a dream it is true please do what you the hearer are able to to further our retelling our story frame in a new way by keeping our second story working for the betterment of all of us working here and far I hope this twice born story that second story will continue as my born again story has for me I found new life in the religious sense of our main perspective 25 years ago as in church history Christians have in turn consecrated more bishops so have peer counselors educated peers to become peer counselors and have thereby created jobs for many of us as a system of care plays that's the second story and now for the campus supported housing I've come to appreciate how peers can work together through communication compassion and common experience in order to get through some tough times or simply to take a break and reflect on things there is a unique and powerful dynamic that takes place at the rest of the house it is not one of power and preaching rather staff and guests live or work on tours participating in groups talking or just hanging out in the common room or out in the beautiful backyard sometimes people are surprised when they are told that staff does not direct their activities particularly when they have recently been in locked care or other facilities it is my hope to see second stories stay and move forward in wonderful ways in my experience in the mental health care system I found it to be the most helpful avenue to maintain my well being and have observed first hand the positive impact on the lives of many of the guests I've seen come and go and it has made a big difference in money thank you so we have about 7 minutes or less before we start closing the ceremony so would anybody like to step forward and speak maybe from the provider community or family hi everyone my name is Jess and I have a complicated relationship to second story because on the one hand I am an employee of your compass also I work for our supported housing program as a counselor and on the other hand I am a neighbor of second story and I want to speak to the neighbor piece first because I feel like it is a really important one because there is such a huge stigma against mental health housing in your neighborhoods you are not part of the mental health system or even if you are often times there is this idea that a mental health house of whatever sort pure rescue or pure clinical is going to somehow harm the neighborhood and I am here to tell you that that has not been true from my experience with second story and if anything they are kind of the best neighbors in the neighborhood on the street and I am a little biased I am also co-workers with the peers that run the house but I can any one of us that live on the street can go to them at any time of the day or night and be greeted with a smile and with out reached arms and they are always willing to communicate they have also held community meetings and they have done movie showings and stuff like that that I feel have gone I think a long way to showing that they are a positive part of any community and I think that that is going to be a really scary and exciting thing going forward as the peer support network grows and more houses like this pop up so again very exciting because we are going to start breaking down those walls of stigma and also really scary because the backlash is really really scary and so part of this is really really scary and I would like to ask that people if you can and if you feel it start having conversations with people about breaking down that stigma and really re-humanizing each other in any way that we possibly can and then also as another service provider so as a housing support counselor I also have seen some of my clients go to second story go in and they are such a shut down, hopeless state and come back with renewed life and that's been amazing I also worked in locked care for about 5 years and walking into that work was really in itself dehumanizing to me as a staff member so I can't even presume to speak for the clients themselves but I can imagine I don't even know how people get better in locked care whereas I don't know how they couldn't get better at places like second story and so just that visceral feeling it's so great to walk into second story people smile at you, they look at you like you're going to be a friend, they know you are it's just great to feel that hope and that warmth there don't forget to sign in everybody sign in, make sure we sign in for C sign out and evaluation form great so we have a sign out form sign out and evaluation form at the back you can on the way out it helps kind of give the county understanding of how the training was, how the program went so we have time for one more person and then we'll start to close if there's one more person that wants to step forward to speak then we can we will I'm fortunate enough to be one of second story staff I came to second story by accident and because of that I was convinced that I was having sin I landed in the middle of a social experiment full of love and kindness towards all others traveling the journey of life while I had second story a co-worker asked me to take a survey for her daughter of course I said yes she asked a series of questions and one of them was how do you feel about being mentally ill my response was I never thought of myself as mentally ill I felt like I was experiencing an emotional crisis one that I sought support for and started a healing journey to make me the compassionate person I am today I had a really good support system and that made all the difference perception is very important at second story we hold the space and allow each individual to unfold their healing journey second story is a rescue a place of love and kindness through peer support I am one of the newest staff members at second story even though I arrived quite by accident or by divine intervention I feel fortunate and honored to be a part of this cutting edge approach to healing emotional crisis and trauma the guess at second story will tell you if I didn't come to second story I'd be in the hospital it's an amazing transformation that can happen in a two week period not the guess are magically cured what we do is start to set a foundation of love and kindness through open communication peer support participation in house activities chores groups meaningful connection with peer counselors and other peers our guests find their balance and start the process of regaining their self esteem here guests come to believe that they can start anew and build a second story one with a view of their innermost dreams and aspirations which may be a permanent job a place to live starting school or just taking one class while staying at second story individuals have a nice warm clean cozy environment packed with food and drinks music TV and community activities it's a place to heal a place to catch your breath feel safe and get validated for who you are a child of the universe it's been shown that isolation is the true killer of the soul with support care and concern people thrive the research results and the second stories of those individuals that you've heard today show that people are touched and healed by their experiences with second story our hope is that this model of healing emotional crisis and trauma through loving kindness will take hold across the united states and beyond the old model of stigmatizing and shaming people having a mental health diagnosis is no longer valid approaching clients with dignity and respect goes a long way towards their healing and their opinion of themselves and if we are accepted and treated with respect it is easier for us to respect and love ourselves it's contagious love is all there is to quote a famous guitar player our hope for the future is that more people find out about our program and what we are offering our other hope of course is continuing funding which I guess we got which is wonderful I am hoping that the research will be a strong indicator of the success we are experiencing people's lives are being rebuilt and there is not hospitalization involved we would like to see a kinder less clinical more peer counselor based interactions about and with wonderful leaders like Adrian and Inbal who have given us so much support and believe in our mission they have helped us to move forward with this wonderful grade thank you all for being here okay thank you everybody and so we will now the final dissent is about to happen we are going to land in 10 minutes and off into our days I was going to say that every story starts with kind of a start from the dream but it also starts to see quite like a grain of sand so every story starts with kind of a grain of sand and it was Sylvia Karris that kind of brought it to light in the community and she is an up here activist leader in San Francisco and it took a family member to flood her along and looking for a place to take us in and that was Jenny Gomez and she wonderfully got stretched so she was in that place and so that little grain of sand talked into Yana Jacobs office she's a computer Yana is on lunch break or something she's a computer just drops that little grain of sand right into the it's not an ink cartridge it's not a typewriter it's a keyboard goes this little grain of sand Yana has no choice but actually just to start typing until that grain of sand starts to break up into little particulates gets into the rest of the keyboard and it gets into the computer and it starts getting into the consciousness of each and every one of us so we kind of from seed from sand to bird to keyboard to Yana actually bringing this program to Santa Cruz it's a community baby and now it's a four year old toddler and so I wanted to just offer Yana to be able to say the final words and thank you we've all been here together working toward it together but just looking around the room just seeing all the people and what this dream is becoming and growing into and it's only going to get better it's going to be in South County we can start moving to South County we can do that but we've got just and just to say that you know without a team to everybody that has worked and I just love to for people to stand up for just a moment if you work at Second Story and our apartment because it's so important and that means everybody even people in South County so Yana will close us out everybody and thank you Thank you Adrienne that was a funny introduction Yana to my name is Yana Jacobs and I had the honor of the seed that fell with Sylvia another person at the state level who asked if I would write a grant for SAMHSA to bring in a transformation grant for a peer respite that we needed one in Santa Cruz so I did a lot of research on what peer respites were about and it really fit with my belief system at the time I had been the chief of adult outpatient services and I'm always really a believer that the people who were the experts on wellness were the people we were serving and so having a place where people could be supporting each other rather than going to places where other providers were telling people what was best for them just never really made a lot of sense to me because we were forgetting the expert in the room that was usually sitting with us so peer support just seemed like it made sense and we needed more peer support we needed more of an active community of people speaking up and so it felt like if we had a center in a place where people could really model peer support that we could grow that and build it in Santa Cruz and in fact I literally had been crying listening to them and giving a presentation because it was the first time I heard sort of the outcome of what the vision was and you know there's a video of me opening with the grant in the community we had a whole meeting at MHCAN when we got the grant and I mean I sat there believing that this was all going to be possible but the reality is I didn't really know and I wasn't sure but I had a lot of faith and belief that this really could work if the people rose to the occasion and it's been probably the most interesting work I'd ever been involved with in my 30 plus years in the county and it's just so incredibly heart-warming to see that it really did happen just like we wrote about in the grant and just exactly what my vision was going to happen is really the results that Bevin was talking about, the things that people say when they go through this program are what we want people in the word recovery has been out there and so overused that I don't even like it anymore but what you're hearing from people's stories is this is what true recovery is about I mean people are just living their lives and taking away the labels and kind of a medical model that's been telling people forever that they're sick and that they have an illness and a disability you can't work with that as a provider because it's working against the grain of being a human being and so when you get to work in a place like Second Story and people get to go to a place like Second Story it starts to remove one of the biggest barriers that I think we all struggle with as providers which is how do you sit there with somebody and help them when they're already in a one down position and they've been told they have a serious illness and they have to live with it the rest of their life it's such a hopeless kind of introduction to mental health and it's really hard for the people at Second Story to undo that for people who have been in the system it's a lot easier for the young people who have come in and are allowed to stay a lot longer because they don't ingrain with that message so there's less undoing that has to take place but I can't tell you how thrilled I am with everyone that the money came through because it's been more nerve wracking than a lot of you need to realize that it's an expensive program to run and because it's a different model and they don't bring in half their revenue with Medi-Cal dollars like all the other programs it makes it very expensive and using Medi-Cal dollars will be a challenge because again that's the medical model and people are going to have to do that dance when that day comes forward but I have faith that people will be able to be as creative with that as they've been with doing the work at Second Story but it's really a I'm just so relieved wondering are they going to get the funding to be able to move forward because this is the culmination of the grant we are in June and the federal dollars go away on June 30th and the county have to step up and take over the entire budget and that's a huge budget to take over and I'm so grateful that Eric, the leader of the Mental Health and Substance Abuse department really saw the vision and really believed in peer support and was here to support that because you don't know how fortunate you are to have a leader who got behind it 100% and was really trying to make sure that would happen so you've got Mental Health Service Act dollars now that they're going to carry you forward and who knows what the future is going to bring with the peer certification process that's going through the state now that's going to allow people with lived experience to have their own certification and their own classification of billing Medi-Cal that should change how they're able to do the billing so that it will support who they are and their integrity to do so without making them into more of what we used to do but bringing something new forward so I'm kind of rambling but I'm just really happy that we made it through the grant and the program really lived up to what I wrote at the grant it was just a vision at the time we were the first peer respite in the state of California we've had the honor of hosting people from all over the state who've come to find out how we did it and they wanted to replicate it in other counties what did you say there's three more now that have opened up I know there's numerous more that are in their planning process today and will be opening up so you also pat yourselves in the back you were the cutting edge county that was able to demonstrate a peer respite in our state or a pretty big state and we are joined with all the other peer respites nationwide and Adrienne and other people communicate and they share what's working and what their struggles are and one more thing I want to share Laysha who was the evaluator at the beginning and she wrote the evaluation section when I was writing the program piece shared with me a story just last night that came in it was a Forbes story and it was about open networks versus closed networks and I was thinking about that today because we were referred to as a hybrid and that meant the peer respite was one that was a closed network it was one that was only peers and they had no county involvement they had nobody that was touching it or doing anything to the program unless they have lived experience and honestly I didn't really agree with that because I felt like if we were going to change the system I've always worked from within trying to change things and being part of it and I felt like if we could have a program that could affect all of us and have an open system we would learn a lot more and we were all going to change together if you have a little closed system of people with lived experience then that magic that they're doing in Second Story you wouldn't get the benefit of even knowing that about it and so we have these two systems working parallel but they both be closed and it would be kind of more of the same us and them and so it's been very challenging I know for a lot of providers they'd say to me I don't feel welcome when I go to Second Story and I'd be like now you know how the clients feel but they don't feel welcome either and so there's been a challenge and I've worked that out how do the staff make the providers who really share the same common goal everybody is working in this field because we care about people and we want to help people and I know that everyone who works in County Mental Health has that desire and I think it's always been a odd thing to think that you can learn from the person who's been diagnosed and labeled but I hope that a lot of the providers who had the opportunity to go to Second Story had really had their eyes opened and their minds opened and realized there's a lot for them to learn and that we can all teach each other that there's a sharing and back to me it's the beauty of the broader open network that's been created through the collaboration of having County and Compass as a contract provider and the peers all working together and all having to solve this problem together it's been hard but it's been really creative and it takes all these minds together to kind of solve the problems and I don't think you would have had this much success and be able to penetrate the system and continue to make changes as you go I'm hoping that the staff and the therapists who are sitting here are learning from what really works because if your goal is to help people recover and get out of the system and not be permanent with the clients of the system there's something you need to learn at Second Story because it works and Bevan was telling you about that so you might want to get some of the electronic version of what she shared and really read it over again and share it with others because you go to trainings and you take classes and you read books and I think there's a lot of the answers are right here in your own community and I really encourage people to go and sit and spend some time there and if you really listen you might really learn what it's all about so thank you and thanks for making it happen