Episode 117

[Music] hey everybody Yours Truly Chris Burns founder and chief executive officer at Peaks recovery centers we are live at the 49th annual winter Symposium interviewing you already know it amazing professionals but even better humans really excited to bring you the next guest today director of quality and compliance at Circa Behavioral Health Care ma O’Neal an amazing professional but an even better human check us out all right well I’m so grateful to be here was just a phenomenal guest professional and even better human being M O’Neal with Circa Behavioral Health Care how are you doing today May I’m great thanks for having me here absolutely so great to actually have you in studio you know we had you on a couple years back and Brandon had you on virtually and I just know when we get your energy in a place the people the audience can really connect with that cuz one of the things that really speaks to me about who and what you are is authentic and I’m so grateful to have you in there we met ma years ago probably 2016 or 2017 when we were going through our first Joint Commission survey and it’s been so cool to be not only supported uh through her through the Joint Commission but also as she’s moved into these other roles and really been Dynamic and leading organizations in the compliance regulatory issues and things of that nature so what are you doing now for circa Behavioral Health and and what do you love so much about it you seem to have so much passion behind what you’re doing well I kind of have to give you guys a little bit of credit for that you guys are my last joint commission survey that I did um and I was moving on to my first role as a compliance officer for an organization and to be able to go having seen such a wonderful program right as a surveyor in this field for 30 some years you see a lot of programs that are okay you see a lot that are not so good so to see people like you guys that are doing good work with good leadership and then serving clients in a good way it’s just a it’s inspiring right and it made me want to do more of that and help more people do that so what I love is that this field attracts people who are helpers I think we come from families and communities that need our services and with even post pandemic though it’s even worse now right more clients in need there’s more um need for services so we’ve got to find those people and build those services that are doing the right stuff and I don’t think it’s hard to do that but it’s hard to find the people that care about it enough so I’m hoping to find more of those people I love that too you’re actually bringing up something for me that I know we went through we did a Dar leite training with you organizational Heth what are you finding within organizations you know we were just sitting in a talk that talked about organizational burnout staff leading the great exit um what are you experiencing within organizations that’s is so disconnecting right now yeah well I don’t think it’s that much different than the rest of the world right we know burnout is epidemic right now in every field but in Behavioral Health we just don’t talk about it I think because we’re mental health professionals we don’t want to admit that we maybe could be burning out right I know when I was burning out in 2013 I didn’t know what it was and I didn’t want to admit it um and then we have I think burnout is number one I think next is turnover when people are burning out in our organizations then they’re leaving or they’re quitting or they’re just sort of checking out and not doing the work so then everyone else is having to pick up the slacks and then we’re getting even more kind of unstressed and that and then I think the culture gets impacted people are feeling stressed we don’t have the support we need leaders are feeling like why aren’t why isn’t the job getting done why are people leaving I can’t find good staff and we do a really good job of sort of blaming and shaming well we yeah young people don’t want to work today or no one wants to come do the hard stuff or um and I just think we have to acknowledge that we’re part of the problem as organizations As Leaders we have to do something different in what we’re bringing to the table right when I was burning out I worked for an organization that I couldn’t ask for help and when I did they said well may do more yoga or something I don’t know what to tell you it’s your fault right yeah you hear about self-care a lot and I don’t like that term either because I really feel like it has to start with the organization with Role Models as from the leadership and then we have to have teams that do it in our daily work you know as a compliance officer I think our job is to build in mindfulness and healthiness and ways that make us the Daily work easier and then we’ll have healthy staff we can’t just demand staff to be healthy yeah this so true too and one of the cheap causes of burnout is is actually not naming it right not naming the ISS right something that I’ve noticed lately is the teams coming to me they’re like you know we’re burn out we’re doing a lot of things and um our new Clinical Director pemma white stepped right in and she said here’s what we’re going to do we’re going to get an administrative day each and every clinician can just close the door to their office have a bit of autonomy have the family picture there turn on some classical music and just do their administrative work whereas before it was very much um a disconnected process we see a client followed by another client followed by another client followed by another client and then I have all this data entry and this note taking and so it becomes really burdensome and really disconnected from uh the documentation from the session and so we’re finding just little implementations over the last few weeks and that was one of them I saw the staff literally the clinical team
go and so what are you seeing on your side of things like what are some of the chiefs of burnap because it’s happening so much more now than it was 15 years ago at least in experience well I think the pandemic is part of it right we just know the world is under more stress we’re all a little more scared a little more fearful a little worried kind of what’s going to happen I think also we’re setting better balance like I don’t want to work 12-hour days I want to be home with my family I don’t want to be gone because what if something bad happens um so that’s part I think the reality check of we all need better balance in our lives but I also think the clients that we serve are tougher you know they they’re more acute they’re more complicated we got family stuff and medical and legal and so you know when I started the field um we had different units for mental health or addiction or the drugs were over here and now it’s all one client with all these issues so I think we have to then look at the documentation administrative issues and figure out how do you make a clinician’s case load manageable and their daily schedule manageable so and to me as a compliance officer I think we have to carry some of that like I love and my job at Circa as a fractional compliance officer we can come in and take that off of you I don’t want anyone who serves clients to worry about compliance I want to make it easy it’s in your policies it’s in your protocols I do your quality meeting for you you know we’re doing your performance Improvement like we make it easy so the the burden is off with people that are doing the direct line work with clients yeah that’s a really big deal and and can really like alleviate some of that I find some of our clinicians especially in leadership roles to the talks Point earlier it was like a lot of these people on leadership roles are being pulled out of of some of their day-to-day passions to sit behind a computer screen and data entry and I saw some really good ways for using you know the advances within the technology space in our field to help support and counterbalance some of that intensity that going miss in space and something that I don’t often think of you know it used to be 15 years ago I always talk to my brother about this I like you get a gold star for never leaving the office you know you get promoted because you know and I heard things like sleep when you down you know and everybody anybody on leadership or the people that work 12 hours a day they never put their phone down and I think we’re actually learning that that’s not the way it’s not the way I love when I when I uh went to my first compliance officer job and I tried to build that help build that culture and I was at our corporate office in Nashville and there was with couches and stuff in that room and I was in there talking to someone and one of the call center staff came in and laid down on the couch and my instinct as a prior leader was like um aren’t you aren’t you on the clock like should you be sleeping in front of the compliance officer but that that’s what I told you to do that’s what I I taught you is okay right and I was so proud of that person to do that but we absolutely have got to change the mentality right my new mantra is happy and healthy staff are ethical and compliant to provide quality and safe care we can’t just demand you to be a good clinician a good provider if we’re not building the environment that makes it easy to be ethical compliant and happy and healthy because you have to have all three yeah so that’s my new dream to help build that in organizations that in the daily flow in the expectations in the Supervision in the leadership it’s all got to be there and that’s got to be the consistent message yeah I’m also think all think about your question before the Symposium I should have just said yes and scheduled that because it would have been really nice but as I’ve stepped in back into the CEO role over the last few weeks what I’m seeing is that the work life balance just isn’t there and unfortunately PE some people are working 71 hours others are working 38 hours we just don’t have we don’t have or hadn’t had this efficient way to operate into your point and the Talk plan earlier it’s it it’s on us as owners and providers to ensure that this is carried out and one of the things that I’m telling the tap and even though we’re right sizing the model and right sizing that we can be more efficient and we can take great care of each other and ourselves as a result and so but it has to start with me and I to telling all the professionals earlier I was like I’m not going to work 12 hours a day that’s not efficacious for anything that I have going on nor is it OCA for the facility to have me here that long right you know no not at all and I think too it’s it’s sort of that mentality that we want to I remember when I first on Feld was like first one there last one to leave that was kind of the mentality until I burned out and everyone said well why do you do this like well I thought I had to right I thought it was expected of me but I think it’s really not and I was in a session yesterday on Sunday um and someone said all this stuff sounds like fluff talking about leadership and teamwork and resilience it’s like fluffy stuff it’s really not right we know from the research the companies that take care of their people actually make more money they’re more profitable even in other Industries right if we take better care of our people they will take better care of us and our clients therefore you get higher senses and longer lengths of stay and more money yeah You’ probably even been met with the the comment that oh that’s a very privileged view right right or it’s fluff it’s similar to like family systems and like when we say you know the way out is through not just for the individual but the family and we get to do this and a lot of times families are this very we’re all in a facility right now that tends to be very Qui and we have the privilege of being here we might as well take advantage of the opportunity to recover in a parallel way that’s Lisa Smith’s quote by the way that’s my friend um parallel uh reclaim recovery and she developed the model that’s parallel recovery and it’s built on this idea that the client goes through care sixe curriculum the family does the same thing and it turns out that maybe the need an e model isn’t the most efficacious and the family actually needs to go through grief week family needs to take a look at identity and purpose and really kind of healing from the outside in both organizationally and individually but i’ I’ve heard that comment before with respect to some of these dare to leave oh wouldn’t it be nice if we had time to DARE Le you know we do yeah but that’s I think that’s even to what your point is like if we want clients to be recovering families have to be in recovery but I really almost think until we have systems organizations that are healthy in recovery we’re never going to get that like why do we think our our staff don’t need grief and loss and and support and all this stuff I just don’t think we can expect our clients to be healthier than we are and at this point that’s what we’re asking them to do because our systems are not healthy and our staff are not well but we think they can give it to other people so think we’re almost like making it worse because we’re assuming they’ got it because they got licensure or they’d got some experience or some title you his class yeah exactly know 10 years ago I’m sure you’ll be fine but he really even as a licensed clinician we never got anything about burn out or you know that kind of stuff dealing with insurance companies right the stress that could happen and and just the state of the world today I think is as bernee Brown says like we’re just not well as a people as a human kind so I I would love to look at Behavioral Health and think that we’re leading the way in the well-being of our Workforce and workplaces and we’re not in fact we’re almost like denying that it applies to us which is very strange to me it is very strange yeah in organizational Health when we’ve been organizationally healthy in the past we are just getting so much work done with individuals people are feel like seen valued and heard and you know I’ve also heard the story too like you could be seen valued and heard somewhere outside of the workplace people are here to work what do you say that yeah I’ve had the CEO once say to me we pay him a paycheck but what do they want yeah crazy but you think about we spend the most hours in our day at work whether we’re at home doing it or in a workplace so the majority of our day is spent there and if that is stressful or conflicted or you know tense or whatever it is how can it be productive how can it be helpful and then we go home you know and then we’re unhappy so I just feel like we have to realize that if we’re going to have I remember early on it would be like you want to create an environment with your kids to be a healthy family right I mean you’ve got your boys like you want to have a healthy family you can’t do that just by chance you put a lot of effort and work and time into it but I think in work places we think well it’ll just happen organically you have to put the same amount of work into it like you said when I’ve done that work is when you see the results you know and you can see and it’s so easy to drift like oh we’ll do that meeting next week or we’ll we’ll have that team retrieve next month you know we’ll put it off and put it off and and then things happen and you don’t get to it and then you wonder like oh our census is low or incidents are happening or you know we’ve lost money well why it’s probably because six months ago you stopped talking to your people right it’s so interesting that you’re talking about that now and kind of where Peaks is as an inflection point you you know we’re in some of the most you know I get right sizing and then going through we’re really busy right now we got the conference going on and you know I just felt you we had TJ out here and he’s we’re doing the conscious recovery thing so he’s coming into the team on Thursday and Friday and like we just we need to grieve yeah we’ve lost some friends both clients and staff members that were really big pillars at Peaks and they’re not there anymore and so like we need to come together and build trust and talk about what’s going on and you would think that our industry would be at the Forefront of this right but clearly we’re not on no no we should we should have a manual for it right I mean in my ideal view as a compliance officer that has a wholehearted view of the world is there should be a policy when our organization goes through these changes what do we do well we have Team meetings we have access to EAP we have leadership meetings we have a retreat like there should be like a protocol like we do with when a when a suicide happens or when an incident occurs like there should be a protocall for every client there’s we’re not Health but why don’t we have that for organization we just kind of wing it and help for the best or we kind of just push it aside I love that it’s actually giv me some ideas is like but we’re going to have that protocol yes I hope so cuz then we don’t have to think about when we because crisis is going to happen grief change is going to Happ change is going to come you know it’s going to be intense we work on Behavioral Health why not just know right away hey staff is experiencing burnout disconnection um and sub transfer we just do AV andc right away and from a safety component just feeling safe and being able to settle in the workplace I think that’s huge component yeah yeah so my dream I’m doing a doctoral program right now and my dream is and my research is going to be about measuring burnout if it plays measure do you measure your burnout what does that look like how do you know in your staff if Ma’s team is burning out or and then um what’s your turnover I me that’s the easy data you know your turnover rate is it going up is it going down what’s happening and then what is your culture is the culture doing well right now and what if we looked at those numbers every month every quarter and then we did something about it like you’re supposed to do with um performance Improvement right we are you adjust yeah oh good we got to do it and then we’re going to develop best practices well if your turnover goes up you should do these three things if your burnout goes down you should do these three like I feel like we should we should have some good protocols some evidence-based practices because know people are doing it out there there’s people doing a lot of the right things just got to pull it together and share it yeah no I think that’s so huge and what that can do like just from an ecosystem and I always go back to like bestl vard folks work and like the body key and the score and like if I’m going into a trauma fi disconnected environment how do I not bring that with me and not only to mention that is sometimes we forget in this field that like you know with all like with all due respect our clinicians aren’t construction workers they’re not hammering nails they’re sitting with some very very heavy Mass story yeah and they’re engag with those people all day long yeah and so are the so is the sport staff and so what are we doing to support them yes especially in our field oh my go and so that’s something I’m very very passionate about moving into and something that I told the team as I come back in as a CEO was like we’re gonna get this part right yeah I will not I don’t have PTO We’re Not Gonna cash out 40 days we’re gonna use it but we need to figure out policies procedures and processes to inform that in a very very efficient way and I think to your point once we have that the metric becomes very efficient absolutely very supportive absolutely I saw Bessel years ago at a conference and I um I went up to him afterwards and I said I think I was I just had my son or my my second child maybe and I went up to him I said to him I something happens to me I that was a weird question I said drri um when I when I hug my children like I feel like my body regulates I don’t what it was he looks at me and he goes um that’s love and I’m just like holy crap I’ve never felt that before but in an unconditional way so then obviously I now now I do with my children and but now why don’t I feel that with my staff why don’t I have love in an organization or with my team like that’s love is the missing piece in our organizations I believe because we’re traumatized because we’re not well and because we don’t have the right supports in place yeah I love that you say that you know when I opened Peaks back in 2014 not only did we open in program with Theodore Rosevelt quote says nobody cares what you know until they know that you care and we dubed that down into client culture and I think over time we forgot to do that with our team yeah in a very connected way and I used to say things to like Jason freeas of the world and I when he started with us back in 2015 said this will be the best JN I’ve ever had well sometimes I still conceptualize that I’m living in a world where we have 15 employees and everything can be solved at lch ship my office and we all have lunch ship hang out and talk about our days while clients are you know offsite at Community Based resources I told myself a story that and then all of the sudden here we are in 2023 and we had 100 employees and no Organization no organizational Wellness platform to inform our day-to-day operations and connect events so it just kind of gets away away from you real quick before you don’t it’s like oh we got to reel that back in and get back to the basic totally and I love what you say too because most people think wow that’s not going to be cost effective but all of your research and your experience both personally and professionally said that these metrics build all of that back into your company yes yes yes the data is out there we know that there are 4 to 500 companies that the military there are places that are doing this and are seeing the results the returnal investment is clearly there um even in other countries doing research that’s showing that it’s like multiples of you know it’s amazing that we don’t do it but I think it be help we don’t have the model for it we don’t have someone yet that sort of said This is how we do it this is what it looks like um so I’m hoping in my research we’ll be able to pull that and then we’ll share that and you can tweak it for your organization it’s not going to be like a um a solution that’s going to fit everybody right every team is different every leader is different but there’s going to be a toolbox of things people can choose from hopefully I can try this I can try that this works for me this doesn’t let’s try everything and then see what happens yeah I love that one word question do you find that and I think this would be somebody uhre maybe some entrepreneurs questions some providers some ownership groups you know if I introduce this model does it create an ecosystem where people just keep playing all the time right what do we do people play all the time what would you say to something like that well I think that was my fear too I I remember early on I used to feel like these people are so needy right knock on my door all day long like f know until my staff said to me ma we we need to be able to talk to you and we we can’t like we like you we like worker for you but you are not available to us like they actually had the I had created an environment where they would tell me that I wasn’t meeting their needs and I love that I did that but I was like well I don’t know what to tell you yeah yeah it’s not gonna happen but until I got ber Brown trained and I realized oh wait it can be different and when you when you let people feel seen and heard then they will react differently to the tools that you give it but it’s got to be skill-based right I can’t just sort of if I join in their in their complaining or I too am complaining that’s what you’re going to have and that gossip and negativity spreads very quickly that’s very contagious right but as ber teaches us so is courage and so is compassion so when you do that it’s very different and like my boss now Devon Wade is a perfect example of that he is like the perfect organizational Health leader and every day he shows up for us he lets me do Dar to lead every Friday and our team meeting so my whole our whole team is getting trained um and every week he leads with vulnerability and authenticity and he we all complain to him but he has his way of hearing it and listening to it and supporting us that just you want to stop that you want to contribute in a positive way so I think that’s our fear while we don’t do it but I gu if you do it in a skill-based way with the right Tools in place it doesn’t become that that fear doesn’t come true I love that too and it’s so interesting you say that I was had the opportunity to go in from our leadership our clinical to because gone through some of these changes people are sad M and they’re hurt and for the first time in two weeks you know differently than meeting with the battlefield Department um I felt like I could be authentic and the room actually called for that and that was actually non-negotiable and as I moved through it I started to see that through me letting down my guard and being where I’m at and maybe jumping down in the hole with them a little bit and be like yeah this sucks for all of us I started to see a level of comfort at settle and safely now we have to have the plan moving forward which will support that um but you’re so right I’ve been able to see it throughout not only my own personal recovery Journey but my professional life some of those rooms they just really demand authenticity yeah for people to lean in and get down for the cause yeah yeah I think sometimes as Leaders we think we need to be like the strong and the knowing and the like oh here’s the solution that’s not what people want and I think my children taught me that the most like uh mom can you stop talking to stop asking questions stop you know let us just be who we are and just listen you know and love us and so my kids have kind of always been my my teachers in that and so I try to apply what they teach me to to the rest of of the world that’s so cool yeah those kids will you’re right it is it is so important to be where you’re at when jumping into this thing called parenting and they actually don’t care what happened at the opice today they want to know that you can sit there these meaningful moments that matter and we do so to transition that into organizations and really allow people to be seen in that um is the way wow and I appreciate you highlighting that for us today I look forward to being a part of this doctoral study uh Peaks has always been huge fan of what you do um and how you do it in a very sincere vulnerable and authentic way um you are a Titan in this industry and I’m grateful that you graced us with your presence today my FR thank you we’re going to change it together let’s do it awesome thank you man thank you