Ashely Grimes is the President of NAMI Florida, the state affiliate of the National Alliance on Mental Illness. NAMI Florida works with its 24 affiliate communities across the state to provide education, advocacy, and care coordination for people with mental illnesses and their loved ones.
In this Q&A, Grimes highlights the ways Florida can strengthen its behavioral health care system in the context of gun violence, workforce shortages, and more.
State of Reform: What is one issue regarding Florida behavioral health that you are particularly concerned about these days?
Ashley Grimes: “Something that’s most concerning to me is youth mental health, our youth and our young adults. It’s gotten significantly worse in the last year. It’s also pretty concerning, the [recent] mass shootings and the implications that that’s typical [behavior] for people with mental health disorders, which is not true. Linking gun violence to mental health disorders is concerning because guns don’t kill people—people kill people, in my view.
We need to teach empathy and how to see a person as a person again. I think we’re missing that in a lot of areas and it’s pretty concerning … Where’s the disconnect? That, to me, is where we should be looking and putting our funding into: preventing crisis situations, preventing people from getting to that point, because it’s very preventable. Early intervention—people doing a lot of these attacks on others are young. We need to invest in more mental health services for them.”
SOR: The implementation of 988 this month, the 3-digit nationwide phone number to a suicide prevention and behavioral health hotline system, could be a way to ensure Florida is reducing mental health crises. How has the work of implementing 988 been going?
AG: “988 is about to go live here in a little over a week. That’s exciting, because it has the potential to really save lives and really get people care without having additional barriers. But right now, we’re not ready for the complete package, the vision. We’re not there yet, we have a long way to go.
There’s so many people that have worked so hard on it, I don’t want to be negative at all. They’ve done a great job, and they’ve gotten funding to beef up some of these call centers, but if we don’t have places to take people when they call 988 or we don’t provide the care, there’s still huge gaps. Florida is already suffering a shortage for clinicians, so that’s a big concern because there’s such a great need and we just don’t have people to implement that right now.
We’re not the only state. Most states aren’t ready. But, a lot of law enforcement agencies have gotten on board [with 988]. They want to be able to address crime. That’s their job. Their job isn’t to be mental health professionals. It’s not what they trained in. That’s not their specialty. They want the help, and they’ve really gone above and beyond to try to advocate [for 988].”
SOR: Addressing the health workforce shortage seems to be closely tied with the hotline’s success. You have previously advocated for bringing more certified peer recovery specialists into Florida—how has the state moved forward with that?
AG: “SB 282 passed this year, so that was a huge step in the right direction for Florida. This was the third year [they tried to pass the bill]. So the fact that it went through this year was huge. It was a big win for peer specialists, but we don’t have enough yet. The state only has, the last time I checked, 780 peer specialists. We have less than 1,000 in the state that are certified. There’s also a need to understand what certified peers do and what their role is. Their roles aren’t to replace clinicians, aren’t to replace professionals. They make the professionals go a little further or be able to spend that extra time with the person. [Peer recovery specialists] can be able to help get social services such as housing, help individuals learn how to make appointments, and how to get insurance. If you don’t know how to apply for insurance, are you ever going to go to the doctor? Somebody that’s been there that can help you with those things does increase your ability to get care.”
SOR: Regarding substance abuse services in Florida, have there been any recent policy improvements from the last legislative session? Where do you think Florida can still improve?
AG: “As far as positive, I’ve seen a big shift in support for families, which I think is very important because when someone’s in active addiction, families being trained on how to handle that, how to talk to them, improves outcomes tremendously. I think that that’s a win for the state that families are being considered more.
I think the fact that fentanyl [test] strips are still illegal in our state is an improvement that needs to be corrected immediately. I think that sheriff’s offices, or county police stations, or police officers not carrying Narcan is something that needs to be addressed immediately, for first responders in general.”
SOR: Are there other behavioral health issues Florida policymakers and other stakeholders should prioritize in the coming months?
AG: “I hope they focus on youth services in schools instead of going in the opposite direction. I hope that we learn to have open and honest communication in schools, that everybody’s respected. Parents, students, teachers, everybody. I hope that both sides learn to work together. There’s extremes on both sides, and extremes are never going to be best for the mass majority. I think that when both sides work together and try to create some policies that are maybe in the middle, that would get a lot better results.”
This interview was edited for clarity and length.