I find myself returning again and again to James Baldwin’s quote that Amy Etzel used to open day one of our Behavioral Health Summit – “Not everything that is faced can be changed, but nothing can be changed until it is faced.” This rings true for a person, an organization, and for our country. We have to face issues, situations, parts of ourselves that are uncomfortable in order to create the more equitable world that we talk about wanting.

I think about the times that I did not speak up when I should have, and the times that became uncomfortable after I did voice my concerns. I regret much more the times of inaction. There are certain subjects about which I feel more able to speak up – and I am sure this is true for all of us. Some of these moments require us to point out where our friends, colleagues, or family members are showing bias or a microaggression of which they may or may not be aware – laughing about the amount of letters in LGBTQ+, thinking that someone who is black does not need as much pain medication as someone who is white, joking that women are not good bosses because they are too emotional. We all need to point these moments out.

I think about the many ways that our Bree Collaborative has tried to point out the more systemic issues in our health care system and worked to make change. Awareness – facing these issues – is the first step but is not alone sufficient. In our shared decision-making recommendations, we talk how organizations go through the same stages of change that a person does – precontemplation – contemplation – preparation – action – and maintenance. These stages are similar to the exercise we went through together on day two of our Behavioral Health Summit. We asked our attendees to pick an action area, think about their current state, envision the ideal state, think through barriers and resources needed, and pick necessary team members to make the project work. Some organizations are already in this preparation stage while others may need to be made aware of why screening for suicidality is important enough to spend time doing.

Facing change is hard work – we are here to help. All of our webinars and the summit are now available on our Bree Collaborative YouTube channel. If you have a moment, I would encourage you to look at our list and see which topic might be a good starting point for you or your organization – maybe trauma-informed care from our summit day one – maybe motivational interviewing from the June webinar. After this first step – you can move into preparation (to use the stages of change) we encourage you to complete our action plan worksheet. For each of our behavioral health topics we also have tools to help with implementation – a shorter and more succinct checklist – a longer assessment that includes all the recommendations – and a list of core measures to track progress.

These can be hard conversations to have and we want to support our health care community as we move into and through these stages of change – reach out to us at bree@qualityhealth.org.