Community-Based Solutions: Grassroots Mental Health Innovations That Work

[00:00:00] Speaker A: Into the Fold is part of the Texas Podcast Network, the Conversations Changing the World brought to you by the University of Texas at Austin. The opinions expressed in this podcast represent the views of the hosts and guests and not of the University of Texas at Austin. Hi, welcome to into the Fold, the mental health podcast. I'm your host, Ike Evans and today we're delighted to bring you episode 176, Community Based Solutions. Grassroots mental health innovations that work. [00:00:33] Speaker B: I keep coming across this time and time again, that every community has its own legacy, its own challenges, its own opportunities and its own trajectory which precludes one size fits all policies and appropriate approaches. Which gets us back to, to where we started in this conversation, that there's a premium on self determination, on allowing the community to be clear or be encouraged to be clear about what it seeks and what its outcomes are. [00:01:13] Speaker A: Hello, I'm Ike Evans and welcome to the podcast. Today we are continuing our season long theme, Mental Health in Transition, Navigating Change and Building Resilience. Today we are talking about community based solutions, but we're approaching this through the lens of funders who go into rural communities in the hopes of creating impact. It is just this situation that the Hogg foundation for Mental Health has enthusiastically found itself in for the better part now of the last decade, and certainly since the launching of our well Being in Rural Communities Initiative in 2018. When it comes to rural mental health, or trying to make a difference for the sake of it, before you can even get to solutions and innovations, there's a lot of what we could call brush clearing, such as addressing mistrust, the lack of resources, the power dynamic that always exists between funder and grantee, among many others. Brush clearing that has to take place first. So what does this brush clearing look like and how can it be done with efficiency and care is a question that I think is going to be hanging over this conversation. Which brings me to our wonderful guests for today, Tammy Hines and Ricky Barra, both senior program officers for the Hogg foundation, among many other hats that they wear. And also joining us remotely are Brian Dabson and Alan Smart. Brian is originally from England and has over 40 years of experience in public, private and nonprofit sectors on both sides of the Atlantic dedicated to expanding economic opportunity in rural areas. Alan Smart is a member of the Hawk Foundation National Advisory Council and is a national spokesperson and advocate for improving philanthropic practice and has written extensively on rural mental health. Welcome to all of you. [00:03:41] Speaker C: Hey Brian. [00:03:42] Speaker B: Hey. [00:03:42] Speaker D: Hey, Alan. [00:03:43] Speaker C: Hey Alan. [00:03:44] Speaker A: One of the guiding questions I think for this conversation is ways that Funders. And by that I specifically mean organizations who have a certain measure of power and influence and they don't want to be too heavy handed when it comes to the power dynamic between funders and grantees. And so I'd love to know from the quartet here just what you have learned about how it is that you can still kind of check the boxes that you need to check as far as your own requirements, your own goals, but still not squelching the kind of grassroots energy and enthusiasm that your grantee partners bring to bear. [00:04:37] Speaker C: Well, I think the first thing that comes to mind for me is, interestingly, one of the things that we've found, and we had read quite a bit about this before we started this initiative, but I think it's come to be true, is that a lot of the solutions that are effective in a community are already there. They've been identified. There either hasn't been intentionality put behind it or funding put behind it. You know, there's been subgroups of community members that have come together and talked about these issues, but don't really know how to move forward with things. And so when you start bringing those people together, those ideas come out and sometimes they're completely innovative because the subcommittee, the subgroups of community members have already been talking about this for a while. And maybe the powers that be in a community haven't. Maybe they haven't had these particular innovative ideas or they haven't had the energy behind it, again, the funding, the intentionality. And I think when those groups come together and there is this intention put in inclusiveness and really trying to make sure that the community collaborative is representative of the full community and you get these ideas and you get this energy. We put a little bit of funding in and now they start to move and now they start to move toward an environment that is actually mentally healthier, that offers more opportunities for people to be mentally healthy. And so to me, that's a really big message for us as a funder, that we don't need to come in with all the answers. We need to give people the flexibility to create the answers, to identify the answers, and then kind of step back and try very hard to keep our power and privilege as muted as possible. I think we still know that it's there, but I think that we try very, very hard only to use it for good and to. [00:06:53] Speaker A: And I just want to jump in and add that I know people away about the word privilege. I've always been of the mind that privilege doesn't have to be a bad thing and that it can absolutely be leveraged for good. [00:07:10] Speaker C: No, I appreciate you saying that. I think that's a very good point. I think I've already gone to that place in my mind, so I forget that it also often has a very negative connotation. And that in my mind, yes, you accept that you have privilege and you realize that there are opportunities to use it positively. And I think we've been very intentional about trying to do that. Going back to this idea of trust in our communities and our grant partners. You know, as Rick says, we were doing trust based philanthropy before we knew it had a word. So it was definitely one of those things that was important to us to really give that power back to the communities to make all these decisions. [00:07:53] Speaker D: Yeah, great answer. Wow, that's a great question. I think a couple things come to mind is how you have that balance between, you know, kind of what the funder is interested in and then, you know, allowing the communities to really drive the action. For us, it was coming up with really a goal that was aspirational, Create mentally healthy communities and not prescribing or dictating that. You're going to do this, you're going to do that, you're going to use this tool, you're going to use this approach that basically we said, here's our aspirational goal to create mentally healthy communities throughout Texas. You five have been selected and you inform us so, you know, you inform us on how that's going to happen, how that can happen in your communities. I think the other piece that to just add to what Tammy was talking about was these communities, every community, and not just these five that we're funding each one of them and every community, I think throughout the country, and as Brian and Alan probably can attest, has tremendous assets, resources, relationships, there's tremendous history. And I think that's one of the things that we've learned in funding community based, community driven work is that you're going to have to get through some of that history and be able to bring people together that, you know, oftentimes, you know, have not been wanting to get back into a room with each other for different reasons, whether, you know, oh, that person, you know, that organization poached my folks or they beat us out of a grant or they wouldn't, you know, collaborate with us on. So I think one of the things that we found is that when we can kind of create this level playing field as a funder and say we want community members to be really involved in this, in this endeavor, and to ensure that there's true community representation. Because one thing I will say is that when we read all the literature about funders who were funding community based type work, one of the things that was very prominent in each one of them was say, and they would say, and engage key stakeholders. And for me, that's code for the usual suspects. The non profit leads, the agency leads, you know, kind of the folks that have always been at the table to make decisions for communities and in some respects with good intention. But I think one of the key pieces that we saw that was missing is that thing that, you know, that Tammy always brings to the table in terms of, you know, community representation, community voice, it has to be there. And so that was a seminal piece that really set our project apart from everybody else's and, and was in many respects a deal maker or deal breaker for the communities. And so I think the other challenge and tension was that many people often think immediately about services and they go to like, oh, we can launch these programs and services. And it's really not about that. It's more of an upstream approach where you bring community people together and talk about what are the things that are preventing us from creating a mentally healthy community for ourselves and then trying to identify what some of those elements are. So really having the community drive the action and the dialogue. [00:11:15] Speaker A: Okay, Brian, so kicking it to you. Let's say that a funder goes into a rural community. And I think that's kind of the framework that we're going to be using for, for most of this conversation about grassroots innovations. Let's say they go into a rural community with the intention of checking their own privilege. Just in your experience, what things might get in the way of that or what can make that more complicated, I guess, than one might imagine. [00:11:57] Speaker B: A number of thoughts come to mind. I mean, I appreciate entirely what Tammy and Rick said about trying to check their big foundation power as they move in. But there is always going to be a dynamic where the community will try and figure out what is it that you really want, what are your expectations? And they will try and cater to those expectations as best they can because essentially they want your money. So I think the first thing, there is a series of tensions, it seems to me, in this sort of relationship. So establishing expectations on both sides up front seems to me to be absolutely key. Recognizing that there is always going to be the so called power imbalance or mixed expectations. I think one of the elements which is always going to be a challenge is about how do you measure success or the outcomes from this endeavor and whose measures are they? If it's the foundation saying, look, I need to achieve these outcomes, they may not necessarily align with what the local community feel important. Yet if the community gets free rein as to do basically what it wants and choose its success measures, then the foundation isn't going to get the return on the investment that it's looking for. It has to be a genuine partnership, a collaboration. And so I see the sense of a negotiation that should take place in a safe space to allow both sides to be really clear about what it is that they're trying to do and what outcomes they see it also. And I think this has already been mentioned, but I just want to emphasize it. If the foundation or the funder is coming in with some really specific programs or projects or ways of doing things in mind, then it's sort of missing the point of community engagement. And I like the idea that many people are talking about now of actually investing in the organization or in the structures themselves so that not only are you talking about trying to get something done in the next few weeks, you're actually investing in the long term in that community, in its relationships, and in building the leadership capacity across. So it becomes more like investing in the enterprise of the community as opposed to investing in specific projects. But I just want to mention one final tension which I think is real, and that is the question of scale and urgency. I mean, if for instance, we're going in, we really want to improve mental health conditions in an area, particularly when there's a lot of stressors in the community, then something that's going to last a decade or going to take a decade to see results is soon going to lose the interest of the participants. There has to be some short term wins, but at the same time moving towards something which will make a real difference over the long term. So I guess what I'm saying is that there's a whole set of tensions, inconsistencies that have to be negotiated and understood. And if we don't have that understanding up front, then that all sorts of things can go wrong very quickly. There's going to be disappointments all round. And the idea is to build on the energy and the commitment and get something done. There have to be results both for the community and for the people who are providing the money. [00:16:35] Speaker A: Okay, Alan, so, so listening. Are there any particularly vivid cases that come to mind for you regarding the tension that Brian just spoke about or even ways of circumventing that people that you've learned about or had the chance to help to develop. [00:17:04] Speaker E: Well, I think, I think we've heard a number of, a number of examples, even the broader concepts we're talking about of kind of the, some of the disconnect, the dissonance between what's now been as trust based philanthropy or we could talk about as, you know, partnership models or community engagement models. But yeah, if the funder's expectation is a set of results or a performance of a model, all the community engagement work, which to Rick's point is yes, often with traditional stakeholders, I often use the term gatekeepers in rural places, people have benefited from being out front or benefited from relationships with funders or powerful people or maybe very powerful people themselves. If, if the end is prescribed, the process is certainly less than genuine. I think that's an important piece for funders to keep in mind that to really get deeply involved in rural community engagement work where people are helping develop their own solutions. Tammy pointed out often the, the answers are embedded already. Maybe just need some energy or some structure that a funder's support might be able to help with that all that type of prescription that funders sometimes need or sometimes are just use it, you know, do it that way in a bigger city or an urban model. The disconnect between the two is quite profound and often funders can't see that. The term trust in these kinds of discussions is very interesting to me in the rural context because we often talk about the community trusting the funder and often in the vast majority of the cases I would say the funder gets to define if they have gained the trust of the community by, by their own definitions. So it's, it's not even a, it's kind of, it's not kind of a fair fight of who trusts who because the founder gets to define what the trust looks like and, and declares victory because they have gained trust. I've been to so many foundation conferences, people are bragging on their work in these rural communities. Well, we gain the trust of the community. Well, who told you that? I think for the most part the funder is still defining that. So that's a critical kind of missing part of the relationships of who gets to define. Brian talked about who gets to define what. The outcomes are similar. The other thing I'll point out about trust is if you have lived and worked and done leadership work of any kind, whether it be from a grant making seat, elected official, or you're just a multi generational community stakeholder, you know that there are all sorts of factions within a rural community. Even if it's only 2,500 people who do not trust each other. Some of that goes back historically. Some of that has to do with places being incredibly under resourced and just vying for financial and other kinds of assets. Funders often miss the idea that just bringing people together does not negate the historic tensions and mistrust that people have of each other. So the work, the work is very difficult, certainly worth doing, but it's not just about, well, the funder needs to get the community to trust them. It's much more nuanced than that. But both Tammy and Rick pointed out just the critical importance of getting beyond the people who have institutional positions, whether it be in the nonprofit side, governmental libraries, Parks and Rec, Planning commission, all those kinds of things. Those are often people have been trained to behave with a funder in ways that the funder finds palatable, but may not reflect the spirit of the community or the needs of the community. Finally, I'll say I think this work is often easier in communities where there has been little to no interaction with funders in the past. You can actually talk about mutual benefit, mutual goals much more quickly, I think, than communities that are used to producing results for funders. They, they are often particularly governmental funders. They are locked into certain ways of compliance and performance that don't speak to the kind of deep community engagement you're talking about. So it's all of this work requires a pretty profound mental shift on the part of funders, but also often on the part of rural nonprofits who have been trained to behave in a certain way. [00:22:48] Speaker A: So, Rick and Tammy, you don't really know what you're walking into at the front end of any kind of involvement, and that's even within a city like Austin that you think you know pretty well, because so much of it has to do with who's present at the table. So we're calling this Grassroots Innovations that Work. The word innovative is pretty loaded because people tend to think you're referring to things that are really exotic or have never been tried before. That's not really the sense in which I mean the word innovative. Sometimes it can just be like just a suite of strategies that have never been deployed at the same time in a particular way. And so about what you've learned in the course of your work in rural communities in innovative ways, whether they spring entirely from your own minds or not, of getting around some of these tensions or even things that were brought to you by communities that have just been surprisingly effective. And then Brian and Alan yes. Feel free to chime in kind of with your own thoughts as to that. [00:24:12] Speaker C: Well, I think one of the first things that comes to mind is, and I'm touched by some of the things that Brian and Alan were saying as well. So that kind of plays into my recollection of this particular situation, which is that we went into the pilot of the well Being and Rural Communities Initiative with this intention of checking our privilege and checking our power and trying very hard to. To learn from our communities and not prescribe how things were going to occur or what needed to occur. One of the things that I think we were particularly proud of is that we didn't set the measurement. We had technical assistance available for our communities to work with to determine what they wanted to measure. And I think we still really stand by that. And, you know, to the point that we, as Brian was making, we didn't end up with data that told us whether what we did was successful because we were deferring to the communities to tell us what they thought was successful. So ultimately we ended up looking back on all of that and saying, okay, well, now that we've been doing this for seven years, it would be interesting to have some sort of a retrospective and to look back on this whole process and try to look at it holistically. So we've approached it from that angle. But I think one of the things that I want to really impress upon is that the communities, and I think they were in many cases communities that hadn't had, I would say three out of the five had not had a lot of funder interaction. The other two, I think, had had so much funder interaction, they were tainted. And so I think it was a very different experience. I think that they, on both sides, they kept looking to us to give them answers. And we would consistently say to each other, well, that's not what we are here for. So we would turn around and say to them, we want you to find the answers in your own community. We are here as a sounding board and we can certainly listen to what you're struggling with. And we actually like hearing what the communities are struggling with or coming up with. But we don't want to be the solution because we don't have the solutions sitting in our offices in Austin. That's not where the solutions are going to come from. And so we, we would continue to put people back toward the collaborative, back toward their, you know, the residents in the community. And over time, they got to where they expected that answer from us. But it did take a while And I thought what Brian was saying. No, I'm sorry. What Alan was saying about the trust made me laugh. That the funder defines in the relationship, the funder is defining whether the community trusts them. And I think that's hilarious because that's exactly right. We're the ones sitting here going, well, I think the community trusts us now. But did anybody actually tell us that? I don't remember, to be honest. But I find that amusing and think that there are a lot of assumptions that go into things like that. And I think that we had many, many, many conversations and we attempted to be completely trusting of the community. And I will say too, that as we've gone on, I think that's. We've been challenged on that multiple times. And I think we still try to keep coming back to, that's not the intention of this. That's not the spirit of this, for us to decide how these things were going to go. I'll stop there. But I find this really fascinating. I think it's very interesting. [00:28:13] Speaker D: Yeah, it reminds me of a piece that Alan wrote years ago, and it was something like the Program Officer of the 21st Century, or I can't remember the exact title. He'll remember it, but it was really an eye opener for me in terms of like, you know, the. The role of the Program Officer in philanthropy has always been, you know, kind of checking the boxes and, you know, more quality control assurance. Where I think the way he described it is that really the Program officer of the 21st century in terms of, you know, supporting communities doing this type of work, are more like cheerleaders, you know, maybe does some coaching, some mentoring, sometimes some marriage counseling when you're trying to, you know, kind of work, help people work through things. But to Tammy's point, I think we've stood pretty fast on our position that we are not here to figure out your solutions. We always flip it back as have you discuss this with your collaborative. If the collaborative is at a, you know, kind of impasse, we have suggested and recommended, it's like, okay, well, maybe you should bring on somebody who can help facilitate and kind of an outsider who can come in and kind of help you kind of see things in a different way. Sometimes when you're in the weeds, all you see your weeds. So I think, you know, and that's been very productive for all of the sites in terms of really going outside of their circle, so to speak, and bringing in somebody who can help them see things in a different way, help them try to maneuver and get past and to kind of come to some consensus on some of the matters that they're dealing with. I think the other thing that I'm reminded of also in looking backwards is that one of the things that I think help kind of start to mend some of those bridges between community partners is really trying to message that, you know, each one of them has kind of their own mission and vision and agendas and all that, but that no one entity can do it by themselves. And that it's important to be thinking about like, how can we create a greater, be a part of something, a greater good, be something bigger than the part. And I use analogies or illustrations oftentimes because they make sense to me. But if a car is stalled out on the road and only one person gets behind that car to push it, it's not going to go very far. If you get a bunch of people to push it, but they're all circling the cars and pushing in that direction, the car's not going to go far. But if you can get people inspired by a vision of why it's important that we all push in this direction and what can be accomplished and achieved collectively with our efforts pushing in the same direction, then you can get that car to move. So I think that's what we've kind of been thinking about over the seven years in terms of how to influence and how to support communities and moving in that common, you know, that direction, creating that community vision. That's really their vision. And so I think that's a really big piece of how you kind of bridge mend those bridges, those tensions that exist in every community because of just again, there's history there, there's a variety of reasons. But to be able to help people see that they can be a part of something greater, a greater good that will serve the people in their communities. I think that's kind of one of the things that I kind of draw on as one of our experiences that we've seen and that we've learned that has been very helpful for communities to kind of move forward. [00:32:06] Speaker A: Okay, so maybe the innovation is that you're funding a process more than a product when it comes to collaboratives. Brian Allen, I'd love to hear from you two just regarding, let's just call them innovative approaches to building trust that either funders have figured out themselves or have been brought to them by communities that you can speak to. Alan, why don't we start with you? [00:32:47] Speaker E: Yeah. I'm going to actually touch upon something Brian said earlier. Funders in rural places who, who don't have any urgency and want people to be engaged over a five or ten year period that is rolling a big boulder up, up a hill. There's got to be some, and it's part of trust building. Some sense that the funder can deliver something can be an asset and it could be as simple as they can make a call to the congressman's office that the local people just can't or haven't been successful in trying to pursue. So the low hanging fruit idea to try to build some trust and, and get people to believe you are real is really an important concept to do any of the longer term work. The idea that people who have multiple, multiple roles and multiple systems and perhaps even personally are struggling financially and the ravages often in many states, opioid use and job loss want to be on a five or ten year path with a funder that's difficult. They have to see some early, mid, late wins. And I think those are the kinds of things that actually build trust. When people say oh wow, that happened. We've been working on that for years and it could be something very, very, very small, an extra day at the mental health clinic or there's now an opportunity for younger people to interact in a positive setting after school. But yeah, you need to be hold the two concepts together. The systems change and really building a community mindset around improved mental health in a rural place that, that's long term work. But concurrently people have to see progress, they have to see it's real. They have to see you are providing value, you're not just running them through a series of meetings. So I think there's something really kind of important there and I would almost position it as well, you're doing the relational work that, that perhaps will lead to kinds of creative, innovative solutions, meaning things people hadn't thought about. There's often a need for things that are a little more transactional or a little more visible to the community or the public at large. So I think that's something to kind of hold in place. I'm going to stop there at another thought, but it's going to take us in a different direction. [00:36:14] Speaker B: I just wanted to build on what Alan was saying. You do need some concrete results and it's good if you can have a little pocket park or extra hours at the clinic and what have you. But what I've been thinking about a lot is there are some issues which have a major impact on a community. Whether it's floods or a hurricane, whether it's a Plant closure, whether it's a complete change in government policy, there can be all sorts of things that happen which can have a major impact on that community. And the way the community deals with that is often if they can deal with those things successfully, it's because they have built over the years good relationships, good understanding of what different people bring to the table and that they can pick up a phone and ask somebody for something and they don't have to be wondering, well, who can help me with that? Because they already know. So in some ways these small scale efforts can be the building blocks, the foundation for major efforts down the line. And I agree entirely with what Alan was saying about having small wins, measurable things so that we're not just running people through a process, but in some ways we also have to have people ready for what is going to come down the pike. And it's increasingly likely to be a weather event. But it could also mean it could also be something like, oh, they're going to open a rare earth mine just down the road, which, or they're going to reopen coal mines. There could be all sorts of things which could have a major impact on the community. If they've got this infrastructure in place, then they're in a much better way to be able to come up with solutions or approaches to deal with those major problems. So I think that if you could set these sorts of activities in that larger context, then maybe that's another way of getting the community and all its players to see that they have an important role to play down the line. And the funders themselves say we're investing in this building of a stronger network, interactive community capable of dealing with anything that comes to hit them. [00:39:06] Speaker E: If I could just add something as Brian just reminded me of something which I think funders don't do enough is, but is actually part of trust building or allowing people to identify their assets even in the least resourced rural places. There have been examples could be, you know, in the way Brian just described response to flood, hurricanes, tremendous job loss, where people have come together in innovative, creative ways, sometimes with urgency, sometimes over a year or two, and solved a problem or had a community response that they are proud of. And it may have been 10 or 15 years ago, but those are the kinds of examples, reviving those examples or trying to strengthen the even informal networks that were created then. Those are some of the prime examples that allow people to see, I think, themselves in solving the next set of issues. And the case of hog that might be specific to mental well being but it creates kind of a concrete platform where people can say, oh yeah, we really responded to that and here's why we think it worked and why that was different than maybe how we're doing business today. But a funder is in a great position to revive these kinds of stuff, success stories, and allow people to be proud of what they've done in the past and projected into the future. [00:41:00] Speaker A: But working in rural community over a period of years, I'm sure that there are complaints that you hear variations of, you know, multiple times from a lot of different people. And so my next question is basically just in your sense of what rural communities really wish that funders understood about them, if it can be kind of boiled down to one or two things in your experience. So, Brian, why don't we let you take a swing at that one first? [00:41:40] Speaker B: I think there's a couple of things which jump out at me, is that rural people are not some different species to be treated differently from elsewhere. They have the same needs and aspirations as all Americans, whether it's financial security, economic opportunity, affordable housing, healthcare, education, and they want to be respected for the contributions that they make. I think sometimes external folks will come into a rural community and treat them as though they are some exotic species. And nobody really likes that sort of approach. The problem is that the delivery mechanisms for services, the questions of low resources, people over committed with all the roles that they have, makes it difficult for some of the actions to be implemented that they would all like. So the first thing I think is to recognize that there are some structural challenges, but the people themselves have the same aspirations. And the second is that there isn't a single rural America. This ought to be something that is obvious, but I keep coming across this time and time again that every community has its own legacy, its own challenges, its own opportunities, and its own trajectory which precludes one size fits all policies and approaches. Which gets us back to the that where we started in this conversation, that there's a premium on self determination, on allowing the community be encouraged to be clear about what it seeks and what its outcomes are. [00:43:46] Speaker E: Yeah, I think there's so many things that funders do that is counterproductive to be an effective rural funder. And some are out of arrogance. But I believe that is diminishing. I recall an episode about 20 years ago with a major national health funder visiting us in rural Louisiana and we were describing issues, you know, just tremendous prevalence, morbidity, mortality, related diabetes. And then I experienced a five minute lecture about how people just needed to eat more healthy foods. And, you know, do you know that there was an American Diabetes association protocol that would make them healthy? This was a senior level person at a national health funder who was so ignorant of, you know, income disparities and food access issues and history. I mean, you know, you could go on and on. And they were, they were defiant that, you know, we as a funder were not holding, in this case, rural black communities to the standard that they need to be to. And no one could be funded for diabetes work unless they were going to do it in this kind of prescribed way. I think, as I said, I think that's diminished. But some of it is those kind of structural issues. You cannot have a nurse home visitation program based upon an urban model where you might visit 10 or 15 clients over a couple days if the clients are 80 miles apart, just given the frontier geography or the mountain geography. Similarly, just the lack of understanding of kind of the resources that are employed. There is not a psychiatrist, there is not a fully developed community health worker program, and on and on and on. I think the third piece that's important is many funders try to do work in rural places as if they are going to educate the local people on the serious mental illness in their community or the serious diabetes. Go back to that example or, you know, the educational disparities. Everyone is completely aware of those things. They may feel completely frustrated and fatalistic about the ability to change those. They are very, very aware of the problems and wish they were in a much better situation. But the funder as educator of the problem is one of the fundamental mistakes that funders make in rural places and almost sets you up from failure from the first discussion. [00:46:58] Speaker A: Rick? [00:46:59] Speaker D: Yeah, I think one of the things that I'm reminded of, and I'm sure Tammy was probably going to talk about this, so I'm going to preempt her, is that doing funding this type of work as a funder means also letting go means doing things very, very differently than what you're accustomed to. And it could be just a really dramatic shift, pendulum swing. There's got to be a lot of work that's done inside, inside the foundation, you know, and that's really kind of taking that hard look and that look in the mirror and think about how do I need to really rethink my role and how do I, how do I behave or how do I execute that? And so this is something that's been part of our journey as a foundation as a whole, but certainly in our individual roles as program officers that Tammy and I have really, you know, looked at literature, reflected on our own biases and assumptions, and had to, you know, kind of work through some of that ourselves and then be able to articulate that to the rest of the foundation on why we should, you know, allow our grant sites to make decisions on how they spend the money. There has to be that parallel work that's done. If we're asking communities to really come together and mend bridges and work together, that's some of the work that has to be done internally within foundations as well. And I don't often hear a lot of that piece because the foundations are so focused on the giving aspect and funding this type of work in communities that you don't hear a lot about foundation in terms of the work that they have to do within to actually kind of work in parallel fashion with what we're asking communities to do. [00:48:51] Speaker C: I love that. I think one of the great things about there being two of us on this project is inevitably one of us is going to pop up and say, well, I think they should do this, and the other one has the responsibility of saying, and it's not up to you. And it's a great dynamic, I think, between the two of us to consistently challenge each other in this way of. Is it even something we need to be weighing in on? You know, because they will consistently come to us. Even now, they will consistently come to us for. For advice or coaching and things like that. And as Rick mentioned earlier, we want to be available. We have a relationship with the key people, not the traditional key people, but the key people in these communities. And so we certainly are trying to maintain that as well. But that's a fine line. And I think we try to walk that as carefully as we can. And I'm sure we've screwed it up, but I think that our intentions are always there, and we also try to talk with them about this. So if we think that, you know, somebody comes to us and says, we really would like for you to weigh in on this, we come to each other and talk about, should we? And then inevitably we'll go back to them and explain whether we decide we are or not. And if we decide we're not, we talk through why not? Because we want them to. To maintain that power within their community. They don't need to take on our solution with more weight. And that's been a real hard pill to swallow because as people who try very hard to mitigate that, it is still there and it is still a challenge to deal with. I Wanted to go back to one thing you asked though, Ike. You were talking about, what do communities wish funders knew? And I immediately started thinking about all the nonprofits that I had worked for long before I was ever in this role, and how frustrated I would get with funders and thinking about, you know, you would spend all this time on a proposal and you put your heart and soul into it, thinking that you were telling them exactly what they needed. And I think consistently, a message that the organizations that I was working with, consistently, we would feel is this sense of they don't understand that we know what we're doing. And I think that has evolved a lot over time, which I think is great. But I still think there's a general mentality that funders are trying to fund. And this goes back to the idea of funding programs versus processes and things like that, that when we go in with a very specific program and want it designed a certain way, we're basically telling them that we know better than they do. And that's something I've seen evolve over time. I can only specifically speak to hog. I definitely think that we've evolved from being way more prescriptive to being far less prescriptive and really being excited about the process and funding the process. But I absolutely remember being part of these nonprofits who really felt so strongly about what we were doing, having the evidence base behind it, doing these things for years. And what we really needed was support doing the work we were already doing. [00:52:27] Speaker A: So this is an opportunity to use your voices, to amplify anything that is good and wonderful that is going on in communities that you just think that the larger world of philanthropy just should know about. If you can imagine a world in which all the great things that communities come up with, the great ideas that get hatched, could ever be brought up, could ever be brought up to scale. [00:53:00] Speaker C: So there's a lot of specific things that I've heard communities doing, but I hesitate to spend too much time on that because again, I think the communities have to come up with these things themselves. So one of the greatest things that I see is the inclusion of people who are typically not included. And I think there's such a power and innovation that comes out of that. And some of this goes back to what both Brian and Alan were talking about in terms of this balance of urgency and being able to do things. Quick returns on investment versus this balance of long term investment and really thinking about how are you going to make long term changes. And I think it's so important that communities have the ability to create that balance themselves. [00:54:00] Speaker D: I think kind of what comes to mind for me is, you know, the idea around this, creating mentally healthy communities. And I've always seen it, that it starts at home, it starts in blocks neighborhoods, you know, and it permeates throughout a community. And one of the things that we've seen with these five sites in particular, and hopefully with the ones that we'll be funding in this next grant program, is the creation of these collaboratives as being kind of the go to in their community for information, education, resources and support around mental health. Most people, and I think all of us have been in the field for a long time. Certainly when I was in graduate school, the issue, one of the big challenges that I heard constantly when I was in graduate school was about workforce. We need more doctors, more nurses, more psychologists, more social workers, et cetera. 20 years ago, what's the conversation? We need more doctors, more nurses, more psychologists, more social workers, workforce. Ten years ago, you know, you know, this is tape. You know, I was at national grant Makers association last year, you know, I was part of a panel and we kind of threw out the question, like, what is the biggest challenge facing behavioral health right now? Immediately the first thing that came out was workforce, more doctors, more nurses. And you know, so I think my comeback and challenge is that they are not going to parachute out of the sky tomorrow and land in our rural clinics. Not going to happen. So we have to really think and rethink how we can support communities as coming together and creating places of support and information and education, trusted sources, safe spaces where people can go to get that. Because not everybody needs a licensed psychiatrist. Psychologists, social work people, most people, when they have a mental health or in some kind of crisis or some situation, they just need a place that they can go and be heard and try to get some information, some education, some resources and support. And I think that's when we think about how do you create mentally healthy communities? I'm not talking about downstream, what happens in the four walls of a clinic. We're talking about what happens. How do you build a mentally healthy community? So those are the things that come to mind as I reflect on kind of the work we've been engaged in. And then as we look towards the future, how we can scale some of what our experience has been through this seven years, soon to be eight years of work in our well being in rural communities. [00:56:53] Speaker A: Brian, if you could just shout it out to the world. Some of the good things that you've seen go on in rural communities. [00:57:04] Speaker B: I want to take us to the Pacific Northwest, quite away from Texas. Thirty plus years ago, there was enormous strife within forest communities because of major changes in the way that forests were to be managed. It became sort of jobs versus environment conflict. And when I talk about conflict, this was serious stuff. There was violence, there were use of firearms, there were communities just torn apart between those who wanted in some way to have a more sustainable forest and those who saw their jobs disappearing because there was no more logging, no more processing of the timber. Over the period of time a number of organizations established which did their best, did a really good job actually, over the years of bringing these warring parties together, together, whether they were from the Forest Service, whether they were from private companies, local communities, tribes, everybody who had an interest in that, in trying to find a resolution. Thirty years on, we still have many of those organizations in place who are very much promoting the idea of land and resource stewardship with rural economic development, with job creation, with community wealth building. This has all been done locally with different participants and really deep community engagement all the way around and not necessarily with any outside, although there'll be lots of outside support. Most of the driving came from local organizations and local individuals. And I just wanted to talk about the way that they saw active participation in community development instead of waiting for a single solution to appear from outside the community. And I think I just want to make this quote, a shift in community psyche and coffee top talk from anger, frustration and despair to hope, pride and optimism is critical to making communities attractive to young families and workers and builds bridges throughout the community, creating opportunity and momentum. It just shows that a major crisis 30 years ago created a whole way of working which is still very much in play today. And where you're beginning to see communities growing again and attracting young people. And there's a very strong mental health element in that of the way communities move from despair to hope and looking forward to the future. All the work that's gone on in the forest really does give me a great deal of pleasure to say this is how we should be approaching some of these most intractable problems. [01:01:02] Speaker A: Okay, Alan? [01:01:08] Speaker E: Yeah, I'll take a. I'll take a little different tact and kind of run through a short list of things that make me quite hopeful about, you know, community's ability to move and make progress and do the things. To Tammy's point, they know our issues and they. That they feel they have some really good ideas and solutions embedded there already. One would be, and a friend of mine, Dr. Luke Smith, who's a psychiatrist in the Triangle is actually one of the national leaders is the development of a model for rural community mental health workers. We've had community health workers for 30 or 40 years and many states and insurers paying for those. But he has about 25 people in the field in rural communities who he's put through a pretty rigorous very community centric curriculum and now is advising funders and state officials in a number of states and gets to Rick's point around workforce but is probably just as important around bringing communities together and helping people problem solve. The second I jotted down I'm seeing a lot of movement here in the southeast in rural places on the reuse of empty church buildings for community purpose. There's so many, you know, aging of congregations, change in church going patterns. There's so many church facilities often in decent shape. Some are not under, you know, denominational umbrellas that are now being looked at to reuse for a whole variety of community uses. Some of them very community health mental health care type settings but others more just community gathering places and places that didn't, didn't have anything that would make sense sense or that could, you could actually bring 200 people into a room. So very positive. Similarly, just the explosion of rural non profit media just another tool I think to allow people to see themselves in some, some ways in, in very positive ways to do storytelling in other cases to really highlight things that people are talking about. But there's no way to get kind of get the message out. And there might be deficits or gaps in health care or community perception on opioids for example. And the last thing I'll mention, there's certainly, and I've been saying this for a number of years, but I don't think the trend line is over yet. There's certainly more new funders who are doing very intentional rural work, some of them very, very large. Patterson Family foundation comes to mind which is in rural Kansas and Missouri. Believe they're over a billion dollars now and is only rural. And those those kinds of funders didn't exist 10 or 15 years ago as well as other funders who now have a very targeted rural portfolio. And along with that I'm increasingly speaking to rural philanthropic leaders, whether they be on the program side or COO or CEO who actually come from a rural background. And when I started on this journey 30 years ago that was except for certain kinds of family foundations that was almost unheard of. And it's less true of the national funders unfortunately. But place based funders increasingly Thinking that maybe having a rural background would be very useful in philanthropy. So great to see. [01:05:05] Speaker A: So this has been a wonderful conversation. So just to recap, not going to be easy to do. Funders being willing to listen, being willing to deploy their privilege in savvy ways for the benefit of those who have less of it. Also being willing to admit that they don't know everything and that their own success hinges on communities willingness to do a lot of the figuring out work for whatever it is that they hope to achieve and just kind of proceeding with a modicum of emotional intelligence. It's another kind of trendy phrase in mental health. And that kind of is more art than science. Knowing when to step forward and when to kind of pull back. And it takes some months or even years of engagement to know exactly what kind of dance partner you have with a given community. Alan, Rick, Brian, Tammy, thank you so much for taking the time today to share your considerable accumulated wisdom. It's always a fraught topic but always very important, you know, to just take every opportunity to hash out and think through the relationships between funders and historically under resourced communities. And so we really do appreciate it. [01:06:56] Speaker C: Thank you so much. [01:06:56] Speaker D: Yeah, yeah. Thank you all. [01:06:58] Speaker C: And thanks Brian and Alan in particular. We really appreciate you guys doing this. [01:07:02] Speaker A: Okay. [01:07:03] Speaker B: It's been. Thank you so much. [01:07:06] Speaker A: For our 80th episode back in 2019, we wanted to share key takeaways from that year's Robert Lee Sutherland Seminar, which took place in Bastrop, Texas. For one special day, people from across Texas, from all walks of life and professions converged to learn together and share inspiration around the theme of working together for rural well being. And so for that special episode, we caught up with some of the attendees to get their reflections about the topics that were discussed at the event. And two themes really emerged. The need to strengthen connections and to move upstream. Here's a quick listen. [01:07:58] Speaker C: I was given the opportunity to come to today's seminar by the SFA School of Social Work. Dr. Cooper. I believe one of the biggest challenges is educating people, making them aware that there are resources out there for them. We've done a lot with the community cafes, but there's still a lot of work to do. We have an organization that's called Hungry for Hope. And it is an organization that assists returning citizens and supporting them. And what I have found is that. [01:08:42] Speaker E: We'Re not the only county that is. [01:08:45] Speaker C: Dealing with this city situation. And it's a very important one. [01:08:49] Speaker A: And so that encourages me. [01:08:53] Speaker B: I'm involved with the Nacogdoches County Community Collaborative, which is one of the five grantees under the well Being and Rural Communities Initiative. I think one of the biggest issues we face is just the lack of resources in terms of mental health services and trying to figure out how to bring people together and leverage the resources that we do have to overcome those challenges. I think just the opportunity to hear what other people are doing and the approaches that they have to dealing with the challenges. It's always interesting to hear different approaches, different ideas, maybe something you can use or sparks a new idea that you can take back home and use in your county. [01:09:32] Speaker A: The voices that you just heard belong to azar Coulter and Dr. Steven Cooper, who were both involved with the Nacogdoches Community Collaborative that was funded through the Hogg Foundation's well Being in Rural Communities Initiative. That collaborative has evolved into Better Together and remains a Hawk foundation grantee partner. Dr. Cooper, you should also know, is now a member of the Hawk Foundation's National Advisory Council. I dropped a link to the full episode in the show notes, so check it out and that does it for this episode. We're glad you could join us. Production assistance by Carissa Sazor, Kate Rooney and Daryl Wiggins. And thanks as always to the Hawke foundation for its support. If you have comments or anything you would like to share about the podcast, feel free to reach out to us at into the Fold at awesome Utexas. Edu. Especially thoughtful comments will be acknowledged during a future episode. You're My hour Mental Health Matters. Please leave us a review and subscribe to us on your preferred podcast platform. Transition Music by Kevin McLeod Taking us out now is Anna's Good Vibes by our old friend Anna Harris. Thanks for joining us. [01:11:50] Speaker E: It.