Why don't we just jump into our first question here. How do you handle transportation issues that may limit the social activities of participants, Patrick, particularly if you're trying to get them into these programs? When people live in a relatively small community, it's not such an issue, but part of that social budget can be used for transportation. In most communities that have some form of mass transit, there are reduced rates or even free rates for people with disabilities to get about. Through these support groups, people work together, so somebody in the group may have a car, may be able to help people to get to where they're going, but it's whatever strategy works in the community. Now, we have some groups that are starting up in more rural areas, and we know that transportation there is a major issue. Those groups try to solve it as a group process with the facilitator helping them to work out strategies to overcome these problems. Here's a somewhat related question around barriers. We have someone who wrote in who's in the process of putting together a caregiver support group who was wondering what you would suggest as a topic to help get caregivers in the door. What do you think about hooks that you can get to try to get people to get over their own internalized stigma around addressing loneliness and getting them to join a community such as this caregiver group that this participant has written about? That's an excellent question because we also know that caregivers also experience very high rates of loneliness and feelings of isolation and exclusion. The way that we addressed it when we did the pilots, because we did address it, we did a little spinoff group of caregivers, but the way we addressed it was through the people that we were working with and through the ACT teams with the pilot programs being able to connect us to individuals, caregivers in the community, if they had family members or if they had professionally paid, if they were in some type of self-directed care program, then perhaps their caregiver is the program itself. But it's really important to do it. The only way that I know to shortcut it is by working with the people that you provide services to, to be able to connect to their caregivers. We did also publicity for these programs. So most communities have some sort of announcements about community groups. We even got write-ups in some of the smaller papers in Northern Virginia about the group. And so it announced that flyers were given out throughout community mental health and the ACT teams. So we promoted it in every way possible. And like I said, we did get a group of caregivers and that would be a next step really for this program. Our next question is really around, asks about the difference between online communities versus live. And I guess the question here is really, you know, at a time when so many, when people are more connected than ever via their smartphones and social media platforms, such as Facebook or Instagram, are those communities as good or a stand-in for live community engagement? And how do you balance that against maybe low resource environments where the feasibility of people getting to kind of a live gathering may not always be practical? Do you have thoughts about that, Patrick, about the value of online? How it ranks to the five? Again, this is a perfect question for the program I described that we ran with Mental Health America. We've been trying to figure out how do we accomplish these same type of things in an online environment? Because we know, particularly in rural and Western frontier states, that distance is a major reason why people can't connect to community because it's not accessible to them physically. So if they have the availability of interactions through social media and online groups that come together, we know that that's a benefit for some people. And for many people, it's their primary way of connecting to other people. We've tried to figure out how we could, you know, tweak this program into an online program. And what we've decided this year and this coming year, we're launching a new initiative with the same goals as this program, but by building online interest communities. And so we will have a, in fact, in March, we're going to kick off the whole program with an online event talking about the effects of loneliness and looking at the science behind it, and then looking at the science behind inclusion and participation in community. And then we're going to look at some of these programs more in depth, and we're going to kick off this community, online community of people that will be able to work in whatever interest areas they have, and they can go into multiple interest groups. And there'll be tools available that we're currently now building that will be used for people to practice skills on their own, because the skills that they need for social interaction online are very different than the ones that they need when they actually go and sit in Starbucks. So, it's a great question. It's not an easy one to overcome, but for many, many people, that's their primary connection to the world around them. I'm wondering if you could talk a little bit about loneliness within the peer community themselves. I know that on other webinars, we've kind of talked about some of the tension that peers find themselves in as both kind of representing communities that have had lived... Those who have had lived experience, and also being part of the treatment team, and that sometimes they're kind of caught between two worlds. And I wonder if we know anything about peers themselves who work in mental health and the loneliness or isolation they may feel, and what its relationship may be to burnout, and whether or not they stay in the field. Any thoughts on that? Yes. Again, this is... Especially in peer support and people who become peer specialists, this is a major issue too. And when an organization first decides that it's going to have peer support in their array of services, generally, they bring in just one or two people. We hope that they never just bring one person in, but even when they bring in a small group, you're in a new environment as a peer specialist. It's not your natural environment that you've worked in before if you haven't had previous experience with this. So a feeling of being not quite part of the team right away, and feelings of separation and loneliness, and then the stress of dealing with other people's issues on an ongoing basis. What we've tried to do, and other peer organizations and other non-profits around the country have done the same thing, is that we try to create support groups, either live support groups in the community where peer specialists or peer support workers come together, or their online communities, or regular teleconference type communities, because peers do need support, and they can feel extreme. Peer support workers do need support, and they can feel extremely isolated by the experience of doing what they are there to do. And like I said, one of the things that we worry about always, and I know it's a big question that comes up with any agency that's contemplating introducing peer support, is what about burnout? The burnout rates for people working in peer support work are not extremely high, but they do exist, but we have found that by providing peer support to our supporters, we can overcome most of that, because then also it's that same thing of, like the support group we talked about before, you come together and the group kind of strategizes solutions to the problems that you're facing. So this gives, again, that sense of somebody has your back, somebody is supporting you as you go out into the world to provide the services that you want to provide. And I think it goes to something you mentioned earlier around, you know, there's a lot of neurobiology around the sense of belonging and how that promotes well-being, and so anytime you're connected to a community is helpful. We have a general question around MHA, and it says, what is the time commitment for MHA peer partner training, and is there an online training version? Do you want to speak a little bit about MHA's programs? Yes, so the peer partners program, we have, all of the materials are available on our website, though we are updating them right now, so I would wait for the new version to come out in January. But we also have, every group that's started up, we provide them with a webinar training. It's not a very long training because the peer specialist who might be running this group really has only a time commitment of four or five or six hours a week in order to prepare for the groups, to run the groups, and provide some one-on-one or telephone support for individuals who might be having a little more difficulty in even forming bonds with the other members of the group. So it's not a big commitment, but it does require some training, and we do provide that for free. And another somewhat related programmatic question, which asks, can agencies apply for the It's My Life peer partners program, and how would they do that? Yes, they can, and probably the easiest way would be by going on mentalhealthamerica.org, and actually, it's MHA, we just changed our domain. It's mhanational.org is our website, and just, or you can just Google Center for Peer Support. We have a separate center in the Mental Health America website that deals with all of our peer programs and our certification programs, and then you can find It's My Life peer partners through that center by looking through the menu of available programs there, and you can download the materials. Like I said, I would wait until the end of January when the new materials come out, but yes, and you can, and through that, you can connect with us. It's not even really an application. It's any group that wants to do this. It's available, and we do have a small amount of grants for organizations that maybe need a little help to run this program and to use peer support as the facilitator. It's about $10,000 to $12,000 a year. We have availability of a small number of $5,000 grants to assist new organizations. We're trying to target largely peer-run organizations because we really want to see this grow within the peer community.

transportation issues

community programs

caregiver support groups

online communities

mental health support