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Story by Cleoniki Kesidis
“Outreach is not easy work,” says Judy Gardner, executive director of the National Alliance on Mental Illness in Washtenaw County (NAMI). “It’s relationships building. It’s showing up. It’s building trust, and it takes a concerted effort.”
Since early 2020, NAMI has used millage funding to invest that concerted effort in outreach work in underserved areas of Washtenaw County. And while they’ve encountered challenges, they’ve also seen how critical outreach is.
“The need is just getting greater and greater,” says Maria Alfonso, project manager at NAMI, observing that with the stress caused by the COVID-19 pandemic, many are experiencing mental health issues for the first time in their lives.
Those individuals may not have the knowledge or network to find the help they need. In some cases, even community leaders aren’t aware of all the resources available or how to access them.
The need is especially high in certain communities in Washtenaw County, such as Ypsilanti, Ypsilanti Township, and Whitmore Lake, which have significantly worse mental health outcomes than the rest of the county.
“The discrepancy is jarring,” says Alfonso. “The goal, for us and all our nonprofit partners, is to get these communities to have the same positive outcomes as the rest of the county.”
“We have the resources in Washtenaw County to provide mental health services through Community Mental Health regardless of insurance status,” says Gardner. “But people still just don’t know.”
The purpose of NAMI’s millage-funded project is to make sure these communities know what resources are available.
But outreach isn’t straightforward.
“Initially, when we got this funding, I thought, oh, we’ll just show up, bring our resources, and folks will take them,” says Gardner.
She found it’s not that simple.
Communities that have been underserved and marginalized can be very hesitant. “The people sometimes feel forgotten,” says Gardner. “They’re questioning, what do you want from us? Who are you?”
This is especially true for a stigmatized subject like mental health, which many people aren’t comfortable discussing with those they perceive as outsiders.
“I don’t see that as a barrier, though,” Gardner clarifies. “I see that as something that’s going to take time and effort. Relationships don’t happen instantaneously, especially if you’re building relationships in underserved communities who don’t have a lot of trust.”
Building relationships with boots on the ground
To build that trust, NAMI first connected with nonprofits that had been working in the community for years.
“We’re grateful to our partners that a lot of them let us in,” says Alfonso.
Then they just kept showing up.
Whitmore Lake had movies in the park last summer and NAMI attended every one. Gardner joined a health and equity leadership team and asked if they needed masks, hand sanitizer, or other resources. Through Boots on the Ground with Ypsilanti Community Schools, Gardner and other volunteers, including many high school youth, went door-to-door in Ypsilanti neighborhoods providing information about NAMI, school, and community resources.
NAMI also dramatically increased their social media presence. And they more than doubled their Ending the Silence presentations at schools, an outreach and education program that is particularly important because of how early intervention for mental illness in youth can have a significant impact on their later success.
While NAMI is a volunteer organization, it requires staff to organize the volunteer activities.
“What’s been great about the millage dollars is we’ve been able to hire some additional staff,” says Gardner, which lets them invest in the relationships necessary to build trust in the community.
“It’s allowed us to be the boots on the ground, helping people get in the door to get treatment,” adds Alfonso.
The outreach has led to more participants in NAMI’s peer-to-peer and education programs. They’ve opened three new support groups and are seeing more attendees from Whitmore Lake, Ypsilanti, and Ypsilanti Township.
“If we didn’t have these millage dollars, we would still be advertising on our website and through social media,” says Gardner. “But everyone doesn’t have access to the internet. You really do need to be boots on the ground.”
Supporting faith leaders to support communities
NAMI has also reached out to faith leaders, who are trusted sources of information for their congregations.
To build those relationships, NAMI organized a faith leader conference in fall 2020, and held a second virtual conference last year.
The conference had over 60 attendees from both rural and urban areas of Washtenaw County. Because each leader serves an entire congregation, 60 leaders adds up to “a huge amount of outreach,” says Alfonso. Attendance and engagement increased from 2020, which Alfonso believes is because faith organizations are seeing so many people in need of mental health support. A NAMI-WC partnership with the Five Healthy Towns organization also helped bring in more attendees from rural areas.
“We are very excited about the interest from leaders in the faith community in knowing more about how to help their congregations,” says Gardner.
The conference highlighted resources faith leaders can share with their congregations, as well as information on mental health. The goal was to help faith leaders identify when a member is going through a crisis, when someone is experiencing worsening mental health, or when a family may need more support, and to give faith leaders the knowledge to connect people to the appropriate resources.
“They get tools and resources, but they also get to meet each other,” adds Alfonso. “What comes out of it is a group where they can share ideas on how to help their community, and how to support their own mental health as religious leaders. They deal with so much, and their own mental health is just as important.”
Another key aspect was presentations from people living with mental illness.
“What we see over and over is the stigma,” says Alfonso. “The stigma touches everything.”
Many faith leaders expressed concerns about supporting someone experiencing a serious mental health incident in their place of worship.
“There was definitely fear of whether the person may be violent, which is very rare for someone with a serious mental illness,” says Alfonso.
Because of this stigma, NAMI’s outreach focuses on both knowledge sharing and normalizing mental illness.
“There are still many people who don’t realize that there are tons of people who have some form of mental health condition. Most of us are just your average person. There’s not a huge difference between us and someone who doesn’t have a mental health condition,” says Alfonso, who lives with mental illness herself.
Because NAMI is peer-based and all their volunteers either live with a mental illness or live in support of someone who does, they’re able to normalize mental health on a personal level.
“Sometimes just being there and being upfront with your diagnoses is enough to normalize a mental health condition and open people up to think more critically about how they viewed it before,” says Alfonso.
Making mental health information accessible to all
In addition to the Faith Leaders Conference, Millage funding enabled NAMI to hold several focus groups, key informant interviews, and conversations with community leaders in 2020 to see what needs Ypsilanti, Ypsilanti Township, and Whitmore Lake had.
“What came out of that is that people don’t know where to go,” says Gardner.
Many community members and leaders either aren’t aware of resources or aren’t sure how to access or use them.
“Even if you give people access to the CARES hotline, there are a lot of community members who don’t know what to say or may downplay their mental illness and then may not get the care they need,” says Alfonso.
NAMI can guide people through the process of calling the CARES hotline, but they wanted to create something more widely accessible.
So they’re creating a booklet.
The booklet is meant for an individual with little to no mental health knowledge who has a mental health concern, or has a loved one with a mental health concern. The readers may not know mental health vocabulary and may have limited access to transportation or other resources.
“When you hear ‘resource booklet’, you tend to think something really dry,” says Alfonso.
“But we want this to be inviting,” Gardner says, adding that Invisible Engines, an Ypsilanti nonprofit, is doing the graphic design. “We want this to be something anyone can pick up and understand, even if someone is in a crisis themselves. We’re being very intentional in making sure someone having difficulty will be able to find what they need.”
The booklet will include bus routes to care providers, a diagram of what happens when you call the access line, a short list of providers, and more.
The booklet also explains basic mental health vocabulary. “It’s almost like there are these magic words,” says Alfonso. “We call it the whisper network of mental health. If you don’t know the unspoken code, you may not get the care you need. So we wanted to teach that and make it accessible to everyone.”
NAMI plans to publish the booklet this spring. In addition to traditional places for a booklet, like hospitals and libraries, NAMI will place it in everyday spaces like grocery stories so people can pick it up easily. Invisible Engines has designed it to be eye-catching but discreet, so people can take one without concerns about stigma.
The fact that the booklet is physical instead of digital contributes to reaching more people as well.
“We chose a low-tech option to meet people where they’re at,” says Alfonso. “With the pandemic, a lot of us in the nonprofit field have seen the extent of the issues around internet and technology access. So we’re trying to make our resources as low-tech as possible.”
Diversity: key to reaching more people
As NAMI continues to invest in outreach, they’re seeing demand for their programs increase, and they’re adding more staff and volunteers to meet it.
“We need to have more staff and a more diverse group of outreach staff and volunteers,” says Gardner, noting diversity is key in improving their outreach.
Most who volunteer or work for NAMI are people who have attended their programs, or family members of the attendees. “They feel our classes are amazing, so they want to give back, and that’s how this community grows,” says Gardner.
When people from a given community aren’t attending NAMI’s classes, that community ends up underrepresented in the organization as a whole. And while NAMI’s outreach so far has increased the diversity of the people in their classes, they still have work to do.
Gardner says she frequently hears, “I want a therapist that looks like me. I want to go to a support group, but I want more folks to look like me. Do you have a younger support group? Do you have more African Americans?”
“It would be wonderful to have people show up and see people who look like them,” continues Gardner. “It gives a sense of belonging and increases the comfort level, especially when you’re speaking about something as vulnerable as mental illness.”
NAMI is making particular efforts to reach out to the Asian and Middle Eastern communities in Washtenaw County. Connecting with each community requires adjusting their outreach, says Gardner.
“You’ve got to go out, make those relationships, build that trust, and bring people in. And that doesn’t happen overnight,” she adds.
“The millage was the spark for us,” says Alfonso. “It gave us the ability to focus on these areas. But even after our project is over, we’re still going to be working hard to build that trust.”