
shortly before my or after my 40th birthday I got in a car and merged onto
birthday I got in a car and merged onto
birthday I got in a car and merged onto a highway on the way to work and
a highway on the way to work and
a highway on the way to work and suddenly my heart was pounding and my
suddenly my heart was pounding and my
suddenly my heart was pounding and my chest was tight and I couldn’t breathe
chest was tight and I couldn’t breathe
chest was tight and I couldn’t breathe so I pulled off to the side of the road
so I pulled off to the side of the road
so I pulled off to the side of the road I made a quick phone call to my wife
I made a quick phone call to my wife
I made a quick phone call to my wife Sherry and left her a brief message that
Sherry and left her a brief message that
Sherry and left her a brief message that I loved her and then i called 9-1-1 a
I loved her and then i called 9-1-1 a
I loved her and then i called 9-1-1 a short time later the paramedics arrived
short time later the paramedics arrived
short time later the paramedics arrived and they loaded me onto the ambulance
and they loaded me onto the ambulance
and they loaded me onto the ambulance and they put nitroglycerin under my
and they put nitroglycerin under my
and they put nitroglycerin under my tongue nitroglycerin I thought wow they
tongue nitroglycerin I thought wow they
tongue nitroglycerin I thought wow they must think I’m dying too so he loaded me
must think I’m dying too so he loaded me
must think I’m dying too so he loaded me into the ambulance and they took me to
into the ambulance and they took me to
into the ambulance and they took me to the local emergency room the emergency
the local emergency room the emergency
the local emergency room the emergency room doctor there ran a number of tests
room doctor there ran a number of tests
room doctor there ran a number of tests and she came back and said to me I’m not
and she came back and said to me I’m not
and she came back and said to me I’m not really sure what’s going on with you but
really sure what’s going on with you but
really sure what’s going on with you but you don’t seem to be in any immediate
you don’t seem to be in any immediate
you don’t seem to be in any immediate danger and so I was discharged from the
danger and so I was discharged from the
danger and so I was discharged from the hospital with a number of referrals for
hospital with a number of referrals for
hospital with a number of referrals for follow-up and so then over the next
follow-up and so then over the next
follow-up and so then over the next several weeks
several weeks
several weeks I saw a variety of specialists received
I saw a variety of specialists received
I saw a variety of specialists received a variety of diagnosis was started on a
a variety of diagnosis was started on a
a variety of diagnosis was started on a variety of medications to treat
variety of medications to treat
variety of medications to treat everything from heart disease to acid
everything from heart disease to acid
everything from heart disease to acid reflux and then a couple months later it
reflux and then a couple months later it
reflux and then a couple months later it happened again but this time I was able
happened again but this time I was able
happened again but this time I was able to immediately get in to see my longtime
to immediately get in to see my longtime
to immediately get in to see my longtime doctor so he sat me down he said Tom
doctor so he sat me down he said Tom
doctor so he sat me down he said Tom look there is nothing wrong with your
look there is nothing wrong with your
look there is nothing wrong with your heart what’s going on with you and after
heart what’s going on with you and after
heart what’s going on with you and after a conversation about everything that was
a conversation about everything that was
a conversation about everything that was going on in my life in that time he gave
going on in my life in that time he gave
going on in my life in that time he gave me the correct diagnosis of having
me the correct diagnosis of having
me the correct diagnosis of having depression and anxiety and it was
depression and anxiety and it was
depression and anxiety and it was manifesting itself and he’s terrible
manifesting itself and he’s terrible
manifesting itself and he’s terrible anxiety attacks that were making me feel
anxiety attacks that were making me feel
anxiety attacks that were making me feel like I was dying I was really lucky I’m
like I was dying I was really lucky I’m
like I was dying I was really lucky I’m a mental health professional I went to
a mental health professional I went to
a mental health professional I went to my medical provider thinking I’ve had a
my medical provider thinking I’ve had a
my medical provider thinking I’ve had a medical condition but he saw the larger
medical condition but he saw the larger
medical condition but he saw the larger picture he saw me as a whole person and
picture he saw me as a whole person and
picture he saw me as a whole person and he was able to identify what I was
he was able to identify what I was
he was able to identify what I was facing were challenges related to my
facing were challenges related to my
facing were challenges related to my mental and emotional well-being
unfortunately this is not the norm in
unfortunately this is not the norm in our country the medical mental health
our country the medical mental health
our country the medical mental health and addiction treatment systems are
and addiction treatment systems are
and addiction treatment systems are existing in these separate silos
existing in these separate silos
existing in these separate silos and they’re creating this fragmented
and they’re creating this fragmented
and they’re creating this fragmented difficult to navigate maze a game of
difficult to navigate maze a game of
difficult to navigate maze a game of hide-and-seek in order to find the care
hide-and-seek in order to find the care
hide-and-seek in order to find the care that one really needs this leads to
that one really needs this leads to
that one really needs this leads to overly narrow diagnosis and at times
overly narrow diagnosis and at times
overly narrow diagnosis and at times really bad outcomes for folks where they
really bad outcomes for folks where they
really bad outcomes for folks where they end up in emergency room hospital beds
end up in emergency room hospital beds
end up in emergency room hospital beds and other institutional settings at the
and other institutional settings at the
and other institutional settings at the highest cost and likely the least
highest cost and likely the least
highest cost and likely the least effective treatment in the long run so
effective treatment in the long run so
effective treatment in the long run so to see how this plays out in real life
to see how this plays out in real life
to see how this plays out in real life let’s follow the story of Emma who’s in
let’s follow the story of Emma who’s in
let’s follow the story of Emma who’s in fourth grade
fourth grade
fourth grade Emma’s teacher expresses concerns that
Emma’s teacher expresses concerns that
Emma’s teacher expresses concerns that she’s often absent-minded in the
she’s often absent-minded in the
she’s often absent-minded in the classroom at time she’s falling asleep
classroom at time she’s falling asleep
classroom at time she’s falling asleep and she’s making frequent visits to the
and she’s making frequent visits to the
and she’s making frequent visits to the school nurse with a variety of
school nurse with a variety of
school nurse with a variety of complaints of aches and pains Emma takes
complaints of aches and pains Emma takes
complaints of aches and pains Emma takes her to the doctor her doctor after a
her to the doctor her doctor after a
her to the doctor her doctor after a brief visit gives her a diagnosis and
brief visit gives her a diagnosis and
brief visit gives her a diagnosis and sends her home likely without having
sends her home likely without having
sends her home likely without having evaluated or treated all her needs so
evaluated or treated all her needs so
evaluated or treated all her needs so how does that play out for Emma
how does that play out for Emma
how does that play out for Emma continued difficulty in the classroom
continued difficulty in the classroom
continued difficulty in the classroom maybe getting in trouble at school
maybe getting in trouble at school
maybe getting in trouble at school leading the tension at home adding to
leading the tension at home adding to
leading the tension at home adding to the stress of whatever she’s already
the stress of whatever she’s already
the stress of whatever she’s already trying to cope with that’s an example of
trying to cope with that’s an example of
trying to cope with that’s an example of how the fragmented health care system is
how the fragmented health care system is
how the fragmented health care system is failing us but thankfully this is
failing us but thankfully this is
failing us but thankfully this is changing we’re changing the way we’re
changing we’re changing the way we’re
changing we’re changing the way we’re caring for people’s mental and emotional
caring for people’s mental and emotional
caring for people’s mental and emotional well-being as well as our physical
well-being as well as our physical
well-being as well as our physical health we’re recognizing that mental
health we’re recognizing that mental
health we’re recognizing that mental health conditions and addictions are
health conditions and addictions are
health conditions and addictions are genuine health conditions just like
genuine health conditions just like
genuine health conditions just like heart disease or diabetes and this shift
heart disease or diabetes and this shift
heart disease or diabetes and this shift is laying the platform to move away from
is laying the platform to move away from
is laying the platform to move away from this fragmented system to one that is
this fragmented system to one that is
this fragmented system to one that is more integrated and treats the whole
more integrated and treats the whole
more integrated and treats the whole person it’s leading the integrated care
person it’s leading the integrated care
person it’s leading the integrated care experiences so how would this change for
experiences so how would this change for
experiences so how would this change for Emma Emma’s mom takes her to the doctor
Emma Emma’s mom takes her to the doctor
Emma Emma’s mom takes her to the doctor the doctor now realizes wait a second
the doctor now realizes wait a second
the doctor now realizes wait a second there’s more going on here than just a
there’s more going on here than just a
there’s more going on here than just a physical illness and her mom are able to
physical illness and her mom are able to
physical illness and her mom are able to go down the hallway and make an
go down the hallway and make an
go down the hallway and make an appointment with a social worker one
appointment with a social worker one
appointment with a social worker one that specializes in working with kids
that specializes in working with kids
that specializes in working with kids and that social worker is able to take
and that social worker is able to take
and that social worker is able to take the time to make a full assessment of
the time to make a full assessment of
the time to make a full assessment of all of them as needs now the social
all of them as needs now the social
all of them as needs now the social worker the doctor Emma and her
worker the doctor Emma and her
worker the doctor Emma and her are able to work together to create a
are able to work together to create a
are able to work together to create a care plan that addresses all those needs
care plan that addresses all those needs
care plan that addresses all those needs this is an example of how an integrated
this is an example of how an integrated
this is an example of how an integrated care approach can be transformational in
care approach can be transformational in
care approach can be transformational in the lives of those that we serve there’s
the lives of those that we serve there’s
the lives of those that we serve there’s another innovation I want to share with
another innovation I want to share with
another innovation I want to share with you
you
you it’s the growing recognition in the
it’s the growing recognition in the
it’s the growing recognition in the healthcare system that unless one’s
healthcare system that unless one’s
healthcare system that unless one’s basic needs are met good overall health
basic needs are met good overall health
basic needs are met good overall health is very difficult to achieve we referred
is very difficult to achieve we referred
is very difficult to achieve we referred to this as the social determinants of
to this as the social determinants of
to this as the social determinants of health you may be familiar with Maslow’s
health you may be familiar with Maslow’s
health you may be familiar with Maslow’s hierarchy of needs developed by Abraham
hierarchy of needs developed by Abraham
hierarchy of needs developed by Abraham Maslow this well-accepted theory
Maslow this well-accepted theory
Maslow this well-accepted theory maintains the endless one’s basic needs
maintains the endless one’s basic needs
maintains the endless one’s basic needs are met it’s higher too it’s hard to
are met it’s higher too it’s hard to
are met it’s higher too it’s hard to achieve those higher-level goals and
achieve those higher-level goals and
achieve those higher-level goals and aspirations in your life the social
aspirations in your life the social
aspirations in your life the social determinants of health is a similar
determinants of health is a similar
determinants of health is a similar theory that maintains that unless one’s
theory that maintains that unless one’s
theory that maintains that unless one’s basic needs are met good overall health
basic needs are met good overall health
basic needs are met good overall health again it’s very difficult to achieve
again it’s very difficult to achieve
again it’s very difficult to achieve simply put it means that if people don’t
simply put it means that if people don’t
simply put it means that if people don’t have a decent affordable place to live
have a decent affordable place to live
have a decent affordable place to live access to adequate amounts of
access to adequate amounts of
access to adequate amounts of nutritional food and other basic needs
nutritional food and other basic needs
nutritional food and other basic needs met all the best care in the world may
met all the best care in the world may
met all the best care in the world may not make a difference what if Emma and
not make a difference what if Emma and
not make a difference what if Emma and her mom are living in a homeless shelter
her mom are living in a homeless shelter
her mom are living in a homeless shelter or in their car what are the medical and
or in their car what are the medical and
or in their car what are the medical and behavioral health providers supposed to
behavioral health providers supposed to
behavioral health providers supposed to do about that I’ll tell you what
do about that I’ll tell you what
do about that I’ll tell you what increasingly medical providers and
increasingly medical providers and
increasingly medical providers and behavioral health providers are
behavioral health providers are
behavioral health providers are partnering together with social service
partnering together with social service
partnering together with social service providers in order to develop
providers in order to develop
providers in order to develop comprehensive care plans I mean now
comprehensive care plans I mean now
comprehensive care plans I mean now we’re really getting it somewhere not
we’re really getting it somewhere not
we’re really getting it somewhere not only having Emma’s medical and
only having Emma’s medical and
only having Emma’s medical and behavioral health needs met but also her
behavioral health needs met but also her
behavioral health needs met but also her basic needs and everybody working
basic needs and everybody working
basic needs and everybody working together as a team on her behalf
together as a team on her behalf
together as a team on her behalf there’s a movement going on around the
there’s a movement going on around the
there’s a movement going on around the country and here at home where medical
country and here at home where medical
country and here at home where medical providers are increasing their ability
providers are increasing their ability
providers are increasing their ability to identify and assess the behavioral
to identify and assess the behavioral
to identify and assess the behavioral health needs of those that come to them
health needs of those that come to them
health needs of those that come to them for care also they’re increasing their
for care also they’re increasing their
for care also they’re increasing their ability to provide treatment for those
ability to provide treatment for those
ability to provide treatment for those behavioral health needs
behavioral health needs
behavioral health needs coinciding with those changes are
coinciding with those changes are
coinciding with those changes are changes that are happening in to
changes that are happening in to
changes that are happening in to behavioral health system where
behavioral health system where
behavioral health system where behavioral health providers are
behavioral health providers are
behavioral health providers are increasing their ability to recognize
increasing their ability to recognize
increasing their ability to recognize the medical conditions
the medical conditions
the medical conditions of those that come to them for
of those that come to them for
of those that come to them for behavioral healthcare and they’re
behavioral healthcare and they’re
behavioral healthcare and they’re increasing their ability to treat those
increasing their ability to treat those
increasing their ability to treat those needs either within their own practices
needs either within their own practices
needs either within their own practices or in partnerships with other medical
or in partnerships with other medical
or in partnerships with other medical providers and so you can begin to see
providers and so you can begin to see
providers and so you can begin to see we’re trying to aspire to create this no
we’re trying to aspire to create this no
we’re trying to aspire to create this no wrong door system in order to get the
wrong door system in order to get the
wrong door system in order to get the care that’s required for your whole
care that’s required for your whole
care that’s required for your whole person it’s estimated by the American
person it’s estimated by the American
person it’s estimated by the American Psychiatric Association that one-third
Psychiatric Association that one-third
Psychiatric Association that one-third of all adults that are receiving medical
of all adults that are receiving medical
of all adults that are receiving medical care also have a paper behavioral health
care also have a paper behavioral health
care also have a paper behavioral health condition such as depression or anxiety
condition such as depression or anxiety
condition such as depression or anxiety if there are 300 of us here today that
if there are 300 of us here today that
if there are 300 of us here today that means a hundred of us are facing these
means a hundred of us are facing these
means a hundred of us are facing these challenges a third of the neighbors in
challenges a third of the neighbors in
challenges a third of the neighbors in your neighborhood a third of the
your neighborhood a third of the
your neighborhood a third of the students in our schools
students in our schools
students in our schools additionally 70% of people who are
additionally 70% of people who are
additionally 70% of people who are receiving behavioral health care also
receiving behavioral health care also
receiving behavioral health care also have a coinciding medical condition so
have a coinciding medical condition so
have a coinciding medical condition so this can range from persistent headaches
this can range from persistent headaches
this can range from persistent headaches to insomnia to more chronic conditions
to insomnia to more chronic conditions
to insomnia to more chronic conditions such as diabetes and guess what an
such as diabetes and guess what an
such as diabetes and guess what an integrated care approach will not cost
integrated care approach will not cost
integrated care approach will not cost more money in fact we think it will not
more money in fact we think it will not
more money in fact we think it will not only dramatically improve care but it
only dramatically improve care but it
only dramatically improve care but it will do so at a lower cost
will do so at a lower cost
will do so at a lower cost it’s estimated that an integrated care
it’s estimated that an integrated care
it’s estimated that an integrated care approach will save commercial insurers
approach will save commercial insurers
approach will save commercial insurers Medicaid and Medicare 26 to 48 billion
Medicaid and Medicare 26 to 48 billion
Medicaid and Medicare 26 to 48 billion dollars a year just in our country alone
dollars a year just in our country alone
dollars a year just in our country alone how is this possible
how is this possible
how is this possible well it’s possible because when people
well it’s possible because when people
well it’s possible because when people get all the care they need when they
get all the care they need when they
get all the care they need when they need it in the communities in which they
need it in the communities in which they
need it in the communities in which they live they’re able to avoid those higher
live they’re able to avoid those higher
live they’re able to avoid those higher cost stays in emergency rooms and
cost stays in emergency rooms and
cost stays in emergency rooms and hospital beds and other institutional
hospital beds and other institutional
hospital beds and other institutional settings again likely at the least
settings again likely at the least
settings again likely at the least effective care for them in the long run
effective care for them in the long run
effective care for them in the long run we can do so much better
we can do so much better
we can do so much better for those of us that have heart disease
for those of us that have heart disease
for those of us that have heart disease and also suffer from depression and we
and also suffer from depression and we
and also suffer from depression and we can do so much better for those of us
can do so much better for those of us
can do so much better for those of us that face mental health challenges and
that face mental health challenges and
that face mental health challenges and need specialized assistance in order to
need specialized assistance in order to
need specialized assistance in order to care for conditions such as diabetes and
care for conditions such as diabetes and
care for conditions such as diabetes and we sure don’t need nitroglycerin to be
we sure don’t need nitroglycerin to be
we sure don’t need nitroglycerin to be put under our tongue to know that now is
put under our tongue to know that now is
put under our tongue to know that now is the time to begin to make these changes
we can begin to work together as a
we can begin to work together as a community asking individuals to join in
community asking individuals to join in
community asking individuals to join in together with us in order to face these
together with us in order to face these
together with us in order to face these issues not just alone but together core
issues not just alone but together core
issues not just alone but together core issues that we face in our communities
issues that we face in our communities
issues that we face in our communities such as chronic homelessness addiction
such as chronic homelessness addiction
such as chronic homelessness addiction and mental illness for example in the
and mental illness for example in the
and mental illness for example in the city of Everett the city is partnering
city of Everett the city is partnering
city of Everett the city is partnering with law enforcement medical providers
with law enforcement medical providers
with law enforcement medical providers mental health providers addiction
mental health providers addiction
mental health providers addiction treatment providers low-income housing
treatment providers low-income housing
treatment providers low-income housing providers and social service providers
providers and social service providers
providers and social service providers in order to create comprehensive care
in order to create comprehensive care
in order to create comprehensive care plans to help with a chronic homeless in
plans to help with a chronic homeless in
plans to help with a chronic homeless in our community all of us bringing our
our community all of us bringing our
our community all of us bringing our expertise to the table and developing
expertise to the table and developing
expertise to the table and developing holistic care plans one by one to help
holistic care plans one by one to help
holistic care plans one by one to help these communities rise up off of the
these communities rise up off of the
these communities rise up off of the streets get a place to live get a job
streets get a place to live get a job
streets get a place to live get a job and rejoin us as community members if
and rejoin us as community members if
and rejoin us as community members if you know someone that could benefit from
you know someone that could benefit from
you know someone that could benefit from an indicator integrated care approach
an indicator integrated care approach
an indicator integrated care approach would you suggest the resource because
would you suggest the resource because
would you suggest the resource because they do exist the Everett clinic for
they do exist the Everett clinic for
they do exist the Everett clinic for example provides behavioral health
example provides behavioral health
example provides behavioral health treatment to those to whom they also
treatment to those to whom they also
treatment to those to whom they also provide medical care and a compass
provide medical care and a compass
provide medical care and a compass health we are beginning to more and more
health we are beginning to more and more
health we are beginning to more and more provide medical care to those that come
provide medical care to those that come
provide medical care to those that come to us for behavioral health care we
to us for behavioral health care we
to us for behavioral health care we don’t have to stay stuck in the system
don’t have to stay stuck in the system
don’t have to stay stuck in the system that isolates us from the care that we
that isolates us from the care that we
that isolates us from the care that we need and we can imagine and we can
need and we can imagine and we can
need and we can imagine and we can envision what it would begin to look
envision what it would begin to look
envision what it would begin to look like if integrated whole person care
like if integrated whole person care
like if integrated whole person care were widely practiced in our communities
were widely practiced in our communities
were widely practiced in our communities people who are frozen in their situation
people who are frozen in their situation
people who are frozen in their situation having their suffering eased and
having their suffering eased and
having their suffering eased and regaining their lives of emotional
regaining their lives of emotional
regaining their lives of emotional richness again the homeless having all
richness again the homeless having all
richness again the homeless having all the systems come together and
the systems come together and
the systems come together and approaching them with a whole person
approaching them with a whole person
approaching them with a whole person care approach that really allows them
care approach that really allows them
care approach that really allows them the best opportunity possible to get off
the best opportunity possible to get off
the best opportunity possible to get off the streets get into treatment get a
the streets get into treatment get a
the streets get into treatment get a place to live
place to live
place to live and begin that road of recovery to a
and begin that road of recovery to a
and begin that road of recovery to a life that’s full of purpose parents who
life that’s full of purpose parents who
life that’s full of purpose parents who are ill and addicted
are ill and addicted
are ill and addicted getting there suffering ease so that
getting there suffering ease so that
getting there suffering ease so that they can be the parents that their
they can be the parents that their
they can be the parents that their children need them to be to move beyond
children need them to be to move beyond
children need them to be to move beyond the hopelessness despair and anger and
the hopelessness despair and anger and
the hopelessness despair and anger and regain the confidence and enthusiasm to
regain the confidence and enthusiasm to
regain the confidence and enthusiasm to raise their kids I think this is our
raise their kids I think this is our
raise their kids I think this is our best shot at attacking the opioid crisis
best shot at attacking the opioid crisis
best shot at attacking the opioid crisis both across the country and here at home
both across the country and here at home
both across the country and here at home so many people with opioid addictions
so many people with opioid addictions
so many people with opioid addictions have everything going on they have
have everything going on they have
have everything going on they have medical challenges addiction challenges
medical challenges addiction challenges
medical challenges addiction challenges mental health challenges basic need
mental health challenges basic need
mental health challenges basic need challenges and unless we come together
challenges and unless we come together
challenges and unless we come together and bring forward an approach that
and bring forward an approach that
and bring forward an approach that addresses all those needs I don’t think
addresses all those needs I don’t think
addresses all those needs I don’t think we’re going to make any progress in
we’re going to make any progress in
we’re going to make any progress in terms of helping them as individual or
terms of helping them as individual or
terms of helping them as individual or in attacking the problem as a whole a
in attacking the problem as a whole a
in attacking the problem as a whole a friend of mine told me about an
friend of mine told me about an
friend of mine told me about an experience that some have when they’re
experience that some have when they’re
experience that some have when they’re receiving treatment for AIDS it’s called
receiving treatment for AIDS it’s called
receiving treatment for AIDS it’s called the Lazarus effect and in the treatment
the Lazarus effect and in the treatment
the Lazarus effect and in the treatment process they move from being frail
process they move from being frail
process they move from being frail skeletons and then they rise up out of
skeletons and then they rise up out of
skeletons and then they rise up out of that process the perfect pictures of
that process the perfect pictures of
that process the perfect pictures of health I’ve seen this happen at compass
health I’ve seen this happen at compass
health I’ve seen this happen at compass health people come to us and they’re at
health people come to us and they’re at
health people come to us and they’re at the end of their rope they don’t have a
the end of their rope they don’t have a
the end of their rope they don’t have a home they’re ill they have mental health
home they’re ill they have mental health
home they’re ill they have mental health challenges they have addictions and they
challenges they have addictions and they
challenges they have addictions and they don’t have any hope but when we’re able
don’t have any hope but when we’re able
don’t have any hope but when we’re able to embrace them as a whole person we
to embrace them as a whole person we
to embrace them as a whole person we give them that best opportunity to raise
give them that best opportunity to raise
give them that best opportunity to raise them up and have that experience to
them up and have that experience to
them up and have that experience to regain lives that are full of recovery
regain lives that are full of recovery
regain lives that are full of recovery and purpose and so I ask that you join
and purpose and so I ask that you join
and purpose and so I ask that you join me in shaping and sharing a new future
me in shaping and sharing a new future
me in shaping and sharing a new future of health that treats the whole person
of health that treats the whole person
of health that treats the whole person and gives all of us the best opportunity
and gives all of us the best opportunity
and gives all of us the best opportunity to live lives that are full of good
to live lives that are full of good
to live lives that are full of good health and happiness thank you
health and happiness thank you
health and happiness thank you [Applause]
[Applause]
[Applause] [Music]
”
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