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You Are So "Awesome” – NOPE!

You Are So “Awesome” – NOPE!

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It’s Not Enough To Be “Awesome”

So you call your program “Awesome”.

You can not open enough “Awesome” rehabs, hire enough “Awesome” counselors, distribute enough “Awesome” medication, or open enough “Awesome” intensive outpatient programs to arrest the ongoing addiction epidemic.

The issue is not “messaging”, or insurance parity or funding for early education and prevention.

All of these “interventions/programs” touch only a fraction of the “problem”.

Willing & Wanting

These programs all lean on the fundamental assumption of a “willing client” who shows up and does what he or she is told…

“You gotta want it”…

I heard it proudly proclaimed in a professional setting again yesterday.

The “hit bottom” attitude and mentality is pervasive throughout the industry.

It’s Stunning.

I’m not even sure people know how they sound when they spout this stuff. Or do they actually believe this shit?

The issue is very fundamental. The issue is easy to identify and can be effectively addressed.

In a cost effective manner.

One More Time…From The Top:

  1. 90% of people in need of help never never get help.
  2. When you ask them why they don’t get help: only about 5% say I tried but couldn’t access help.
  3. The rest say something like “I don’t need” help. Which, by the way, is a predictable and naturally occurring psychological defence response. In most cases its not even true. In most cases the person is scared, full of shame, full of fear. And this can be processed.
  4. Society responds to the people who say “I don’t need help” by saying “let them hit bottom and have enough pain” and they will come to treatment and do what they are told.

Private treatment organizations have annual conferences to celebrate how excellent they are at working with people who do as they are told

Every “innovation” is focused on the willing client.

There Is A Solution:

Consider this, there are programs like FAVOR Greenville (and others) that are experts at engaging the “unwilling client”.

There are outreach models from other aspects of healthcare that can be benchmarked.

WE CAN CONNECT TO THE DISCONNECTED. And connected people GET BETTER.

It’s a fact. Lower health care costs. Less time in jail. Increased employment. All of the quality of life indicators improve.

Stay In Your Lane

This service CAN NOT be delivered by treatment providers. Stay in your lane.

Let us do what we do. You do what you do. If you back off you will get more “clients”.

You will get more “heads in beds”. You have no idea how to do this type of work.

The hit bottom mentality is deeply ingrained and will take decades to work its way out of the collective industry culture.

Think of FAVOR Greenville (and others) as a vendor you can hire.

State governments. Private providers. Insurance companies and others.

The 5-Year Model

Hire us and watch the return on investment as people show up for outpatient appointments; stay out of emergency rooms; return to the workforce.

NOTE: this is NOT a “warm hand-off” model. This is a 5 year follow up model.

Be careful where you shop for this specialized service.

Like a shady mechanic. They will take advantage of you because you don’t really understand how this works.

You Can Do More

This model can be parsed out much further and deeper. There is more we can do.

The entire referral process could be changed. Changed to increase engagement. But I don’t want to distract.

You can use this…. but caution. Talking like this will get thrown out of the club.

You won’t be invited to speak at this year’s “We Are Awesome” conference.

Calm down… It’s just a discussion.

Focus On The System Richard Jones Recovery Cartel

Focus On The System

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The System

NOTE: When we talk “ The System ” we do NOT mean the “state drug and alcohol system or state mental health system” solely. Although the government organizations are part of the system.

I focus on the system in a much larger sense.

In a manner consistent with the following definition: “An organized, purposeful structure that consists of interrelated and interdependent elements (components, entities, factors, members, parts etc.). These elements continually influence one another (directly or indirectly) to maintain their activity and the existence of the system, in order to achieve the goal of the system”. (BusinessDictionary).

Behavioral Health

In the case of behavioral health the system includes:

  • Government mental health and substance use disorder systems (providers; public payers such as Medicaid; single state authority; state mental health departments etc…)
  • Private addiction treatment providers (rehabs and such)
  • Private mental health providers
  • Healthcare providers involved with MH and SUD patients
  • Researchers and academics focused on behavioral health
  • Federal agencies: SAMHSA; CSAT; DMH; NIMH etc..
  • Private/commercial insurance payers (BC/BS etc…)
  • Accrediting bodies such as CARF, JCAHO, COA etc….

and others I am missing.

That said.

Consider The Following

A sociological fact as true as the law of gravity. Substantial change and transformation of our behavioral health system CAN NOT arise within the existing system.

The system will not eat itself. No one is going to work toward the elimination of their own livelihood.

No one is going to disavow the principles and paradigm they have promoted for decades. Rare is the person who can reverse field and change their opinion even if it means they lose power or position or prestige.

The fear is too great. The unknown is too anxiety ridden.

A great person takes the next step despite great personal risk.

However, most will play to the middle. Hoping to not ruffle feathers. Hoping to make it to retirement. Toeing the company line. (BTW, THE RECOVERY MOVEMENT HAS A COMPANY LINE AS WELL).

The Facts Are

We will only see incremental improvement. Any change MUST fit within the framework of the larger system.

This incremental improvement will be celebrated and championed as great progress and breakthrough. (See the celebration of a “Medicaid code” for peer recovery as an example).

Many in the “movement” will go along with this process as the movement is slowly but surely consumed by the legacy payers and providers. People will get positions of prominence and “stay in their lane”.

We will hear that all of this is progress and better than nothing. People will take what they can get.

Whats Next?

This leaves us with 2 logical options. In terms of next steps.

1) Accept incremental change as the norm and live with it. Accept that this behavioral health system is the best possible behavioral health system available and live with it.

2) Create an alternative system. From soup to nuts starting with “how it gets paid for”. Create it outside the system. Add value. Solve problems. And then we get some leverage with the existing system.

FAVOR Greenville

AT FAVOR GREENVILLE WE HAVE DONE THIS REGIONALLY IN SOUTH CAROLINA

Why can’t it be done nationally? At scale.

A Good Place To Start:

The creation of a new business model, in the substance use disorder treatment/recovery space, is necessary for any substantial progress toward acceptable outcomes.

Service diversity and innovation will only come if reimbursement changes.

Follow the money.

The doers will figure this out. We need more entrepreneurs in this space.

Unless you think everything is good to go?

How long until retirement?