Transcript
Speaker: Hello and welcome to Pod for the People.
Speaker: I'm your host, Dr. Tammy Gouveia.
Speaker: Each week I invite everyday Americans, community activists, and status quo disruptors to share stories about the power of connection and finding the courage to heal our political divisions.
Speaker: So folks, today I am so super excited for our guest, someone who has become a very dear friend, a quick friend, a fellow social worker, Carla B. Montero, who has an MSW and an LCSW.
Speaker: She's doing really important work every single day as an addiction clinical social worker, an emergency psychiatric social worker,
Speaker: She's been a lifelong social and racial justice advocate, and she took all of this experience and ran for Boston City Council at large last year.
Speaker: Carla, welcome to our show.
Speaker: Hi, Tammy.
Speaker: Thank you so much for having me on your show today.
Speaker: I'm so excited to be with you, not only because you're a social worker, but because you are an amazing friend and someone that I have watched in the statehouse and have just, you know, really been proud of the work that you have done to advocate for people in the city.
Speaker: We're all in thinking about the well-being of everyone and not just the people in your district.
Speaker: So thank you so much for all of your support and all the work that you've done.
Speaker: Thank you.
Speaker: That's very kind words, and I really appreciate you saying that.
Speaker: It's been a true honor to serve as a state representative and to run for lieutenant governor and to meet you along the way.
Speaker: I don't remember exactly when or where we met because I feel like we've known each other forever and ever.
Speaker: We have some similarities in our life experiences, our professional experiences.
Speaker: But do you remember when we first met or how we first got connected?
Speaker: It's funny because I think we got connected with something to do with NASW.
Speaker: That would make sense.
Speaker: Yeah.
Speaker: And I don't remember if it was around like the Roe Act or it was around something around.
Speaker: I remember Jamie was on there and a few other people.
Speaker: Definitely was through NASW.
Speaker: It does feel like a long time ago.
Speaker: It does.
Speaker: Yeah, definitely.
Speaker: Yeah.
Speaker: And of course, you know, the work with the Roe Act here in Massachusetts to secure reproductive rights for folks in the state of Massachusetts has been something that's been critical.
Speaker: It predated the Dobbs decision.
Speaker: We did pass legislation this session to advance reproductive rights even further post Dobbs.
Speaker: I'm sure we will see more activity there.
Speaker: in the Massachusetts legislature in the next session and even at the local level.
Speaker: So I'm pleased that that is the work that brought us together around reproductive justice because I think we both share a commitment to supporting and advancing everybody's right to full bodily autonomy and to bring their whole selves to their work, to their church, to their government, and to their community.
Speaker: So just thinking about being able to bring our whole selves to the work that we do, you and I have something that's pretty unique in common that we share.
Speaker: We were both candidates for office as single moms.
Speaker: as social workers.
Speaker: And we've worked really hard, I think, to support our children also while advancing our education, buying a house on our own, and just really living that day-to-day struggle while trying to take care of ourselves and take care of our children, take care of our families.
Speaker: And just the challenges of struggling financially.
Speaker: When I was running for lieutenant governor, I would sometimes share the story that I've needed to borrow money to buy a gallon of milk or to put a couple gallons of gas in the car.
Speaker: I wonder what your experience really has been like.
Speaker: how you see this relating to why you decided to run for city council and why you do the work that you have been called to do every single day.
Speaker: Thank you, Sammy.
Speaker: And these are great questions.
Speaker: And thank you for sharing your own experience.
Speaker: Cause I think that that's what made you a great state rep and made you a great candidate for a Lieutenant governor because of your own lived experience.
Speaker: And,
Speaker: so many of us who can relate to that.
Speaker: You know, over the years, it has been so many challenges that I've experienced financially, but there are a few that really stick out for me.
Speaker: And one of them is around housing insecurity.
Speaker: And, you know, I was living with my mom and it was a two bedroom apartment.
Speaker: There were six people living there.
Speaker: And this was prior to me having my son.
Speaker: And my sister and I also shared a room at that time.
Speaker: But I moved out shortly after having my son and moved in with his father and his family.
Speaker: But then when the relationship wasn't working anymore, I didn't really know how to ask my family for help.
Speaker: I didn't know.
Speaker: I mean, I guess I could have, but I also had so much pride, right?
Speaker: Like I had a baby and now I moved out and now here I am trying to come back, which I'm pretty sure would have been completely fine with my mom, but it was just hard for me to
Speaker: to ask or, and also feeling like a burden, right?
Speaker: So I hit, I remember going to the Department of Transnational Assistance, also known as the welfare office with plans on going to a shelter with him.
Speaker: And I had packed food, clothes, and some toys for him because I didn't know what that experience was going to be like.
Speaker: And I was afraid.
Speaker: I felt like I failed as a mother and that I failed myself.
Speaker: That was one of the times that was really tough for me.
Speaker: But there was another time where my son was extremely ill, you know, fever, cough, runny nose, watery eyes, everything you can think of that comes with colds.
Speaker: And I had to take him to work with me because I worked for a wireless company and I could not afford to take the day off.
Speaker: If I didn't make quota, then I didn't have a paycheck.
Speaker: And I heavily relied on that income to pay our bills, to buy food, to fill up the gas tank.
Speaker: And I had him sleeping in a grocery store carriage with his coat as the pillow and my coat as the blanket.
Speaker: And that day, I think, is one of the times that I think of frequently.
Speaker: And it's just so emotional for me because I think that was one of my most heartbreaking moments in my life.
Speaker: Because, you know, I just remember him waking up here and there and me having to hug him and then lay him back down in that carriage while I worked those eight hours.
Speaker: And I worked nights and I was working until nine that night.
Speaker: So that was a really challenging time because I didn't have a babysitter and I had to go to work.
Speaker: And so I didn't really have much of a choice.
Speaker: And that is something that I think so many families face.
Speaker: And you share the story about, you know, having to borrow money to purchase milk.
Speaker: And I also have a milk story, going to the store to buy milk and having the exact amounts for the milk, you know, down to pennies.
Speaker: And my son asking for a 25 cent bag of chips and me not having the money for it and
Speaker: Thankfully, when I would say maybe next time to him, he'd say, okay, maybe next time.
Speaker: But that's another time that just was so heartbreaking for me because it only cost 25 cents, but I did not have that 25 cents.
Speaker: I only had enough to buy the milk so that he could have his oatmeal in the morning for breakfast.
Speaker: And so I think that there are so many families who struggle, whether you are receiving financial assistance for food or not.
Speaker: I think it's so challenging because when
Speaker: and I was only getting $110 a month.
Speaker: And then when I started working and I was only working earning $10 an hour, they decreased my food stamps to $10.
Speaker: Of course, I couldn't afford to buy food with the $110 I was receiving, nevermind the $10.
Speaker: And if you think about, you know, by the time you purchase your onions and peppers and seasonings and all of those things and meats, it's just really difficult to really purchase all of the things you need to make meals for a month at $110.
Speaker: That's why I decided to run because I think that people like us are the people who should be in office who should be, you know, helping with in designing these policies that are impacting people every day because if you aren't in those people's shoes, how do you know what they need, how do you know what works, you know, even thinking about daycare and these vultures.
Speaker: You have to have 20 hours of work.
Speaker: Well, why is it that we never allocate time for parents to recuperate after having a baby?
Speaker: People have postpartum.
Speaker: There's all kinds of things that happen, but we're constantly forcing people into the workforce before they're even really ready, right?
Speaker: Causing some more mental and emotional struggles.
Speaker: Absolutely, yeah.
Speaker: And some of the things that I'm sure folks shared with you, how grateful they were that you were running for office because you were telling their story.
Speaker: And that would happen to me repeatedly.
Speaker: Even though I'm a white woman, I've had a lot of opportunities and privileges that come with being a white person in this society and still resonated.
Speaker: The stories that I shared about financial struggle
Speaker: with individuals of color, with folks who are immigrants, with people who have just fallen on hard times, and talking and having the vulnerability that you had, that a number of candidates in this election cycle had, and really sharing their story and being open-hearted and really, truly vulnerable with that,
Speaker: I think if people, yeah, you get it.
Speaker: You get it.
Speaker: You understand at least a little bit.
Speaker: And it is, you can have the most amount of empathy, but if you've never really carried the shame,
Speaker: And the fear that comes with being a single parent and trying to put that food on the table or the shame that comes along with, gosh, I just want to buy my kid a 25 cent bag of chips and I can't pull that together.
Speaker: And so that those feelings of failure or not being enough and not being able to give enough, what's needed in our politics and in our discourse in general.
Speaker: I'm wondering if you can share a little bit, and you touched on this, but stress and uncertainty and fear, those things have consequences.
Speaker: You touched on this a little bit.
Speaker: They can sometimes have consequences on, you know, friend relationships or on our ability to get enough sleep and take care of ourselves or drink enough water through the day or just carrying too many burdens.
Speaker: So we're not able to get out and go,
Speaker: for a walk, which is good for our heart health and good for our mental health.
Speaker: Can you just talk a little bit about what you may have experienced or what you see even in some of the clients that you work with, what these financial pressures really do to mental health and well-being?
Speaker: Yeah, I think, you know, it's tough because we, you know, you mentioned sleep, we don't have sometimes don't have time to sleep, right.
Speaker: And there's that cycle of if you don't get enough sleep, that triggers your anxiety, then your anxiety triggering the fact that you can't sleep, you know, so it's just you're on this revolving circle, this rotation of depression and anxiety, lack of sleep and stress and all of those things.
Speaker: And so
Speaker: Oftentimes, as you know, it's hard for adults to get treatment for themselves because they're focused on caring for their children.
Speaker: They have to go to work.
Speaker: They work in multiple jobs, so they don't have access or time to get a therapist or to get the services that they need.
Speaker: Your relationships with people, things often change, right?
Speaker: Whether it's the themes in your life, whether you're a student, a mom, whatever it is, the friendships start to change because people don't always understand what you're going through, right?
Speaker: And I think that
Speaker: There are times where you're someone who's always there for your friends or, you know, you're both always there for each other.
Speaker: But there comes a time where maybe one is just so burned out and they can't be there for you in the way that you, they once was there for you or the way you expect them to be there, the way you want them to be there.
Speaker: And sometimes people, you know, would say things like,
Speaker: you know, ever since you bought your house, you think you're too good for everyone.
Speaker: When in fact, I was actually working 80 hours a week to pay my bills, to renovate, to take care of my son.
Speaker: My mom had lost her job and she was living in the projects and I was working to get them out of there and, you know, to buy a house and all of those things.
Speaker: And so people often don't see your struggles.
Speaker: There was a quote that I read a while ago that said, people often dream of the glory, but never think of the pain.
Speaker: So while people were watching and saying, oh, she bought a house, this is so great.
Speaker: No one's seeing what I'm actually going through, right?
Speaker: Like I'm working 80 hours a week.
Speaker: I remember going to pick up my son at my mom one night, at my mom's house one night.
Speaker: And I think I might've just been sitting there staring or something.
Speaker: And my mom looked at me and said, Carla, what's wrong?
Speaker: And we locked eyes.
Speaker: And I kid you not, I bursted into tears.
Speaker: And I couldn't stop crying, you know, and my mom just hugged me and kept asking what was wrong, but nothing really happened.
Speaker: I just was exhausted, you know, from working, you know, 80 hours a week, doing double shifts, cooking dinner,
Speaker: taking my son to sports, like starting dinner, running to the football field, coming back, you know, all of those things that we have to do, all of these responsibilities.
Speaker: Doing it all alone, the running back and forth all alone and how planful you have to be to make sure you have every piece that you're going to make for that dinner so that you don't have to add an extra errand.
Speaker: You're like cooking dinner.
Speaker: Exactly.
Speaker: You're cooking dinner and prepping dinner for the next day, you know, making sure they're doing homework.
Speaker: I mean, there's just so many components that come with that.
Speaker: And so,
Speaker: I can't answer the phone at night because I need to focus on cooking dinner, making sure my son's homework done, make sure we take our showers on time, go to bed on time.
Speaker: So it was really difficult.
Speaker: So that put a strain on a lot of friendships.
Speaker: And so some friendships lasted and some didn't, you know, and I, but I became severely depressed and, you know, had anxiety because, you know, anxiety and depression often will come together.
Speaker: And, you know, I remember pulling into the parking lot at my job and just crying and crying and crying and,
Speaker: at the time was not diagnosed with any mental illness.
Speaker: And so I didn't know what was happening to me.
Speaker: I just would cry.
Speaker: My boss would call and say, hey, where are you?
Speaker: And I'd say, I'm in my car and I can't stop crying.
Speaker: Or I'm in the bathroom at work and can't stop crying.
Speaker: He'd say, I need you on the floor.
Speaker: I'm sorry.
Speaker: Are you okay?
Speaker: But I need you on the floor.
Speaker: And thank God he was such a good boss.
Speaker: But there were times where I couldn't stop it.
Speaker: I'd come from the car and go into the bathroom at work, hoping it would stop.
Speaker: And I'd
Speaker: look in the mirror and I keep trying to get myself to pull it, to pull it together.
Speaker: And I just couldn't do it.
Speaker: It took a while before I could pull myself together.
Speaker: And I think that that happens to so many people, right?
Speaker: Like where you're just at hitting rock bottom and you don't know how to ask for help.
Speaker: You don't know what to even ask for.
Speaker: Like, how do you support yourself in that, in that moment?
Speaker: And being so aware of what's happening to your body.
Speaker: right?
Speaker: I mean, crying uncontrollably or not being able to breathe nausea and not understanding what all of those physical symptoms are really telling us, which is we have some serious help that we need because we're overwhelmed, exhausted.
Speaker: The exhaustion is a really important thing that I, an important aspect that seems to also get overlooked.
Speaker: So
Speaker: Yeah, because when we're mentally struggling and then we don't take care of ourselves, our bodies start to tell us it's time to wind down.
Speaker: It's time to stop, whether that's fatigue, the nausea, all of these things that we start to experience.
Speaker: And I think there's also that you're working so much, right?
Speaker: So you're physically exhausted, all of that.
Speaker: But also thinking about the emotional strain that is happening, right?
Speaker: When
Speaker: Like for me, wanting more for myself, wanting more for my son, wanting to have this sense of security in my life financially was a struggle because I felt stuck at my job.
Speaker: I didn't want to work nights anymore.
Speaker: I didn't want to work weekends.
Speaker: You know, I wanted to just take care of my child.
Speaker: and spend that time with him, you know, and I have to request a day off because my son has a field trip or something because I couldn't do those things because I felt stuck at my job.
Speaker: I didn't have a degree, right?
Speaker: You feel like there's no way, you just feel so suffocated because there is, it just seems like there's no way out of this cycle.
Speaker: And so that becomes very, very exhausting.
Speaker: Yeah, absolutely.
Speaker: And it's the lack of having choices, right?
Speaker: that being really, really stuck.
Speaker: But also something else that you said, being caught in a cycle, I think a lot about how much more joy I have in my life now that I am in a much more financially secure place than I was even four years ago.
Speaker: And that's because
Speaker: I have a fiance and we live together and we share our bills.
Speaker: But when you're carrying all of the household responsibilities, all of the financial responsibilities, the caretaking responsibilities, when you're carrying those by yourself for so long, it can be difficult to find those moments of joy.
Speaker: And it starts to feel like that we're in a place in our society where joy is just something for the privileged.
Speaker: And I have
Speaker: a real hard problem with that because it goes back to bodily autonomy and being able to be your whole self.
Speaker: And that includes being able to really be present and engaged for those family celebrations and those moments of joy and time that we should really be celebrating.
Speaker: So I wonder if you have any thoughts on how you find joy and how can we structurally invest in conditions that
Speaker: do foster joy for everybody, regardless of what their financial, racial, or socioeconomic background is?
Speaker: Yeah, I think in the moments of struggle, right, it's so hard to find joy.
Speaker: And I think even for me, I still have trouble finding joy at times.
Speaker: And I was saying this to someone the other day that I forgot, I forget what it's like to be happy sometimes or to enjoy something.
Speaker: I forget
Speaker: I forget that feeling of joy when something great happens that I enjoy because I am a social worker, as you know.
Speaker: We don't get paid enough.
Speaker: And so I'm still constantly working.
Speaker: My son is 20 years old.
Speaker: And I work four jobs, you know, full time, per diem, contract, all of that, right?
Speaker: Because I'm still trying to make sure that I don't end up in a place where I could possibly lose my home or, you know, not be able to purchase food.
Speaker: I mean, there's inflation going on right now with food.
Speaker: I don't qualify for any financial assistance.
Speaker: And that's for a lot of families who may have a decent paying job and they don't qualify for any additional resources.
Speaker: So they're still constantly having to work a lot.
Speaker: And so
Speaker: Last night, I think, was one of the nights that I have gotten the best sleep in a very long time.
Speaker: I fell asleep around nine and got sleep last night.
Speaker: I feel much better today.
Speaker: And I felt so good about that.
Speaker: I've been dancing around the house today.
Speaker: I've been having, you know, in between patients.
Speaker: It's been feeling really great because...
Speaker: I think that, you know, as clinicians, right, or people who are serving the community, we're often listening to so many traumas and so many different things people go through all the time that sometimes we also call it vicarious trauma, where we are absorbing the consequences of the experiences that people have when they're expressing their stories.
Speaker: And so kind of get into this bubble where sometimes it's hard to find joy, but I love
Speaker: you know, listening to music, one of the things that brings me joy is I always decorate for the holidays early.
Speaker: So in October, I put up my tree and everyone's like, why are you always putting up your tree?
Speaker: It's too early.
Speaker: It's not even Thanksgiving.
Speaker: And I read an article a few years ago that said that people who decorate early for the holidays are much happier.
Speaker: And I've been doing that ever since.
Speaker: And I am much happier.
Speaker: I love it.
Speaker: That's a really good tip for anybody who needs to get out of the doldrums of the darker weather and the colder weather, but also just the challenges that so many of us are facing every day.
Speaker: Let's talk a little bit about the work that you are doing and the traumatic things that you are hearing and seeing.
Speaker: And you've been doing this work, this social work on families that you're working with.
Speaker: So yeah, just would love for folks to be able to hear what is it like every single day listening to the traumatic experiences that people are suffering with?
Speaker: That can be really hard some days.
Speaker: I grew up in Dorchester in a community that was plagued with gun violence, substance use, crack cocaine era, the war on drugs, so many different things that impact me day to day.
Speaker: You know, I sort of just ended up in addictions.
Speaker: You know, I think that the things that impacted my community when I was growing up, criminal justice reform, mental illness and substance use.
Speaker: And so I've been an addiction social worker for the past two years, have been in that same clinic almost five years as a resource specialist supporting clients.
Speaker: connecting them to different resources, screening for social determinants of health.
Speaker: And, you know, it's been challenging overall, right?
Speaker: Like listening to people's traumas, but also watching families who are, you know, looking for their children, calling the clinic because they can't find them.
Speaker: They don't know if they've overdosed somewhere and having to,
Speaker: not being able to communicate and say, well, they have been coming to their appointments or they haven't because of HIPAA.
Speaker: And so you have to, can't disclose anything.
Speaker: And as a mom, it's so heart-wrenching to think of a mom trying to find their children because they want to know whether they're dead or alive and you can't share any information.
Speaker: And so it's really hard sometimes, you know, dealing with that, but also with patients, you know, hearing patients who have carried their pain for so many years.
Speaker: I have patients who I always quote,
Speaker: the saying in substance use that addiction begins and ends with pain.
Speaker: And it is true no matter how you look at it, whether it is broken leg or broken arm or trauma, emotional trauma, there's some point where that person experienced some type of
Speaker: pain.
Speaker: And so really learning to address what those underlining issues are is what can help people to stop to mitigate some of the substance use.
Speaker: And I think there's just so much stigma around addiction and the consequences of it and that people don't really understand it.
Speaker: And so the consequences of that is that people stigmatize.
Speaker: Well, why don't they just stop drinking?
Speaker: They don't want to change their life.
Speaker: They're doing it because they want to do it, you know.
Speaker: But actually your body becomes physically attached to it in, you know, biologically.
Speaker: And so your body starts to crave it at the same time.
Speaker: Or also it's really hard sometimes because there aren't a lot of resources at times where, you know, especially during the pandemic where detoxes, some detoxes are closed down.
Speaker: A lot of places weren't accepting people.
Speaker: They had to put a whole plan together in terms of how people were going to get screened before they went in.
Speaker: Some patients don't have phones.
Speaker: So how were they going to call to contact them to let them know that they could come in?
Speaker: But also, I work in an ED at a pediatrician hospital.
Speaker: And throughout the pandemic, you know, more and more children were experiencing suicidal ideation, anxiety, depression, and, you know, alcohol use in adults as well.
Speaker: I forgot to mention that.
Speaker: So all of that has really impacted so many families.
Speaker: And it's just the pandemic, on top of everything else that families were already going through, it just really exacerbated the mental illness situation.
Speaker: all around.
Speaker: And no one was ready for this pandemic, right?
Speaker: No one knew this was going to happen and the mental effects that it was going to take on people.
Speaker: And so you have people in the ED who are boarding two months at a time waiting for placement to go somewhere.
Speaker: But how, you know, thinking about it, having someone in a room, right?
Speaker: They can't walk around because of COVID and all of those things.
Speaker: It's sometimes counterproductive, right?
Speaker: But we have to keep them there because we have to keep them safe.
Speaker: And so we need to figure out a way to create a system that
Speaker: actually helps families instead of them, I'm sorry, helping them instead of sending them to the ED, porting them in a space where they can get the support they need, that they're not in an ED for overnight, just waiting to be seen, to be screened because there aren't enough rooms.
Speaker: And so, you know, kids being on Zoom all the time, Zoom fatigue, having that isolation, things that help develop children, like first dance, being rejected at dance, or your first kiss, or all of those things, right, that shape us, you know, that uncomfortable feeling when someone doesn't want to dance with you.
Speaker: All of those things shape kids, you know, it shapes them, it shapes who we are as adults, all of our different, all of the things that we experience in life shape us in one way or another.
Speaker: or prepares us for something.
Speaker: And so those were a lot of challenging moments for families, and especially not being able to find a clinician to see your kids as a shortage of therapists, as a shortage of providers everywhere.
Speaker: That has been probably part of the most daunting experience as a provider who doesn't
Speaker: have a place to refer people to.
Speaker: And the boarding issue has been a problem for a while.
Speaker: I worked in a pediatric psychiatric hospital a long time ago.
Speaker: We didn't have enough staff then.
Speaker: We know we still don't have enough staff now.
Speaker: We don't have enough beds.
Speaker: We don't have enough therapeutic foster families.
Speaker: I mean, the list really goes on.
Speaker: when it comes to the system that's supposed to exist, that I think a lot of people, unless you're touched by mental illness in a family member, particularly in a child, you don't really have a full understanding or appreciation for how hard it really is to find a pediatric therapist that
Speaker: What do you think is driving a lot of these issues?
Speaker: You did talk about pay a little bit.
Speaker: The fact is you are a master's level educated person and you're still working for jobs to make sure that you are covering all of your bills and are able to support yourself and your family.
Speaker: But what are some of the other issues that you're seeing as to why we don't have enough social workers and care providers, particularly of color, who speak multiple languages?
Speaker: And what could incentivize and support folks in choosing these very critical fields?
Speaker: Like, I just feel like our economy will not get back on track unless we make major, sincere, meaningful investments
Speaker: in our care providers, in our social workers, our psychiatrists, our psychologists, what do you see?
Speaker: What's your perspective on that?
Speaker: I think there's a number of different things that affects this.
Speaker: And so I think that, you know, obviously pay is like the number one thing, right?
Speaker: If you want to retain people, people also have to be able to
Speaker: you know, live and feel financially secure, right?
Speaker: We're asking social workers, you know, we use the massive hierarchy of needs, right?
Speaker: And we talk about basic needs.
Speaker: And we're asking social workers to support patients with basic needs and refer them out and support them
Speaker: but their own basic needs are not being met.
Speaker: So how can we expect social workers to empower other people or to be present if they don't know where their next meal is going to come from, or if they're going to lose their place to live, or if they can't take care of their children, they're dealing with their own internal stressors or personal stressors in addition to trying to support other people.
Speaker: But I, I'm pretty sure that if people felt financially secure, they're
Speaker: It would allow them the ability to fully function and bring their whole selves to work places to retain people because they're not having to look for another job that pays more constantly.
Speaker: The educational system for social workers, we have to work, most of us, especially people of color, we have to work full time.
Speaker: I worked 40 hours a week.
Speaker: I did internships for 24 hours in the same week, went to class for 10 hours a week.
Speaker: And then I had to do homework, study.
Speaker: I didn't cook the whole entire time.
Speaker: My son had a credit card and that's what he used for breakfast, lunch and dinner.
Speaker: I mean, I had grocery shops, so there was things here, but I was eating chips and candy all day because I didn't have time to cook.
Speaker: And that was all that was left in the vending machine by the time I got to class.
Speaker: And so I was struggling.
Speaker: And then also living in a community that was just plagued with gun violence that year.
Speaker: I think there was about 50 something murders that year.
Speaker: And so every time I would drive home, either I would be driving by yellow tape.
Speaker: I remember driving by Columbia road and someone had been shot in the car and so I could see the shattered windows.
Speaker: And so that was triggering for me because I had been losing friends since I was a teenager, you know, since I was in middle school.
Speaker: And so I,
Speaker: Anything, you know, gun related triggers me and I go into fight or flight mode and I just get really ill.
Speaker: And so those are things that people are navigating daily while trying to be clinicians.
Speaker: Like we want to do this because we want to help people, but we're also struggling with other things.
Speaker: And if the job is also not paying us well, that's another added layer.
Speaker: But I think that we really need to think about paid internships for people.
Speaker: I remember sometimes saying, am I learning enough?
Speaker: Because I'm so exhausted that I don't know if I'm retaining all of this information.
Speaker: Am I going to be a good clinician?
Speaker: You know, constantly questioning myself.
Speaker: Leadership tracks for social workers.
Speaker: It's almost not a thing.
Speaker: And if we think about like for admins, for example, there are, you know, admins, lead admins, senior admins, you know, this whole track, project manager, you know, it just kind of goes up, right?
Speaker: But for social workers, it's either you're a social worker, you can maybe be a director somewhere.
Speaker: But if you're in some facilities like hospital settings where the doctors, MDs are the hierarchy in there.
Speaker: And so MD will always be considered before you for a director position.
Speaker: And so it depends on where you are and what system you're in.
Speaker: And so I really think that these systems really ought to think about this a little bit differently because as a social work profession, we're the only ones that really look at things through a whole systems lens and look at wraparound services and all of these resources and support that can actually support people.
Speaker: And I think that that is great.
Speaker: that we're being underutilized and undervalued in so many ways.
Speaker: But I think that those are some of the ways to start with, you know, retaining people.
Speaker: Also, loan forgiveness that they just rolled out has been really great.
Speaker: And I'm so thankful that they didn't lock people into one location, but that you could transfer to another place that is still
Speaker: within the criteria and within their program.
Speaker: So I'm thankful for that.
Speaker: That will be really helpful to people because the loan payments are really high.
Speaker: And so if you're not earning enough and then you also have to pay for your loans, it can be pretty expensive.
Speaker: Some people have asked me, oh, do they really need all of that training?
Speaker: Isn't this really easy work?
Speaker: And the fact is, no, you have to really understand human psychology, human behavior, triggers, trauma.
Speaker: the environments, the emerging research that's coming out nearly every single day about understanding what is evidence-based practice, how do we make sure we're not causing harm, that we're also applying an equity lens and a justice lens because of, to the point you made, the level of violence that many folks grow up with and see on a very regular basis is traumatizing, is triggering.
Speaker: does stop people in their tracks from being able to pursue educational opportunities or employment opportunities because they have the experience of what you described, sitting in their car crying their eyes out and not understanding what's going on because we can only handle so much difficulty at one time.
Speaker: And this is what, to your point,
Speaker: that holistic lens that social workers bring can save our state money in the long term because we're not going to just have address one aspect of a person's mental illness, but really work to address the environmental aspects as well as the emotional and mental aspects as well.
Speaker: So I appreciate you sort of highlighting what we need to be doing here in our state when investing in, particularly in
Speaker: our social workers.
Speaker: Yeah, we talk about preventative care all the time, right?
Speaker: We talk about preventative care and so many studies have shown that preventative care helps in the long run.
Speaker: It saves people money, the stress, all of those things.
Speaker: It decreases a lot of those things when people are actively engaging in preventative care.
Speaker: I think also like in terms of the mental health care system is also there's the licensure barrier, right?
Speaker: Some people don't have the money to pay for all of these things.
Speaker: You know, I remember, I think it was like $173 for the application, $260, I think I just paid for the exam itself.
Speaker: And then I have to pay, I think, $80 something for the licensure.
Speaker: I mean, it's just really expensive.
Speaker: And, you know, sometimes people don't get a job right after school.
Speaker: So how much is it that they have to come out of their pocket to pay for the licensure?
Speaker: And then studies have shown recently, you know, ASW had released an article that showed that people of color, Latinx, and Asian community have lower rates in passing these exams.
Speaker: And so that's something that
Speaker: NASW is working on to possibly help to eliminate the LCSW exam.
Speaker: So we've gone to school, we've done our internships during that time, and then we get out and we have to take this exam, right?
Speaker: But not much has changed between graduating and
Speaker: And that licensure, right?
Speaker: So why are we taking a license exam when we fulfilled all those requirements?
Speaker: Because I myself had failed the LCSW twice by two points and then by one point.
Speaker: And so, and I had to pay three times for that exam.
Speaker: And it was so upsetting when, when that, that study came out, you know, when the results of that study came out, because
Speaker: I am one of those people, a person of color who wasn't able to pass that exam on the first two tries.
Speaker: So that's something that I hope that is eliminated to help people to start working, you know, so they can start getting the clinical experience because that will deter people from getting vaccinated.
Speaker: their license, and then they can't get a job.
Speaker: I see so many people on social media who say, I've taken this exam two, three times.
Speaker: I give up.
Speaker: I'm not taking it anymore.
Speaker: And so that leaves so many people who are well-trained to be social work out of the workforce.
Speaker: And I think that that's something that we really need to look at and how to support clinicians and for jobs to be embarrassed for these licensures, because it is job related.
Speaker: You need it for that job.
Speaker: To your point earlier, where you mentioned how someone said, you know, do we really need all this training?
Speaker: And I'm so glad that you mentioned how hurtful it can be
Speaker: Because I say this all the time and I've been meeting to make a video about it on social media because there are so many people who are not trained clinicians who are always giving advice about mental health.
Speaker: And I always think it is totally okay to share your own personal experiences.
Speaker: But to give mental health or medical advice online when you're not a practicing clinician, it's so harmful to people.
Speaker: And it can be harmful in so many different ways.
Speaker: And so we do need all this training because there's so many things that matter.
Speaker: Absolutely.
Speaker: Ethics.
Speaker: We take a whole semester ethics course, which is critical to the things that you're pointing out as well.
Speaker: And one thing I do want to highlight is that we do have legislation pending in the legislature to change the licensing exam.
Speaker: That hasn't happened yet.
Speaker: hasn't happened yet.
Speaker: I do hope that it will happen in the future because of some of the challenges you've pointed out here.
Speaker: Not only does it drive away people who have already gone through and spent all their time going through school, going through the internship, going through training, doing the work, but if they end up leaving and saying, forget it, I've tried two, three times, I can't pass it, and they go take another job, they're also going to tell all of their family and friends,
Speaker: anybody who they know in their network who might be thinking about going to social work school, they're going to say, don't waste your time because what if you don't pass the exam?
Speaker: You'll be exactly where I am, you know, thousands of dollars in debt.
Speaker: exhausted from having worked so hard and not really getting to the point, to the place where we need to be.
Speaker: So there was something wrong systemically that we need to address, which leads me to, I think probably the last question, which is how do you think we can make the case
Speaker: from a societal level, that investing in the mental health workforce, investing in social workers, investing in behavioral health in an even bigger, more robust way, doing some of the things that you've talked about here, career ladders, and really having respect
Speaker: for the value of the work that we perform and how it really does positively impact individuals, families, and communities.
Speaker: But how do we make that case and how do we help people understand mental health as a public good, just like we invest in education?
Speaker: And they still need to invest more in education.
Speaker: So the most critical pieces, right, like education, the education and mental health is the two things that they should really be investing in.
Speaker: And it doesn't seem to be a priority.
Speaker: You know, I think COVID is a great example.
Speaker: of why we should continue to invest, right?
Speaker: Like we saw an increase in interpersonal violence.
Speaker: We saw an increase in substance use.
Speaker: Overdose rates had increased a large amount.
Speaker: Also even overdose rates in Black youth was one of the most shocking numbers to me was had increased by 86% in ages about 15 to 24.
Speaker: This is overdose death rates.
Speaker: That's not in the front page of the newspaper either.
Speaker: You know, it's like tucked away in the CDC, you know, and so...
Speaker: These are things that are so crucial.
Speaker: The numbers are there.
Speaker: The data is there that there is an increase in alcohol use, that is increase in suicidal rates or just so many things.
Speaker: So many people were isolated during the pandemic.
Speaker: And that sense of loneliness really causes depression and anxiety and worsens other symptoms.
Speaker: And we think about it like when we do these assessments, we always ask, who's your social supports?
Speaker: We know how important social supports are, whether it's a colleague, a friend, a community center or whatever it is.
Speaker: And we need to make sure that we are investing more in these things.
Speaker: And I think
Speaker: as I mentioned earlier, you know, creating something between families and the ED, right?
Speaker: Like how can we support families in that way?
Speaker: Because the ED is really, you know, not really built for anything other than to screen for immediate support, right?
Speaker: Crisis.
Speaker: And so,
Speaker: If someone doesn't meet criteria for inpatient level of care or for a CVAT, you know, any type of unit that is inpatient, then we have to discharge, right?
Speaker: If the person is not suicidal, if they're not at imminent harm to themselves or others, then they get discharged.
Speaker: And families just become very upset, very discouraged, very
Speaker: because they don't feel like they're being helped by us in the emergency departments.
Speaker: But it's, you know, they don't meet the criteria, right?
Speaker: But I understand that the child is feeling depressed and in different things.
Speaker: But if they're not suicidal and they're not imminent harm,
Speaker: then there's really not much we can do.
Speaker: I mean, we share resources.
Speaker: We contact a primary care doctor.
Speaker: We do all of the things that we can do.
Speaker: Give them coping tools, whatever we can do.
Speaker: But what if there was a place before the ED that can help families who are not in crisis, who their kids are not?
Speaker: Obviously, as a parent, we're all going to feel like our kids are in crisis, and I'm not saying that they're not in crisis.
Speaker: I just mean in terms of meeting criteria for inpatient level of care or higher level of care.
Speaker: If there's a place that we can send people to in between that to help those families, to help give them the resources and support, connecting to a psychiatrist, you know, I think those would be really helpful to parents.
Speaker: It will also release some of the burden on the EDs and the beds that are being held because there are times that we've had lines in the ED going outside the door.
Speaker: And people have waited overnight into the next day to just be seen, to be assessed, and then to be sent home because their child doesn't meet criteria.
Speaker: So we really need to look at the structure of the healthcare system, the mental health system, and how, where are the gaps and what do we need to fill?
Speaker: And it needs to be something that's 24 hours too.
Speaker: The ED is the only place that people have to go to.
Speaker: And so if we can create something else that's 24 hours,
Speaker: And obviously we need more clinicians and psychiatrists and different people in those spaces, but somewhere where we can really help families when they are feeling like their families are in crisis.
Speaker: But there's just so many things that I think we can do to support families, you know,
Speaker: Even starting at the schools, teaching kids coping schools at an early age.
Speaker: I think everywhere we go, you know, people should be learning these tools in their communities because, you know, I often will teach, do talks about trauma, anxiety, and depression.
Speaker: And so I usually highlight symptoms for people because
Speaker: I could say anxiety, depression, and trauma all day, but they might not know what I'm talking about, right?
Speaker: But the minute I start to name those symptoms, like nausea, fatigue, you know, is your room messy?
Speaker: Do you have no desire to clean it?
Speaker: Giving certain examples, kids' hands just shoot up in the air over and over again, multiple times at multiple symptoms.
Speaker: And it's because a lot of times people don't know how to identify these symptoms as a mental illness.
Speaker: There are also times where people, especially people of color who go into hospitals,
Speaker: to be seen.
Speaker: And I was one of them who was never diagnosed until I was in the ED after contacting my primary care numerous times and providers just telling me to go home and take deep breaths.
Speaker: And all along I had anxiety.
Speaker: And same thing happened to my brother as a kid where they would send him home every week.
Speaker: And later we found out that a teacher was locking him in a closet at school.
Speaker: And so that's why he was having anxiety.
Speaker: every Sunday night, every Monday morning.
Speaker: But no one addressed that.
Speaker: They just told my mom to go home.
Speaker: Here my mother was missing work, taking the tea to go to the hospital, only to not get any answers ever until I was diagnosed as an adult and shared my symptoms with my brother and family.
Speaker: And that's when we, most of us discovered that we had anxiety.
Speaker: And then our parents.
Speaker: So we are genetically predisposed to anxiety and we never knew that.
Speaker: Because no one's ever really assessed us, you know?
Speaker: And so those are things I think that are key points, you know, in terms of the prevention and assessing every patient, doing the general anxiety disorder screening, depression, the PHQ-9, PHQ-7, all of those things.
Speaker: And for screening for substance use, because it's really important for us to get to the root of the problem early on and help clients identify what their triggers are and what's affecting these things so that we can support them.
Speaker: Yeah, and I think one of the things that you talked about earlier is really the need to focus on prevention.
Speaker: That's really where we want to be spending a lot more time, energy, effort, and resources.
Speaker: And then to the point you just made here, identifying early, if we can't fully prevent some of the traumatic events that occur in our lives, then if we can't totally prevent those from happening, identifying our
Speaker: very human, normal responses to traumatic incidences, whether they're ongoing traumatic incidences, unfortunately, like community violence, or maybe childhood abuse or childhood sexual assault, or maybe it is just biological, physiological, and it needs to just be
Speaker: understood.
Speaker: And I think so many of us are talking about mental health and mental illness coming out of COVID.
Speaker: There was a recent study done by Kaiser Permanente that demonstrated that 90% of Americans agree that we have a mental health crisis and that we are, so many people are contending with that.
Speaker: But also in that report, it showed that
Speaker: You know, young adults in particular are not talking about it.
Speaker: They're not telling their family.
Speaker: They're not telling their friends because, and you started this at the top of this interview, because we don't want to be a burden to our family members that are already have a lot on their plate.
Speaker: Or maybe it's shame or stigma.
Speaker: So there's more work for us to do to de-stigmatize, to help people understand that our bodies are reacting to what's going on in our mental health, you know, the nausea, the fatigue.
Speaker: And, you know, not feeling motivated, not feeling joy.
Speaker: So getting more of this out into the everyday conversation, which is partly why we're doing this podcast, right?
Speaker: Pod for the people so that we can talk about these issues, but also really make the case for why we have to invest in these areas of our communities and of our society.
Speaker: I just thank you for being here.
Speaker: part of this conversation.
Speaker: Is there anything else that you would like people to know or understand before we wrap up?
Speaker: Yeah, I just always like to share some resources.
Speaker: If people are feeling suicidal or feeling like they're in crisis, calling the 988 number for support.
Speaker: There's also different places that you can search for mental health support.
Speaker: Like Eno Psych is available if you're looking for
Speaker: a clinician of color.
Speaker: Psychology Today is another website that you can search for, but also connecting with your primary care doctors and asking them to connect you to behavioral health if they have one at their location or their partner hospital.
Speaker: I think those are some really important tools to use because I think people often think that the way to access mental health support is through the ED, and you don't have to do that.
Speaker: You can consult with your primary care doctor.
Speaker: And there's also the...
Speaker: Look at SAMHSA for some resources and support around mental illness, substance use support.
Speaker: And so there are a lot of resources out there and there are so many people who are struggling.
Speaker: And I know it often feels like you're the only one.
Speaker: We want you to have hope that there is help and there are people who are waiting to help you.
Speaker: And so there are a lot of different resources that are available.
Speaker: So just keep trying.
Speaker: And I just want to wish everyone well and happy holidays.
Speaker: Thank you for all of the resources you shared.
Speaker: I will also put them on my website, TammyGovea.com.
Speaker: You can click on the podcast link in there.
Speaker: I will also put links to some of these resources that Carla has pointed out to us.
Speaker: And I think another big takeaway, these resources exist because mental illness and substance use disorder are treatable.
Speaker: And there's a lot of treatment out there.
Speaker: It's just a matter of matching people
Speaker: matching you or a loved one with the right resources.
Speaker: And that's one of the things that we're really hoping to try to do here.
Speaker: So, well, thank you so much and happy new year and we'll be connecting again soon.
Speaker: Thank you for listening to Pod for the People, where we share everyday stories about health, dignity, and opportunity for our collective well-being.
Speaker: To learn more about how you can be part of a thriving community, building a future of opportunity for everyone, please follow me and check me out at TammyGovea.com.
Speaker: Also subscribe to this podcast, as well as doctor's orders, my latest newsletter at TammyGovea.substack.com.
Speaker: Have a great day until next time.
