NAMI South Dakota
Report date
December 2020
What has been most instrumental to your progress?
As part of the first strategy in the community innovation process, 'increasing collective understanding', we created Listening Posts in each of the four communities targeted by this project. We invited key stakeholders to a public forum and asked them to consider mental health issues and needs. Six questions were asked: 1. What does the community need for mental health education? 2. What does the community need for support for individuals living with a mental health condition? 3. What does the community need for support for family members and caregivers who have a loved one living with a mental health condition? 4. What does the community need for advocacy for individuals living with mental health conditions? 5. Who else needs to be part of the conversation about mental health? 6. What strategies has the community already tried to address these issues? There was tremendous participation in these meetings, and the discussions were deep and thoughtful. The responses from stakeholders were put into a document for each community to use as a springboard for their work on community innovation. The information gathered in this way was invaluable to the entire process.
Creating collaboration between the four communities was essential to our work. The themes that emerged from the Listening Posts and subsequent discussions were diverse and unique, but there were some common threads. A major part of our work was connecting individuals to each other so they could discover both their differences and commonalities. As the key members in the community work groups got to know each other through shared activities, they began to identify ways they could help each other and share resources. This is where the 'light bulb moments' happened. The second piece of the collaboration process was in assisting the work groups to make connections with other stakeholders in their communities, and the communities at large. We were the 'connectors' in this process, providing opportunities for discovery and meaningful discussion between groups of people who had sometimes felt alone in their struggles to create change and promote recovery in their communities. We felt privileged to observe the deepening connections and vulnerable conversations that led these four communities to begin a new way of looking at mental health as a collective issue that affects everyone.
Our title, 'Moving from Illness to Wellness' was a motivating force throughout this process. Learning with our four communities how to re-frame the conversation about mental health led to important conversations with community members about the very nature of what we call mental illness. It became clear that what was necessary was a collective understanding that we all have mental health, and it is an ever-evolving part of our overall health. Because everyone has mental health just like they have physical health, it's easier to understand that everyone can have problems and also that everyone can improve their well-being. We used SAMHSA's 8 Dimensions of Wellness to talk about and promote wellness in each community, and it was universally embraced among those with whom we interacted. Our work group members were very successful in implementing wellness education and activities they designed into their community work. This led to one of the most important parts of this project, identified as a priority by each community-- the reduction of stigma. Changing the language we use to describe mental health conditions has made a difference.
Key lessons learned
We must continue to engage with people in new strategies and activities as the community evolves in their understanding and acceptance of mental health conditions, as these are not static processes. Growth brings both new opportunities and challenges. What we begin must continually be evaluated and adapted to changing conditions. This was most evident in 2020 as our communities experienced a new way of living during a global pandemic. Meetings, work groups, conversations, education, and activities took on a new tone and a new look in a totally virtual format. We successfully transitioned our work groups and community members to online experiences with support groups, classes, and wellness activities becoming more important than ever before. Together, we need to discover new ways of connecting with people and decreasing the isolation that can be so crippling. This work has just begun all over again in 2020. We're confident that the people we have come to know and work with during this project are well-equipped and motivated to move forward in their communities with a renewed sense of purpose. The connections they forged with each other are continuing to be helpful today.
One thing that was evident from the beginning of this project is that it is really not about us. NAMI South Dakota facilitated and supported the process, but the individuals in the work groups and communities did the work together. The identification of community needs drove the process, and it was crucial to recognize that community members are the experts in their own town. Coming in from the outside, we have a blank slate before us as we listen and discover issues and needs from the people who live and work in a community. Listening to members of the four community members talk with each other showed us that there are things about that specific geographic region that are unique, as well. The local volunteers and community leaders are the faces and voices of change. Our role in the process was to provide opportunities for them to talk about their issues and work with each other on solutions they themselves prioritized. We were the assistants, if you will-- the inviters, the note-takers, the suppliers of some resources and education-- but the work was done by the individuals who spent two years creating understanding and change in their own communities.
Reflections on the community innovation process
Initially, we worked to increase collective understanding through Listening Post sessions so that stakeholders understood the existing mental health supports available in their communities. Each community identified their needs in the areas of education, support and advocacy. This provided a basis for how ideas were generated to implement a solution to the problem of creating a comprehensive plan for expanding mental health supports. NAMI volunteer leaders in each community identified short term goals for service expansion, led meetings and wellness events, and participated in retreats with leaders from the four communities. This allowed them to focus on issues that were unique to their rural communities and identify strategies for addressing priority areas. The retreat experience gave volunteer leaders the opportunity to share successes, identify group resources, and brainstorm ideas for solving problems. Mental health leaders also received additional training that supported the current work and areas where there was an identified gap. NAMI SD delivered a number of trainings in specific peer-led courses that were requested by the communities.
Progress toward an innovation
Each of the four communities achieved a significant level of breakthrough that was unique to the problem of expanding mental health services. Strategic planning was done collaboratively through scheduled retreats that allowed the leaders to develop SMART goals and share experiences and knowledge. The support they received from one another and from NAMI SD was crucial in their progress. Highlights include working with local law enforcement agencies on supporting and expanding crisis intervention training and a mobile crisis program; being included in a variety of community problem-solving initiatives regarding mental health; expanding their volunteer base and increasing the number and quality of wellness events; creating new community partnerships with hospitals and mental health centers; developing information-sharing strategies on social media; working to develop community suicide prevention programs; and bringing mental health education to students, school staff, and parents.
What it will take to reach an innovation?
We felt that each community reached a level of breakthrough that was unique to their particular circumstances. However, due to the COVID-19 pandemic, the problems of access to mental health supports becomes more magnified as ever more people are experiencing symptoms and difficulties. In addition, the delivery of services that our communities had developed must now take place on virtual platforms, raising concerns about the lack of technology, training, and access. We will help them explore new strategies to address these issues going forward.
What's next?
In addition to continuing to explore new online options for our communities to offer peer-led mental health support, education and wellness, there is a need to continue offering technical support for their ongoing collaborations and initiatives. We will assist our volunteer leaders as they work within their own networks and community partnerships. We also are committed to continue providing opportunities for the four grant communities to work together in a virtual space until it is safe to return to activities that can be held in person. This will require at least quarterly online meetings to foster conversation and further sharing of ideas. We also plan to replicate aspects of this grant model in our work with other communities in South Dakota. We have begun the Listening Post process in another community and are developing a local advisory group to guide our discussions and take the lead in strategic planning. This has proven to be a good blueprint for us to use in identifying resources and equipping volunteers to be successful problem-solvers as they address mental health needs in their communities.
If you could do it all over again...
We tried hard to enter the grant period without any preconceived notions of what we would find or what would happen. We were not surprised, though, to discover that there were many similarities between the communities and the needs and gaps they identified. What made the process challenging was just how different they also were from one another. Each was in a different place in regard to how much community conversation and engagement had occurred, and each had unique strengths and resources. This required a lot of communication between the leader groups, as they sought to understand and help each other. We needed to keep our expectations out of the process and trust the volunteer leaders to solve problems within their own community and with the assistance of the larger group. Our technical assistance helped them work through strategies, and the training and programs we provided at their request allowed them to approach problems with confidence. Once the leaders were able to get in front of their communities with new ideas and resources, they began to build new partnerships and alliances. We were continually impressed by their innovative thinking and creative solutions.
One last thought
We felt a need to document the work of this grant with a video that allowed our four community groups to share their knowledge and experiences with others. It will provide a showcase of their work and help to ensure a continued level of support, while also giving other communities a roadmap for implementing grassroots change in how mental health supports are offered. We also ended our grant period by conducting interviews with the volunteer leaders who were involved with the project. They were able to identify areas of growth and collaboration that promoted local change and improved services. We plan to continue offering our support and opportunities for further conversation and problem-solving. We know that mental health needs will only grow in communities across our state, and this process helped us see the potential for collaboration in a new way. We want to thank you for this opportunity and the impact it has had on individuals, families, and communities in South Dakota.