Episode Transcript
Speaker 1 00:00:09 Hello, fellow stewards. My name is eWAY. So from Rethink Health, a Ripple Foundation initiative, we're hosting a new podcast called Unsung Stewards in Turbulent Times. And it's about leaders like you who are taking responsibility to tackle the big question of our time. How can we design systems with the conditions that all people need to thrive?
Speaker 0 00:00:34 You're
Speaker 1 00:00:35 Not alone and wondering, can we break from business as usual in practical ways? How do we effectively lead communities and institutions to think and act in ways that will actually make a difference? And where do we find the courage to step forward when so many want to preserve the status quo? In this series, you'll hear human stories about real people in real places who are taking on these questions and making a real impact. Today we are speaking with Patrick McNamara, the CEO and president of the Palm Health Foundation in Florida. During a covid 19 Disaster Funders meeting, pat listened to the usual smattering of top down crisis responses based on evidence, but he wondered what solution would emerge if Palm Health engaged local resident leaders, people he calls context experts, to take the pulse about the needs of the specific neighborhoods, which would then inform how the foundation should be allocating resources. Palm Health's approach got hyper-local as a result.
Speaker 2 00:01:48 I have never lost that conviction in terms of, um, it's about dignity. It's about recognizing and, and practicing dignity and, and how we work with, um, everybody.
Speaker 1 00:02:04 Stewardship. It's not just a theory, it's happening all around us. Good afternoon, pat. Thanks for joining me
Speaker 2 00:02:13 Today. It's a pleasure. Thank you for having me.
Speaker 1 00:02:16 So Pat, I'd like to begin today's conversation by asking you, what is it about your life journey that draws you to be a steward of wellbeing in Palm Beach County?
Speaker 2 00:02:25 So the two things that were really formative from my, my upbringing were fate and also the family tragedies that we experienced. And so five of the seven of us of the siblings wound up having pretty significant mental health challenges, mostly in adolescents and somewhat typical of the, the course, but from eating disorders, anxiety, depression, substance use, bipolar disorder, and all of this sort of came almost like outta the blue, seemingly it was like a new phase in my family's period where prior to that time of extreme challenge, we were like almost a picture perfect family. Um, we were actually featured in the Times Pick, um, as a, a lawyer's big family. And it was a, like a local spread and of just a few years before things really started to change, uh, for the worst we were raised in being Catholic. And particularly with the, the Jesuit tradition, there's a phrase called being men for others.
Speaker 2 00:03:29 And I was always drawn to that concept of, and the Catholic social teaching, um, and social justice. It also was one of the things that really helped me one of the hardest times was when, um, I lost my brother. He took his own life. He was, uh, 21. I was 19. We were both at Georgetown University. Uh, we were very close, but that really changed my life. It was like an Adam bomb going off where prior to that I was a government major. I was planning to go to law school and after that I changed my major to, uh, psychology and then wound up going to my master's in social work. Those are definitely two of the most formative things that really play into and I think are, are also why I gravitate to this idea of stewardship when it comes to, I, I always had the thought in my family and as I went through graduate school and everything else, what my family went through, what I went through, I can't imagine putting myself in the shoes of other people that I'm studying about in terms of much more marginalized experiences and, and whether it was in America or in other, you know, parts of the world and how they would deal with whatever challenges they had without having the same level of resources that my, my family had access to.
Speaker 2 00:04:42 And that always stuck with me that we were fortunate in many ways because we were able to get the resources and have access to, uh, the different forms of, of help and of all of those different extreme trials, you know, having lost my brother that said, all of us are doing great now, you know, with families of our own, they on the flip side of post traumatic stress, they refer to as that post traumatic strength that, that you can find. I really believe that there is something there to that. And so this idea of stewardship and, and access to resources and being able to move beyond just my individual experience and look at what it means for other people's experiences and learning to value that and how we can bring about greater opportunity access and always building on, on strengths. You know, all of those things were formative from what our family experienced.
Speaker 2 00:05:42 And then my, you know, change in terms of professional development and my personal life leading to this is what I, I find to be my life's purpose. I had really, for her, all intents and purposes, almost the second mother, uh, who helped to raise us. And she was, she took care of our home. My mom needed help. I would never call Ida a maid Ida, and she's black, uh, just a wonderful human being. And the younger kids, you know, include myself. I was the fourth on down. We really, she was like another mom to it. And so in graduate school we had to interview somebody who was different from us, um, on several different dimensions and including color of skin, whatever else, and, uh, interview them and get to know more about them and, and get their life story. So I interviewed Ida for, we wound up talking for, it was probably a good four hours, and I learned things about her that I had never thought to ask before.
Speaker 2 00:06:37 That was the beginning of, of a, of a small recognition at that point. Or, you know, somebody that I, I loved and and respected, but had no shadow of a, of an idea of what their life's experiences were like previous and had different, I mean, and, and really tragic. I mean, you can imagine being black and in New Orleans and, uh, she was more from the, a rural area. Some of the things that she shared with me. I just, that also planted a seed for it. It took a long time for me to honestly come back to professionally looking at systemic racism, being at the heart of so much what we we deal with. But that was the beginning of a recognition.
Speaker 1 00:07:18 Wow. Well, thanks for your vulnerability and courage, pat. What what really strikes me is the way you didn't stop at your own personal pain, but you really connected it to a broader solidarity with human experiences outside of your own. So tell me, you know, when the pandemic hit, how did the Palm Health Foundation respond?
Speaker 2 00:07:38 We talked internally as staff about, okay, so what's going to be our response here, given just the high level of uncertainty, what's out there? Our partners that we work with on a pretty regular basis, were already moving towards absolutely necessary, but much more traditional responses. It was the same group that have come together and that we've been a part of for, uh, dealing with hurricane and other natural disasters. So it was like a disaster funders group that was meeting, and we were talking about what we would do and how they would vet applications for assistance from nonprofits and that sort of thing. And we expressed interest in, in participating in that, but at the same time, more from connecting our efforts, which are much more connected on the ground level than a lot of our partners have been when it comes to being able to take the pulse in particular neighborhoods and working with residents and not assuming that we had all the data that we would need.
Speaker 2 00:08:33 And so complimenting sort of the data that most of the other funders would've access to with feedback loops in each of the neighborhood, and we said that we felt that that would be really valuable. We just have a healthy skepticism, frankly, of more institutional answers. I feel that usually institutions respond to these sort of crises with a lack of information and often with the top down approach of decisions being made. So what we have become very interested in is this, uh, complexity science and applying that, uh, with resident voice and really honoring hyperlocal solution and as much as possible, looking the ability to, uh, encourage mutual aid and to leverage the, the natural folks who are already viewed on their block or in their areas as trusted community leaders who can go out and collect stories from folks.
Speaker 1 00:09:28 The Palm Health Foundation used a tool called SenseMaker to gather stories from local residents block by block to get a pulse on what their needs were. When Covid 19 hit, the tool relied on connections they had to hyper-local leaders. So if I'm hearing you correctly, when Covid happened, the dominant gravity was to respond with top down institutional ways from disaster relief content experts and the Palm Health Foundation wanted to compliment that approach with your linkages to socially anchored leaders or context experts.
Speaker 2 00:10:04 That's exactly right. Had we not been at this for over four years in particular communities and having already had those relationships, there's no way we've been able to do it overnight. It is absolutely essential to, to take the time to build trust and in those relationships in these communities because so many of the particular communities are used to having well-intended program efforts come in with solutions, um, and in some ways get conditions to, okay, so like, what are you gonna do for me next? You know, as opposed to asking and developing the relationship. And, and so what do you think is a solution? You know, and, and how can we really as, as hyperlocal and uh, as relevant to, uh, those hyperlocal areas, what do you guys think? And the, I just kept hearing an expression back before I came to the foundation. Whatever you do for me, without me, you do. To me, that really struck a chord for me because I recognized that I had become really good at designing programs and doing things to people with a lot of good intention, but it was extremely humbling to understand that I needed to begin to adjust the way that I was directing my former organization. And, you know, have we not had that momentum in those relationships, there's no way we would've, you know, thought, okay, we're gonna do sense maker at the beginning of the pandemic.
Speaker 1 00:11:28 Pat, could you share a story about a particular instance where, where this approach really helped, um, residents in a more powerful way?
Speaker 2 00:11:37 A story came on as a person who, uh, had a chronic illness was shut in and their last check had run out and they were pretty dire straight. And so that prompted us to set up a, a rapid results process. Instead of us making the decisions on those rapid results, we, we pulled together a team of folks who would review the stories, and this was volunteers from some partner organizations and they would say, yeah, we absolutely need to reach out to this person. They would do it with a phone call to start. And then in terms of material support, we developed the neighbors Helping Neighbors fund refer to it. So we carved out $200,000 from our funds and offered that on a one to one match basis to the community and set up local hubs, mainly in like churches and a couple of other non-traditional sources where they would distribute the funds, we would send them the funds, and then they would decide in terms of, okay, based on the needs and the stories and what we're hearing they would distribute. And so it was a, an alternative meant to compliment the folks who would fall between the cracks of the otherwise good and substantial relief efforts of things like the CARES Act and other, you know, things happening.
Speaker 1 00:12:51 What I'm hearing, pat, is that actually you were able to act with, with more agility and more efficiency, putting the funds towards where it's most needed. Um, in that specific block or in, in that specific congregation,
Speaker 2 00:13:04 There was a blind child and there were three kids, single mom living with the grandmother. The single mom had just lost her job. Grandmother was able to work, but uh, did not have any means of transportation, was also participating in this, uh, circles program where she was trying to help move the family outta poverty. And so one of our partners was aware of this family. So anyway, we come to here, this story, and then at the same time when we put it out to the community that we were was gonna do this match and were open to donations, got a call from an attorney who had just bought a new car. He had a 20 Lexus, um, with like 30,000 miles on it and he wanted to donate. We've never taken a car donation before. We looked into all the ins and outs of it, figured out how we could, uh, without taking title, facilitate transfer from this attorney to this. So that's just another example of literally neighbors helping neighbors by being the sort of the, the go between for facilitator.
Speaker 1 00:14:04 Another example of how Pat and the Palm Health Foundation have focused on hyperlocal solutions and context experts is through their focus on racial equity and mental health, particularly in Delray Beach, Palm Health and its partners have brought the Racial Equity Institute to facilitate workshop on race equity training.
Speaker 2 00:14:23 I, I have to say, one of the best experiences for me being involved in this kind work, going to those sorts of challenging conversation meetings. I went to one in Delray when I first started at the foundation, and it was, uh, open Citywide and they had over 120 people. And we're talking from the city administrator and professionals, uh, neighborhood residents and others, all for this groundwater presentation, talk about race equity and how Delray Beach was going to continue to make advances in, uh, equitable behavioral health. Uh, for instance, one of the, the folks was there started a, uh, they call it cuts and conversations, mental health conversations, barber shop specifically for black males. And so, uh, that has kind of taken on a life of its own in, in a good way and the recognition that most of our mental health and behavioral health attempts have fallen short on the community engagement front. And rather than bringing participation in from what we refer to as context experts, we were all so used to, uh, just deferring to our content expertise when it comes to behavioral health, mental health, that it really changed things up when we honored the folks who had lived experience dealing with the mental illness.
Speaker 1 00:15:42 It sounds like what you're really doing is investing in, in local leaders and capacity in these turbulent times. And I saw in one of, um, Palm Health Foundation's strategic documents, a quote from one of the great organizers and professors, Marshall Gans. Um, and, and I believe he defines leadership as accepting the responsibility to create the conditions that enable others to achieve shared purpose in the midst of uncertainty. Could you just reflect on that quote, pat?
Speaker 2 00:16:14 I've committed that definition hard, um, because of all the definitions of leadership, it was the one that I had gravitated to most. And when I first came to Palm Health Foundation, I said it in my first board meeting, and I mean it's, I think most of our staff have committed to memory as well. And to me, Marshall's approach on organizing its leadership is what we need. Many people make the mistake of confusing authority with leadership. If you're in a position of authority, you need to exercise that authority with leadership. Doesn't matter what position you're in, you can exercise leadership. Its very much a servant leadership model that honors the context experts and recognizes that you're operating in uncertainty. And as Marshall always used to say, if you have certainty, you just exercise authority. It's when you have uncertainty that you need to exercise leadership. And that's so true.
Speaker 1 00:17:08 I love that. And engaging, engaging context experts and resident leaders seems like, you know, a nice and effective concept that you, but you seem to have a really strong conviction in this. And I'm just curious, you know, where's that from and, and what makes this real for you?
Speaker 2 00:17:24 The conviction for me over time, from a faith standpoint, I firmly believe with everything in my being that we've all been, no matter what your religious beliefs are, but we've all been stamped with the image that endows every single human being with a dignity that is inherent. And so practicing dignity became the biggest thing for me in terms of getting beyond the hypocritical nature that we often have and how we devalue each other. I have never lost that conviction in terms of it's about dignity. It's about recognizing and, and practicing dignity and, and how we work with everybody. So with that in mind, I had one, you had asked if I had any quotes or any poems or anything like that. And this is almost like a little bit of both. You're an on being fan. I don't know if you ever heard the uh, uh, John o Donahue interview again and again, it's not what you have and who you are that's decisive. But rather it's the way you are towards them, the way you behold your immense, mysterious lighted, whether it's a burden to you problem to be solved, or whether it's a wonderful mystery to actually be celebrated and deepened and that you are in the new light every day. There is something eternal going on inside everyone. And to me that is dignity and practicing dignity is always about, it's how you are towards them.
Speaker 1 00:18:47 Wow, that's beautiful. Each of our lives are a wonderful mystery to be celebrated. Thanks for sharing that, pat. I'm curious, you know, even though it's as simple as practicing human dignity, you know, many of the things that you're, you're talking about and the things that you're doing are so counter-cultural. What type of resistance have you experienced and and, and have you navigated that resistance?
Speaker 2 00:19:15 There's been this tension for, for some time that I've been aware of in the social services arena in general, uh, in community development, behavioral health, you know, uh, you name it. But almost like a tyranny of evidence based programming. And if it's not evidence based, then we're not gonna fund it anymore. And it's not valuable. I have an appreciation for evidence based programs cause I, I've seen how it can be helpful and, and can offer some solution, but this is where it gets into the science of, uh, complex adaptive systems. And I believe the way that the world has frankly changed in terms of context dependence, it's usually been from within in terms of our board allowing us to, to go in this direction or initially they really wanted it to be quantifiably, you know, evaluated and came in with a sort of master plan and didn't realize what they were getting into.
Speaker 2 00:20:07 And thankfully have continued to understand that this is in, in many ways, as you said, countercultural not conventional but valuable. So where is the value? And, and so we have continued to help focus our board. And now increasingly with others that we had previously gotten a lot of resistance from our partners that are much more traditional to now they're asking us, well, how do you do that? Cause especially when it comes to the community engagement part, there's been lip service paid for years about, you know, you need to ask the community. Well, so often it winds up being tokenism or, or somehow, um, you know, a focus group or, or these other things without there really being a meaningful participation from folks and just how much that changes. You know, you can't ask the community how do you define behavioral health without them being open to, well, that's a definition that's very different from the way that the context experts did.
Speaker 2 00:21:02 So how do we begin to reconcile those things and, and work together on that? And that's been tremendously helpful to kinda roll with the resistance and be patient enough and to encourage others to be patient enough for the good things to come. And we used to say all the time, trust the process, trust the process, and this work is not for everybody and it's not, you know, there's a place for the more traditional way of doing things, there's no doubt about it. So I'm never going to be, you know, it should be one way or another. But we believe strongly that our approach is a, is a necessary compliment. And uh, and I guess in having these kind of conversations with board members or like with the CEO of a, uh, of a partner organization or whatever else, I can talk the talk of program design and you know, what works and what doesn't in evidence based program.
Speaker 2 00:21:52 I can do that and, and I can, you know, share with people what my experience is. But then when it comes to like, okay, so where's the evidence based program for dealing with racism, this systemic racism, there is not. And you know, it's just an example of in some of the most stubborn challenges in our social ills, there is the sense that we can somehow technocratically problem solve our way out of them. And I just, at every step that I can let folks know that the technocratic problem solving process is, is an important thing that we never should get rid of, but then unless we compliment it with this respect for human dignity and the other human being and context experts who had perspectives that we have no idea about, the sense making that we need to do is never going to happen. And so we are always going to fall short unless we create space allows for that sort of sense making as the world has only become more complex and, and frankly difficult to understand.
Speaker 2 00:22:50 And most people punt on the whole idea of sense making culture changes really, really are, you know, that's what we're after. One of the things that helped with that was helping, uh, in terms of value was seeing that what we're after isn't necessarily the quantifiable wins, but policy win. And so if we could collect policy wins, small p big p, small p being how organizations operate in their own internal ways of operating big p public policy, that's really what we were after in terms of the results that we were seeking. And so once folks understood that, they understood that it wasn't just a, a feel good aimless activity or at trying to, you know, bolster democracy in general, but that it really is after making changes and it's at the policy level, that was the most tangible thing that folks could say. Ah, now I get that.
Speaker 1 00:23:42 And I wanted to end by asking you, what do you see as the role of foundations like the Palm Health Foundation in stewarding wellbeing in their communities?
Speaker 2 00:23:53 I feel pretty strongly about this. Um, when it comes to, there's the government sector, there's the private for profit sector, and then there's the nonprofit sector. And, and especially when it comes to US foundations that have power in terms of resources, financial resources, I view that that money is really best suited for as risk app. It's not like risks that you just take blindly at all, but it, to me, it's best used to continue to push at the boundaries and fill in the gaps that those other sectors can't or won't. And so I, the more we have talked about that internally and with our board and coming to a comfort level that what would you rather have? Would you rather invest in a social return on investment that it's going to take years to determine just, uh, in a quantifiable way what sort of change we've been able to make or have, but it winds up being absolutely substantial and and transformative.
Speaker 2 00:24:50 Or would you prefer to go a safer route in terms of the ROI on the investment and I can demonstrate it to you within six months or, um, there's a case to be made for both. And so I think that foundations that are place based have a role for helping folks transition to this whole idea of context dependence and leading the way on really exploring how do you do that and how do you do it well? Because again, government is never going to be able to do it. And private for profit businesses are never gonna be able to do it. And the for profits, for the most part that are do not have endowments like ours need to stay in business and don't have the ability to exercise this kinda risk where we're looking to go next. How do we move our piece to a much larger effort where we're not steering it, but it's part of a Palm Beach County health equity network and beginning to pull together partners about hashing out that idea and what the possibilities are.
Speaker 1 00:25:49 Well, thank you Pat, for this fascinating conversation. I'll definitely continue thinking about it. I really just appreciate you, your journey and the time you were able to spend together today.
Speaker 2 00:25:59 Fantastic. It's been fun. Anyway,
Speaker 0 00:26:04 Patrick
Speaker 1 00:26:04 McNamara is the CEO of the Palm Health Foundation in Florida. You can learn more about the great work of his organization at the Palm Health foundation.org. This podcast would not be possible without the talent of Bobby Millstein, Jane Erickson, Brad Gerard, and Jessica Estelle Huggins. I'm your host eWAY. So Rethink Health, a Ripple Foundation Initiative, and you're listening to Unsung Stewards.
