Mental Health at Scale: Serving 12 Sites Without Losing Your Clinical Soul | Pete Vernig, RCA

[0:00]  It's having that shoulder to cry on. It's having that shoulder to cry on. It's having that person to listen to them. It's knowing that there's somebody out there who cares for them. That's one of the biggest protective factors — knowing, hey, I have this person or these people out there. They care about me. They want me to be healthy. They want me to be able to get better. That's a big reinforcer for so many people.

People actually, unfortunately, lose their lives from stigma because, you know, when we look at mental illness, substance use, suicide, and overdose are realities in this area. And, you know, when people need help but they feel like they can't get that help, when they're ashamed, when they're embarrassed, when they feel like they're weak if they reach out for help, that really is a big barrier.

[0:45]  For some people, it increases their likelihood to get care that, you know, somebody who maybe isn't going to drive 20 minutes across town and sit in a waiting room in order to talk to a therapist. They might if they're able to log on and talk just like we're talking right now. But for some people, even driving 20 minutes and sitting in a lobby isn't an option for them because those services just don't exist in their local area.

[1:16]  [music]

[1:29]  Welcome back to an episode here on the Hard Podcast. Pete, man, you started as a college software engineering major and switched to psychology freshman year, which is kind of crazy because most people want to take that direction — chasing money, chasing stability. What actually happened? What made you flip everything, man?

[1:47]  Uh, you know, I enjoyed what I was doing. I like the way that engineers look at the world. I think I try to still solve problems in that way, but I wanted something where I could more directly help people. And, you know, don't get me wrong, folks who work on designing the software systems that run our day-to-day life are helping a great deal, but I really wanted something where I could more directly help people and impact those needs.

So, you know, I looked at what my options were. And to be honest, one of the most interesting courses I had taken in my entire college career thus far was an introductory psychology class. Just something about thinking about the way we think, the way we feel, the way we act — that was interesting to me and really exciting. So I realized at that point that I wanted to do something in healthcare. I wanted to do something that involved helping and exploration of the mind. And you know, that kind of was the opportunity there.

[2:34]  And is that why you got all these acronyms behind your name? I'm just, as we're coming together, I'm like, "Wow, I don't know if I've seen all these acronyms, man." Is that what made you get all these acronyms?

It just happened. Life's just a life thing. And then you, you know, life just happens. I mean, I have been a student my whole life. Learning is one of my favorite things to do. So, you know, I just look at it as I'm always looking at what's the next thing, what's the next area that I need to develop in? Where are my strengths and where are the areas that I could do better? And, you know, one of the ways that I try to do better is to learn actively and to identify whether it's taking a course or reading or studying or whatever it happens to be — that's kind of where that comes out.

[3:29]  We just literally talked about books and you talked about learning. Is there a favorite book that you probably learned a lot from that you could share with somebody that is watching right now?

[3:39]  Um, you know, I really like a series of books written by actually a pseudonym but Sam Shem. He is a physician who wrote some books starting with a book called The House of God about his residency in the Boston area in the 1960s. He was in his residency, but he then updated several works, and yeah, they're semi-autobiographical. They're not word for word exactly what happened, but you know, from there he completed a fellowship in psychiatry and went on and actually had a distinguished career.

But you know, his books sort of talk about the healthcare field from the inside from the point of view that, you know, not everybody always sees working in a hospital or in a clinic. And you know, I read that book about his residency before I completed my internship, which is a similar process in psychology, and you know, it kind of phrased or formed the way that I looked at things in an interesting way. So, you know, I've always liked his books — big fan of his work. He actually had a couple of new ones that just came out recently. I'm reading his most recent one, which is about working in healthcare during the COVID pandemic. So, you know, he's kind of updated that throughout the years and, you know, throughout his career.

[5:05]  Man, been doing this for a long time. You talked about when he started, he's still writing books about the pandemic. I imagine a pretty good story too because it really shifted a lot of things, man. And even for you, the shift has been a lot. Like you started as a case manager in Denver's public mental health system — substance abuse, severe mental illness, the deepest really end of the pool if you ask. What did that experience teach you that no graduate program ever could?

[5:36]  I always say, man, school is really good in black and white, but the life experiences you learn out there, man, it's like no other.

[5:38]  Oh, I learned things in that job that I could never have learned in a classroom. You know, that's the other side of being a lifelong student — learning from the experiences that you have. But, you know, really I had the foundation of an undergraduate degree in psychology, which is a lot of really interesting things — that's why I liked it — but not a lot of the practical of, you know, how do you actually sit down with a patient who is living with a mental illness or living with substance use disorder and work with them.

So, you know, I think that your analogy of the deep end of the pool is really accurate. I went in, I had some training, had some really good supports. I mean, wonderful people that I worked with, but then it was like, okay, can you go out into the community and do a treatment plan with this patient because they need a new one? And so, all right, I'm learning how to do that.

[6:26]  And, you know, there's what you read about a mental illness and learning about the symptoms from a textbook, which is really important and foundational. But then there's when you see that playing out in an actual human being and you see, you know, their humanity alongside the symptoms and you see the way that that impacts their life. You see that much, much bigger, fuller picture than just a list or a description or a case vignette in a textbook. And you know, that's the kind of learning that's invaluable in healthcare in general when you talk about mental health and just that lane of things.

[7:11]  So, I don't know if I told you this, but my mom is to this day homeless and has been a drug addict on drugs her whole life.

[7:20]  Um, and recently I spoke to her brother, and it looks like she's, you know, in a rehab or trying to get better. That's kind of been her whole life, right? I'm 36 years old. That's kind of been her life. But I always feel like there's still hope. Would you say there's still hope for someone that's been kind of in this space for the last 30 years of their life?

[7:35]  Well, absolutely. There's hope. You know, first of all, I'm sorry to hear that. I understand, from a lot of experience, the impact that that has on families. Having a loved one, someone you care about who's dealing with that is one of the most challenging things that a person in a family can go through. But there is always hope. That is, you know, what a lot of the work that I do is predicated on. We may see somebody in treatment for a substance use disorder, their 10th time in treatment. And we always say, you know, we never know if this time is going to be the time that works or if the next time is going to be the time that it sticks.

But in addition to that, there's the time in between the times. So we tend to think of, you know, somebody has a substance use disorder, they go into treatment. Um, and after a while, they experience a return to use or a relapse, which unfortunately happens. Substance use disorder is a chronic relapsing illness. Relapse is often times a part of recovery. And we think about that relapse as, okay, you know, it didn't work. But in reality, you know, what's that time they had between when they completed treatment or, you know, you have really treat complete treatment as part of a lifelong process. But what was that period that they had before they experienced a return to use or a relapse? Sometimes that could be a few months; it could be a few years. And that's really valuable time too.

So, we try not to think of it as much as like a pushing the reset button every time, but that, you know, in the same way that a chronic illness can return, you know, if somebody is living with cancer and it's in remission, there's always a chance that it could return at some point in the future. If it does return, that doesn't negate all of the time that they were living in remission.

[9:08]  Or, you know, other things like diabetes is something that can require lifelong management. So, you know, that's kind of the way that we look at it. But the most important thing to keep in mind is that, you know, even when things seem hopeless, there's always help. There's also hope for recovery. Mental illness and substance use are difficult to live with, and they're difficult for families to live with, but they are absolutely treatable, and you know, there's definitely no reason to give up hope.

[10:01]  I so crazy and we'll kind of continue on this just because people are dealing with some of these situations, right? Like I would say now as an adult with kids, I am more understanding, right? I give a little bit more grace and realizing that somebody's life was impacted due to the uncontrollable, right? Um, and it was I think about it all the time. It's like, you know, she had 10 kids and someone through these conversations asked me a question, Ephrain, how would you feel if your kids were taken away? Right? And then I automatically like I would lose my mind, right? And when you think about what has happened in the situation is that there was a woman that was probably already kind of dealing with situations and then she was in a relationship where drugs were already kind of present and then that happens, right? Your kids get taken away and that goes that spiral. Then you try to have another. So I now give more grace, but I also feel like, hey, because I do work kind of with mental health in a space, it's like allowing someone to know, look what God did in my life and that you still have purpose. I'm a big believer that one story changes somebody's life. Pete, we talk about rehab. Do you think it's also stories? Is it, you know, families coming back to allow them to know that they're not alone? Like what are some of the things you've seen that really change somebody's life on the other side?

[11:37]  Uh, you know, on the other side it is family. One of the big things — or it actually doesn't have to be family — it's the community support. This is something that we know from years of research. It's something that we know from our experiences in clinically working with patients. Those who have supports in the community have much better outcomes for substance use disorder as well as for major mental illness. So it's having that community support — those people who are going to help them. You know, first of all, it's the structural piece. So, if somebody has a follow-up appointment after they leave treatment, helping them to get to that appointment, making sure that they take their medication, making sure that they don't sort of drop out of treatment a little bit further down the road. So, that level of support, that structural support is important, but it's more than that too. It's having that shoulder to cry on.

[12:35]  I love that. I love that you've really just kind of been drawn to this work, man. Um, you've also said you've always been drawn to the people with the highest level of need. Where did that come from? Like just listening to you, man. Clearly you have this passion and purpose of just helping others. Where did it come from?

[12:51]  Um, so that actually, you talked a little bit about my very first job that I worked clinically when I was working as a case manager. I basically by luck ended up working in the system in Denver at the program that serves the highest needs individuals. It was the clinic that specifically focuses on what at the time we called dual diagnosis. Now, we would be more likely to call a co-occurring disorder, but folks who have both an active substance use disorder and major mental illness, bipolar disorder, schizophrenia, etc. So already at the highest need, and it was kind of interesting that one of the things that I had learned about substance use disorder as an undergraduate is like, oh well that's just very, very difficult to treat. Like, okay, I went in understanding that with compassion but not knowing much more than that. And, you know, ended up in the specific clinic in the system that I was working in and kind of ended up in the highest level or highest needs treatment team.

They had some different teams that were based on stratified level of need. So I was on the highest need team. We had the smallest case loads but who needed the most attention. And I just really fell in love with the work there. And, you know, I would meet my patients sometimes in their apartments or hotel rooms where they lived. I would sometimes meet them in homeless shelters where they were staying or in the hospital — in the state psychiatric hospital. Sometimes, unfortunately, in jail or in prison. But I just really fell in love with that and just saw the level of need and the fact also that with support people could regain a certain level of functioning that people could live in the community. You know, it wasn't always pretty. It wasn't always perfect, but that people weren't just lost. They weren't a lost cause. And that continued throughout graduate school. So I became interested in working at the hospital level because, you know, these are situations where you have somebody who's admitted, they're in crisis. We would always say a person is coming to us on the worst day of the worst week of the worst month of their life. And our job in a short-term hospital setting was to help stabilize them, get them the resources that they need, help them to learn a few coping skills, some tools that are going to help them psychologically, get them connected to the services that are going to help them in the long term after they leave the program, get them stabilized on medication that's going to help manage their symptoms, and then pass them off or hand them off to the next level of care. And I just, you know, that was truly amazing work when I started doing it and spent a lot of my career working in hospital systems.

[15:32]  And now you're at a different organization. If you could just kind of talk about the organization and the title that you currently hold.

[15:38]  Mhm. Absolutely. [clears throat] So currently I'm at Recovery Centers of America. So we operate both inpatient or residential substance use and mental health treatment programs as well as outpatient programs as well. Um, it's kind of cool, the role that I'm in. My title is vice president of mental health services, but that's just a fancy way of saying what I do. My sole job is to support the people who are at our sites doing the work. So, I support our inpatient and outpatient clinical leadership. Um, I work on developing new programs to meet the needs of our patients and the communities that we work in. Um, I get to help with, you know, when we open new facilities in new areas. So, you know, really exciting work. It's something that I enjoy a great deal.

[16:25]  We actually have a pretty decent reach too, which is something else that's very fun about the work that I do. We have currently 12 inpatient programs and 14 outpatient locations spread across eight states. So, you know, mostly in the east coast of the United States, as far to the west as Chicago and Indianapolis. But, you know, I spend about half of my time going out to the various sites spending time with the patients and the clinical leadership, and you know, that's really what I love about my role.

[17:00]  How do you maintain a real clinical culture and a unified mission at that scale? Because most organizations, let's be honest, kind of lose it when they grow this fast.

[17:11]  Yeah, that's not easy, I have to say. So, one of the most impactful things I think that has been a part of my time there is rolling out a unified clinical model that works across all of our different sites. So, you know, there's obviously going to be some variability based upon the needs of patients in Chicago versus in South Carolina or in the Boston area. You know, there are some differences, but making sure that we have consistent clinical programming. So, you know, that involved a lot of training for our staff at the time, a lot of continual training when we bring on new employees. It involves regular meetings with our clinical leadership, both individually and in groups. So I spend a lot of time meeting with our clinical leaders, spending time on-site in our programs, and then ultimately, you know, we have a lot of work that we do to kind of measure our outcomes. We're very big on basically giving ourselves grades — you know, grading our programs and how they do and grading ourselves too because ultimately how all the programs are doing is my grade and tells me if I'm doing my job. So, you know, that's been a big part of the work.

But ultimately, you know what it is, it's the culture and the people. It's not me. It's not anyone at the enterprise level. It is the therapists at our sites. It's the case managers. It's the nurses. It's the physicians and the other staff who are working every day with our patients and, you know, who really buy into our mission and care about the work and care about our patients and have this passion to serve their communities.

[19:32]  If the Heart and Hustle podcast has ever sparked any idea or made you think differently, do us a favor. Make sure to share this, post it on LinkedIn, or even text that nonprofit friend that you just have. Whatever works, this is what keeps the conversation going and allows us to just grow this community together. Seriously, we appreciate you. I say culture is everything for sure, man. You can always feel when you're in an organization with a culture that is top-notch. Listening to people like you that are at that level, I can see why the culture is what it is, right? There's so much passion; you care for what you do, and that always you can tell in someone as well.

Um, you know, I think we talked about this and I think it's really good to bring up again is that there's siblings that grow up in the same household and may experience some of the same things but go completely different paths. And I'm one of those that I've seen it in my own family. What explains that, man? And what does it tell us about how we should kind of be designing treatment?

[20:18]  Uh, so that's always something that's been very interesting to me — people in similar environments and how, you know, exposed to some of the same things, they can go in very different directions. Um, you know, in your example of siblings who live in the same household. So you have, you know, if they're biological siblings, they share a certain amount of genetic information. So, genetics do not control everything. They don't determine everything. It's not really a deterministic model, but we know that they do impact us a lot. So, you know, people are going to have some genetic similarity and they're going to have some similarity of experience, but also there is a lot of people's experience that is not always going to be shared.

There is a lot of, you know, people's personalities that, you know, even if you meet people who are identical twins, who have pretty much identical genetic makeup, they may have very, very different personalities. So we know that obviously genetics may create certain predispositions. They may make it, you know, just like somebody's genes can make them more likely to develop heart disease or diabetes. They can make them more likely to develop a substance use disorder or a specific mental illness, but they absolutely don't determine that.

So, our personalities, the experiences that we have, and the way that we process those experiences are so important. Um, you know, to that point outside of a family unit. Uh, that's something that I was really interested in when I was doing research in my graduate program looking at people. I always wondered, you know, why you have two college students who may be doing generally the same thing. You know, a lot of people at that point in time experiment with alcohol, may experiment with other drugs. And you'll have one who really starts to struggle with that and who gets kind of mired down in that and who, you know, they end up having some problems with that later on. And yet you'll have others who, you know, they just sort of grow out of it or it just sort of seems like when you talk to them or when you look at what they've been through, like they grow out of it.

So I was interested in, you know, what are the differences? Why could these two people be doing the same thing now but it's going to look very different down the road? One of the things that I had found is that it's honestly a lot of it is motivation. So why is the person engaging in that behavior? If somebody is drinking, somebody's using drugs to change their emotional state. So, you know, they're feeling anxious. So the coping skill that they have is they reach for some alcohol or a drug or they're depressed and they're using drugs or alcohol to try to lift their mood. A big one is trauma — the experience of trauma and the aftereffects that can have and using drugs or alcohol to try to mitigate those effects or moderate them. That puts them at much higher risk of developing a substance use disorder later on down the road as opposed to somebody who's just using it to try to change their emotional state.

[23:25]  And would you say that you're just, you talked about a lot of this research. Are you still doing research? Because I ask myself these questions all the time — like I should have probably chose a different career because I ask these questions, man, especially as I get older and realize all these brothers and sisters and wanting to help others. It's like, why? You know, I ask myself all these whys. Are you still asking these whys?

[23:52]  I am absolutely. So, part of learning is asking those questions and trying to figure out ways that we can ask those questions and potentially try to begin answering them. So, that's another thing that I can do fortunately in my role at RCA is we're currently looking at — actually one of the things we talked about is readmission or relapse into back into a program. So when we have people who complete treatment, there will be a certain percentage who will, you know, unfortunately experience a relapse; they'll return to treatment. And what I'm working on right now is being able to better predict who those individuals are based upon things like demographic factors like gender and socioeconomic background, based upon things like depressive symptoms or anxious symptoms, experience of trauma, based upon their participation in treatment.

And then if we know who those people are who are at higher risk, we can provide services then to try to prevent them from experiencing that relapse. So that's what I'm working on right now. Uh, you know, really it's identifying that risk and putting things in place to mitigate that risk, which ultimately, you know, we're too early on to really say that we've seen any success with it, but if we did, that would be such a big thing. Uh, you know, not necessarily in answering a question that I have, but in being able to provide better care for our patients and, you know, to support their families because ultimately when we have somebody who leaves treatment, what their families have been through has been, you know, I can't even imagine the things that they've gone through, and they have a lot of hope in, you know, that this loved one finally agreed to go get treatment; they're getting help. They have so much hope, and we want that hope to translate into some good outcomes for them.

[25:52]  I love that. And through all this, man, there's still that stigma, right? And stigma doesn't just hurt feelings. It actually stops people from picking up the phone, I would say. What does it actually take to break that stigma? And why talking about it openly is so powerful? I mean, I'm one of those that since I share the story for the first time, I remember still sharing the story for the first time in my 20s, crying. Pull over on the side of the road, man. I could even say it. I was actually texting the story. Now I share the story you know 10 plus years now realizing that every single time I share that story, somebody else opens up. From someone the expert, why do you think sharing it openly is so powerful?

[26:30]  Uh, well, you hit the nail on the head with stigma in that, you know, we a lot of times think about stigma that people with mental illness and substance use face as just being an unpleasant thing or a bad thing that happens socially or in our culture. But it is actually dangerous. So, you know, not only is that unpleasant for individuals and their families, but that stigma prevents people from reaching out, prevents them from getting help. People actually, unfortunately, lose their lives because of it. So to your question of why talking about it helps, it's because it builds that personal connection. It's easy for me to sit and think like, oh yeah, people with a mental illness or they just need to snap out of it or they're just weak. It's a character flaw. Doesn't really impact people that much. Uh, but when I hear somebody actually share their story, when I know somebody who has a mental illness, when I know someone who has struggled with substance use or addiction, that personalizes it for me and that makes it harder for me to ignore. And it also educates.

So, by talking about it, we are educating and breaking down the stigma because we're showing it's okay to discuss. So, one of the effects of stigma, so many people learn this isn't something we talk about. They may have learned that from their family where this is a family secret and we don't talk about it. They may have learned it in their local community where, you know, we don't talk about when somebody is struggling with that. They may have learned about it from society in general where it's something that, you know, is posted on social media or people laugh about it, and it's something that is, you know, seen as an object of humor as opposed to an actual illness. We would never laugh at somebody because they have cancer. So why would we laugh at somebody because they have another type of disease? But it's that education. It's showing that it is okay to destigmatize. We can talk about it because ultimately if somebody is struggling, the number one thing I want them to do is I want them to tell me. I want them to reach out. I want them to be open. I want them to ask for help because we can't always know what somebody is going through. You know, sometimes you can look at someone and you can see like, wow, that person's really going through something. Uh, and you think maybe I should talk to them. But so many people suffer in silence. And you can never tell by looking someone in the eye or listening to their voice what they may be going through behind the scenes.

[29:20]  So helping people to know they can reach out is so deep-rooted, right? We grew up in households where we're told to keep what's happening in our house inside of our house. I was actually talking to another leader out of Ohio State, and he mentioned how he was mentoring this young boy, and you know, the young boy just wouldn't open up in therapy, obviously because we're told to not. And he went in and he says, "Listen, you know I love you, right?" And he's like, "Yeah." He says, "I would never put somebody in front of you that's not safe. This is an okay person to talk to." And because of that, he was so much more open to that therapist. And the therapist then says, "Hey, man. I've never seen him open up so much." But sometimes it takes just conversations for us, right, that have probably created that stigma in our kids' lives to say, "Hey, like I know what we said in the past, but it is okay to seek help. It is okay to talk about your problems." So many times, man, you talk about your problems, you don't even know who's standing in front of you and what they can actually do. That's the most scary part about it all — is that why not talk about it? And I'm not just talking about mental health. Sometimes just life be lifing, right?

[30:51]  Is saying these things because you just don't know how somebody could instantly change your life in those moments. So, I love that you've given your whole life to this. And I still think though in communities that you're in, you talked about all these different locations that there's communities that still don't know you exist. What is that awareness gap actually costing the people you're trying to reach?

[30:54]  Uh, you know, it's very interesting. Sometimes when we'll go into a new community or a new state, new city, you know, sometimes there's other providers in the area and you know, there's just not enough services. But I've talked to people in communities who have said, you know, there's nothing like this that's available around us. And that's one of the difficulties in healthcare in our country — is that it's kind of a patchwork and that we have some of the best hospitals, some of the best services that are available both in terms of physical healthcare and psychiatric care for things like substance use disorder in the world. But it's such a large country with so many different regions, so many different cultures, so many different laws and other things that determine the type of services that are being provided.

And, you know, even in a state like Pennsylvania where, you know, you have a very large city in Philadelphia, you have another large city in Pittsburgh on the other side of the state, there are still very rural parts of the state that may not have the same level of access to services. So part of it has been, you know, new ways to get people access to the care that they need. This is one of the reasons why I've always been a huge advocate for telehealth — that, you know, for some people it increases their likelihood to get care that, you know, somebody who maybe isn't going to drive 20 minutes across town and sit in a waiting room in order to talk to a therapist. They might if they're able to log on and talk just like we're talking right now. But for some people, even driving 20 minutes and sitting in a lobby isn't an option for them because those services just don't exist in their local area.

[32:25]  So that helps us to reach people in the far-flung corners of the state in places where, you know, somebody does not have the time or the mode of transportation to seek out those services. So that's been an incredible tool. It's been accelerated obviously by the pandemic. You know, that's something that existed before, but it is so much more mainstream now. So that's been one of the big tools. Um, and then another piece is just the awareness and, you know, the fact that not everyone knows that the services do exist. A large percentage of people with diagnosable mental illness with substance use disorder don't actually get effective treatment, and some of that reason is that they don't understand what the options are.

So a big part of our job is educating people, educating families, educating communities. This is what treatment looks like. I mean, if you look at our website, half of it is just like this is what treatment is, and this is what it looks like. This is somebody's experience in treatment. It's about education.

[33:28]  I love it. And now with everything you're mentioning, there's also AI thrown into that, right? Is that a good thing or a bad thing? Because people at 2 am that maybe a family member needs help. They don't know where to start. They're scared. They're embarrassed. And maybe they don't want to call. I've seen people say, "I'm going to a chat to maybe have a conversation." Is that a good thing, a bad thing? Do you still think that there's some parameters that need to be put around that or what are your thoughts?

[33:54]  So, AI as a tool is not necessarily a good thing or a bad thing — just like the internet is not a good thing or a bad thing. The internet was new. There was just a sort of a reaction in a lot of education and academia — and certainly not everyone, but like, oh don't you can't trust that, don't look at that, just ignore anything that's online. And in reality, well again, it's that the internet doesn't have an agenda; the internet's not a person. It doesn't have motivations. It's just a collection of information, and there's some really good information there.

What happened over the past 20 years is that's been incorporated into curricula. So now they're teaching in schools how to identify good information. And when you search for something online, how do you know when something comes from a reputable source and it can be trusted versus when something is just, you know, some person in their living room just typing something out and it's just their opinion? They're entitled to their opinion, but it's not authoritative.

So kids are now being taught how to identify that, and you know, again, that's us incorporating a new technology and learning how to use it in a responsible way. We haven't figured that out with AI yet. Uh, so you know, hopefully 10 years down the road they'll be teaching how to use AI responsibly because again, it can be very helpful. You said you use it. I will say I've used it for things. It can be a very fantastic tool. But not misusing it is the key.

[39:40]  And you know, especially a lot of adults can figure that out. Not all adults can figure that out, but you know, children, young people whose understanding of the world is still forming, their self-identity is still forming — that's really difficult to be given, you know, again, this sort of friend that you can talk to 24/7 who's going to give you answers and seems to know everything.

[40:00]  Yeah. No, for sure. And I hope not even 10 years, man. I hope that it happens even sooner because, as you mentioned, we're in the times of radio when people thought radio was what? That's crazy. TV, the internet, and now it's just AI. It has been around. You know what's crazy is I speak to people that have kind of been in the military, and it's like, man, when you think about it, AI has always been here. Like, we've been using it. Maybe out to the public, it's new, but it's always been around. It's now at the forefront, and now people are using it.

You're seeing a lot of jobs definitely get cleared out because of it. Um, but also I think there's a lot of jobs being presented around what AI does. So, um, I love that you're like, we should use it. Let's put some guard rails because absolutely I do agree.

[40:40]  I ask you, man, as we start to wrap this up, Pete, if you had a magic wand to change one thing today in the way that we communicate with our community to make sure that they got these resources, what would it actually look like to you?

[40:55]  Oh wow. That's a really good question. So, you know, in the vein of the discussion that we've been having, I think that, um, you know, what I would love to see is just more conversation that is authentic, that is direct around these issues. So, you know, the availability of resources because again, the resources are out there but so many people don't know how to access them.

Um, I think that, you know, just greater penetration in the social psyche. Um, you know, I think that there's been a decrease in stigma around mental illness. There's been more of an acceptance over the past 10 years or so. But also along with that, it's not necessarily always been good information or accurate information. People use therapy terms or what they think are therapy terms like gaslighting and, you know, I need space. Yeah, they throw a lot of this out not always understanding it and has almost become a little bit divorced or separated from its real meaning.

So, I think that if we could have a discussion that is fact-based and that is destigmatizing and that is honest about what this looks like for people, what it looks like for families, what it looks like for their communities and for society as a whole, I think that that would go a long way to helping people get the support they need.

[42:36]  Pete, I was listening to you, but when you said gaslighting, I'm like, did Pete just use the words gaslighting? Pete, what that's like a young terminology there, man. You're hearing this often.

[42:45]  Oh, I hear that all the time. And you know that a lot of young people like to use that term, but it's certainly not a new term. Uh, you know, it's actually quite old. But it's become in vogue to use a lot of this terminology today, which, you know, I guess is not necessarily a bad thing that people are willing to talk more about the way that they feel and, you know, the quality of their social interactions and, you know, what they need to feel safe.

Uh, and at the same time, I think that, you know, again, we need to make sure that we're having good conversations that are connected to reality and are supported by facts.

Pete, we keep doing this, man. We're what, almost 45 minutes into this conversation, and you just dropped so many gems, but there's people that may not be able to continue this with us, but they want to know exactly where to find information. What is the website? What is the social that people can really start to tap into? Maybe they do have questions. Is it Facebook? Like what are some of those channels you guys have out there?

[43:46]  Uh, absolutely. So, anyone who is looking for any help or support, if you are struggling with substance use or mental illness, you have a family member who is, or you just want to learn more, we do have a website. It's recoverycentersofamerica.com. Um, you can also search for us on any of the socials — Instagram, Facebook, any of them — just search Recovery Centers of America, and we'll come right up.

Um, if you're looking to talk to someone, it is 1-800-RECOVERY. Nice, easy to remember phone number. Uh, so if you wanted to get in touch with someone and talk about treatment options for yourself or somebody else, uh, if you have a family member that you're a little bit concerned about but don't know what to do, please call the number 24/7. We'll have somebody who will be able to talk to you and, uh, give you that fact-based discussion with you, tell you what treatment really looks like, what options really are out there.

Um, you know, even if that option isn't us, we just want people to get help. Um, and then one other that I certainly have to say because we have talked a little bit about things like depression and suicide, if ever, you know, anyone out there, you're in a position where you or somebody that you care about, you're concerned about potentially doing something to harm yourself, 988 is now nationwide. You can reach the suicide helpline, 988. Just pick up the phone and call. Again, it is available 24/7. There's always somebody to talk to you. So, you know, please take that step and reach out.

[45:18]  I love it, Pete. Man, I thank you so much for your time. You have been a true blessing that allowed me to just really ask you any questions, and you did not disappoint. You got so many gems, guys. These are the type of conversations that we love to have. There's so many things that are happening in our community, so many resources, especially in a time right now where there's fear going on. There is the unknown, and there are organizations that are really leading you to the paths that you want to be on.

So Pete, we thank you for the work that you've done, the commitment of your whole life journey to just be able to be in this spot. We thank you. My name is E Fra. This is Pete. We'll catch you on the next one.