The Harris Center for Mental Health and IDD is the largest mental health & developmental disability care center in Texas and provides services to over 88,000 people every year in Harris County. The organization’s mission is to transform the lives of people with behavioral health and IDD diagnoses through an accessible, integrated and comprehensive recovery-oriented system of care. Many of the people The Harris Center serves have limited resources, so the organization strives to provide cost-effective services with the highest level of care so that people with mental disabilities can live with dignity as fully functioning, participating and contributing members of the community.

We spoke with Wayne Young, CEO of The Harris Center, about how his organization uses the Lifesize platform to deliver personalized care and consultations to their clients. Lifesize also helps Mr. Young stay in touch with a workforce of 2,300 employees spread across 86 care locations throughout the Greater Houston area. Recent events surrounding the COVID-19 pandemic has made Lifesize an essential tool for running and maintaining The Harris Center’s operations.

Transcript

Note: Transcript has been edited for clarity

John Yarbrough:

Hi, everyone. This is John Yarbrough from Lifesize and I’m here today with Wayne Young, who’s the chief executive officer for The Harris Center. Wayne, thank you. How are you doing?

Wayne Young:

I’m doing great, thank you.

John Yarbrough:

Well, we appreciate you making time to speak with us today. To kick things off, I’d love it if you could just share a little bit with me about The Harris Center. Could you help everyone understand what the organization is all about and the services you provide?

Wayne Young:

Absolutely. So The Harris Center, our full name is The Harris Center for Mental Health and IDD. We are the local mental health authority for Harris County, which is the third largest county in the country. We are responsible for ensuring service delivery to people who have serious mental illness and intellectual developmental disabilities, and our charge is really to provide services to those who have very limited resources. They don’t have insurance, they’re uninsured or primarily they may have Medicaid, but those who don’t have a lot of resources and need fairly significant help. They usually have very complex life situations and needs.

John Yarbrough:

When did the organization first launch and can you share a little bit about the origin story behind your involvement with The Harris Center and, and when this large Metro area that is Harris County first realized that this was a service that it needed to provide for the community?

Wayne Young:

Yeah, so we are in that group or cluster of providers that are often referred to as community mental health centers. We, like most of them, came about in the mid to late ’60s. As they began to try and transition people out of state hospitals and back into communities, they began to establish these community mental health centers to provide community-based supports, care and treatment for those individuals that we were trying to get back into their community and living in the community so that they would have all the benefits and luxuries of a home and community and partnerships and relationships and kind of all of the social context that all of us enjoy and appreciate.

Wayne Young:

So The Harris Center was in the mid ’60s created, we are technically a unit of government, and so we were established by statue. We are not a part of the county government, although the county is our sponsoring entity. In fact, our governance structure is created of a board of trustees who are appointed by our county commissioners. So through that appointment we are accountable to our county and charged with meeting our community’s needs.

John Yarbrough:

That’s amazing. So switching gears a little bit, we obviously are all experiencing a very significant and evolving health crisis right now with the spread of the coronavirus. But before we get into that, I’d love it if you could just speak a little bit about the time period leading up to this. Prior to the coronavirus, how would an organization typically provide the services that you provide to the community? What does that look like in terms of in person interaction with these folks you provide your services to versus some of the virtual programs that you also provide?

Wayne Young:

Absolutely. So it would say that really prior to my arrival, almost everything we did was face to face and traditional based, right? It was the way probably most providers had been delivering care for many, many years and we began to try and accelerate and move towards some virtual service deliveries. We did some innovative work. We just finished up a year long pilot with the Harris County Sheriff’s office where we use Lifesize and some mobile technology to allow us to actually provide a mental health counselor consultation with law enforcement when they respond to 911 calls in the community.

Wayne Young:

So we were doing some stuff. We began to do some clinic based remote tele-psychiatry. We would have providers who might be doing locums work for us in another state and we had our clients here and we would connect them using the Lifesize platform to deliver that care. But it was really kind of innovation driven or kind of necessity. It wasn’t a large scale rollout of the platform or reliance upon the platform, at least. We had rolled it out so that all of our equipment and desktop was consistent with and could utilize the platform, but we were not relying upon it on a day to day basis in the way that we are now in the face of this virus and our response to that.

John Yarbrough:

Yeah. Well, let’s talk a little bit about that. So how has the coronavirus impacted normal day to day operations? What are some of the things that you’ve had to change as a result of social distancing policies being rolled out by local and state governments, as well as federal recommendations from CDC, HWO and others? What does it look like for you and your team and the folks that you’re providing care to today?

Wayne Young:

Yeah, it is kind of turned it on its head, if you want to know the truth. It is upended significantly. We found ourselves … I had been on vacation and I came back and on Monday we said, “Okay, we got to get together and think about what this is going to look like if it progresses,” and this was several weeks ago. “How are we going to deal with a remote workforce?” We had seen some other large communities began to move towards shelter in place kind of scenarios or work from home scenarios, and literally that night on the news was our county judge saying that we’re moving in that direction and in fact we want people to work from home as much as possible and social distance. So the next morning we came in and said, “Okay, what we’ve been thinking about is a phased out approach,” or a phased in, depending on how you’re looking at it. “We got to turn that on its head.”

Wayne Young:

We’re a large … particularly for a behavioral health organization, we’re large. We’re about 2,400 employees, specifically focused on delivering services to behavioral health in folks with IDD. So within a matter of about a week, a little over a week, we transitioned about 1,700 t0 1,800 of those employees to working remotely from home and delivering care either via phone or via our telehealth platform. So it was a dramatic shift. It was one that no one would ever intentionally try and make that kind of shift over a seven day window.

Wayne Young:

But necessity ruled and not only do we need to ensure that we continue to deliver services and we’re an essential service provider, we’re an essential provider business. So we do have a responsibility and a need to stay open. But we also, even though that was the case, wanted to try and protect our clients and our staff as much as we could as well. So while there might not have been a requirement that we transitioned as quickly as we did, it felt like the right thing to do from a community standpoint and for the overall good of our folks served in our community and our healthcare care providers that are really working hard to try and make sure that we all stay healthy in these times.

John Yarbrough:

That’s incredible. That’s an incredible amount of change over a very short period of time. So you mentioned these changes started happening several weeks ago. When did you know that it was time? Was it based on the recommendations of local officials? Was that the tipping point when you decided that this was a time to start moving staff remote and thinking about virtual alternatives to the way that you did business?

Wayne Young:

That really is the trigger for it. Like I said, we were kind of having some dialogue about like, “Let’s get ahead of this.” Right? And then joke’s on us. Three or four hours later we were no longer ahead. We’re behind. Right? We appreciate those elected officials. We value their guidance and their input and it did accelerate our timeframe to try and meet that. We do still have some … we run a variety of emergency psychiatric services that are still operational in a face to face way. We also deliver our behavioral health care for our jail system, so we have not moved exclusively, but again, 75, 80% of our workforce is now remote. It was their guidance that was kind of the trigger that said, “Okay, we have to do it quickly as well.”

John Yarbrough:

You’re chief executive officer for a team that’s fairly large and you provide care to a community that’s incredibly large. I grew up in the suburbs of Harris County and so I’m very familiar with the Houston area that’s sprawled, just this large metro area with a massively growing population.

John Yarbrough:

What is your day to day looking like right now? How are you balancing both your own time and trying to be a leader to your staff as well as continuing to ensure that you’re able to provide these incredibly important services to the community?

Wayne Young:

Yeah, it is. Much like probably my team members, it’s a little bit up ended and a lot of it is being done virtually. I’m still coming to the office every day. I feel like if I’ve got a team that I’m putting out in the field, I need to mirror that and model the responsibility to ensure those services happen. So I’m still here, but a lot of our meetings … This morning we are partnering with the public hospital system in our community to roll out Epic, is our electronic health record and the implementation go live was yesterday morning. We had planned on a big party where we would have breakfast and snacks and our leadership team would come together, and there’s about 120 in our leadership team, and instead that event and that rollout happened via Lifesize and remotely.

Wayne Young:

So we had four people in the room. It’s a big room. It normally holds about 120 people. So we had four people live, very appropriately social distanced, and we had our partners from Wisconsin were on the phone and we had local public hospital folks and they were a part of the presentation, the normal kind of slideshow and that deal and that rollout still needed to happen. We can’t afford to get behind by a month or two because we need now more than ever probably for that record to get alive as quickly as it can so we can provide better collaborative care. So everything from big meetings to small individual, even my … We do have some folks that are still working here directly, but a lot of those even individual meetings, we’re using the platform for that so that we can maintain that distance and try and help ensure that everyone is a safe and healthy as possible.

John Yarbrough:

Yeah. Well, talking about your use of Lifesize for a moment and sounds like everyone’s sort of finding the tools to stay in touch with one another. Any changes to how you’re talking, keeping in touch with your team right now? Are you a finding yourself more inclined to use video or are you trying to shy away from it because you feel like you’re on the phone all day? What is your communication like these days?

Wayne Young:

Yeah, I think it’s a hybrid of phone and video. I think there’s times where that conversation just works better when you can see each other, especially to me in small team meetings. The big ones can get a little unwieldy sometimes. If you’ve got 120 people on the line, the background noise and the mutes and all that stuff gets to be a little tricky. But if you’ve got a meeting with five or six people, we’re almost exclusively doing those using video. Individual ones are having both video and phone, depending on what the nature of it is and that connectivity seems critical and that seems to be true for our workers who are delivering care as well. They seem to be flexing back and forth based on what makes the most sense. Some of our clients aren’t comfortable with technology and they would prefer a phone call and some of them really value the video.

Wayne Young:

It seems to me that this is an opportunity to try some things that we probably would have never wanted to take the risk of trying in a normal plan, a business continuity perspective. I’m curious to see what our learnings are going to be. I think it will change the way we work well into the future, even when we can get back to normal. I think there’s going to be some new norms about this that we all just develop and realize this can work very well for us.

John Yarbrough:

Yeah. Well, speaking of learnings and again as a leader or somebody that’s having to make really important decisions in real time with the climate and there’s different variables changing all the time, what are some of the things that you’ve learned through this process a few weeks in and where do you think that you have decided that you’re going to … you have conviction about the way that you need to keep your team together or that you need to coordinate with your stakeholders inside and outside your organization? Any key lessons learned three weeks into a health crisis that we candidly don’t yet know how long it’s going to take, how long we’ll be living in this new normal?

Wayne Young:

Yeah, I would say there’s a couple of lessons I’ve learned real quickly and I’m grateful for all of them. One is the ability to trust your team, right? There’s a lot of angst about will the services get delivered and will people be connected and will we be able to ensure that we keep delivering the care that we need to deliver to help our folks stay healthy and in recovery in the community? There’s been almost … we’ve got some dashboards that we’re able to look at and there’s been almost no drop-off in that component. So that’s exciting to me, to be validated that our team members are doing what they need to do and they’re committed to our mission. So to go from an organization where almost no one works from home to where almost everyone’s working from home, you haven’t developed the policies and the processes and the confidence and the culture that supports that so you don’t know exactly what that’s going to look like when you flip that switch.

Wayne Young:

But it happened and happened naturally. I think it’s been validating to me. The other thing I think is to provide a little bit of grace, right? So I’ve had some employees who they leapt in, grabbed it with both hands and were off and running. Right? I’ve had some other employees who they need a little handholding, they need a little extra support. We can’t do elbow to elbow support right now because of the distancing, right? But they need somebody that was there to walk them through this and we assure them a little bit too, because they weren’t comfortable with it. It wasn’t how they were trained. It’s a different model. They worry about does it have the same efficacy as it does and trying to provide that reassurance and getting, frankly, some of the research that suggests it is very similar in terms of outcomes.

Wayne Young:

But each employee or many of our employees seem to develop and be comfortable at a different pace and allowing for that flexibility and a little bit of grace that goes with it to allow people the opportunity to learn at a different rate and be uncomfortable with it and say that they’re uncomfortable and support them through that, I think it’s been really important for us and our workforce as well.

John Yarbrough:

Yeah, that’s, I think, important and flexibility and meeting people where they are I think is clearly something that’s meaningful for everyone right now, just a feeling like they have an outlet for their concerns and experiences. Wayne, well I really appreciate the time. Before I let you go, I was hoping I could just ask you to speak a little bit about the importance of mental health care professionals and services during this time. Obviously one of the things that’s top of mind for your community, for mine here in Austin, Texas and all over the world, is the impact the coronavirus is having on people in terms of stress and trying to manage through a health crisis that most of us have no precedent. We’ve never experienced something like this before. How do you think about both your organization’s purpose, your employees, the work that they do as well as how you’re serving a community and what I would imagine about as much of a time of need as any other that we’re likely to experience.

Wayne Young:

Yeah, absolutely, and I think from a personal level, I think we all need to recognize that this does impact us, right? Even people who don’t have … traditionally haven’t experienced some mental illness or had mental health issues or mental wellness challenges, they are going to be faced with new normals and challenges to that psychological safety that they’re experiencing and give themselves room to let that be normal and to experience that and to be okay with it and to talk to people about it. There’s something about … if you allow it to become stigmatized or you’re uncomfortable sharing it, it just makes it more powerful. To that point, we set out two weeks ago, a little over two weeks ago now, recognizing that there was a local need and there was the general angst and anxiety and stress.

Wayne Young:

It wasn’t a mental illness, it wasn’t depression. It was what does our world have? What’s happening in our world? What’s going on? How’s this going to be different? How am I going to get back to normal? When am I going to get back to normal? That disruption of people that’s happened in all of our normal social institutions. Churches and schools and work, those are three big institutions in our world and they’ve all been up ended in a way that none of us would have imagined just probably a month or two ago. So we did start off and we set up a local COVID-19 mental health support line to just provide trauma informed support and psychological first aid to those who are struggling. It was well received and in fact within about a week and a half it became the statewide COVID-19 mental health support line.

Wayne Young:

So we actually have a state wide support line people can call and reach out to at any time. It’s manned by counselors 24/7 to provide that support because this is impacting all of us and we set it up different than our normal crisis line. Every mental health community health center in Texas has a crisis line that we man and provide that critical crisis access to people for. But this isn’t crisis oriented. This is every day stress and angst and so we’re averaging right now between 175 and 225 calls a day on that line from all over Texas with people who are struggling. Frankly, we’re validating and supporting that. It’s not unusual for them to be experiencing the stress that they’re experiencing and we want to be here to support them with that.

John Yarbrough:

Well, on behalf of myself and the entire team at Lifesize, I want to say thank you to you personally as well as your entire team for the work that you’re doing. We recognize that many respects, they’re the front lines of providing a service that everyone in the world is … I think would agree is just essential and incredibly important right now. So again, thank you for the time and we appreciate all that you’re doing.

Wayne Young:

Again, part of what started this conversation was my expressing gratitude for y’all opening up your platform. Literally I had said to my IT guy, “We got to figure out how we get more spaces on Lifesize,” and he came back with the announcement that said y’all had expanded out and it made a huge impact. It was one less thing we had to figure out how to deal with and overcome in that stressful window of time.

John Yarbrough:

That’s kind of you to say. We’re glad that there’s at least a small thing, some steps that we’re able to do to support organizations like yourself. So thanks, Wayne. I appreciate the time. Thank you for sharing your story with us, and we’ll be sure to include the information about the hotline in our content that we put out.