Rikki Harris on Mental Health Resources in Tennessee
Rikki Harris, CEO of Tennessee Voices, joins the conversation to discuss the pressing mental health issues Tennesseans face and the state's unique preventive measures. The episode delves into Tennessee Voices' mission, emphasizing collaboration and community-focused care, while also exploring the challenges of nonprofit leadership. Harris shares insights into effective self-care for mental health professionals, the importance of resilience in youth, and the critical role of parental support in improving mental health outcomes. This episode offers a deep look into the preventative strategies and leadership principles driving one of Tennessee's pivotal mental health organizations.
About Rikki Harris
Rikki Harris serves as the Chief Executive Officer of Tennessee Voices (TNV), a nonprofit organization dedicated to transforming mental health systems for children and families. With more than a decade of leadership and master’s degrees in both Marriage and Family Counseling and Christian Education, Rikki leverages her academic foundation and deep commitment to community advocacy to spearhead initiatives across the state.
A two-time Nashville Emerging Leader nominee and recipient of the Health Heroes Award, Rikki has co-authored white papers and contributed nationally to policy advocacy and curriculum. In partnership with TNV founder Tipper Gore, Rikki continues her dedication to ensuring equitable mental health services across Tennessee.
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Spencer 00:35
You are the CEO of Tennessee voices, and really at the intersection of what a whole lot of people are asking questions about right now, which is mental health, trauma, how to be a parent at a time when people feel like it is harder than ever before to not screw it up and be a good parent. And Carli and I live that every single day, we've got four kids, 1312, 10 and five, so we have an eighth grader all the way down to a junior kindergartner, so that we are going through it. So welcome to the show. Really excited to be able to have you here. Why don't you take just a second to tell us what Tennessee voices are? Well, thank you for having me. First of all, I love the work that you all are doing with this podcast. So Tennessee Voices is a Tennessee specific nonprofit serving families and individuals across Tennessee and all 95 counties, just making sure that there's access to care, that there's options for care. We have a variety of care so everything from in home support and really intensive therapy to outpatient settings where you come in the office for medication and therapy, all the way to 24/7 housing for adults who have severe and persistent mental illness, so a wide range, with a new focus on preventing all of these things that you're talking about with children and working with young families, new moms and babies. So this is a new, new, growing avenue of our work is really focusing on prevention. Some take an approach of having a faith based approach to care. Some don't, not to the exclusion of it. But do you all have a posture as it relates to any faith driven component to it, or because sometimes you see in these things that there are so many things that are intertwined between mental health and spirituality and community and all these things, that sometimes they flow together. How have you all thought about that as you're thinking about your mission?
Rikki Harris 02:57
It’s a very appropriate question. We are bipartisan nonprofit organization contracted by the state of Tennessee. We don't currently have faith-based work in the organization. I will say for me, personally, I view the human as biological, psychological, spiritual and social. So I think a whole person includes spirituality, and this is something that I seek to educate my staff around, is just understanding how spirituality fits into this mental health picture. And I also worked on a PhD way back in the day, I'm going to be at abd for life all but dissertation, but my focus was on how much people want to include spirituality in their mental health care. And it was interesting to find that across all the research, most people want to include their spirituality and their mental health care. They understand the intersection. So it's an it's an interesting and tricky time to deal with that, both as as an organization that's not faith based, but also as a person who really believes there is this, there is this intersection there.
Carli 04:09
I love how you talk about prevention. I think as parents of four, and we are no different than a lot, which is, you have four kids, right? And you think they're going to be similar, right? They come from the same place, they have the same relative DNA makeup, etc, and then they're just so vastly different. And you find that these mental health challenges will really impact one and another is completely has no clue what's going on, right? And it's it varies. And as parents, there feels like there's no playbook, right, like what works for one kid just truly does not for another kid and vice versa. So when you talk about prevention, I would love to know how to prevent some of them and we can joke light heart.
Rikki Harris 05:00
About some of the damage I'm sure I'm doing to my children just by being a human being, raising four kids and working and trying to do all that at once. But what does that actually look like on a scientific level, on a data process driven level, how do you do that? Yeah, this, this question is packed full of what could be loads of information, but I'm going to boil it down. One of the things that you're so right about is there is no playbook. There's not a one size fits all parenting. But there are these early stages of life where we can set up connection and attachment, if you will, but connection with our kids in a way that helps us learn our kids and how to parent in that individual way, and so early in life, helping moms understand this attachment, learning your baby's cry, responding to the cries, making sure that you have those serve and return, is what we call it, those interactions with babies while they can't talk or communicate and we have no idea what's going on in their little brains, we can have these interactions, the smile, this hand touch, and these little back and forth that teach a child that we are here. We're we're the person that's going to respond to your needs throughout your life. And you set up that early connection that then becomes, they become teenagers, and that connection becomes so critical, because the heart connection with a teenager can really help you understand, what does this child need that is different than my other child. I have two exact opposites. I parent them so differently, even to the point of when they got cell phones, because one had different needs than the other, and so it is almost if I can speak freely, personally, an act of our spiritual faith, to learn from this child what this child needs from me as a parent. And it's hard, it's hard to parent that way. Takes a lot of effort. I feel like that takes a load off my back, because our kids are so different, and I think we are really in tune with those differences. That are what those differences are, but there are those moments of, well, am I being fair, right? And I know fair is a moving target, and not everyone's gonna get everything, but over the course of their life, and are we being equivalent in like, what you're getting, our resources, our time, our energy, and I love what you're saying is it may not look fair for a while, because they don't need the same thing. That's exactly right. Do I love you the same as my other children? Absolutely, that's what's fair. Do I love you enough to parent you differently? Because that's what you need absolutely, because that's what's fair. So it's hard. It's shifting the thinking a little bit. But man, those early connections, I cannot tell you how impactful they can be long term.
Spencer 07:55
It is amazing for a role as important as parenting. How astonishedly, astonishingly little training we get for that moment, and not just that moment, but that whole season of our lives. Like Carli and I, when we had our first Zoe, and we're there at the hospital, and they're like, Okay, you can go home. And it's like, you really feel like you can't be serious. You're not. You're not seriously gonna trust me with this human to go home and like, You mean, like, drive on the roads and get back to our house, and it's incredible. And the resources that often we have is just how we were raised. I mean, that's it. And most people, statistically And realistically, don't have awesome examples of what a mom looks like, what a dad looks like. And there's a lot of things that part of Carli and I's role and outlook has to has been to say we want to be generation cycle breakers to say these are things that happened that end with me, that end with our relationship, and will not be carried forward. So it sounds like that Tennessee voices spends a lot of time around resources and the equipping of resources. So maybe talk a minute about that, because I think it goes hand in hand with the preventative aspect to it. But talk about the resources that you all enjoy.
Rikki Harris 09:30
This is exactly why we at Tennessee voices don't just treat a child when they present with a mental health issue. We believe in family focused, system level treatment that encompasses the family and then also the community at large around those children. There is so much research to show families are where it's at. The impact on changing the mental health crisis is through parents. And educating parents is one of the things we do at Tennessee voices. We have parent. Training programs, multiple models, one of which is called nurturing parenting. And it is those early days of coming home from the hospital and knowing how to nurture this child, to foster a relationship, that leads to this very connected, this very stable, warm home environment that then becomes the safe haven, the bubble in which your child goes into the world and retreats back to to feel like, oh, I can do this, because the world is a little hard right to take on. And so it is those early learnings through education and working with vulnerable families, families at risk, to ensure that they know. And I wish it was available. We're a nonprofit, and we are focused on specific populations of people of need, but I wish it was universal that there was an opportunity for every parent to have some training around how do I do this? How is how am I going to be successful as a parent long term, from day one?
Carli 10:59
Because so much of what moms and dads? I guess I can speak from the mom perspective. Best are told, is super contradictory, right? Like I realized early on, we were on a trip celebrating some family members, and we were very pregnant with Zoe at the time, and I tried to pick up a book about how to help your baby sleep. And I remember, I got maybe a couple paragraphs in, and I started breathing any and I started getting really stressed, and I threw the book like I left it on that trip, because it made me so stressed. And then everything I looked at is like, be with them all the time. Never put them down, attach right? And then the other side is, well, if you never put them down, then they'll never be put down, and then they'll never thrive as a human being. And breastfeed. Don't breastfeed. Prioritize your husband, prioritize your infant, to the point that you just as a woman, as a parent, feel like you have been brow beaten before you even start. And that doesn't even include the helpful hints that you might get from siblings or family members or other people in your church community, and so I appreciate your approach, which seems to be very based on data, and what actually works, what actually moves the needle for families?
Rikki Harris 12:18
Yeah, you're describing something I experienced as a new mom, 100% overload of information. Where am I supposed to be paying attention? What's the most important thing? And new moms are the most vulnerable, because we completely operate out of fear. We don't know what we don't know, and we're scared we're gonna mess it all up, and we own it, as if anything that happens, the outcome of this child's life, will be my fault somehow, because I didn't know. Well I will say, I will say, This is why there's birth order. If you, if you look at characteristics and birth order, it starts to make sense. New moms and dads are scared. They parent out of fear. Their children become the ones who are type A and, you know, we don't even let them touch a buggy in the grocery store. We cover it all up. And by child two and then three, we're way more relaxed. And our kids tend to be a little more adaptable to the world and go with the flow, and you look at birth order, and those characteristics stand true. I think what is so hard is the fear based parenting is fed to us even in all the chaos of information, it's still fed to us that if we don't do something, something bad will happen to our children, and if we allowed something, it could create a problem that we never intended. And I just go back to breathe and know that if you can create this connection and communication with your child, even from infancy, to understand their cries and understand what those cries mean and the needs they're asking you to meet. You can, in fact, intuitively begin to parent from from a perspective of I know this child, and even if someone tells me I need to let him cry it out all night, that's not the cry coming from my child, and I need to respond. And so it it's it's so hard to get there because we let information tell us to do something that we instinctually know we shouldn't do.
Spencer 14:25
One of the things that's unique about your story is when you came to Tennessee voices, there were fewer than 25 employees, and you have 10x that place over that time. And that's an incredible story of growth that Carli and I get to work with a handful of nonprofits, and few of them, very few, have anywhere near the business acumen that it takes to scale like that. They have the heart. They have the heart to 10x it overnight, but they don't have the business side of it. So can you. Talk a little bit about your leadership and what your mission has been at Tennessee voices, because we've kind of talked about all sorts of different things that we all care about, we can all relate to. But what's the mission that has let you 10x in an environment that it's not easy to 10x at any point in time.
Rikki Harris 15:21
Yeah, it's not easy at all. And I will tell you, part of our mission is collaboration. We believe in transforming the system through collaboration. That belief is deeply embedded in me, in this system level environment that I was describing, when we work with a child, we don't just work with a child, we work with a family. I think the same is true in our industry. We have to be willing to work in the larger system and understand that we can't meet every child and family's needs, that we have to now involve the friends we have around the needs of the family, and when I become so selfish as a leader that I don't want my clients or customers to go anywhere else to get their needs met, then I'm responsible for figuring out how to meet everyone's needs, and that is a quick fix to failure. There's no way I can do that. There's no business I know that can meet every single need. And so we have really focused on this growth through collaboration, this understanding that better together is actually better for families and people in Tennessee, and through that, we focus on people with lived experience. Working for Tennessee, voices and people with lived experience come with a passion that says, I have been where you have been, and I will help you, and the power of that is truly transforming this is also not a clinical service. We have clinical services, but this peer support is not clinical and it was my mission to grow this because we have a behavioral health workforce shortage, and people are out there looking desperately for mental health care, and it's just hard to get because there aren't enough people, and so waiting lists are long. So believing that the power of human connection, if I know what it's like to sit in your shoes and I've done it, why can't I help you? And so that's sort of been a impetus for growth, and as a leader, I honestly, personally experienced this in my family of origin, with a brother who had mental health issues. So for me, it's it's personal, growing this service for families, just like the one I grew up in, is my heart's mission.
Spencer 17:46
And so just from a broad overview of 250 employees, can can you help us understand just a little bit of what the business model looks like? To say, all right, of the 250, 80% of our employees are doing this function and and do you get paid for that function? And just just help us understand some of the landscape from there? Sure.
Rikki Harris 18:11
So most of our funding comes from state contracts through Departments of State, and then some of them come through TennCare billing, and others through trainings and maybe a little tiny bit of private pay, but our focus is on people who can't afford services. So we're really looking for ways to support people who can't come and pay for services from us, and that's the state contract that's helping, right? And our founder, Tipper Gore, created a HOPE Scholarship for people who didn't have TennCare, didn't have private insurance, maybe couldn't afford the co pays of their private insurance. So there's this other bucket of money that allows folks to have services. So philanthropy is a piece of how we get the work done as well. But I will tell you, for me as a leader, it's one of my favorite topics. I feel so fortunate to be trained in mental health and then get to lead, because there's a different perspective on the workforce. And people post pandemic changed. It just they just did, and work habits changed, and so we've had to reinvent ourselves, even since 2020 to understand how to respond as employers to people's needs. And it's totally informed by what we've been providing for our clients for years.
Carli 19:36
Tell me about since what I love most about this organization is that you are so Tennessee focused. It's made by Tennesseans. For Tennesseans helping people that otherwise wouldn't have a voice in this space and wouldn't get the care they need. As such, I'd be really curious to know, I don't know if you check in with peer groups, state by state, I would assume you do what is uniquely impacting 10. The CNS that maybe is across the United States, but is really specialized to our home state.
Rikki Harris 20:06
Yeah, we do talk to our friends in other states a lot. We participate in groups across the US and compare notes. We're particularly unique because we're part of what's called a family run organization, group of organizations who are driven by people who have experienced mental health challenges or parented children who have experienced those challenges. So when we talk to our friends, first of all, we're one of only three of the largest family run organizations in the US, and we hear so many stories of how Tennessee has a special sauce, and they ask us, what? How do you have all these services? Why does Tennessee accept peer support so much more broadly than other states? Why does Tennessee have such a great crisis response better than most states, I will tell you, this is the cheesiest answer I'm going to give you. But it really is true our Volunteer State mentality. Now that doesn't mean we have volunteers, but that means that I have people who work for me from a very altruistic they've been born and raised here. They have been deeply ingrained in the culture of Tennesseans who believe that helping each other is a priority for us as humans and that community that we've created, the connection between us is the special sauce, I think, than any other state that I've talked to.
Spencer 21:31
How do we measure success in Tennessee? Voices to start with, like when you are giving KPIs or rubrics to your team. How do they know that they're making progress? What are the markers you look for?
Rikki Harris 21:48
Yeah, so there's broad and then there's very defined markers. We use assessments for mental illness, like depression scales or we look at adverse childhood experiences. We compare data large and small, both inside the organization and to the state. What we're looking for is, Are people feeling better faster? Are parents having less stress around parenting their child with mental health needs? We use a particular Tennessee based tool called the caregiver strain questionnaire developed out of Vanderbilt many decades ago, broadly used in our organization to understand is the work we're doing actually helping moms and dads and caregivers have an easier time with parenting a child with mental health needs. That's a huge marker. The rest of it is comparing our state nationally. How are we doing in Tennessee? And this is what drives how we choose what we work on as an organization. If we are low in our numbers for mental health and children, why? And then, how do we create programming to address the why? So we're constantly looking for any markers of health, mental health. We we do pay attention to social determinants of health. So what's happening with poverty and food insecurity? Those are all important markers for us, but ultimately, we would really like to go out of business. I mean, if the KPIs we looked for for the real deal, we shouldn't have any clients like that would that would be the ideal goal.
Rikki Harris 23:27
But obviously making client sorry, obviously making services accessible. Yeah, that's the point. Yeah, are people getting the help they need without waiting for months to get in. That's what we've got. That's our biggest KPI.
Carli 23:43
And what's the state of mental health in Tennessee? Because I feel like you're uniquely poised in all these different Democrat demographics across 95 counties. I'd be curious to hear. I know people have changed post COVID, but what are you seeing the most? What are, what are Tennessee's in uniquely struggling with in the mental health space.
Rikki Harris 24:04
For children, it's very much the same as the rest of the country, anxiety, depression, suicidal ideation, particularly in girls as a state, opioid addiction is still an issue for Tennesseans. We know a lot about children's mental health, globally, nationally, but in Tennessee, we have this interesting dichotomy. There are our statistics are the same as the rest of the nation, but there are so many preventative programs in Tennessee that it will take us a decade or more to see if they're working. They're not. They're newer programs, so we have to wait this out. But there are so many people, and I'm so hopeful in this state that are paying attention to children's mental health, it has grown in funding just in my 10. Years in this state, in this field, children's mental health has grown in funding leaps and bounds, hundreds of millions from state dollars insurance coverage, ensuring every child, even those without TennCare, have safety net coverage. So I'm hopeful that the next generation has a reduction in mental health crisis. I think that's where we're headed. I hope that's where we're headed.
Spencer 25:25
I'm always in the business world obsessed with measuring something right. If you can't measure it, you can't manage it, and mental health, just in and of itself, is incredibly difficult to measure right. I mean, everybody's standard of what feels right is different. I mean, it's so personal, but then there's also an added complexity in that there are meaningful parts of society where it's under reported. So you could see the case numbers drop, but that may not be a good thing, because they either can't get the care, or there's so much stigma around it, and so I still wrestle with, like, a comment you made earlier was to say, if the numbers are low For like, you know, childhood trauma or whatever you're measuring. Help me just go one layer deeper of just what numbers would be low. Is it the number of cases? Is it the surveys that you're getting from the families? Is it from the doctors? I just really want to understand better how to measure it, because it's so important, and clearly a ton of resources are getting put into it, but I want to make sure that we're looking at the right thing to know what is working, especially if we have to wait 10 years to find out over something, we better really make sure we're looking at the right metrics.
Rikki Harris 26:58
It's such a good question, because what we're looking for is a reduction in adverse childhood experiences. So there is a scale to measure how many adverse experiences a child has had in their life. Those are abuse, any type of abuse. Parent incarcerated. This could be death of a loved one or caregiver, drug use in the home there's, there's about 10 real strong markers, and then several other traumas you could consider, but we're looking for an overall reduction in childhood trauma, okay, adverse experiences, and if we reduce the number of adverse experiences, then the then we hypothesize that there's less mental health concern, because trauma impacts the brain so much so that it creates these mental health issues. So that's as deep as we feel like we can go, is if we could measure that and get less adverse experience.
Carli 27:53
Gosh, that's so helpful. Yeah, people talk about mental health, and it's this rainbow, right? And I think what you're really looking at is what we can touch and feel, because there will still always be people born with a chemical imbalance 100% and you know what, if you're born with a chemical imbalance, you can work on it. And there are things that you can do for that, but that is different than what we can attack with state dollars, and what we can try to do for our state to make it a great place to raise families, and I think it is, I just think there is a lot of opportunity for growth in that space. One thing, when we are researching you and your organization and all of this before we came here, is you love to talk about the resilience of children. And I just would really love to hear you spout off on that for a minute.
Rikki Harris 28:39
Yeah, it is one of my favorite topics, because, well, first of all, I'll reference the book you all have talked about before, the anxious generation. And I know that you all have read the book and that you've engaged other guests on this topic, but to me, it's the best single, latest bit of information we can tangibly use to help parents understand resilience, because resilience is very misunderstood, just by definition. It is so complex, but so simple. At the same time, is building this belief within a child that they are capable to take care of their mental health, to overcome hard things. And when we talk about resilience, we're talking about normal childhood, very little traumatic or adverse experiences. We're talking about, how can we start on day one, building up a resilience. And for me, I have two teenage girls. They're 14 and 17. It's teaching them how to manage their own little I don't say little to make it seem like it's not important, but but little problems in childhood and practice is practice, these little things that are happening. My friend didn't include me and I didn't get invited to the birthday party. I love this one because it's the opportunity to teach and train resilience, how to not go back. I can be a jerk to that person who didn't invite you to the party. How to think about it in a different way as a as a child, your brain is only working with so much development. So how can I actually layer my thoughts about this? And giving kids a chance to practice in those moments for 18 years is the catalyst for becoming an adult, working in a job, getting rejected, not getting what you want, and pushing through. These are, these are ways in which we can guide resilience. There's a lot on this topic, for sure, I guess that is hard.
Carli 30:33
Yes, you're parenting. When they feel something, you feel something. And I think sometimes I know, or I'll put it this way, I'll speak for myself, my worst parenting decisions have come from trying to shield them from something that maybe was really hard for me, but if I dig down, I think selfishly, I just don't want to relive it again through them and letting them go and find their own resilience feels like I have to find my resilience again. And even in a adult body that is approaching 40, that feels like reliving trauma and pain and all of the growing pains that you have to do all over again. And so I'd ask you, as the expert in the room and in this field, where are our blind spots? What are some of the resilience building activities that we are probably shielding our children from that we shouldn't.
Rikki Harris 31:33
Okay? People may or may not like this. This is my this is my number one view. We need it from having girls, I don't have boys. So this may not ring true. I'll say that getting involved in their in their drama, I have seen it since kindergarten with my kids moms who, as soon as child goes home and says my friend upset me today, they're ready to call that child's mom and have conversation. That has been true across, I mean, from kindergarten all the way through for for me and I made a rule with myself that I will not get involved unless it is something really serious, like we've hit someone or there's some offense that address right? But in just childhood stuff, I won't be involved. I will tell you, as my kid, how to go back and have the right conversation with your friend. I will train you. I will I will empathize with you. I will understand how much it stinks, but you're still doing it. Same gets true when they're in high school. My teachers mean they don't they don't teach me anything. I'm making bad grades because of them. It's their fault. The first thing we want to do is email that teacher and start, start laying it out what they haven't done. And I hold back and I say, don't do it, because the best thing I can do is tell you how to go have a conversation with that teacher. And one thing that I've gotten a lot of things wrong as a parent, but one thing that my husband has helped support, that I think has been really right for our family, is this, it's teaching them to advocate for themselves when they need to to have a courageous conversation when they need to, and to stay in a positive space with people as much as they can. And when, when we have our children interact with adults, we always have adults say, Wow, your kids are like they they talk to adults like, like adults. We say, Yeah, we kind of made them do it since kindergarten. It's on you to go work these things out, not me, and if and if you can't, I will help you, but you're going to try first. And I think that's just the number one starting point for at least me as a parent and my husband is we will not solve every single problem and we won't get involved in their peer issues.
Carli 34:03
Super helpful and relatable, because it's it's really not easy. It's so hard, we can sit and be like, Oh, that makes sense, right? But then when they come home crying, or it's equally as hard when you have one come home and relive a conversation, you realize they were the mean one, and you want to call a parent and be like, I promise you, she's not mean. I promise you, she's not a mean girl. I promise you, we're parenting this to the best of our ability, and instead talking to her about her actions and being like, Is this how you want to be, and trying to send her back to live with the consequences of like, maybe she made the wrong choice. That's equally as hard.
Rikki Harris 34:46
Yeah, I think absolutely hard. I'm not even gonna it's easy. I'm not even gonna act like I didn't want to call some parents or a teacher a few times, but just holding back on that and really saying, This is the moment life when failing or. Messing it up won't harm them. Let them fail or let this sit.
Carli 35:06
It helps to have a target though. Don't you think like you're so metrics driven and mission driven. It's like, okay, I'm not just letting this sit because I mean, or it's painful. It's like, I'm letting this sit for the ultimate goal of grit. Yep, and that's a very different way to think about it.
Spencer 35:24
I think there's an interesting overlap in your philosophy that you express there of saying, hey, there is a place for resilience and grit that I think also has contributed to you being the leader that you are at Tennessee voices, because most leaders of nonprofits that I see have, as we talked about earlier, endless heart and the mission is the mission, and the thought of selecting a particular focus area means that there's a lot of people that are not going to get care, and for many nonprofit leaders, that is just an unacceptable outcome, even if it means the destruction of the entire enterprise, which it often does. And there's so few nonprofit leaders that gain that perspective before it's too late, before they've had to learn that the hard way. So I would love it if you'd maybe just talk for five or 10 minutes about leading the number of people that you lead in a nonprofit space, because it is really hard. I'm on the board for Focus on the Family Carli and I serve on various boards where one of the realities of nonprofit worlds is that when you're competing on compensation, you are materially below the private sector. And oftentimes, although not always, it results in the talent pool that you have access to attract and, importantly retain, gets diluted a lot too. And so can you talk for a bit about how you have been a leader and speaking to other nonprofit leaders in this space that you, of anybody, could tell us a lot of stories that would break our hearts. I mean, you've seen trauma that is unimaginable for most or all. But when you're talking to your team to say, Hey, these are not always are things to solve. I can imagine that there's a meaningful number of people that would hear that and say, well, Ricky clearly doesn't have any heart anymore. You know, now that she's running this thing of 250 employees, she's lost her priorities. So can you speak to that as a leader?
Rikki Harris 37:56
First of all, I think there is this understanding, and this is the impetus for my decision to write a book that I'm almost done with on leadership, because there has to be this understanding of a person's intrinsic values that led them to this career path of empathy, this this altruism within them That leads to to the path of choosing a career to help someone else, and when you understand that intrinsic value, you can work to lead in the intrinsic value versus the extrinsic value. The extrinsic value is important. I'm always talking about how much our industry needs to pay better nonprofit, but also mental health. There needs to be a better parity between what we pay for doctors and nurses versus what pay therapists.
Spencer 38:50
It's a double whammy, right? I mean, it's not only nonprofit, right, mental health, right? You've got two detractors going,
Rikki Harris 38:55
100% we have got to do better. And we, and I talk about this a lot, and spend a lot of time looking for ways to advocate. But while I'm doing that, there has to be a parallel and maybe even a greater interest in the intrinsic value that brought someone to the work. Because if I can understand, and I do because it's something intrinsic that brought me to the work, if I can understand why they showed up to work at a place like this to help people, then I can continue to foster their happiness in the organization. And so we used a happiness scale called the happiness index to look at our staff's work happiness. We've used other platforms, like inner Gage, which is what's used by taught workplaces USA Today, the Tennessean uses top workplaces, we started to really focus on their burnout, how to protect their their burnout, how to protect them from secondary trauma. We started talking at nauseum to our staff about self. Care, and how much we know that they're exposed to secondary traumas, that they showed up because they've been through stuff, and now they're hearing it over and over and over. So there's this option, potentially, that this work triggers stuff for them. And so we I started saying, We've got to pay attention to the people who are working for us and their mental health, but not to the point that I need to go metal in their mental health care. They need to be able to do that on their own privately. That's not for me as an employer to say, you know, you should have mental health care. It's up to me to teach them how to take care of themselves and and know what their own needs are. So I started teaching them self care and working on annually, in the beginning of January, re teaching every year, there are these four buckets of life. Goes back to what I said in the very beginning, your mental, physical, social, spiritual, you have to be thinking about how you're taking care of yourself in all those areas, and so I led them through, several years ago, a process of creating a vision for their year through self care, not set goals and go achieve them. If that's you, that's great, that's me, but that's not everyone, but this, if I take care of myself, then I'll have these outcomes and helping them focus on and giving them permission to focus on their their self care, even during the work day. So if you need to go to therapy in the middle of the day, we're creating space for you to do that, figuring that out if you just need to get up and take a walk around your neighborhood once a day, because sitting at your desk is driving you do it. If you need to read a book as a manager on how to be a better manager for an hour in the middle of your workday, do it. It's just people have thought, oh, I had managers say I'm allowed to read a book on management while I'm on the clock. Yes, absolutely you are. But it is this focus on intrinsic value that has been, I believe, the reason for success. So our happiness index scores were over the threshold. There's sort of this mark between one and 10. It's like a seven that you need to hit to say that you've done well with your employees. And we actually hit above seven. Then on our inner gage scores, there are 12 or 15 markers of success. If you've done well on your on your survey, you can get a badge saying you've done well in these areas. We had 12 of those. It really, I believe, is this focus on the person that because I know why you showed up to work like this. Why you showed up to do this work is what's inside of you, and I care about that, and I will help you foster that, and I will help you protect that. The belief that I really care, I think, supersedes the extrinsic.
Carli 42:58
I don't want to take this too far as a left turn. But I just, I just have to ask, because I think everyone has these buzz words that like get under their skin a little bit. And I think that you so beautifully articulated one of mine because you took it to a different spaces. I really struggled as a working mom with four kids and trying to support all the things, this idea of self care, because the former valedictorian in me, right? I love a goal set. I love a goal set, and I but if I set the goal, I'm going to meet the goal, even to my own detriment. And so years ago, I had to get off that wheel of setting goals for myself year over year, because I realized I have a reading goal, and I will become a horrible parent in December, because behind my ring goal. It happened this year. I'm on Audible like, trying to reach my goal, because I'm just such an overachiever in that way. So I have to be very, very mindful. But what you've said about self care is I have found these incremental ways to add maybe one or two things a year to what I'm already doing. Being like, I really see a hole here that would help if I would fill it just like, in 10 minutes twice a week. But my problem is, everyone's like, take care of your self. Care do this. And I'm like, a bubble bath is not gonna help my mental Thank you. If somebody tells me to go, go, take a minute, go, take a bath, it's like, while the kids fingers are under the door and the dog walks into like, the water and it like, it just truly, it makes me matter when someone tells me to take to, like, do self care. So I really appreciate those four buckets. And I would just love to ask, and then we can totally get back to metrics and nonprofit running and all the things. What would you tell someone like me that gets really stressed when someone's like, Hey, you seem really busy and there's a lot on your plate, make sure you take care of you. And I'm like, if I had 10 minutes to take care of me, I promise I would. Yeah. What do you tell perhaps those hypothetical people?
Rikki Harris 44:53
I've been triggered in this way, because I have been you in the past, and. I think what I've learned, and it's funny, because I use the bubble bath thing too. Self care is not a bubble bath Thank you. It is knowing yourself enough to give your self permission to do something different. So if you're the one that's like, I have to get this reading gold now I have to set these goals, and they have to be stretch, and they have to be big, and I have to be able to look back and celebrate it at the end of the year, and if I don't, I've failed. And if you know that about yourself, then your self care becomes giving yourself permission not to set those goals. Your self care becomes scaling the goals back, because you know you, and that's where it's been really fun to teach my staff these things, because if you are that person, a vision board may be the worst thing you could do. Right? If you are a person who's creative and kind of like relaxed about do a vision board, cool, but I have staff who are like, I don't participate in this. And I say, congratulations, you're practicing self care. Because there are, there are very unique ways to practice self care, and it is not a one size fits all. It's just like parenting. Knowing how to parent your kid means you know your kid, and you're intuitively responding to the kids needs because you've learned and studied that child. Same is true with ourselves, and that's where I think the work we do on ourselves, whether it's in therapy or through spiritual means or through whatever the investment is so good to know yourself and to allow yourself to govern or to guide yourself in the way that makes sense for you, instead of a book that says you should set a vision board, stretch your goals, yada yada yada. Wait, I know me, I'm not reading that book, but thank you for putting it out for the people who will respond to it. So it's just permission to say, yeah, for me, self care is not setting those goals for myself, but enjoying my reading all year, because when I get to I want to like it? I don't want to read it as fast as I can to check it off my list. I want to like it. Maybe that helps. I don't know it does. That helps.
Spencer 47:14
Tennessee is such a huge state, you know, you go side to side, and it's every bit of nine hours to get from end to end. And one of my favorite stats is, if you are in Kingsport, Tennessee, you are closer to Canada than you are to Memphis. That is a true story. You are closer to Canada than you are to Memphis. And that is a huge challenge for a mental health resource because it's already scarce, and you're trying to figure out, how do I cover this vast territory? So can you talk about just how Tennessee voices doesn't become Middle Tennessee, Tennessee voices or Memphis voices? So just talk about that and how you all tried to approach covering this type of needs that vary a lot between northeast Tennessee, Middle Tennessee and East Tennessee and West Tennessee.
Rikki Harris 48:12
This is a very real challenge for us and for any organization serving the state of Tennessee, for all the reasons that you said, we try to think of it as three regions. So just like others, three grand regions of state, West, Middle East, and even this last few years, we've segmented northeast as thinking of it in its own region. Because what we've learned is there are so many different needs of each group, right?
Spencer 48:39
They will be very happy to hear that, because I can a lot of Northeast Tennessee feel like that. The rest of Tennessee believes that the state ends at Knoxville, and it does not.
Rikki Harris 48:48
I would agree that we do think about it that way, for sure. And I have come to appreciate not only through Tennessee voices, my husband, a few years ago, had businesses in Bristol, Knoxville and Johnson City, and getting to spend time there and just appreciating the differences, I completely get it. We have always had staff who work out of the counties that we serve. So all 95 counties our staff are kind of grouped in regions, even broken down beyond the three or four, and we really seek for them to inform us about their region. The way that we do that is our staff participate in coalitions, committees, work groups, councils in all of those specific areas and the states. The way the state is divided up through DCS is eight, eight or nine regions. I mean, there are different iterations. But if you really group the state in smaller pieces, and you get people plugged in, our staff plugged into those communities and the work they're doing in those communities, it becomes really easy to understand the differences in the needs. I also chair the Department of Mental Health. Health, Public Policy and Planning Council, and in that group, it's a really smart way to do the work. And if I this is my shout out to the Department of Mental Health and Substance Abuse Services, because they group people all across the state, in different regions. They meet in these councils. They do needs assessment work. They roll up all the needs assessments into one big document and cluster the top priorities for each region. That document goes to the commissioner of mental health, and she uses that to prepare her budget proposal every year for the governor. It is so organized and such a machine in the way that they do this, that they I'm telling you, I get as the Chair, I get to read all of the different regions, priorities vastly different across, but there's always common threads throughout. So it's such a fun process to pull all the pieces together and watch how the governor hears the commissioner say what's needed in terms of mental health and substance abuse in Tennessee. And I can tell you, as hard as it is, we can't take it all on, but I've watched the commissioner, the current commissioner of mental health, really listen. She attends the meeting, she shows up, she really listens and considers the feedback that's given to her through that needs assessment process. It is incredible and organized, and I think, a model of how you manage a state that has extremely different needs from end to end.
Carli 51:37
Love that I like to ask a question. So as you're seeing all of these needs, and they the threads, but they're also vastly different. I wonder, what do you think people's biggest misconception is when we talk about youth and mental health, and it is this buzzword, but what do you think people are really missing on this topic that you could shed light on?
Rikki Harris 52:03
Oh, man, that's huge. I think I'll speak to what I think has happened, and then maybe can get at what people are missing. We've done a really good job trying to reduce stigma as a society. I think what happened? We gave a language to students that we did not define. We gave them a lot of language in mental health, depression, suicide, anxiety, trauma, but we did not define what those terms mean, where it becomes clinical in its path and what to do about it. I think we help them understand they could speak to their feelings, but it's almost like if I feel sad about something that happened at school, I'm depressed and that confused and scared parents, and now we're taking our kids to care because they're saying they're depressed, and I don't know that we fully fleshed out the difference between daily or even like stages of life concerns and clinical issues for parents to be able to make a right decision about care. So that I think that's part of what has been misunderstood and what's sort of happening. And then kids use trauma language a lot, and trauma needs to be better defined, because there are, there are positive stressors in our life, and then there are toxic stressors in her life. And so really looking at the lay of the land, I think it's this toxic stress thing that needs to be better understood, so that we can prevent and protect children from the toxic stress, but continue to expose with confidence so the positive stress, so that we can then teach and they can learn.
Spencer 53:54
That's great, Ricky. We could cover all kinds of additional things and just go on and on. We have a tradition we do at the end of each podcast that we give you three short sentences to have you fill in the blank. Okay, so I'll read you a sentence. Read the sentence back to me with the blank filled in with whatever comes to mind. Okay, all right. Here's the first one. Access to mental health services is important, because blank,
Rikki Harris 54:24
These are good.
Spencer 54:26
You're like all three we got. They're all all tricky for you.
Rikki Harris 54:29
That's really good. Access to mental health services is important because the faster people get care, the faster we keep getting better as society. It's good for everyone?
Spencer 54:43
Tennessee needs blank to more effectively address mental health challenges.
Rikki Harris 54:53
So many things I could think of to go in the blank, but Tennessee needs more mental health care for professionals.
Spencer 55:06
That shortage is so acute. It's,
Rikki Harris 55:08
it's, it could be a whole podcast. Yeah, yeah, yeah.
Spencer 55:14
Leadership in nonprofit organizations requires blank.
Rikki Harris 55:22
Mm, leadership in nonprofits requires, I'm gonna say, guts, but I feel the need to explain, because I think all leadership requires guts, but in nonprofit, you will never get ahead of the old adage of nonprofit, of being, you know, wearing many hats, and all the things that people say about nonprofit if you don't have the guts to fight and do something different, and we talked about it earlier, that focus, that laser focus on mission and keeping your heart on the part that you were assigned to do as a leader and not getting too distracted.
Spencer 56:09
Well, Ricky, I can tell just in this time with you that you're a great leader. I would say that you would make a heck of a for profit business leader out there, and perhaps you missed your calling in that space, but clearly this is exactly where you should be absolutely and to see what you're doing in the mental health space is really important. Learning about Tennessee voices and knowing that we as a culture, as a society, have a huge problem. And there's a million people lining up to say, why? But you all are truly there in the trenches with the collateral damage of it all, and saying, You know what? We can reduce it to say we know that these things cause fire, like this form of trauma causes a fire in somebody's life. These are, these are 10 things that cause fire, so let's just light fewer matches and and that, remarkably, de politicizes the whole conversation, because there is not many people that are, you know, pro childhood trauma in X, Y and Z ways. I mean, it's just not, it's like, we're all like, let's have less of that, and I think that's a great framework to go through, but I also think that as a result of what you've done here, you're going to have the chance to be able to speak to nonprofit leaders that are likely almost all a lot smaller, that want to understand how To do more of what you've done. And so I hope you really lean into that, because you probably see it. But Carli, and I definitely see it that as acute of the shortage there is in the mental health space, there is an acute shortage amongst people that are in leadership and nonprofit, that have an amazing heart, but have no idea how to do what you've done in your time. So it's been really nice to have you here. And congratulations on your success at Tennessee voices. Thank you for helping us get a lens into the work that you're doing, and we're excited to give you a little megaphone today, and hopefully you end up putting out more and more of those causes of fire and give us a better generation for tomorrow. Well,
Rikki Harris 58:28
Spencer and Carli, thank you. I appreciate you bringing light to this topic. So appreciate it.
Spencer 58:39
Ricky Harris with Tennessee voices, the CEO there. I really liked hearing her leadership. It is clear that she's doing very important work at Tennessee voices work that as long as there are humans on this planet, still, there's going to be a need for people like her, organizations like Tennessee voices, she joked saying our goal is to go out of business someday, and all that's happened is her organization is 10x so I appreciate the aspirations to it, but the Reality is that this is going to be needed more, not less, for the days that are ahead. And to hear her style of leadership was not like most nonprofit leaders that I get to talk to. She had real clarity of the mission, and she understood that not everything is hers to solve, and in a space where it would be easier to default towards, well, let's just be empathetic to everything, because mental health is so vast. Instead. Said she kept focusing on the childhood traumas and say, we know that these things statistically result in bad outcomes for our children, so let's try to have fewer of these things happen.
Carli 1:00:16
Yeah, I thought that was powerful. I thought it gave context and voice to what, not only what Tennessee voices is trying to do, but, you know, I think a lot of times we sit and we think, oh my gosh, who am I to be able to solve this epidemic right of childhood mental health crises? And she, she identified the elephant, and now she's gonna start eating the elephant, right? Like the old adage says it's like, how do you be an elephant, bite by bite? And so she identified and named the elephant. And that is so powerful in a place where we feel so helpless. One thing that I also found really interesting, something I've been trying to pick apart in my own brain and my own development, my own work, if you will, is the power of empathy. And she even used it talking about what she trying to do is identify these empathetic people and how to lead empathetic people in an empathetic field. And kind of a buzzword of this generation of this time and space. But what is and isn't empathetic? And I think I'm naturally, we say this all the time, like I naturally would lean on the side of being so empathetic that I would outgrow my scope of work, right? I think everything is mine to do, and every pain point is mine to fix, because I can't stand it. And in my own development, realizing it is not empathetic to have do the work or it is not empathetic for it would not be empathetic for her to try to so broadly fix it, that she fixes nothing, and that there's boundaries around empathy. And when you go outside your scope of work, in that space, you don't you no longer empathetic. You're actually being a harm. Yeah, and I think that that relates to nonprofit work. I think it relates to for profit work. I think it relates to government work, and I think it relates to my job as a wife and mom too, of knowing what is mine to do, what isn't mine to do, and where do I actually harm when I'm trying to help?
Spencer 1:02:15
Yeah, I like how she talked about burnout too, because that's another one that can get hijacked really quickly into very poor work habits, poor work ethic and overall lack of productivity. To say, well, we don't want to burn out. We need this work life balance. And that can go too far, for sure, but I think she did a good job of saying this industry in particular has unique aspects to burnout, because most people that are attracted to providing mental health services have something that they're drawing on themselves like there's a reason why they're here to serve others, and they're doing it knowingly, for less pay than what they would get as other types of medical professionals, and doing it in a nonprofit setting is another way that they're going to unfortunately be paid less so addressing some of the realities of the people that make up her staff to say we have to be extra aware of burnout and secondary trauma here, I think is a really smart approach that didn't at all to me, smack of We just want you to have great work life balance. And I think we had a lot of fun. In the episode, you did a good job of a couple different times saying, it's not a bubble bath, you know, if I hear one word, person tell me that I must smack them. And that made it really real. And I think it was fun to see her come to life in that as she laughed with you. Of just, yeah, these are a whole bunch of garbage things that are that voodoo, psychology science stuff that isn't actually the real thing. Here's the real thing, no, because
Carli 1:04:11
the goal isn't to just like, feel good, right? The goal is to equip yourself with what you need so you can keep fighting. And that's a very different mentality. And I think too to your point earlier, we are meant to have a purpose. We are meant to have a target. We are meant to aim and shoot. We are meant to go and the least happy people I know are the people that don't embody the sense of purpose that don't say I don't care if it's hard, I don't care if I don't sleep, I don't care if I don't feel good. I have something I have to get up and do. And on one hand, you think that's better, like my kids think that all the time. Oh, I can't wait for school to be out, and I can't wait to not have to do this sports season or that. Yeah, and then they get kind of listless because they don't have their mission to go on. And so I think what she was speaking to is these are really mission focused people that just don't know how to take off and put back on the armor that they need to carry to do their job well. And I think that's unbelievably relatable, not only to every other leader in every other sector, but to everyday people just trying to carry the mental load of what they have to do day in, day out, and not let it take them down.
