Empowering Mental Healthcare: Talking with Alexa Brainin, CEO of Smokey Point Behavioral Hospital

Empowering Mental Healthcare: Talking with Alexa Brainin, CEO of Smokey Point Behavioral Hospital

[Music] Hello, welcome to Holding Ground, a show that tackles topics in mental health and psychotherapy for individuals, couples, children, and families. Our goal is to promote well-being by normalizing mental health challenges. I’m your host, Laura Richer, a psychotherapist and the founder of Ankorlight Therapy Collective in Seattle, Washington. For more tips and resources on mental health, visit ankorlight theapy.com or follow us on socials at anklite therapy. Welcome to Holding Ground, the podcast where we share a little bit of everything to keep you informed and inspired on your journey through psychotherapy, mental health, and emotional healing. I’m Laura Richer, the owner of Anchorite Therapy in Seattle, Washington. And each week, we dive into real conversations to help you show up for yourself and live a more grounded and connected life. Today we have a very special guest. I’m very excited to have Alexa Brain, CEO of Smoky Point Behavioral Hospital with us today. Hi, Alexa. Hi. Thank you for joining us today. Thank you for having me. I’m so excited. I am so excited to learn more about Smoky Point. Um I know that you serve a wide range of clients there, adults and teens navigating complex mental health issues. So I maybe just tell us a little bit about you. What inspired you to get into this field and what brought you to Smokeoky Point? Yeah, I well inspired me to get into the field. I feel like I’ve just always like wanted to help people and I think if you ask any of my friends, they’re like, “Yeah, that’s her. She’ll do anything for anyone.” Um, were you always the friend that listened to the drama? Always the friend who was like getting the phone calls. Um, and also it just it’s sort of I think in my it just I don’t know that’s just like what I’ve always wanted to do. Yeah. Um, so I think in terms of getting into mental health, I had really great mentors sort of along the way and someone was like to be a therapist, you have to get your masters. So, I I didn’t know that until I was almost done graduating with my bachelor’s in psych. Got my masters, got my counseling license, um got a call asking to interview for a position in a hospital and I like that’s cool and then next thing you know I’m here. So, I’ve been um with two of the hospitals in the company uh now Smoky Point and I was with our sister facility in Chicago. I had a wide range of roles there, uh, all clinical based, and then came out here to join the Smoky Point team, and it’s amazing. I I love the work that they’re doing there. I love the team that we have. Um, the staff’s incredible, and the community is it’s needed. It’s really needed here. It is very needed right now. Well, I know you offer a wide range of uh services and programs and serve a broad client base. So, maybe just tell me a little bit about some of those programs. Sure. So we have a 145 bed inpatient psychiatric hospital. Um the building has six units. So one of our most specialty units is our adolescent unit. So we have uh sort of two tracks running through that unit. Um really just based on what the adolescent is presenting with. So that’s going to be 13 through 17. Okay. And we have a board certified adolescent psychiatrist as well. And so what are some of those issues that teens present with that you treat? You name it. Uh we’re seeing a lot of just depression, anxiety, suicidality. Um we’re starting to see the onset of some of more of the severe mental health issues. Uh auditory hallucinations, vis visual hallucinations. We also see a lot of substance use. So um sometimes there’s a lot of co com coorbidities we see on the adolescent unit, but that’s actually really going to be across the board. So then the rest of our units are adult units. We’re going to have uh two three units of a little bit more um intense level of care and then we have a dual diagnosis unit. So that’s going to be uh both detoxes offered on that unit and then uh patients who are looking to work through issues with both their mental health and substance use and then a general mental health unit. Okay. All right. And so those are all inpatient programs and then you also have outpatient programs as well. Yes, we have a really great outpatient program and every inpatient track has a matching outpatient track. So, we offer an adolescent program, a dual diagnosis program, and then several mental health tracks as well. So, when uh someone’s looking to just access IOP, they’re going to be able to complete an evaluation and they’ll be put into the program that’s best needed for what they’re looking to work for. Yeah. So, people can start in intensive outpatient. They don’t always start in residential. Correct. Yeah. So, they don’t always have to start in inatient. Um they so we have staff on site 247 that can provide assessments at any time. That assessment is really going to guide the clinician who’s performing them as to what the best level of care is going to be. So if that’s inpatient obviously then they’ll be hospitalized. If it’s outpatient they’ll be able to start our IOP program. Okay. And so for somebody that was maybe seeking services or had a loved one that they were seeking services for, how would you know what kind of program you might want to be in? What for example with inpatient? what kind of um issues would be presented that would indicate that maybe somebody does need inpatient care. So impatients typically that’s going to be the highest level of care. So someone who is um really in crisis whether that means they’re thinking of taking their own life, they’re thinking of harming others, self harm, psychosis. Um there’s really those are probably just like very small in terms of the wide range of things that can be occurring. Um, but that’s going to be sort of that immediate crisis that’s needing stabilization. Uh, for some people that that still they can just be extreme levels of depression or really high levels of anxiety that are keeping them from living their dayto-day successfully. We can treat those on the impatient side. For some people, they’re not needing that intense level of care, but they’re needing something more than uh before they come see you once, once a week therapy. Um, so our outpatients five days a week. We require a minimum of a three-day a week engagement just to make sure they’re really getting what they need out of those programs. Okay. And would they be presenting for similar issues just not need as high a level of care? Yeah. But it could be substance use or depression or anxiety. Yes. Absolutely. So what are some of the common challenges that you’re seeing in mental health right now? Maybe even just across the age groups. What are some common issues you’re dealing with? I think we’re all and and obviously maybe you’re seeing this too. I think well first just the access to care. People feeling confident to access care is really barrier number one is like how do I access it? What do I do? Where do I go? So we’ve really just tried to be as accessible and as available as we can. they were so many just levels of anxiety, varying levels of depression, and we do we see a lot of um people looking to get help with their substance use um and just like longterm mental health struggles. So, people that maybe have um been in in uh care or you know, receiving treatment for certain diagnoses for 20, 30 years and they’re just still needing that level of support. Okay. And it and and speaking of access to care, I know you try to make that as easy as possible that you take multiple insuranceances as well as Medicaid, but that is tough for people to be able to navigate and know where to go and how to handle it. How do you help them? Yeah, absolutely. So, and I mean most of it is present on our website. We also have a 24hour line that you can call and ask those questions to as well as an online inquiry forum. But we do we take Medicare, Medicaid, all the managed Medicaids, and then, you know, we’re contracted with most private insuranceances uh so that we can really just provide care to to anyone who’s in need. I’m sure you’re aware like mental health access is limited. Yeah. And um it’s hard to find and also it’s scary to sometimes admit we need the help. So just being we really try to eliminate that barrier by being able to not have finances be a concern. So, how does your team support people that are in crisis? What does that kind of look like when somebody comes to you and they they maybe they don’t know how to navigate the health system and they don’t know what insurance they have? Yeah. No, that that’s a real thing that we see every day. So, really uh really what you’re asking me is like what is the intake process is kind of what that looks like. So, uh, whether someone presents to us as a referral from somewhere else or they walk into the facility, they will be greeted by my front desk staff who will just really ask like, “How can I help you?” And what they’re really asking is, “Are you here for an assessment? Are you what are you really needing right now?” We’ll then get them paired up with one of our intake clinicians. Our intake staff uh go through a pretty comprehensive psychosocial social evaluation so that we can then get those next steps. um whether we’re going to provide referrals. They’re they’re not needing inpatient. They’re just feeling like they’re not sure where to turn. We’ll get calls sometimes just asking for referrals like, “Hey, I I don’t know how to find this or do you know where I can start looking? We’re going to provide that s those services as well.” Um or our own, right? So, inpatient or outpatient levels of care. If they’re not meeting either of those, we’ll make sure that we give them a referral list that’s within network of their insurance. Luckily, we have ways of f helping people find their insurance. So, if they’re not sure or they’re not sure um there’s systems that we can use to try to help navigate um to make sure that they know if they’re covered or or work with them to make sure they can still access care. So, that is so fantastic. One question I wonder about is do you have families, maybe parents of teens or maybe loved ones, um, who want to get somebody into services, but maybe that person is a little resistant or there are challenges to that. So really, we have a team of people that are ready to help at any time. So sometimes really what it just takes is uh getting that loved one on a call with one of my staff to just hear about the process or the program and that they don’t have to do it, but it doesn’t feel as scary as maybe they’re thinking it is. So we’ll go through uh the the programs that they experience every day and the intake process and the any barrier they’re thinking exists, we can walk through with them. We can give families referrals. we can walk them through um best steps that you know they can take in terms of just um talking to their loved one getting kind of external support maybe especially with an adolescent maybe who they have the best rapport with and maybe it’s not mom and dad but it’s the school counselor or uh their their best friend or their best friend’s mom. So um we can kind of just give some of that support to try to help that person get the care that they need. Oh that’s fantastic. What are some things that if somebody’s kind of questioning, you know, should I call Smoky Point? Is this the right place for me? What are some of the things they might be experiencing that would indicate to them that you would be a great resource? Any true mental health question, I’m like, just call because you don’t know. And really, I I can’t stress this point enough. Mental health has quite the stigma around it. even though we preach self-care and and we we’re talking about it more and more that it’s really scary to say like I’m I’m not okay. So, I just always encourage anyone if you’re not sure or you just want to know what we have or if what you’re experiencing might be something we can work with call send an email because sometimes phone calls even seem scary. We have an email system that’s connected to the website that goes to our leadership team that will get you a response pretty much within a couple hours. Um, we will we’ll support you even if we’re not the right place. We’ll make sure you get connected to the right place. Um, so that you know patients it’s I don’t want to say it’s brave to get help because that’s stigmatizing it, but it’s hard. It’s scary. So, if we can break down all those barriers and just be the main point of contact for all things mental health, that’s okay. Yeah. We want to be that for the community so that people know, I I don’t know, but Smoky Point might be able to help me. Yeah. And I love that about Smoky Point that you are trauma informed and you’re working to destigmatize things like substance use or serious mental health diagnosis where people really can benefit from treatment and get better and live whole lives. Yeah. Yeah. That’s our whole goal. That’s it right there. We just want people to be healthy and and successful and um mental it’s real. Mental health is real and and it’s a work in progress. We’re all a work in progress and we just want to be a part of that journey. Yeah. And we have come a long ways, but there’s always a lot more that we can do. Absolutely. Well, I had the honor of touring Smoky Point a a month or two ago and it was just such a fantastic facility and I wonder if you can tell me some of the things that are special about your facility, maybe different from other places. Yeah, absolutely. So, I know Yeah. When we toured around you got to see our game room. So all of our patients get to access that. It has life-size Jenga and all all the fun things because mental health care is not sitting in group all day. It is not talking to a therapist all day, but sometimes it’s just engaging in a healthy social setting. It’s engaging. It’s getting out. It’s um healthy coping skills. So we have a game room, we have a gym with a fitness instructor, we offer yoga, we have a bunch of outside time um which I mean it’s beautiful here in Washington. So we want people to be Yes. We want people to be outside. We want them to have fresh air because what we really, you know, the the goal of of inpatient, outpatient is to help you build the skills so that you can be successful when you leave us. The goal is not to have you with us, send you back out and hope the best. We want you to be successful. We want to be teaching those skills. So, making sure we incorporate other things into the day is therapeutic, is teaching those skills and and um even just time management, right? Sticking to a schedule for some people is huge and just building routine is huge and really helps them get regulated. Um I love that you say that. As therapists, we’re always trying to work ourselves out of a job. So, the goal is not to be in therapy forever. Sometimes clients will ask me that. I mean, how long am I going to have to come and see you? The goal is that you get the treatment that you need and then you can live your life. Yeah. Yeah. Yeah. That’s, you know, from the time I was working on the floors till now and uh yeah, we the goal is for you to succeed and I’ll always be here and we will always be here at Smoky Point if you need us, but the goal is for you to succeed and that’s okay if it’s not the first time around. I express that to families. My staff’s been amazing with um patients who sometimes, yeah, if they come back, that’s okay. We just have to figure out what the work’s not done. I love that you say that. The work’s not done. We can figure it out. and our staff are just really working in that trauma-informed care space, really making sure that we’re providing the best resources we can upon discharge and and providing them while they’re in house. But it’s okay if you come back, but the goal is is that even if you come back, you still you you still did succeed. Yeah. There’s like a bump in the road. That’s okay. Yeah. Just a little more work to do. Well, are there any uh exciting things on the horizon for Smoky Point? Any new initiatives or programs or growth that’s happening? Yeah. So, we’re always sort of looking at what is the community needing from us and then how do we match that. So, just in the last year alone, we’ve added um you know, we sort of added another specialty unit to really meet the needs of the community, which was just another intense uh adult unit. We’ve definitely opened up more beds for adolescence. So, we have up to 40 adolescent beds that we can uh provide that level of care, which can be really hard to do. And then we also brought back our dual diagnosis outpatient group. Um so that had stopped for a while just that wasn’t the need that was being seen and now we’ve brought it back and there’s just that’s what’s needed. Yeah. Serving all kinds of clients. Yeah. So we really do we look at the referrals that we get but also um getting out into the community. So talking to schools, talking to other referral sources, talking to community agencies and what are they seeing? What are the barriers? And then how do we at Smoky Point help fit that. Yeah. What are some of the needs that schools are having right now? A lot of just support around anxiety and depression. A lot of um just where to get help it sounds like because um you know the adolescent you want them to be a part of the treatment. You want them to feel empowered to steer their treatment in a way and it’s a delicate balance when you’re working with a teenager. So, um, we really encourage just we really encourage them to to take hold of their and so working with schools or working with community agencies getting the student to or adolescent to share what it is they’re looking for, what they need. As you know, as a we don’t just like dive in to maybe what we know is going on. Um, but just kind of letting it be a very safe and natural space. Yeah, that’s what we’re there for. Have you noticed an incre an increase in demand after the pandemic? Increased anxiety, increased depression, especially for teens across the board. I really would say across the board um in both facilities I’ve been in, but especially here at Smoky Point, we have seen such a high need for mental health services. I think some of that is because during the pandemic, so many systems shut down. Um and then the barrier the barriers just kept growing to care. uh whether that was because people’s jobs changed or their locations changed and places closed or um you know we saw a lot of things move virtually that’s not for everyone virtual work’s not for everyone so and some places didn’t come back from that they didn’t decided not to go back in person so a lot of need pro I mean I don’t know about for you guys but that’s something on the impatient side we talked about a lot is we saw a high need during uh the pandemic but what we were really prepared for is what was going to come after Because especially in younger adults and adolescents, you’re not meant to be inside. Yeah. You’re not meant to be inside without your friends or socializing for that long. And they I would say those are the two populations we’ve seen the most need come out of. We have seen the same thing at Ankorite that teens and I think we’re seeing a lot of it now really struggling during the pandemic of course being virtual being at home. Um but even afterwards just the lack of socialization uh really increased anxiety and depression for some kids and they’re dealing with it even even today five years later. Yeah. Well, and we think too, right, external things, whether that’s school, work, hobbies, always gave people an out because we don’t know what’s happening behind closed doors or what someone’s home life is like, whether it’s positive or negative or maybe it’s just really lonely. So, for someone to be stuck alone in an apartment for months and months at a time because their work went virtual and couldn’t see your friends. Yeah. There’s still we’re still seeing the fallout from that. Um, so really high levels of depression, really high levels of anxiety, really high levels of just fear around socializing. Yes. Um, and getting back in almost back into a routine because the routine had become so introverted. Yes. Exactly. See a lot of that. Oh, Alexa, I’m so glad that you could join me today. You have shared so much great information about mental health and how to access resources. And just for anyone who’s listening who might be in crisis or who’s trying to support someone in crisis, what would you recommend for them? Yeah, call us. Seriously, if you are in crisis, you are welcome. You don’t have to call. Just show right up at our door. Um, you can always present to a local ER. You can always call a crisis line. But you truly, our doors are open 247, so you can just walk in and we’re there to support you. So, yeah, anyone needing help 247, we’re there. Fantastic. And if people want to learn more information about uh Smoky Point, where can they go to find you? Yeah, smokyointbehos.com has all of the basic information and they’re welcome to call as well. I mean, they’re welcome to ask to speak to me. Any of my team, any of the staff will be able to provide all of this information and really walk you through those next steps or answer any questions they may have about accessing care. Fantastic. Well, thank you so much for joining me today and sharing so much valuable information. I really appreciate it. Thanks for having me. This was fun. Thank you. Thanks for tuning in to Holding Ground. For more tips and resources on mental health, visit ankorlite theapy.com or follow us on socials at ankorite therapy. This podcast is for the purpose of education only and is not a replacement for mental health treatment. We suggest you seek out the support of a trained professional for help with your specific situation. Stay tuned for more upcoming episodes.

In this episode of Holding Ground, Laura sits down with Alexa Brainin, CEO of Smokey Point Behavioral Hospital, for a timely and eye-opening conversation on the state of mental health in the Pacific Northwest.

Together, they address the alarming rise in anxiety, depression, suicidality, and the growing need for substance use disorder treatment—issues that are hitting the PNW particularly hard. They explore the regional factors contributing to these trends and share insights into how individuals, families, and communities can respond with knowledge and care.

Laura and Alexa also break down what higher levels of care really mean, when they’re needed, and how to access them without fear or stigma. This episode is a must-listen for anyone seeking clarity on mental health services, whether for themselves or someone they love.