Adventures in psychiatric reform: 31st March

Welcome everyone!

Welcome to the update newsletter portion of the psychcrisis.org Substack. This started as an email I sent to roughly six friends a few months ago, in exchange for emails of encouragement with heart emojis in them. (Those are still, and always, appreciated.)

What did I try?

• I applied for, and got, a $60K grant from Emergent Ventures to start this organization! To be honest it will be mostly going towards paying me a salary this year as the fledgling org’s only employee. 

  • This also triggered a number of heartfelt, personal, and occasionally slightly overwhelming messages of support from strangers who wanted to encourage the work I’m doing. This was -so- fucking beautiful and I’m glad for it. I hope my heart can grow to the size needed to take all this in.

• I moved this mailing list to Substack, (slightly more legit than my spreadsheet of email addresses) and published two posts:

  • Funding alternatives to inpatient crisis care

  • The Relational Reimbursement Paradox

• I am building a board! 

  • I need to do this next in order to legally start the org.

  • It needs only be tiny and I have one member lined up already; I only need one more. If you know of someone who might be interested, with aligned interests and knowledge and connections for fundraising in particular, please tell me.

• I’m prototyping a ‘make fast decisions in a crisis’ website

  • It’s really difficult if you’re in crisis yourself or have a loved one in crisis to decide what to do and when to do it. Existing websites are too complicated and avoid mentioning the realities of crisis care like the risk of sectioning. The vision is to be something that ranks high in the Google results for searches like ‘what to do when someone’s suicidal’ and integrates accurate information about the programs available without getting overwhelming or out-of-date. Lots of assumptions to test here, but the MVP’s in progress.

• I went to Peerpocalypse in Oregon

  • I talked to the directors of a handful of advocacy and licensing nonprofits and learned about how funding and labour market constraints influence their operations

  • It turned out to have predominantly addiction-recovery focused attendees, and few crisis organisations; this probably isn’t an event I’ll focus on in the future

• I finally told all my parents what I’m doing :P (Those closest to me are sometimes the most intimidating audience). 

What happened? What worked? What did I learn?

• The agreement to do funded research I mentioned in the last update fell through. Main learning is to always have backup plans, but I think that was already becoming clear!

• (Possibly only exciting to me, but) After around six months of persistence and emailing maybe six different people (some of them, repeatedly) I finally got ahold of a 100-page retrospective document from Parachute NYC I’d been hunting for. I am excited to use this as the basis of a Parachute NYC case study.

• I’m thinking a lot about how to develop ways to measure the success of bets and stay accountable without getting locked in to plans that rapidly become outdated. I’ve been exploring the ideas in pivot-triggers.com (with influences from product management) and want to find a way to document the bets I’m making and how they turned out in a way that accumulates over time. I came up with a -lot- of ideas for bets. My hope is this will make sense to at least some EA-adjacent funders too (even if it’s not quite cost-benefit analysis).

• I reviewed a bunch of planning documents and meeting minutes from the Alameda County MH crisis departments, to figure out how to build relationships there, and wrestled with feeling somewhat disheartened for a little while–it’s evident that there are good people working on sensible projects with reasonable amounts of money and feeling like they’re making some progress even if the field as a whole isn’t; I have a lot of respect for them and got more of a felt sense of ‘people are well-intentioned, there isn’t an obvious, dumb solution here that nobody has implemented yet’.  

• I’ve interviewed enough mental health workers that I start hearing the same things over and over:

  • Publicly-funded orgs hire workers who need the hours to get their licenses as social workers or therapists; it seems this is a main reason people accept bad hours and low pay, and why people churn out when they’re done

  • Getting Medicaid billing for anything is a giant pain

  • Workers tend to work via appointments and are pressured to take on high caseloads–15 is low and 50 is high.

  • Funding stability is a main stressor.

• I’ve done a first case study-style interview of a user experience of the crisis system. I won’t spend a huge amount of time doing these I think until I have a better understanding of who their audience might be (local administrators).

What am I doing next?

• I will be at EA Global in London April 15-17, to meet potential hires and funders (I’m no longer going to EAGxBoston). 

• I’ve developed a ‘psychcrisis.org is a small organisation with more than one employee’ budget proposal and have some calls lined up with potential funders 

• I’ll be on a handful of podcasts next week, starting to talk about the project and my plans. 

• I’m still yet to publish the case study on Soteria Alaska, although most of the work has been completed, and I’ll also complete the Parachute NYC one soon. 

How can you help?

• Tell me who you know who would be an ideal second board member! 

  • Ideal traits: business-minded, thorough, a good connection for fundraising, cares about psychiatric reform, and prioritizes systems change.

• Tell me who I should meet, as a potential funder! 

• Share this mailing list, with someone you think would like to follow along.

• I’m currently combining analysis posts with project updates posts into the same stream of Substack content. Do you have opinions on this? Would you prefer they were separate? Let me know!

Much love, to all of you <3