-Welcome to the webinar today, "Building Resilience: Practical Tools for Supporting Survivors' Mental Health in the Workplace." My name is Carolyne Ouya, and I am the senior training and technical assistant specialist at Futures Without Violence, and I'll tell you a little bit more about what my role is. And Yoo-Jin. -Hi, everyone. Thank you for spending your time with us today. My name is Yoo-Jin. I use she/hers pronouns. I'm also the senior training and technical assistant specialist for the National Resource Center at Workplaces Respond, which I'll tell you about in a second. -So a little bit about my background and the project that I am a part of. I have, you know, several, several years of experience working with survivors of human trafficking, domestic violence and sexual assault and also working in workforce development. So I'm able to see the intersections of survivor advocacy and workplace retention and development. I am also a mental-health advocate, currently a grad student in marriage and family therapy and have sat on various boards and behavioral health taskforces in San Diego county. So I'll be coming in with that perspective as well. I'm part of the Promoting Employment Opportunities for Survivors of Trafficking Project, and so we offer training and technical assistance to organizations all throughout the nation who are looking to improve their workforce employment and education opportunities for survivors of human trafficking. And so that could look anything from building resources and tools to providing trainings to your community and helping you build those collaborations that will address topics like what we're talking about today. -Great, and I am focused in our, again, National Resources Center Workplaces Respond, and my focus is thinking about training and technical assistance for organizations, whether it's thinking about survivors who are already in the workplace and also thinking about sexual assault, sexual harassment and workplace culture. And a little bit about my background, prior to Futures, I worked in substance abuse prevention and intervention, and I was a victim-service provider at a domestic-violence center. So both Carolyne and I are bringing some of that on-the-ground experience. I'm looking forward to also hearing from you all. -So we went over this. We'll help you with referrals. At the end of this webinar, after the presentation, we'll have 30 minutes set aside for office hours to answer any, you know, intimate questions that you have all from the ground, and so we'll provide a link for that space. And then we also encourage you to just reach out to us after the fact to help troubleshoot any issues or dive deeper into the different topics that we're mentioning today. There's only so much that we can do in the short period of time when it comes to a huge topic like mental health and workplace and survivors, and so we're going to do our best to be as thorough as possible during this time. So let's talk about the learning objectives. Our goal today is that we help describe sort of what the current mental health challenges of survivors are in the workplace and what the mental health challenges, in general, are in the workplace so that you are well versed in that. We're going to identify the key elements of supportive and person-centered workplaces. So, you know, if you're looking to establish employment partners, we want you to, you know, have good points in mind about how to make those connections and how to determine, you know, what workplace is the best for your community. We're going to go through the 12 stages of burnout because we're think it's very important to know both personally being in the field, but also supporting the survivors that you work with. And then last but not least, we're going to talk about a few strategies that can help enhance the mental health of survivors. So those are the learning objectives we set aside, and, you know, we hope that we hit all of them today. And if not, you know, just ask us questions in the chat box so that we can interact with you and make sure that we're addressing your questions. -Wonderful. Thanks, Carolyne. So before get started, we'd love to hear about who's in the room. So I will be dropping a link to our Poll Everywhere, and just to get a sense of, again, who's in the room and some of the demographics if you could go and take 30 seconds to answer our question. -And we'll reply back with what we're seeing in the Poll Everywhere. -Wonderful. So I'm seeing a lot of domestic violence or sexual violence victim service providers, a few technical assistance and training providers, educators, community members, welcome, other because you do so much more. Yes. And feel free to also introduce yourselves in the chat with where you're calling in from, what you do. -Welcome, Jasmine. Welcome, Blade. So to bring you in on a little secret or behind-the-scenes, our original goal was to have this via webinar or a Zoom room space where we could see your faces and sort of interact with your voices in person, but, you know, it was popular. You all signed up, and so we wanted to make sure that everyone had the opportunity to be a part of this. Regardless of that, we will be checking out the chat box throughout this entire experience. So feel free to, you know, put your questions in there, your comments, your woot-woots, you know? We'll try to make it as, you know, free-flowing as possible, so thank you so much for being here. So we're going to start off with our first interactive question. So go ahead and get your typing fingers together. How do you think mental health shows up for survivors in the workplace? So if a few of you can take some time to, you know, type what your perspective is on that in the chat box, we would love to see that. So I just saw absenteeism pop up. Hello, Deanna. Sara says it affects all aspects of the workplace. We have Amy, trouble focusing on work-based tasks, feeling triggered by statements that people may say. Linda said, "Not being present." Hey, Linda, a part of our team. Decreased morale. These are great responses. Thank you. Bella, self-sabotage. Lack of consistency and self-confidence during meetings. Brandy and Tony, thank you so much for bringing up the role of trauma and triggers, depression. Thank you, Dorisha, for PTSD, low self-esteem. These are great responses. Thank you for putting that in the chat. It impacts attendance and performance. There's abuser-generated risks in the workplace, so thank you for bringing that point up. Expectations for more authentic connection even when e-mailing. So, you know, how to navigate those admin and logistical things. Feeling silence or isolated, digestive issues. Thank you for bringing in the physical components. Being distanced, lack of feeling and belonging. So these are great. Awesome. These are all great, and so we're going to go into some of those things, and know that this is not comprehensive, but it's a good place for us to start. So before we go into sort of some of the details that you have mentioned in the chat box, we want to give you statistics on just what's going on in mental health in the workplace in general, and we're hoping that this let's you know that it's not just a survivor-specific experience. There's many elements of the workplace that impact mental health to begin with. So we want to make sure that you understand that first before we add on the layers of being a survivor in the workplace. So if you look at some of these statistics from the CDC, they've done a wonderful report on mental health in the workplace back in 2018 as well as Mental Health America. Last year at the height of coronavirus, they also did a wonderful report. And some of the statistics that have come out from that are that the workplace is the third leading cause of stress for everyone. So if it's the third leading cause of stress, that should tell you something. One in 10 employees report that their workplace stress affects their mental health, and then four in five employees feel emotionally drained from their work. So this is without even adding on the nuances of a survivor's history. Being in the workplace, demands of the workplace in general, is a place for emotional, you know, toll. It takes an emotional toll on our well-being. And it's also important to know that three in five employees are not receiving adequate support from survivors to help manage the stress. So with these pervasive challenges, our advocacy is not just for survivors, but for the workplace in whole so that it's working cohesively for all the members that are involved. Some other statistics is, when you're going into the work environment, 65 percent find it difficult to concentrate in their work environment, and only five percent of employees agree that their employer is providing a safe environment. So this is letting you know that there's some things missing, and we have to figure out what's missing that's causing these high numbers of disconnection and struggle in the workplace. So understanding that is important. And then when we look at the financial burden of mental health challenges in the workplace, it's pretty high. Depression and anxiety cost the global economy about $1 trillion per year in lost productivity. That's a lot of money, you know? It's not often that we see trillion, so that let's you know that we -- It's something that we really should pay attention to in order to support what we're doing. And then on average, employees with depression miss about 27 days of work per year, which tallies up to about $4,500 per capita cost of that person and their challenges. And then what's interesting to know is that for every $1 invested in mental health, especially evidence-based programs, employers can save $2 to $4 on other expenses. So it's just letting you know that investing in mental health, investing in well-being in the workplace benefits the organization as a whole. So if there are any advocates in the community who are trying to, you know, make a claim or support why it is important to focus on mental health, you know, these are the numbers, and this is the benefits of it that, you know, we hope that you find helpful. So then what does that mean, kind of digging deeper into the overall challenges of survivors, and many of you, being advocates and educators in the field, have already listed so many of these. But the first thing that we're going to talk about is the types of mental health challenges that our survivors are struggling with. Many of you are familiar with it, but we're going to go through it together. So the first is adverse childhood events. A lot of survivors, a lot of individuals, have gone through very difficult, traumatic stressors throughout their lifetime, and so they're carrying that with them just outside of their experience as a survivor of human trafficking and constantly trying to maneuver some of those challenges that they've experienced as a child. And we also know that adverse childhood events has a direct correlation or impact on our physical health and well-being, right? So if you have a certain amount of adverse childhood events, it increases your likelihood of diabetes and heart disease and all of those other physical ailments that can get in the way of your success in the workplace. There's also complex trauma and polyvictimization. So we know that it's not one type of trauma that our survivors have experienced. There are many different types, whether it's community violence, you know, sexual assault, and, you know, whether it's the systems that we're a part of, such as racism and xenophobia that are considered violence in the way that we feel and express in our bodies. We know that there are many different layers of trauma that we're focusing on. There's also polyvictimization. So by the time the survivor is entering the workplace, many have unfortunately been victimized many different times across their lifetime in many different ways. So you're not just navigating the relationship between an employer and a survivor. There's many other areas that they may been victimized. So you have to understand that the workplace itself can be a traumatic or difficult environment to be in and having to navigate that. We also know that if you take it to another level, a lot of our survivors have co-occurring disorders. So in our field, we tend to focus on the trauma. We tend to focus on the depression and the anxiety, but sometimes, we are not giving us much discussion outside of the trauma-informed care to all of the other parts of mental health that our survivors could be struggling with. So that's everything from bipolar disorder, you know, schizophrenia, some neurotypical challenges that, you know, our survivors could be struggling with and then substance abuse and how all of those things can be -- a survivor can be experiencing all at the same time, which makes it very difficult to navigate. So when we're looking at the barriers of care, and I'd also like to plug SAMHSA, which is the Substance Abuse and Mental Health Services Administration. They are a great resource for evidence-based practices and diving deeper into the things that we're kind of talking about on the surface level. So if you haven't had a chance to really go through their content and read it, we encourage you to do so. So we know our survivors are struggling with this. What are the challenges to care? And I know many of you have probably experienced frustration in navigating the mental health system. I will proudly -- not proudly say, but I will say out loud that our system does not work. It's broken right now, and it is not supporting all of us, especially our survivors who tend to be the most marginalized. One reason for that is -- Thank you, Lisa, for that. Yes, yes, I agree. We have stigma. A lot of our survivors are carrying a lot of fear and a lot of stereotypes and preconceived narratives about the mental health and therapy, and so going and seeking help or trusting help is very difficult, and so navigating that stigma is hard. We have lack of culturally inclusive mental health professionals. And so, you know, because our survivors are coming from so many different backgrounds, we don't always have a mental healthcare professional that mirrors that background in which they're coming from, which increases the level of stigma and fear of seeking these services. Another issue is misdiagnosis. So a lot of our survivors will find themselves being misdiagnosed, right, and not having the ability to go through a thorough, you know, screening or assessment to receive the right diagnosis or the right medication. And so we're having a lot of that going on, and if you look at the statistics of how it impacts communities of color, you know, there's a lot of misdiagnosis in that level juts in general without having the identity of a survivor. The next, it's expensive, y'all. I don't know if anyone has taken a chance to really look at how much therapy is or how much medication is when it comes to mental health, but it is way more expensive than something that we can do without adequate support and healthcare support and community support, so that's another barrier. And then the last is that there's enough mental healthcare resources at this moment to really support the needs in the community. So we just wanted to make sure that you're aware of those barriers. If there's something that we have not mentioned, please put it in the chat box. Lisa, thank you for mentioning sexism and racism can lead to a ton of deadly challenges. Thank you so much for your comment. So we're going to make sure that we read through that. So we want you to also see the symptoms of trauma and understand that a lot of co-occurring disorders can cause some of these reactions as well. So we broke it down in emotional, physical and cognitive. And we hope that when you're working with your survivors, you can sort of figure out out a way to sift through the differences between what's considered emotional, what's considered physical, what's considered cognitive because it can help with referring to the right spaces to help support those different challenges. So we already know the numbness, the apathy, the withdrawal which some of you have mentioned, the guilt and the shame, the anger, irritability, suicidal thoughts and tendencies, ideation. We also have physical, which are headaches, sleep problems, chronic pain, pain attacks. So if I'm struggling to sleep, I'm not going to show up my best on a Monday morning, a Tuesday morning, any day, right? If I'm having constant headaches, how am I focusing and being able to get through a task? If I am having gut issues, right, like, how can I make it through an entire 8-hour shift, right? So sometimes, we get stuck on the emotional and sort of mental components of mental health, but we want you to know that it does manifest itself physically. And then the last area is cognitive, so flashbacks, hypervigilance and so any little -- I don't want to use the word little, but anything in the workforce could end up being a trigger, and the person feels that it's a personal attack when it could be just something that's a part of the workplace environment. And then also, it affects memory. So having to remember tasks and kind of work through that experience can be very difficult. So we just want to refresh or let you know about those areas. -Carolyne, I just wanted to uplift something in the chat -- -Yes, please. -... about thinking about folks who have a record because of things like substance abuse and also, in the back of my mind, thinking about in addition to the individual symptoms that folks are experiencing as survivors, the systemic impact of the criminalization of survivors as well, right? So what folks have had to do to survive can often be criminalized, whether it's substance use, even things like homelessness. So these are things that we're going to also bring into our conversation, but I wanted to uplift. -Awesome. Thank you so much for that. And I can't see the full name, but someone mentioned how healthy mental health screenings should be a part of routine healthcare and how there's not a focus on prevention here, which is difficult. Awesome. Thank you so much. Okay. So you've mentioned this. How does all of this impact the workplace? And we've made some comments here and there about that. But increased absenteeism, not showing up because I don't feel well and I don't want to and nobody understands, right? Not being able to concentrate. So supervisors are frustrated because they feel like, "I've told this person to do this how many times, and they have yet to figure it out," right? And so dealing with that dynamic. Increase in personal calls, texts and visits. You know, I always say we do not heal in isolation but in community, right? So having to make those connections throughout the day to get through the day can get in the way of, you know, the task that you have. If there are any, you know, reports or investigations that need to happen in the workplace or in general, there tends to be sometimes an unwillingness to participate in that, or let's say victimization is happening in the workplace, you know, not speaking up about that experience because of everything that the person has gone through. And then also appearing agitated, angry, sad or hypervigilant. We have lack of confidence and withdrawal, and something else that I saw in the chat box that I will lift up, and thank you to the person who brought that up, is the increase of gun violence and retaliation in the workforce that's related to mental health challenges, right? And so without prevention, without the right structures and support systems, sometimes we're unable to see all of those warning signs and flags along the way until it's too late, and it's another headline, right? And so really keeping that in mind and saying what can we put in place? What relationships and structures can we put in place to address that? So thank you for bringing that up. So now, are there any questions? If you want to put that in the chat box, and thank you so much for your feedback. We appreciate it so that we know that we're not talking to, you know, dead space, right? So we appreciate that. Thank you, Anna, for bringing up strangulation, head trauma and how that affects that. Yoo-Jin just put in the chat box, thank you for that, is that we have an anonymous question Poll Everywhere. So if you, for whatever reason, do not feel comfortable putting your question in the chat box, we want to honor that. So go ahead and use the poll that you Yoo-Jin just put in there to ask those questions, and we'll be sure to address it along the way. So I'm now going to turn it over to Yoo-Jin. Step one, the practical step one is really understanding what mental health is, what the challenges are and how they present themselves. So that's step one, the practical tool. The second practical tool is identifying a safe and supportive workplace or what a safe employment partner could look like. So Yoo-Jin is going to kick us off with that section. -Thank you. So we'll be going over elements of a safer workplace, and the reason why we say safer is because we can't ever actually guarantee safety in a space. So these are some ways that we can work to create structural improvements to the systems that we might be in now. So the first being investing in employee well-being in all aspects of the word. So thinking about mental health, like we looked at some of the symbols that affect both survivors and just workers in the workplace, mental health being a very big concern and something that affects so many people. Having inclusive and welcoming workplace environments, inclusive in all senses of the word. We're thinking both diverse and equitable. We're thinking about accommodating and welcoming folks with different abilities, who are neurodivergent, having accessible spaces. We're thinking big. We're thinking about policies and practices that set employees up for success and growth, having a commitment to transparency and collaborations. So we're thinking also about what would it look like to have shared power in a relationship where in the workplace, there tends to be a lot of hierarchy, and when we think about transparency, we can bring in salary. We can bring in pay equity. We can bring in, how do we lift ourselves up in this organization? How do we support each other to do that? Is it clear how people are promoted, how people are paid? And of course, the strong workplace community. So many of us are trying to bring our full selves into our workplace. It tends to be where a lot of us spend a majority of our waking time, and so ways that we can increase community building and unionizing, so that folks can advocate for themselves. And so we wanted to also share a tangible resource that we have called Check Your Workplace. It's checkyourworkplace.com, and we'll be going over a tool called the Culture Walk. This is a tool where we can -- It's a worker-organized tool in which we can think through what do we have in place already in our workplace that can work to make it a more inclusive and a place of belonging and what maybe could we work to implement. So we'll go over a few of them now. Thanks, Sarah, for dropping it in the chat. You can also look it over as I speak. So some of the questions that we invite all organizations to ask is thinking about space, physical space, allocated for non-managerial employees to meet and interact. Are the most desirable workspaces in the building only for folks in higher positions, folks who are higher paid? Do employees feel a sense of connection and access to workplace leadership? How do you know? Do you ever ask and check? Next slide. Thank you. Do the leadership and supervisory roles reflect the gender, racial and other demographic characteristics of both the workplace, the organization and the community you're serving? So this is a big one. This is where we think about equity. Who is on your board? Who is leading the organization? And who is on the ground doing that community and high burnout work? Is it reflecting the people who are in your community? Why or why not? Do employees feel a sense of connection and access to workplace leadership? How do you know? Have you ever asked? Do employees know how and to whom they should report incidents of sexual harassment and violence? And further, do employees know what happens afterwards, after you make a report? This can also be related to the intersections that we talked about. Sexual harassment and violence, racial violence, all of that comes into play here. -Thank you so much, Yoo-Jin, for walking us through that Culture Walk. So those are the big picture questions to really keep in mind about, you know, your own employment environment and any of the employment environments that you want to connect with. And then we're going to dive a little bit deeper about how do you develop an employment partner? So once you know this information, what are you looking for? Before we move forward with that, I want to provide two resources or highlight two resources. The first is the one that Yoo-Jin just mentioned that Sarah put in the chat box, and it's a guide called Building Resilient Workplaces. So it has tips that reviews all that Yoo-Jin just mentioned. The second, based on the part one that we talked about of knowing the symptoms. Mental Health America has a wonderful screening guide or screening tools on their website. So anyone can test that for depression, anxiety, PTSD, bipolar, many of the mental health challenges that are going on. While they're not, you know, an assessment that, you know, a psychiatrist or a mental health therapist can do or are doing, they are a great starting point for any of those that do not have access to that initial assessment. So for any of you advocates who may be concerned about what the person you're working with is experiencing, I encourage you to check out that screening guide and that screening tool and all the tests that are available there because once it's complete, you get a list of resources that will support you through that particular mental health challenge. And then the other thing is the check your workplace, which is the culture walk that we just talked about, so go ahead and save all of that to dive into deeper at a later date. So for many of us, you know, during our training and technical assistance -- Thank you so much, Sarah, for that feedback -- we are looking to build partnerships. Right? Our training and technical assistance work is, what relationships can we make to help make employment and education and the workplace experience easier for survivors? And so a lot of the TTA we're doing is diving into those conversations, and so we wanted to give you a brief taste with the hope that you'll, you know, check us out during office hours and reach out to us after the fact to kind of dive deeper into it. So the first is, you know, be clear about your purpose and goals for partnering. Right? Be clear about the challenges that you're experiencing. If you're not clear about that, it's hard to make relationships about -- you know, it's hard to make those meaningful relationships that address the culture and the challenges that we've all mentioned. The next is to align with the values of the employer or the organization, which Yoo-Jin brought up some great questions on how you can identify what those are. The next is, identify an employer with a detailed and supportive onboarding and training process. So sometimes we're in such a hurry to have our -- you know, get our survivors employment that we don't ask questions about, how are they being trained in the beginning? How is the on boarding process? Is it supportive, or is it terrifying? Right? If I'm starting onboarding, and I'm terrified with all of the challenges that I'm going through, chances of me following through is going to be difficult because I already, from the beginning, don't feel safe in that environment. So as an advocate building these relationships, really look into what that initial starting point is because it can make or break the retention of your client moving forward. The next is developing a relationship with the leadership. You want to be able to check in and say, "Hey, how's everything going? Is there anything that, you know, we can do to kind of support the person?" And then creating an MOU with that person or a contract, so that there are clear guidelines and measures on how you'll address different challenges that may come up. So these are some of the standard things to keep in mind in addition to SAMHSA's principles of trauma-informed programming, which is obviously safety, collaboration, transparency and trust, empowerment, peer support and acknowledging identity, so hopefully having this will get you started on thinking about what it could look like, and then we are willing to sit with you to kind of dive deeper on that. I want to lift up Lisa's point. We learned that the onboarding process for survivors need personal attention and not just emails. Our relationships and their health counts on understanding and feeling comfortable with, like, insurance paperwork and any life decisions like that, so that's a good point, figuring out, is the on boarding process personal or are they clicking through some automated systems? And if it's not personal, what can happen to make it personal? Right? So I'm glad that you have mentioned that. "And then how about leadership training for all employees instead of just training to the leadership?" Great point, so if you're working on the collective culture of a workplace, everyone has to be involved in those conversations, not just the leadership. So these are great points that you're bringing up and can really inform the questions that you ask an employee partner or the questions that you work with your survivor on so that they may advocate for themselves by asking those questions to the employer. So imagine how empowering that can be to be able to have to that type of dialogue, so thank you for bringing that up. So we're going to move into recognizing the 12 stages of burnout, and Yoo-Jin is going to share that with you and why that's important. -Thank you, Caroline, and thank you, everyone, for making this such an engaging presentation. There's so many incredible knowledge and expertise in the room. We encourage you to keep sharing it with us. So we wanted to bring in this conversation about both compassion fatigue or vicarious trauma and burnout to have some tangible tools to understand what could be happening in a psychosomatic or both psychological and body-based way, knowing that this could affect both survivors who are showing up in the workplace and also ourselves. I think it's important to note that much of this information can also be directly related to us as service providers or as advocates and educators, knowing that there are likely also survivors in your workplace, and so this is doubly important for us to think through and implement. So first, the difference between compassion fatigue and burnout: As many of you might already know, compassion fatigue is also called secondary trauma or vicarious trauma. It's the emotional residue or strain of exposure to working with people who are experiencing trauma, suffering from traumatic events, and so this is again trauma-based and related, and it can be built up over time and can also integrate factors that are being experienced structurally and intergenerationally such as racial trauma. So when we think about burnout, it's a cumulative process marked by emotional exhaustion and withdrawal associated with an increased workload or institutional stress, so this could be stress in your organization and also things like, I don't know, a global pandemic perhaps. It emerges over time, and it's not trauma-related, but it can be exasperated if we're also experiencing compassion fatigue. Great. So the 12 stages of burnout: This is a tool we wanted to offer that gives very tangible symptoms and stages of burnout that tend to happen. It can happen in different orders, but this is one way that it can happen, and so this is a tool developed by Herbert Freudenberger and Gail North, and this has especially have been utilized in fields related to the medical field, just given the high levels of burnout here. So as you can see, the first six stages, a lot of burnout tends to first manifest in an active way where we try to work harder, so the compulsion to prove ourselves, like, "Oh, I'm going to just work harder. I might neglect some of my needs," such as physical needs, not sleeping, not eating, working overtime, not attending your medical appointments or seeing your friends or having any kind of work/life balance. A displacement of conflicts: So your problems are being dismissed or you're projecting some of that anger onto others. Revision of your values: So things that you came in pre-burnout are not as important to you anymore. Work is your only focus. Denial of emerging problems: So denial of that burnout is happening. Problems are viewed as, "Oh, it's just because of this specific event at work," or because it's this very specific time, rather than it being a life change of yours. Just reading through the chat, moral injury also being important, absolutely. Yes, definitely, survivors are passionate, helping to manage their time, caring for themselves. Sometimes that can be also a result of secondary trauma, feeling like, "Well, if I'm not being useful or I'm not helping, I'm not needed here," and this can also, you know, complement these symptoms of burnout, so we look at the next six stages. Withdrawal: This is when it's hard to get in touch with people. They might stop responding to calls or texts. They might just stay in their office and do their job and go home. Behavioral changes: This can also manifest through numbing behaviors such as increased substance or sudden substance use. It could be social media. It can be food. Depersonalization: So this is when we're feeling like, "I am outside of my own value and not valuable. I don't really know what I need anymore." Feeling an inner emptiness: So you see the first six stages are pretty active, where we're trying to overcompensate, and the next six stages tend to be where we start to really experience that burnout, and so inner emptiness, feeling like, "Well, what's the point of me even doing this work? Nothing is really going to change," and this is where you can also compensate with different behaviors such as food, sex, alcohol, drugs. Depression: Feeling lost and unsure, feeling exhausted, feeling like there's nothing to look forward to in the future. And then burnout syndrome, so total and physical collapse, time for full medical attention, and another symptom of burnout that can be compounded by this is when we hear anger being projected towards, quote, difficult clients, so when we're hearing advocates or practitioners who have been in the field saying things like, "Well, they're just being such a difficult client," or kind of projecting some of that anger rather than thinking about, "Well, what has this survivor gone through?" This is when we know that we're feeling and experiencing burnout. Okay, just looking at the chat. And just -- Go ahead, Caroline. -Yeah, and the reason we want you to be familiar with these stages is because as an advocate, when you're supporting a survivor, especially when it comes to mental health, we get overwhelmed because we're not quite sure, like, where do we start? What do we address first? How do we address it? Right? And so knowing these 12 stages and how they show up and how they can show up in the workplace is helpful because then you can identify maybe one stage or two stages to work on at a time towards, you know, being well, right? So if a person comes to you and you can say, "Wait a minute, like, they're struggling with trying to prove themselves. What's getting in the way of that?" Right? That's a much easier conversation to have than, you know, the totality of, "I feel unworthy, or I'm not doing -- You know, I'm feeling unworthy or worthless," right? So being able to break out those bigger thoughts into these sections can really help with identifying, "What's the best way to support this person? What's the best resource?" instead of getting overwhelmed by the totality of the experience that the person is getting, right? So for example, neglecting needs, much easier to have a conversation about. Like, "What do you feel you need right now? Like, are you sleeping?" Like, that feels much easier to chew than the entire, you know, trying to tackle the entire workplace in general, which can be really difficult, so that's why we wanted to make sure that you are aware of this. Some things in the chat box, thank you, Michael, for lifting up "Destroying" -- Has recommended the book, "Destroying Sanctuary" by Sandra Bloom. I love a good book recommendation. For any of you that are like that, go ahead and add that to your list if you haven't read it or want to check it out, and then I also want to lift up something by -- I'm going to butcher your name, I think, and I apologize for doing so, but Madgan, I think, and has mentioned the impact of moral injury, being a part of a system that, you know, may be doing institutional violence, or let's say you're a part of a system where you're seeing some of the same victimization that you've been through being perpetuated, right, and how that can affect you and the work that you're doing or can affect a survivor in trying to find home in that workplace, so thank you so much for bringing that up as a point. Jennifer, I feel you. It has been a season of 2 years and so with COVID and supporting survivors, so if you're feeling burnt out after helping people, we hear you, and so, you know, translate some of those feelings into, "What do you think your survivor -- How do you think that that could be manifesting in your survivors?" and helping navigate them through that process. Awesome. -Great, and I just wanted to add in addition to this that, yes, there is a comment that we can also have secondary healing and resilience in this conversation too, and it's not enough for us to know and name these burnout symptoms and then tell people, "Okay, well, go take care of yourself." Many of these symptoms exist in a system in which it is very difficult or almost inaccessible for people to care for themselves, and this is a conversation we'll continue to have about structural care and the need for policies, the need for organizational change rather than telling the people who are most burnt out to go take care of themselves and come back and be ready to produce again, so this is a very important lens that we're bringing in the sense that we're not telling people, "This is just an individual action that needs to happen," within a system that often makes it inaccessible for both advocates and survivors to thrive. And don't worry, we'll be giving you some strategies in how we can do that. -Tomasina mentioned, "Are the 12 stages from a public -- published book or article?" We would say look up -- If you look up "The 12 Stages of Burnout" and you look up these psychologists, Herbert Freudenberger and Gail North, that's a good place to start in terms of reading into the 12 stages, and it will get you to some, you know, really good literature that spell it out. Okay? Awesome. Okay, so we were going to do a bio break, but I'm thinking because of time, we're going to move past that, and then we'll insert the bio break right before the office hours, right, for whoever would like to join in on that. All right. So we're going to ask a question. Now you know what the problems are, which many of you are like, "I already knew that," which is perfectly okay, but, you know, a question that we have for all of you is, "What do you do to strengthen survivors' access to mental health resources?" So if you can take a few minutes to just put into the chat box, you know, what you're doing right now. What is it looking like for you? We'd love to see that, and then hopefully that will inform how we move into some of the resource building part. Okay, so we have, Tony, "Ensure that your organization has employee assistance program." Oh, Lisa, please do not apologize. Like, talk as much as you want. We appreciate all of your feedback and insight, and honestly, it is making my time, so thank you so much for that. Okay. And, Tomasina, the link for burnout is -- Yoo-Jin has just put into there a source that you can go into. So I'm going to read some of the responses to this question that we received. "One of the places I work with, they give five three therapy sessions from a list of mental health providers." That's awesome. "There's consultations through EAP programs. There's transportation, and telehealth is really going on right now. Twelve EAP visits, so they're increasing the amount of EAP visits that are going on. Mental health first aid training." Thank you, Ken, for mentioning that. That's one of the things that we're going to say, so you're ahead of the game on that. "One hour per week of paid mental health with no restrictions." That's awesome. "Training the supervisors so that they're supporting, you know, employees better, 211 and local crisis intervention." Let's see. "There's a new project that allows you to reach out to more individuals that are involved in criminal court and offer support, screening for TBI." Awesome. Oh, they said PollEverywhere has not moved on that. It's okay. Go ahead and just put it in the chat box, and we will engage that way. Okay. So you have a ready-made list on site, and so you have conversations about those resources, one-on-one consultations, added personal days and sharing information. Yes, QPR, Erica! That's another thing we mentioned, so you're ahead of the game with QPR that we're going to mention. "Kindness and respect, education, so a lot of psycho-education, having some time off, you know, providing training to all employees about how to be supportive," so these are great. Thank you for sharing this. You have a grant -- Michael, thank you for sharing that -- a grant to provide free mobile trauma therapy. That's awesome. Well, these are all great. Thank you for sharing that. -Caroline? -So we're going to -- Oh, yes. Go for it. -I was just going to say, I wanted to share a few of the PollEverywhere responses -- -Oh, please. -... if that's okay. -Right. -So I was looking through, "Empathetic and supportive coworker, employee assistance programs, understanding supervisors that know resources, so a lot of affirming of the need for leadership to also be trained in these topics. Ensuring supervisors know how to better support and partnering with local resources and publicizing them," and I also, you know, read in the chat earlier, "Having time for people to actually access it, so not just having it available and saying, 'Go take care of it,' but how can you if you don't have the time to access it in your schedule?" So thank you for these responses. -Awesome, and I see that a lot of you are bringing up, like, workplace policies and HR and supervisors and all of that stuff, and that's why we broke it up between part one and part two, so part one is going to be what's helpful for you as a direct service provider or community-based agency or an advocate, you know, for survivors, and then part two is going to go into the nuances of the employer, right, and what they can do to address this, so thank you for bringing up those points because we will definitely be discussing that during part two, and, Tomasina, I agree with you that free mobile therapy is a great thing. "How are employers informed that they are employing a survivor? Isn't disclosure an issue?" Yes, thank you for bringing that up. Is disclosure is an issue, and a lot of times, back to that conversation about develop -- You know, identifying an employment partner, you are under no requirement, and we advise not to disclose the experiences of the survivor without their consent and to allow them to have the power in disclosing what they would like to in a workplace setting or not. However, as an organization, you can definitely, you know, ensure that an employer has trauma-informed practices and advocating for that in general, right? And so that is usually how we approach making sure that the employer is prepared to work with survivors is, putting it under an overall trauma-informed care lens, maybe an overall sort of gender-based violence lens and just ensuring that, you know, there's equity in the workplace, so those are the different ways that you can engage in those conversations with employers without disclosing the experience of the employer, and so that's one thing to put in mind, and there are organizations that are working on this, and so we'll share with you some of those contacts so that you can have intimate conversations with them about how to navigate that particular issue. And so we're going to go into kind of, what do we do, right? So we know, you know, that our survivors are going through these challenges. We know that they're entering the workplace. We know that there are systems in place that are making it difficult, so what are some of the steps that you can do? The first thing, you know, once you've understood what's going on and kind of what a safe employment agency could look like is truly just, like, safety planning, you know? The more that you have conversations about what could come up in the workplace with a survivor, the more prepared they are when those things come up, and so a lot of people walk into, you know, because we have quick turnarounds and we're trying to deal with, you know, self-sufficiency or, you know, things like that in a quick place, sometimes our preparation period or some of the things that we include in our preparation for the workforce is lacking some critical things to address some of these mental health challenges. So the first thing which we will be really working on, and we're hoping to have a webinar on it, is trauma-informed work readiness. So a lot of times, we focus just on, "Let's make sure they have a resume, and let's make sure they have, you know, they're ready for an interview and have interview clothes," and things like that that are very, you know, tangible to get prepared for the workforce, but we don't really go into deep conversations about, you know, what are the, you know, EEOC policies? If you have been sexually harassed or something goes on in the workplace that you don't agree with, what are those things that you can do to ensure that you're safe, right? What are the company's policies on leave, you know, if you have to take time off? Like, all of those things that, you know, the employer usually takes on could be really great conversations that you have with, you know, a survivor prior to that initial day in the workforce so that when they're hearing it, right, it makes sense or they learned about it, you know, already and they can kind of pick up on those pieces because unfortunately, during orientation and onboarding, that information can get lost, whether you have -- you're experiencing trauma or some sort of mental health challenge or not, right? So incorporating some of those things into your work readiness so that you're having conversations about, "Okay, when you feel like leaving, like, what's our plan for that? You know, how are we going to work through that?" The other thing is just, you know, there's something called a Wellness Recovery Action Plan, and I'm going to put a link to a comprehensive one on the chat box, so give me 1 second to do that. And so WRAP is something that you can do with, you know, for yourself, and you can encourage survivors and walk survivors through, and it has so many questions on there in regards to their mental health and wellness safety, right? And so, you know, I encourage you to kind of look through that document, and if you can't do the entire thing, maybe pick out some key areas that you would like to focus on with the person that you're working with in order to develop a mental health and wellness safety plan, so it is evidence-based. Mary Ellen Copeland came up with it. A lot of organizations do implement it, and so go ahead and check that out. The other one is a stalking sort of safety plan, so some of you have mentioned, you know, the challenges that come with, you know, being victimized and kind of the safety protocols that you have to do with someone who is trying to be, you know, trying to distance themselves from a previous abuser or trafficker, and so SPARK has great resources on how to create safety strategies if they're experiencing some sort of stalking, so include that into your work-readiness plan so that any of those, you know, anxieties or hypervigilance that may come up in regards to that in the workplace can be addressed, and then we also know that the National Human Trafficking Hotline has a great safety planning as well, and there's many others that we haven't even mentioned, so we want to encourage you to really do safety planning and expand it from just, you know, preparing for the workforce with the basics that we know in employment to really addressing some of these safety concerns and issues. The second thing, which I think is very, very important, is partnering with community mental health resources so that that comment in the comment box about having the free mobile clinic is a great example of that, so we saw a lot of examples about having, you know, already made resources and going through them with survivors, and giving it to them as an option for when they are in need of it, which is great. You know, we're not talking against that, and we encourage you to continue that practice, but we also say, "You know, take it to the next level by really developing a relationship with a community mental health provider," and you can do this in many different ways. One basic way is just bi-directional warm referrals so that you're able to refer to them the way that, you know, you've mentioned, if someone is going through something, you can say, "Hey, we have a client. This is where they are, or this is who they are," and kind of connecting with them that way, but coordinated care could be really powerful for your organization. So I'm going to put two resources, two documents into the chat box that come from our human trafficking collaborative network. The first is an advocate health intake tool, so let me see, how do I -- Oh, or maybe I can't do that if it's not a -- Okay, so I think what we'll do with that is, we will attach it to the follow-up tools that we have for you, but our health team, we have a team that focuses on health care, and they have developed a great health intake tool to walk through with survivors, right? And so while it's been tested on domestic violence survivors, the same questions can apply for human trafficking survivors as well, and it goes through questions to figure out, "Do they have a primary care doctor? If not, you know, where do they go for their health care services?" And really walking through that discussion that can sometimes feel very difficult to do if you don't have a guide, and so we're going to send that guide over to you as an advocate that you can use, and what we encourage is just tailoring the questions to mental health, if you would like to make it specific to mental health, right? So it's focusing on overall health, but you can tailor to mental health. The second thing that we'll send you after the fact is, we also have a guide on how to build fruitful partnerships with health care systems, right? And so you can walk through that guide and start building those relationships with the health care system. And then if you can see on the screen, if you're confused and not sure, you know, where are the health care systems in your community, we have HRSA, and then we also have SAMHSA, who has put together a behavioral health finder, and so once you've identified these locations, some of the things that you can do with them is, what would it mean to have a mental health advocate come on-site, you know, and offer office hours, you know, on a biweekly or monthly basis to offer that warm referral? What would it mean to have a space in your area where peer groups can be held from mental health professionals? And a lot of times as organizations, we feel that we don't have the resources for that, but through partnering, you're able to bring that in. The other resource we like to offer is NAMI that has a peer-to-peer program, so partnering with them, they often go to different places in the community and offer workshops and education groups and peer-to-peer support networks, and so the question that I want you to walk away with in terms of partnering is, "What would it mean to bring these entities in-house, and if so, what would that look like?" because often, they already have the funding to provide these services. They just need the people and the space, right? And so these are ways that you can kind of maneuver your way through some of the challenges that your grant funding could have for that. Brianna mentioned, "Our group has a meeting once a month with a psychologist and counselor." Exactly, that's a great example of how you can make something like this happen. Okay. So we only have a few minutes left, so, Yoo-Jin, if you can walk us through the workplace resources. -Absolutely, and thank you, everyone, for sharing the resources you are already implementing or maybe, you know, also inviting you to think big about what could be implemented, and please also catch us for our part two. We'll put the link again at the end where we talk more about these structural interventions. So resources in the workplace: Many of you have already talked about employee assistance programs, EAPs. This can come through something like an organizational therapist, perhaps having affinity groups, and just really uplifting what many of you have already said, that it's not enough just to have an EAP. It's important to have a culturally sensitive, informed and trained EAP provider, so thinking through that. Benefits including, what kind of health care do you offer to your employees? Is mental health care covered? We're thinking through also benefits in terms of leave. Do you count mental health days as part of sick days? How do people -- What is the accrual rate for some of these things? And then mental health conditions again being covered under the Americans with Disabilities Act and requesting leave or having adjusted work schedules or different kinds of accommodations. So this is something that someone mentioned yearly, is that there can already be a stigma of outing ourselves or even requesting that kind of accommodation, so when we can create organizational culture where we are talking about it and we show that we do have accommodations and we happily welcome folks from all different identities, it can create an environment in which someone feels more comfortable and actually accessing the resources that you have. So again, it's not just enough to say, "We have this, but no one is using it." It's important to ask, "Well, why?" -Right, and some examples of those accommodations are, like, modified break schedules or special break location, or a removal of environmental triggers. Some organizations can also use support animals, and so, you know, if someone has been diagnosed with a particular challenge and needs those, just know that they are covered under that, and you can advocate on their behalf in regards. So here are workplace resources that address, you know, trauma-informed practices in the workplace, management systems, and so we're going to put that in the chat box quickly. Oh, it's not coming through, so we'll put those in the chat box, or we'll send it out after the fact, but here is a list: the Management Center, the Sanar Institute, Project Trust. They do great work with workplace mental health and safety and trauma-informed care, so, you know, we encourage you to kind of check out their resources and how you can connect with them for best practices, and then the other, the last things that we want to share with you, and then we'll put the link in for office hours to have, you know, continue an interactive dialog, is some of you have mentioned QPR Suicide Intervention, so, you know, making sure that -- you know, QPR is a wonderful training. It is evidence based. It addresses suicide, you know, prevention and intervention, and so, you know, what would it mean to train all of your survivors at QPR suicide intervention or all of your employers in that? So that's one area that I think would be helpful just to address some of those initial experiences that could be difficult, right? There's also mental health first aid, so I've been part of the organizations where we made sure that, you know, all the survivors had access to a mental health first aid training, and that really opened up a lot of discussion about what they were experiencing and addressing stigma and also empowering, you know, that individual with those skill sets, and the beauty of these trainings is that you can also put it on a resume, so for those of you who are looking to enhance the resume of a survivor, these trainings serve dual purposes of both psycho-education, prevention in terms of how they respond in their community and support their community, and then also being a great resume addition to make that individual even more employable. There's also a great organization called National Conflict Resolution Center, and so they have two great trainings. One is called the Bystander Challenge and the Art of Inclusive Communication, so if you go onto their website, you can learn more about those trainings that they offer to community members, and we've made sure that our survivors have had access to those as well, so these are some of the more practical trainings that you can embed into what you offer to ensure that individual is more equipped in those conversations about their own mental health and how they support, you know, their community. So with that said, you know, in honor of time, are there any questions that we can answer for you at this moment in general with everyone here? There's also a feedback form. You know, it's five questions, so very simple, just to let us know what we can do to improve on this because it's something that we want to continue having a discussion and dialog about. And then this is our e-mails at the bottom so that you can get in contact with us, and then I am going to put the next Zoom room into the chat box, and then for any of you who want to join us for office hours, we'll be in there and we'll be able to kind of troubleshoot any questions, offer best practices that we've seen and kind of dive into this, like, very big overview that we tried to do in a short period of time even deeper. So are there any questions? Oh, we have until 2:30. I completely -- Yeah. Thank you, Hope. We had more time than I thought. I was like, "We're running out!" So we will take any questions and any sort of, you know, dialog that you would like us to have in this moment, and I'm going to review and see if there's anything, yeah, anything that we missed. Thank you, Hope, for that feedback. Okay, so if there aren't any questions, you know, we have 20 minutes left. If there aren't any questions, we'll hang out a little bit, and then we'll go into the office hours room, and we invite all of you to join us in that space so that we can dive deeper. "Can you put" -- Yes, we can put the slide back up with the e-mails. Give me one second. Nope, nope. There we go. And so a little bit more about the trainings that I kind of ran through, the Bystander Challenge really helps individuals if they may be seeing something in their environment and which is problematic or harmful or, you know, goes against their own personal values, especially with everything that we've been experiencing lately with, you know, hate against, you know, our Asian community or against, you know, Black lives, and all those different things that come up. It's a challenge that can help individuals get more comfortable with speaking up or seeking support during those particular times, and then the Art of Inclusive Communication is a training that helps individuals get better at communicating with others who may have different views than their own or come from different backgrounds, and that's been very helpful for our survivors because a lot of you have mentioned in the chat box that sometimes the difficulty is, how do you present yourself professionally in the workplace? How do you connect with your, you know, fellow peers, or how do you connect with your supervisor? So that training really breaks it down in a, you know, wonderful way on how you can understand each other and understand differences before it becomes, you know, the aggression or the anger, so those are great things to put in your toolbox. Lisa, "How do we help our coworkers accept and honor differences?" A great question! I mean, there are many different ways. I will say from the Art of Inclusive Communication, it really is just, like, having more safe spaces to have conversations with each other, you know, and really get to know each other on a human level, and so sometimes we leave the conversation with, you know, these big challenges that we have yet to kind of figure out, and that can be scary because it's easier to run away from that, so the art of it is breaking it down from those sort of bigger and heavier topics to more, "I see you, right? You're a human just like I am. This is what I've experienced. This is what you've experienced. Let's see if we can find common ground on that," so the answer, one of the answers is having more safe spaces for you to connect with your coworkers, and unfortunately this virtual setting has made it difficult for that. Some people have found that it has made it better because you're able to have those conversations, but, you know, that's one way to start. -Yeah, Caroline, and I was just thinking about what you're saying and how -- I can't remember who said this, but talking about how change moves at the speed of trust and how things like equity where we're talking about these challenging conversations really is in relationship, and it's not just about here in the brain where we're saying all the right things when we're not able to make mistakes and also come together and talk about when harm has been done, and so the difference being, there's a difference between disagreeing with something and having an opinion that is based in dehumanization, and I think that's something that we can work through also in our part two webinar in how we can make those distinctions as we work in relationship with one another. -Awesome. -So I don't see any other questions popping up. We have 138 people still hanging out with us, so thank you for that. There is a part two on the 27th, and so, you know, go ahead and, you know, register for that. I think Yoo-Jin had put it in the chat box. She just put it in there again, and then we will be sending out a follow-up e-mail with some of these resources that we've mentioned along with the recording for you to be able to go through it on your own, and then we invite you to the office hours that we're about to have, and then also to reach out to us to discuss this a little bit more intimately because hopefully that is how we can really troubleshoot any of the challenges that you're having, so without further ado, we're going to say, "Thank you so much," and we're going to hop into the interactive Zoom room, and we'll see who shows up for office hours, but we appreciate having all of you here today. -Thank you, everyone. -Okay. Thank you.