Behind the Scenes of Building CMHA
[00:00:00] What does it take to build a national movement for mental health and aging? Today, I. Am drawing back the curtain and sharing my journey of building the Center for Mental Health and Aging with you. I'm gonna share where it all started, the moments I wanted to give up, the challenges I didn't see coming and why I keep doing it. This is what you're gonna learn in today's episode.
So if you have ever had a big dream or are working to create change in your corner of the world or the internet, this episode is for you.
I have been wanting to do this episode for quite a while of a behind the scenes because it's been quite a journey in building the Center for Mental Health and Aging. With the Center for Mental Health and Aging, my goal is to make sure that. Every licensed mental health provider and aging services professional [00:01:00] has the tools that they need to meet the mental health needs of older adults. So if you're a professional, I invite you to download my free guide at mental health and aging.com/guide.
This is a guide for Mental health and Aging services professionals to meet the mental health needs of older adults. So download that guide today. I'll have a link to it in the show notes as well.
So why did I build the Center for Mental Health and Aging?
I wanna start by saying there was no direct line. There were many strings that had to be woven together to create the Center for Mental Health and aging and what inspired me to do so I'm probably not gonna touch on all of the strings because that we would be here all day.
Instead though, I'm just gonna take you back. I was a clinical RO psychologist at the Atlanta VA Healthcare System for. More than a decade, [00:02:00] and I trained students in jaross psychology and providing psychotherapy. I saw lot, lots of patients and fam, older patients and families, people living with life altering medical problems.
And what I would discover while I worked in these large healthcare systems is. Everyone from a health tech to the medical director of a department, when it came to caring for the mental health needs of older adults, they were at a loss. Where do we go from here? What's normal? What's not normal? Literally like once a week, because I was known in the hospital as the RO psychologist that people would come to.
I would get calls from people. People in my personal life, people throughout the hospital wondering where do we go with this? Is this normal? Is this not normal? What we need a playbook, a guidebook to help us. And because there. Just a few years are going to be more people, 65 and [00:03:00] older than people under the age of 18, and less than 2% of psychologists specialize with older adults.
Not to mention other disciplines are underrepresented and specializing with older adults. We are seeing more older adults and in these hospital systems. The providers and the system itself was caring for more older adults and didn't know what to do. So while I was at the va, I created a program called Gero Champions.
And this program, which incidentally was the name of my first iteration of this company this program. Basically was an annual program that was a full day or two day training event for CEUs where staff in the hospital could get trained on mental health and aging, meeting the mental health needs of older adults and their families.
And so this was a big event and it got a lot of acclaim and recognition. And during [00:04:00] that time I had also been bringing grants into the hospital and the, and I had two little kids, and the hospital system itself wasn't supporting the. My interest, it wasn't I felt like I was over overproductive in the hospital.
I was seeing lots and lots of patients. My reports in terms of productivity were always like, I was operating at 110%. I had seven trainees under me. I had, large responsibility and I didn't see really any pathway forward for me in the system. I kept bumping against leadership ceilings, sexism. All sorts of things, especially after becoming a mother.
I experienced a lot of sexism and before. And I was like, you know what? I want something more expansive than this. And I want to be mission driven and have a movement toward making sure that older adults get the mental health care that they need. How do I do that?
Fast [00:05:00] forward, I gave my notice in 2020 to the VA and left in September, 2020. And began to consider could I provide training to professionals? To meet the mental health needs of older adults. I had done this, I would present regularly at conferences and I was serving on the Georgia Psychological Association Ethics Committee, and I would present regularly for different conferences and I enjoyed presenting.
I presented at the Gero champions events that I would put on and got great reviews. And so I thought I could do this. So I put together the Center for Mental Health and Aging and a training committee. Who would then review all of our programs to ensure that they merit continuing education units.
I even at one point as I was building this program this company, I had a list of the professional bodies that I wanted [00:06:00] to get accredited by to provide continuing education. So I had a list. Like those thermometers of fundraising thermometers where you like fill in the thermometer until you reach your goal.
I was doing that in my dining room, which is where I was working at the time, and I, I had American Psychological Association, association for Social Work Boards and NBCC for counselors and the California Marriage and Family Therapy Board.
And, I just had these goals. I had the people who I wanted to be on my training committee. On the list I had the bodies that I wanted to be accredited by on the list. And then one by one, we began checking them off. And the first course that we launched at the Center for Mental Health and Aging was an act acceptance and commitment therapy for chronic pain course.
And it had a great response. We got, many people to enroll. It was successful. We didn't even have all of our accreditations yet, but that didn't deter people. We had a PA and I think that was it. [00:07:00] And and we started the ball rolling and it's been rolling ever since. And here's why it's so important.
Is that when we don't identify and treat the mental health needs of older adults and most mental health needs of older adults go unidentified and untreated, when we don't meet those needs and treat those concerns, Medical problems get worse. The amount of medication a person uses for those medical problems increases medical hospitalizations increase ER visits, increase, and what's happening then, if a person has more medical problems, I.
More financial problems because that costs money. Even with Medicare. Then there's family strain because when all of that's happening, often families involved, if you're lucky, family's involved, but that also can cause a strain on family. And then I. Needless suffering. If we know that we can treat mental health conditions and people aren't getting treated, then people are [00:08:00] suffering needlessly.
And then there's a, an implicit message in all of this, that there's a point in life where you're not worthy of healing and growth or healing and transformation. And that is not what I have seen in my more than 20 years of working with older adults. And also not true. That we, there is no expiration date on healing, transformation and love, which is the point of this podcast.
So I thought, what do we need to do? We need to train people. Most mental health providers don't receive any training. I think most mental health providers, they have the compassion and they have the interest. They don't have the tools. Thank you for your compassion. Thank you for your interest.
Now let's get you the tools, because older adults deserve the best mental health care that they can get, and you as professionals deserve the best tools you can get to meet those mental health [00:09:00] needs. And so that's what my goal is. My aim is.
Building something, anything. Even though it is exciting and dopamine rich, it is challenging. I would have many nights of being up until two in the morning in the morning, editing episodes posting a blog. I have a weekly newsletter which I send out. Which you'll be getting if you're subscribed.
If you're not subscribed, download that free guide and it will subscribe you to the newsletter so that it's mental health and aging.com/guide. And then you'll get a weekly mental health and aging tip in your email box every week. So you know, I have worn and still wear many of the hats here. I have an assistant now, Carol, who's fabulous.
Thanks Carol. And contractors here and there, but really it still is a one woman [00:10:00] show, and I want to scale this, and so it can't be for too much longer a one woman show because I really wanna broaden the reach, meaning that I need to get more people trained in meeting the mental health needs of older adults.
Were not at pace with the aging population, and over the years so I think we probably launched our first course in December, 2021. And then have been going strong since then and I. Because I'm wearing all the hats. I don't have a marketing arm. I am the marketing arm. And sometimes, like this morning even, I did a keynote this week at the UVM Gerontology Conference.
Last week I was presenting at the Aging Life Care Association annual conference in Boston. And still I wake up this morning and I think I am not doing enough. And oh God, this mission, it's so big, and am I gonna reach it? And so this morning I woke up thinking like, this is [00:11:00] too much. Like I don't think I'm ever gonna reach the goal that I set for myself.
And of course, I think the only limitations are the ones we believe in. So that's wrong. I'm gonna reach this goal. And with your help, we can get there because it's our goal to meet the mental health needs of older adults. So even days like today, right before filming this episode, I'm like, is this really gonna happen?
Is this really gonna work? And then I just have to remind myself, put one foot in front of the other. You got this, you can do this. It's gaining traction. More and more people are interested. You can do this. And so where are we now? So it started with that acceptance and commitment therapy for chronic pain.
Now we have more than 30 courses ranging from one hour to an 18 hour certificate course, which launches twice a year. It's, it opens its doors twice a year for professionals. And we're launching therapy for Chronic [00:12:00] Pain Certificate Course, which is launching in the next couple of weeks.
So stay tuned for that. And and we've had the opportunity to partner with large organizations like American Society on Aging with our culturally inclusive trauma-informed care with older adults certificate program that I co-led with Dr. Telsie Davis w with the Aging Life Care Association we've been able to affiliate with them on our end of life ethics and psychotherapy course, which comes out once a year.
As well. That is of course focused on medical aid and dying and the right to die movement, psychotherapy at end of life. Differentiating desire to hasten death when living with a terminal illness from suicidal ideation. And how do we differentiate that and hold space for our clients? We've had the great fortune to collaborate with Dr. Jennifer Steiner on building our therapy for chronic pain [00:13:00] program. So we have acceptance and commitment therapy for chronic pain and cognitive behavioral therapy for chronic pain the impact of bias and the treatment of chronic pain and so many other programs and courses.
What I do wanna emphasize is that all of our courses have a requirement. To integrate and infuse diversity, equity, and inclusion. Not as an afterthought, but really in everything that we do. And so I recently, because we're approved by American Psychological Association, I recently got an email from the.
Accreditation board for being a continuing education provider with a PA and they basically told CE providers that if you're a nonprofit and you cannot include DEI anymore because of legislation, that they will give you a pass on your renewal for not including DEI. [00:14:00] Ah, which is very discouraging for so many reasons.
It just reinforces structural oppression, which I am opposed to. And I want to be clear that we center, basically DEI in everything we do, and, and so we will not be removing DEI from our programs. In fact, we will be strengthening DEI in our programs.
We have this podcast and we offer lots of tools and workbooks and guides to help you meet the mental health needs of older adults, like a driving retirement guide, like how to avoid power struggles and maintain independence even after stopping driving.
We have a family healthcare planning guide to help families get it, get on the same page with. Healthcare planning, like what questions to ask your doctor and how to align as a family. We also have essential documents checklist, and we're going to be rolling out as [00:15:00] psychosocial intake with older adults in a psychosocial intake for chronic pain.
Those are coming. In the near future. So we have a lot of really fun stuff coming and as I mentioned, I get to do a lot of keynotes. Last week a couple days ago, in fact just two days ago, I did a keynote at UVM Gerontology Conference, as I mentioned, and my talk was on post-traumatic growth and what post-traumatic growth teaches us about aging well, , it was so powerful because. 90%. Nine zero. Hear me when I say this. Nine 0% of older adults. Have at some point in their life experienced a traumatic event. Older adults are more likely to experience medical trauma. They're more likely to be admitted to an ICU which it tends to be very invasive medical care.
They may have been hospitalized during a time when acute pain was not managed well. They may have been hospitalized during a time [00:16:00] with long hospitalizations, which is not good for mental health and can be traumatic. I was a medical psychologist in Vermont for almost two years, and the lead of medi medical psychology department where my team would provide psychotherapy at bedside for people who are medically hospitalized, struggling psychologically with the hospitalization or other concerns.
And what I would often say to my students who were predoctoral interns and postdoc fellows is that. Being in the hospital is like being in an active trauma zone. People can crash medically. People may need urgent intervention. People their health and outcomes feel tenuous and scary. Their close to acute pain, they may have had invasive procedures and are recovering from those.
And so even for the professionals [00:17:00] themselves. They're working in an acute sort of trauma environment. And I know the HBO show, the PIT about ERs has been getting a lot of acclaim. A Pittsburgh er, it's called the pit. And many folks are saying, yeah, it resembles what, what being in an ER looks like.
And you can see it's like a trauma zone. And I say that to say that. Just to give some perspective that the, all the people who are experiencing trauma in that snapshot will age and carry that trauma with them, and if that gets fragmented and not into integrated into their life. That can have negative outcomes, but if it does get integrated and it becomes part of the person's life narrative, there's a.
Eric Erickson, the godfather of developmental psychology, [00:18:00] says that as we approach the end or the later stage of our life, we contemplate was my life meaningful. And one of the ways that we answer that question for ourselves is that we need to bring together, we do that through a process of life review or bringing together the strands of our lives.
And when we bring together the strands of our lives, then the point is to bring them into a cohesive whole, into a full narrative that includes the light and the shadow. That, so that there is dimension and accuracy about the life we lived. But was our life full? Was our life complete? Was it meaningful?
Not, was it perfect? Not wa was it free from harm? And so the more we can help people in that life review is one of my favorite types of psychotherapy to do with people. But in that process, and the more we have [00:19:00] tools to do that, we could facilitate as professionals this. Contemplation of was my life meaningful?
We could facilitate bringing together the strands and the strings of the person's life and how beautiful that experience is because it is inspirational, because it reminds us that at every age, healing and growth and integration and integrity is possible.
So where are we now? This year I had the great opportunity to launch our mental health and aging certificate program at. As you can tell, our signature program for the Center for Mental Health and Aging, and students have been giving it rave reviews. Let me just say, the Mental Health and Aging Certificate program is an 18 hour continuing education program.
A self-paced program, and when you complete it, you earn a badge to put on your website and you [00:20:00] that then are entitled to join our national provider directory. Something I didn't even mention 'cause I was so focused on courses, is that we have. A free to use national provider directory focused on meeting the mental health needs of older adults.
So in this directory, are licensed mental health providers who specialize with older adults. So either they have taken a comprehensive training program, or this is their specialty in their career, but they have to demonstrate expertise to be a part of this directory. And because I wear all the hats I vet everyone, I review everyone.
So we launched this certificate program and I wanna share what one of the students who's recently completed this program had to say about it.
Elizabeth, who is a licensed personal counselor in Washington DC says, I just wanna say that I think this is the best training I have ever done. It's amazing how many resources you provide, the pacing of the work and your knowledge are perfect.
[00:21:00] I. So let me tell you, this means so much to me because I put so much into these programs, one, but two, this means that now Elizabeth might just be more inspired to open her practice to more older adults, and the majority of older adults currently are not getting the mental health care that they need, which is why this is so important.
For all of our other courses, we get rave reviews just like this, especially our end of life ethics course, which happens in November, December timeframe. I've also had the opportunity to train Illinois ombudsmen on different and unique considerations related to mental health and aging and long-term care and to the state of Vermont Health Department. And. Greyhawk Health, which is a healthcare agency in Philadelphia.
And so I feel so deeply honored that we get to work with many agencies and [00:22:00] departments and individuals in private practice. And now I'm getting emails from people in Australia saying that they've taken the course. So I am so deeply honored and grateful that y'all are. Making this work front and center that you are joining me in the movement to improve mental health and aging.
So to date, we have trained thousands of mental health providers internationally on meeting the mental health needs of older adults. We have this podcast, which has more than a hundred episodes, more than a hundred thousand downloads, and we're just getting started.
Last year I was at a conference of 500 mental health professionals in Santa Fe, and a woman approached me and said, I came to this conference because I listened to your podcast and resources that you shared in one of your episodes has have helped me so [00:23:00] much with my clients. When I hear stories like this.
This is what keeps me going to hear that we could be providing needed information to help you either keep your clients safe. This had to do with financial exploitation. Keep your clients safe, keep your clients bolstered. Keep your clients free from suffering and harm. This is what lights me up.
This is why I keep doing this work. Also, I want my older adulthood to be filled with possibility and purpose and not these messages of decline and decay. And of course there will be physical decline, of course. But I want the full picture. I want to know that my life is not just about physical decline, that it's also about opportunity and possibility and growth.
That's what lights me up. And when I hear you and your [00:24:00] stories and you sharing that what we offer here has been helpful to you, that is the reason and helpful to your clients. That is the reason I'm so deeply grateful for the work that you are doing to improve mental health for older adults as well.
And this is because it is only with you being here. It is only with your help that we will meet the mental health needs of older adults. So thank you for being here and doing your part and for sharing the message that there is no expiration date on healing and transformation and love.
So if you are looking for continuing education courses. Check out what we have to offer at mental health and aging.com. If you know that your colleagues or your systems are looking for continuing education courses, check out our list of courses. Our Registry of Courses, they're all focused on meeting the mental health needs of older adults.[00:25:00]
And if you're working in a system and you want a group of professionals trained to meet the mental health needs of older adults, reach out to me, contact me. Let's see what we can do. Just rolled something out with the State of Vermont Health Department.
I would love to talk with you about rolling something out with you. And if you're not in need of continuing education right now, get on my email list and get a weekly mental health and aging tip or resource that's at mental health and aging.com/guide. So until next time, thank you so much for being here and joining me in the important mission of improving mental health care for older adults.
I'll see you next week.
I'm Dr. Regina Kepp. I'm a clinical Gero psychologist and founder of the Center for Mental Health and Aging. If you found this episode helpful, would you follow, review, subscribe, and share it with others? It really helps other people to find us [00:26:00] so that they too can join the movement for mental health and aging because as you know, there is no expiration date on healing transformation.
And love. I'll see you next time. Bye for now.