Heidi Otway: Carali, thank you so much for being a guest on this Fluent in Floridian podcast. I'm so thrilled that you drove all the way up from Ocala to join us here in our studio today to talk with us about NAMI and your career and the work that you're doing to help Floridian. So thank you for being here today.

Carali McLean: It's my pleasure. I'm really happy to be here. I'll drive just about anywhere to talk about mental health awareness.

Heidi Otway: Well, I really appreciate that. So we like to start at the beginning and dig into your Florida story. So my understanding is you and your family moved into the Sunshine State.

Carali McLean: We did.

Heidi Otway: And you grew up in Pinellas County.

Carali McLean: I did.

Heidi Otway: Which is one of my favorite places. I lived there too. So tell us about your upbringing in Florida.

Carali McLean: Sure. We ended up in Florida, my father, when he was in the Army in the '50s, he spent some time in Florida and fell in love, and that was his dream. And in 1967, he got a job at WLCY TV station.

Heidi Otway: Really?

Carali McLean: He was in broadcast news and moved us to Florida from Oklahoma.

Heidi Otway: Okay. Now you got to me. What part of Oklahoma?

Carali McLean: Oklahoma City.

Heidi Otway: Oklahoma City.

Carali McLean: Yeah.

Heidi Otway: I lived in Tulsa, Oklahoma.

Carali McLean: Really?

Heidi Otway: Yeah. I worked at one of the TV stations out there. Small world.

Carali McLean: Small world. Wow. So Pinellas County was very, very different in the '60s and '70s. They had cattle ranches, they had orange groves, and McMullen Booth Road, which is now like six lanes and always busy, was a two lane road and sometimes the chickens ran across it and there was undeveloped beach at Sand Key. No hotels, no condos. You could just go out on the dunes and enjoy it. And I know progress, things change, but I do miss that part of Florida. It was a privilege to grow up there.

And because of my father's job with broadcast news, I had some very special privileges. One being, being at Disney World before it officially opened. They had a media day and the journalists and broadcast news people and their families got to come to Disney World before it opened, everything was free. The lines were small. The Haunted Mansion was just the wickedest thing I've ever seen. I know now it's very dated, but in 1971 it was pretty cool.

And the other thing that always stands out as my favorite childhood memory, Apollo 11, and that was July 16th, 1969. And my father forged press passes, which I brought to show you.

Heidi Otway: Really? Wait a minute you all. If you can't see, look at that. Wow.

Carali McLean: I was a 12-year-old press technician. I don't think I fooled anybody with this, but he got us onto the base, so we were actually able to be right on the base when the launch happened. And I will never forget that experience. And he said, "Yes, I lied, but it's history in the making and I want my children to be there."

Heidi Otway: Wow, that is so remarkable.

Carali McLean: It was. And I've always had a heart for the space program and for Florida's part in it, it's exciting that we're such a part of such a forward-thinking adventure.

Heidi Otway: You grew up in Pinellas County, you had this amazing experience with Disney World being the first person there, being a part of what we like to call old Florida. When we didn't have all the highways, we actually had more trees and more outdoor spaces. And so what are you the oldest, the youngest, how many siblings?

Carali McLean: I have an older brother, so it's just the two of us.

Heidi Otway: What was your career trajectory, so you were living there, where did you go to college, how did you matriculate to get into your career?

Carali McLean: Okay. I actually got an interest in psychology when I was about 11 years old.

Heidi Otway: 11, wow.

Carali McLean: And there's a joke in our field that says that when there are dysfunctional families, rich kids hire shrinks and poor kids become shrinks.

Heidi Otway: I've never heard that.

Carali McLean: There's some truth in that joke. And as I mentioned, childhood had many wonderful memories, but there was also some undiagnosed mental illness in my family. And of course in those days, people didn't recognize it. If you could get up and get to work and put food on the table, you must be okay, no matter how you felt internally or how you interacted with the people you loved.

And as a child, I wanted to understand things. I think that's just in my DNA. And I learned about psychology and I thought, "Oh good, a science that has everything figured out. This is great." I had a little disillusion later, but I started reading and it did give me some tools to step back and understand that people's behavior has motives that sometimes they don't even understand. So I really wanted to be a psychologist.

Unfortunately, I got a little bit derailed with an early marriage and motherhood, and I didn't get back into school until I was 29. Then I went to USF. I had started working at a mental health center as a medical records clerk and got to talking with the counselors. And because I'd had that past interest, I started volunteering and helping with groups and found that I really did like that process of helping people. It's something that makes you feel like you did something valuable with your time.

And I was encouraged to go back to school and encouraged to go into social work because it's a very practical degree.

Heidi Otway: Really?

Carali McLean: Social work is welcomed anywhere. We can work in schools, we can work in nursing homes, mental health clinics, government. So I got my bachelor's from USF. And I will tell you that my time at USF felt like finding home.

Heidi Otway: Yeah. Tell me why.

Carali McLean: Oh, it was a wonderful environment where I learned things about myself. I learned things about what the future could hold and the potential that people have to change. And I love social work's perspective. We are very much about the person and environment. We understand that people don't live in bubbles or isolation. They're affected by the family, they're affected by their community, even global things. Look at the Covid epidemic that had an effect on people.

So we can't ignore that. We have to look at that and look at the whole person. And that perspective has, I think, been a foundation for me. So after I graduated with my bachelor's degree, I worked for about a year, and then I went on for a master's degree at FSU up here in Tallahassee. And that was also a great experience, very rigorous. FSU has, I'm going to brag, one of the best social work schools in the country.

And I learned so much about families and helping to counsel people, but also that macro policy level, which is a little bit unique to social work.

Heidi Otway: Tell me about that.

Carali McLean: Social work has its roots in refugee resettlement in Chicago.

Heidi Otway: Really?

Carali McLean: Yeah.

Heidi Otway: I didn't know that.

Carali McLean: So it wasn't like people necessarily having mental health issues, although I'm sure some did. But it's coming to a new environment where you don't know anybody, you don't even know the language, you don't know the customs, and you've left everything behind. And so Jane Addams started Hull House, which is the foundation of social work to help people adjust to new environments and strengthen their coping skills.

Heidi Otway: Wow. I had no idea.

Carali McLean: So we look at not just what's happening within a person, but the policy issues that affect our lives, the decisions that the folks down in the capitol here, down the road make, that has an impact on our mental and physical wellbeing that can't be ignored.

Heidi Otway: I would even say at the national level too.

Carali McLean: Absolutely. There are things going on now that...

Heidi Otway: Yeah, I'm sure are making people feel a certain kind of way. That's so fascinating. What was your first position after you got your master's degree at Florida State?

Carali McLean: I became an outpatient therapist in a substance abuse clinic providing treatment. I had a lot of women I worked with who were involved with the child welfare system due to their substance abuse. And that was very eye-opening because we tend to sometimes be judgmental about people that we think are bad moms, but so many of these women, when you scratch the surface, there was trauma, there was abuse. They weren't parented very well themselves. And so we were expecting a lot out of people that didn't have a lot of resources. So being able to be an advocate as well as to help them to heal and to grow and to reunify, it was very rewarding.

Heidi Otway: Since you brought up Covid and how Covid impacted a lot of people, our mental health, our physical wellbeing, all of those things. And it seems like since that time period, people are more open to having these kinds of conversations about mental health, and their traumas, and their experiences, and all the things that may have shaped who they've become. So can you talk a little bit about how this conversation has evolved since you were in college in your first job and where you are now?

Carali McLean: Oh, absolutely. I think it's grown so much. One of the things that impresses me when I was with NAMI in Marion County on their board, the junior high, I'm sorry, middle school, see how old I am?

Heidi Otway: Oh, that's all right. It's like middle-

Carali McLean: Middle school kids. They have projects where they can pick a charity and they raise money and they give it to the charity. And for at least three years running, they have picked NAMI Mental Health where in the past, one of the teachers had told me, "Boy, it used to always be animals, animals, animals. Now it's mental health." And when we accepted the donation, we would talk a little bit about it. And it was amazing how open these young people are to talking about feelings, to talking about mental health, and they're hungry for resources and information.

And that's a huge change because I know when I was growing up nobody talked about it, that's for sure. And it's even changed from the time when I got my BSW to now there's just so much, as you say, more openness, more willingness.

Heidi Otway: And I would like to explore that just a little bit more from a multi-generational perspective because we have five generations in the workforce right now. And to see, just from my own experiences having a younger staff, they're very open about, "I need space right now because I feel overwhelmed." And the ability for them to say that and have a workplace that allows that kind of feedback. So when you're talking with different organizations and groups, especially in your role right now, do you see that happening in the workplace more where people are allowed to share how they feel and they're not ostracized or minimized?

Carali McLean: Absolutely. And one of the things that NAMI is very big on is workplace wellness. And we have programs specifically to go into a company and to provide training to managers and informational training to employees because we understand that managers aren't your therapist. We know that. So they have a role, they have boundaries. But within that, there are ways to be approachable. There are ways to ask somebody if they're having stress, if they're having trouble.

We encourage companies to write into their policy manuals that your paid time off can be used for any kind of illness, whether it is a mental health issue, whether it is a physical issue. And that makes it okay, that normalizes it. And I do think there's been a huge shift where people are more aware and they are more willing to say, "I need a mental health day."

Heidi Otway: Oh, yeah. We have mental health days.

Carali McLean: "I am having stress, and I've got to take care of myself." And we do, we have to. So that acceptance has been wonderful. Now, statistically speaking, one in five adults does have a mental health diagnosis, and most of these folks are in the workforce, and they are living the best that they can and doing the best that they can. So again, we don't expect companies to be treatment centers, but we want them to be open to this. And it helps with workforce retention.

The statistics will tell you that when people rate their mental health as good or fair, they actually have about two and a half days of unexcused absences or unplanned absences in a year. People whose mental health are poor or fair tend to have 11 average days of unplanned absences. Think what that does to a business. So it just makes sense to have a workplace where people can ask for help and can receive it.

Heidi Otway: So what are some resources that are available to not only the lay person, but also to that organization or that business to help them maybe provide resources to their employees?

Carali McLean: Well, I encourage anybody to go to the NAMI website. It's nami.org. You're going to find a ton of resources for workplace wellness, informational handouts, a lot of links to services. NAMI is very big too on education. We have education for people who have mental health issues and education for their families and caregivers and ongoing support groups as well. And everything we do is free.

Heidi Otway: Well, that's good. It's free, you all so you have no reason not to take it. So earlier we were talking about addressing mental health issues almost at a policy level. Talk about some of the changes you've seen in policy in the state that have been helpful for people who have mental health issues and for the industry in general, for the support and the physicians, the doctors, the social workers who are helping people?

Carali McLean: Some things that have been really good, they have adjusted some of the criteria for involuntary treatment. And it's a fine line because people do have, as one legislator once told me, people do have a right to make bad choices, but there's greater recognition that there comes a point with addiction or with mental health issues where the choices really aren't voluntary.

We've seen the research where people's brains actually change due to trauma and change due to substance use and addiction. You can literally see the changes. So choices become kind of shades of gray. How much is it really a choice? Because originally these kinds of laws, to get somebody ordered into treatment, they had to pretty much be on the verge of harming themselves or others. They've now built in a little bit more willingness to look at is somebody continuing to relapse or continuing to have episodes of psychosis, which every time is causing more physical, emotional, and social damage and can we intervene a little earlier?

And ideally we want to get people into outpatient treatment voluntarily and services voluntarily, but sometimes they need a little push at first. I think that's been one big change. A huge change has happened this session. Senator Bradley sponsored what's called the Tristan Murphy Act. It's named after a very unfortunate man who had psychosis who ended up in prison and committed suicide in prison. Yeah, very tragic story.

And what this bill has done is created several off-ramps. So if somebody's arrested or somebody does come in contact with the criminal justice system and there is a mental illness, they can be diverted to services and resources sometimes under supervision of the court if that's appropriate. Sometimes without that, if that's appropriate. But we finally will have some options. Now the key is going to have services to divert them to.

Heidi Otway: Have you seen an increase in mental health services in the state of Florida over the years?

Carali McLean: Definitely. And one of the things that's very encouraging is seeing a push towards integrated primary care and behavioral health.

Heidi Otway: Tell me more about that.

Carali McLean: Primary care physicians do a lot of mental health treatment, whether they want to or not. They prescribe antidepressants, they prescribe different medications to people. So one of the things NAMI does, we have a program called NAMI Provider where we can go in and help educate primary care physicians and nurses on, "This is how you deal with somebody if there is a mental health issue along with the physical issues that you're treating."

And I had worked at a federally qualified health center, which they are very strong on integrated care. So I was a clinical social worker there, and I loved it because somebody might be referred to a mental health center and they'll never go because they have to go somewhere else, tell their story, fill out paperwork. They don't want people to see their car in the parking lot, whatever. But if they're in the primary care clinic and the doctor says, "Hey, you seem stressed. I've got a lady down the hall who specializes in helping people with stress, will you talk with her?" They will. And then you can engage and you can help. And that's another exciting development that I hope increases.

Heidi Otway: And I like one of the things you mentioned is that you kind of reframed it, it's "Your stress," it's not using the more a negative term like, "You're having a mental breakdown." You know what I mean? So it's almost like the terminology has changed to kind of remove the stigma. Is that safe to say?

Carali McLean: I think that's very safe to say. And that's easier for people to hear, and that opens the door because we do a lot to try to get rid of stigma, but a diagnosis can feel like a label.

Heidi Otway: So what drew you to NAMI? I know you were on the board, you have your master's degree. You talked about, what was it, the BS-

Carali McLean: BSW. Bachelor's of social work.

Heidi Otway: BSW. Bachelor of social work. So what drew you to NAMI?

Carali McLean: NAMI is so unique because we have our origins in grassroots. It started with families sitting around a kitchen table who couldn't get the help and support they needed in 1979. So they started NAMI. They didn't call it that then, but it evolved to that.

Heidi Otway: What was it called, by the way?

Carali McLean: I believe they had... You know what? I don't remember.

Heidi Otway: Okay. We're going to find out. We'll let you go.

Carali McLean: But we've never lost that grassroots feel. And anybody that's working in NAMI or is volunteering or involved, we're either people with our own lived experience with mental health issues, or we are people who have a loved one. So we're not just providing trained knowledge or academic abstractions. We are talking from lived experience. We are talking because we've walked that walk.

Heidi Otway: How long have you been with the organization in your previous positions to where you are now?

Carali McLean: I started with the NAMI Marion board about 2019, and then I became the Interim Executive Director for a year. And then I've been in my current position a little over a year.

Heidi Otway: How are you liking it?

Carali McLean: I love it.

Heidi Otway: You're smiling and everything.

Carali McLean: I do.

Heidi Otway: So what are your goals for the organization? Where do you see it going? We talked about we're seeing changes in general from the way we talk about mental health, the more resources available. What is your vision for the organization?

Carali McLean: Well, NAMI has kind of an unusual organizational structure. We have the national organizations, state organizations, and then local affiliates. And the local affiliates, we have 20 in Florida. They're the boots on the ground. They're the ones doing the programs and education. At the state level we really focus on building capacity, policy and advocacy. And we also train people to deliver the NAMI programs. They have very structured training.

So the vision for that, one of the things we're very big on is expanding NAMI services into underserved counties. We've got an appropriation before the legislature, of course, who knows what's going to happen. But if that comes through, we will start expanding NAMI services into some of these rural counties around Tallahassee where there is a high need and not enough access to services. So that's the vision is to grow NAMI so that anybody that wants to attend a NAMI group is able to do so in their own community.

Heidi Otway: What are the kind of careers that, when we think about for that growth, you're going to need people to be in the workforce, so what are the typical careers for somebody who's working in this industry, in this space?

Carali McLean: Well, with NAMI a lot of our people come from fields totally unrelated to human services.

Heidi Otway: Really?

Carali McLean: Yeah. But they're there because of their own experiences and their families, and they get trained in how to help people using the NAMI tools. So there's really not a specific career path. Some of us are clinicians, but others of us come from totally different walks of life.

Heidi Otway: So we've been hearing a lot about veterans coming back and needing this support. So can you talk a little bit about the work that you all do to support our veterans?

Carali McLean: Yeah. We have a program called Homefront, which is educational program to support the families of veterans and active duty military. And one of our visions is to have more specific support groups for veterans. One of the challenges with veterans is so many of them, especially if they've been through combat, been deployed, they have seen things. And for them, it feels like there is a shadow that never leaves them. There is something that separates them when they come back and they can struggle with feeling that no one will understand, except other veterans. So it's really important, I think, to have groups specifically for them so that you overcome that barrier.

Heidi Otway: Do you find veterans who may have overcome their challenges, moving into this career path to help other veterans?

Carali McLean: I think that happens a lot in the VA. You will see that, and I hope we can recruit more veterans to work with NAMI because the ones that have been able to process that trauma have so much to give.

Heidi Otway: All right. So if you all are listening and you're a veteran-

Carali McLean: Please reach out.

Heidi Otway: Please, reach out, reach out. Because we love our veterans and we want them to have the best life possible for their service to our country. So if you could share one message about mental health with Floridians, what would it be?

Carali McLean: We all deserve support and I believe that we can get to a place in Florida where we recognize that reaching out for help is a sign of strength. And where recovery is not just a possibility, but it's an expectation.

Heidi Otway: Wow. I've learned so much, and I hope our listeners and viewers learned a lot as well. And, Carali, I want to thank you so much for your compassion, your passion, your dedication to Floridians who are experiencing mental health issues, or stress, or trauma, and the resources that you're providing through NAMI. So thank you for all that you do in your organization.

Carali McLean: It is a privilege, and thank you so much for having me here.

Heidi Otway: Thanks.