Integrity–A Personal Code of Conduct

binocularsWelcome back to my blog!  In the space between my last Blog in May and this one, I lost a little steam.  This is the fifth blog post in a series of six that focus on the Aspire Values.  Ironically, this one is on Integrity.  At Aspire, we define Integrity as “doing the right thing, even when no one is looking.”

So let me do the right thing by fulfilling my commitment to writing this blog, even if no one is reading!

Integrity isn’t about following rules; it is a personal code of conduct, defined by one’s values. Integrity means living out your values without regard to how it reflects on you.

Organizations can also be intentional about its values.. Aspire has done that with its PILLAR values – People, Integrity, Laughter, Learning, Accountability, Relationships. I recently attended an executive roundtable led by Jim Schleckser, an author who advises leaders and companies. He said that an organization’s values help all employees know what to do when there is no one to ask. It is how we manage the ‘white space’ or what I would refer to as the behaviors and actions that are not covered in rules, policies, procedures and written codes of conduct. This is a great extension of our value of integrity–doing the right thing when no one is looking or when there is no one to ask!

So, next time you encounter a difficult situation at work where your behaviors are totally up to you, ask yourself, “Am I living out the Aspire Values?” If you can’t confidently say yes, consider an alternative behavior, even if it is the more difficult action! Notice how you feel. Living intentionally is powerful!
While Integrity is personal and not meant to be bragged about, we didn’t say anything about not bragging on each other! Remember, we have a NEW recognition program at Aspire called, “Way to Go!” This is an opportunity for Aspire employees to recognize each other, and for the community to recognize Aspire staff for outstanding work. Everyone can find the recognition form on our website, under “Way to Go!” and Aspire employees can also find it in the Aspire App under “People”. Aspire, I encourage you to be on the lookout for integrity in the workplace, along with our other values, and don’t hesitate to recognize and celebrate each other!


bios_scottAbout the Author: Barbara Scott is the Executive Vice President and Chief Operating Officer at Aspire Indiana. Learn more about Aspire Indiana on Facebook or at its website.

Posted in Business, Uncategorized, Veterans, Workplace Culture | Tagged , , , , , , , , , , , , , , , , , , , , | 1 Comment

Suicide Risk: Clinical Training

In my last post I wrote about Aspire’s BHAG (Big Hairy Audacious Goal) of 0 after 5 (zero suicides after 5 years), in a post titled, “0 in 5: Our Suicide Goal”. In that post I outlined our 5 steps to achieving that goal:

  1. Train employees
  2. Supply clinical decision support tools
  3. Engage those at risk
  4. Implement care protocols that will provide the greatest safety
  5. Use data to improve the effectiveness of these over time

In this post, I will be giving an update on our progress and the strategies utilized to train employees. For those with Zero Suicide Initiatives underway,  I hope this post will provide an opportunity for dialogue on best practices and lessons learned for mutual benefit; I welcome your feedback! For all others, I hope you find encouragement from the progress being made and that this post will help you lend your voice to Zero Suicide Initiatives by staying informed and engaged with this issue. So now to the topic at hand…

When Aspire first began working on this zero suicide initiative in mid 2014, we formed a work-group (the opportunity was missed for “A-Team” or “Z-Team”) of clinical managers, crisis manager, and administrators to lead the effort. Before charging into the fray, we spent several months learning about how other organizations are working to improve care in this area.  In doing so, we found some sound advice from peers that suggested we survey our employees to determine what they already know (or don’t) and what their attitudes and perceptions were surrounding suicide.  So we did! We had a tremendous response from our employees, with about 70% of respondents being clinical providers.  Only 39% of respondents reported any classroom (graduate or undergraduate) level training surrounding suicide and 29% reported they don’t always ask about suicide with new clients.  Finally, only 2% accurately reported the number of deaths by suicide at Aspire that year, with 39% underestimating the number and 59% responding “I don’t know”.  This survey gave us a great deal of information about where we were and how to start the training process.

qprAs we analyzed the results of the survey, we recognized a glaring need that had to be addressed immediately, and that was for our front-desk employees. Anyone who comes through our organization is first met by a front-desk support employee, so it was imperative that they knew to recognize the signs of someone who may be suicidal so they can be connected the proper services as quickly as possible. So we began by providing training for front-desk support employees in QPR (Question Persuade Refer).  This is a national training to assist the public in identifying and acting when they encounter someone who may be suicidal.

Building a training paradigm for our behavioral health service providers was no small task. Many of our behavioral health service providers seemed to believe that treatment of suicide risk occurs in an inpatient setting or is best addressed by treating an overarching condition such as Major Depression.  Neither of these responses reflect the most recent research or inpatient discharge data. So we were struck by this question: How do you impart a lot of information, tools, and techniques onto an audience that is spread across 4 counties, among 18 clinical teams, with new clinical employees arriving every week?  We decided on a training program that consists of several tiered training sessions.

Live training was provided by our clinical trainer and a facility director on how to assess individuals for suicide risk.  This was training in large part about how to have the clinical conversation about suicide, what to look for, and when and how to question deeper than the initial response.  It was also designed to supplement our existing online training, while educating employees about misconceptions and information obtained in our survey.

notes-macbook-study-conferenceAfter the trainers made their rounds to teams for the live training, we initiated training in the use of the Columbia Suicide Severity Rating Scale (CSSRS).  The work-team selected this tool to replace our existing, outdated risk factors rating system, because of its researched validity and reliability, widespread use among fellow treatment providers and ease of use and training for clinical employees.  The CSSRS has been identified as the premier tool for identifying those at risk for suicide and developing an initial care plan, and we wanted the best.

We are now in the process of rolling out new treatment protocols, which were developed with the assistance of Jeffrey Garbelman, Ph.D.  Dr. Garbelman is a trainer for CSSRS, and was able to share treatment protocol ideas from other service providers. The workteam has established and is piloting a set of clinical guidelines/protocols to improve the safety of our consumers at various levels of risk for suicide.  Dr. Garbelman endorsed our protocols, and as we implement them and finalize them, he has committed to work with us to seek endorsement by Columbia University. Live training has been provided to our roll out teams about the content of these protocols and they have set out to begin using them.

In the fall we are providing training in Cognitive Behavioral Therapy for Suicidality.  This training will provide clinicians with evidence based training in the treatment of suicide.  This treatment is applied directly to suicidal thoughts and behaviors, rather than working to only treat an overarching condition.

Finally, we intend to wrap up all trainings with one overall final training that utilizes case examples and has the provider apply the knowledge of all four trainings into the review of the care of sample cases.  Sort of a final project, if you will, on using the information obtained in the training.  

These tiered trainings and the details within them are highly complex, require new learning (as well as some “unlearning” of old paradigms) and require ongoing decision at the provider, team, and supervisor levels. For full and effective adoption, we are planning for annual refreshers to ensure skills and knowledge aren’t lost. To assist in that effort we are introducing clinical decision support tools within our EMR.  Built in items like Safety Plans, CSSRS, flagging for high risk missed appointments, protocol explanations, etc will be vital to assist everyone to be on the same page and provide consistently high safety care to our consumers.  

That wraps up our efforts thus far to train staff and our plans to keep them trained in the future in order to know how to recognize the signs of suicide risk and the proper steps to take in order to prevent it.

Stay tuned…more about our Zero Suicide Initiative in future postings!

So what do you think? What is your organization doing to reduce the rate of suicide in your consumers? As a member of society, what do you see as your role in reducing and eliminating suicide? Share your responses to these questions or thoughts and feedback of your own using the comment feature below!

ProfileAbout the Author: Jim Skeel is the Senior Director, Performance and Outcomes of Aspire Indiana. Learn more about Aspire on our website, or on Facebook.

Posted in Clinical Protocols, Integrated Healthcare, Mental Health, Suicide Prevention, Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , , , | Leave a comment

0 in 5: Our Suicide Goal

sunset-flag-america-fieldsMany of us have seen on Facebook  the #22PushupChallenge to honor the 22 deaths by suicide within our veteran population a day.  And you may or may not know that suicide continues to be identified as a one of the leading causes of death in the US across all age groups, gender, and race and is now ranked 2nd as a leading cause of death for individuals aged 15-44 .   Unfortunately, Indiana exceeds the national average in deaths by suicide per 100k people and Madison County, where we are the largest behavioral health service provider, has an even higher rate of deaths by suicide per 100k residents compared to the state and national averages. We’re right in the middle of the “hot zone” and at Aspire, we have seen an alarming increase over the last few years of deaths by suicide for the people we serve.

Our response? Enough is enough. That is why one of Aspire’s 4 Big Hairy Audacious Goals (BHAGs) is 0 after 5. This means we want zero suicides after five years among those we serve. In an agency where we do behavioral health treatment every day with people contemplating suicide, the idea of zero seems more than lofty, it seems impossible.

So, in a state and community where people are killing themselves at a higher rate than the rest of the country, why make such an outlandish goal to eliminate suicide?  Simple, Aspire is articulating the approach that we, as individuals, want for ourselves, our families, our friends and our communities.  No one who works here wants to lose anyone we know through suicide.  And, since we work in an industry designed to treat this problem, we intend to put forth every effort we can imagine to end it and quickly. In order to meet it, it will require our organization, teams, and employees working together with everyone we serve to achieve it.

Fortunately, we are not alone.  I have been amazed at the successes being made within organizations who have taken on a Zero Suicide Initiative.  Sometime around 2008, while attending the annual conference of the National Council for Community Behavioral Health, I became aware of the initiatives at large healthcare organizations to dramatically reduce or eliminate suicide as a cause of death for their service recipients. Large providers like the Henry Ford Health System, in Detroit Michigan, provided dramatic data on the decline in suicides by improving the identification, engagement, quality of their care, and improved transition planning for those with suicidal thoughts or plans.  In the years that follow, I have seen similar results from places like Kaiser-Permanente, Johns Hopkins, and others large healthcare programs. More recently, within Indiana, other healthcare entities have adopted the Zero Suicide approach in an effort to eliminate suicides within their communities.  Community Health Network and Centerstone have formally launched these efforts, and are inviting others to join.  Aspire will be learning from its peers in order to utilize effective practices and to share our successes with others. While our goal is to eliminate suicide from those we serve, it should be everyone’s goal to eliminate suicide in their circle of influence and we want to play our part in creating synergy and progress towards that goal on a community level.

The gauntlet has been thrown down; the banner has been raised. Zero suicides after five years. In order to reach this goal, Aspire has created a 5 part plan:

  1. Train employees
  2. Supply clinical decision support tools
  3. Engage those at risk
  4. Implement care protocols that will provide the greatest safety
  5. Use data to improve the effectiveness of these over time

Work has already begun on these parts, and in future postings I will share more details about each and the progress being made to reach our zero suicide goal.


Center for Disease Control. “FastStats – Leading Causes of Death.” Center for Disease Control and Prevention. Center for Disease Control and Prevention, 27 Apr. 2016. Web.

Suicide Prevention Resource Center, and National Action Alliance for Suicide Prevention. “Zero Suicide.” Zero Suicide. Education Development Center, 2015. Web.

World Life Expectancy. USA Life Expectancy. World Life Expectancy, 6 Jan. 2016. Web.



ProfileAbout the Author: Jim Skeel is the Senior Director, Performance and Outcomes of Aspire Indiana. Learn more about Aspire on our website, or on Facebook.

Posted in Clinical Protocols, Mental Health, Suicide Prevention, Uncategorized, Veterans | Tagged , , , , , , , , , | 4 Comments

“Medal Winning” Videos of Homelessness

With the Olympics wrapping up yesterday, our minds have been saturated over the last two weeks with the images of bronze, silver, and gold. These colors have taken on great symbolism as the brand of remarkable achievement. In this spirit of this time honored ranking system, Jerry Landers (Executive Director of Aspire Indiana Health, and Vice President, Chief Development Office for Aspire Indiana) and I have taken it upon ourselves to award the bronze, silver, and gold medals to 3 movies for their excellent depictions of homelessness in the United States.


Time out of Mind

Richard Gere (George) plays the lead in the movie “Time Out of Mind”, which depicts George’s existence as a homeless man on the streets of New York City, struggling with his identity
Unlike the two movies to follow, Director Oren Moverman’s focus of the film was not on the circumstances that led to George becoming homeless. Instead, the film takes an observer’s perspective, narratively and visually. What we do learn of Gere’s character is that he has suffered tremendous loss and in the process lost his sense of purpose and identity. We see George use alcohol as a coping mechanism, manipulate others, suffer the harsh rejection of almost all other characters in the film, and struggle through a dysfunctional shelter and social services system as he tries to get by each day. The power in this film is in what isn’t said, in the unknown. Too often there is the temptation to jump to conclusions about those who are homeless. Viewers of “Time out of Mind”, if they have the patience, will gain new insight and appreciation for all that can be happening “below the surface” in this unique population.


Pursuit of Happyness

“The Pursuit of Happyness” is based on Chris Gardner’s true story as a struggling parent being homeless and raising a young son during the early 1980s. Directed by Gabriele Muccino, the film stars Will Smith as Gardner and Smith’s son, Jaden Smith.
“The Pursuit of Happyness” plays an important role in highlighting the misconception that all individuals who are homeless are just lazy. The truth is that nearly 40% of all homeless persons have a job, and when surveyed, the majority of those without employment say they are willing and want to work. “The Pursuit of Happyness” demonstrates how quickly anyone’s circumstances can change, and how challenging the process can be to re-establish stability while homeless. There is inspiration to be found in this story, but viewers should be careful to check their “rose colored glasses” at the door, as Gardner’s intellectual talents and people skills gave him the opportunity for a way out not accessible to most who find themselves in similar situations.


The Soloist Based on the book by Los Angeles Times columnist Steve Lopez, “The Soloist” is the story of an unlikely friendship between an LA reporter (Robert Downey Jr.) and a homeless musician dealing with a serious mental illness ( Jamie Foxx).
“The Soloist” made our top 3 videos list for multiple reasons. The first is that it powerfully depicts the link between mental illness and homelessness. With a masterful performance by Foxx, the audience is able to glimpse into the world of someone struggling with mental illness and how what seem like simple solutions are extremely complex. On the other side, Downey’s performance as a LA Times columnist reflects what many individuals, both in the mental health field and outside it, feel when confronted with mental illness: frustration, disappointment, and the temptation to look down on those with mental illness. However, Downey’s character, Lopez, has the redeeming quality of passionately and persistently believing in Ayers’ (Foxx) potential and intrinsic value. The ability of this film to realistically portray both sides of homelessness in a way that resonates, convicts, and elicits empathy from viewers is what gives “The Soloist” the gold.

So what do you think? Do you agree/disagree with our rankings or did we leave out a deserving film entirely? We want to hear your thoughts and feedback in the comment section below! For those who may not have seen these films, we encourage you to do so and then come back and share your thoughts.

If you know of someone who is struggling with housing, we encourage you to learn more about the housing programs (linked below) available through Aspire and share it with them. We have a 24 Hour crisis line available with caring folks standing by ready to help serve those in need.
Housing Services – Aspire


About the Author: Kevin Sheward, MBA, is a grant writer with Aspire Indiana. Learn more about Aspire Indiana on Facebook or through our website.

Posted in Addiction, Health, Homelessness, Housing, Mental Health, Mental Illness, Uncategorized | Tagged , , , , , , , , , , | 2 Comments

Housing, an Important part of HEALTH!

diabetes-blood-sugar-diabetic-medicine-46173When we talk about health, we often take our homes for granted. If you were to walk out of a doctor’s office with a prescription for insulin or orders to lower your stress by getting more sleep, how would you do that without a home? Where would you refrigerate insulin while taking shelter under an overpass? How would you get a restful night’s sleep in a noisy and crowded shelter with 50+ other men/women? These are just two examples of how, without a home, health is an uphill battle. Because of this simple truth, Housing is a significant social determinant for health.

The Social Determinants of Health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. The conditions in which we live explain in part why some Americans are healthier than others and why many Americans are not as healthy as they could be.

cold-snow-person-winterSadly, roughly 500,000 people were homeless in the US last year. More than a quarter of them were children. According to HUD’s 2015 point in time count, 565,000 people were living on the streets in cars, in homeless shelters or in subsidized transitional housing during their one-night national survey. Nearly one-fourth were aged 18 or under. Many studies suggest that the real number is much higher.

This is why Aspire has such a strong focus on housing. By working to establish practices that positively influence social and economic conditions and those that support changes in individual behavior, we CAN improve the health of people in ways that can be sustained over time.

Aspire provides property management services and various housing assistance programs to the many counties we serve, which include Madison, Hamilton, Boone, Hendricks, Hancock, and Marion. Annually we work with hundreds of individuals that are living on the street. We access a variety of federal, state and local resources to help individuals gain housing. Once they are housed we continue to provide supportive services including working with our supportive employment team to address issues with unemployment or underemployment.

If you would like to learn more about our Housing services please check us out on the web or follow us on Facebook


Johnson, E. (2015). More than 500,000 people homeless in the United States: report. Retrieved from (2016). Healthy People 2020 Leading Health Indicators: Progress Update.  Retrieved from (2016). Social Determinants of Health: Know What Affects Health. Retrieved from


Jerry_LandersAbout the Author: Jerry Landers is the Executive Director of Aspire Indiana Health. You can follow him on Twitter @JerryELanders. Learn more about Aspire on our website, or on Facebook.

Posted in Health, Homelessness, Housing, Integrated Healthcare, Mental Health, Primary Care, Uncategorized | Tagged , , , , , , , | Leave a comment

The Big Lens Video Contest

Sometimes a fresh perspective is needed to find insight, solve a long standing problem, or to rejuvenate the mind. Here at Aspire we work hard to tell our story in ways that are relevant to you and through mediums that are easily accessible. With an ever expanding network of employees, consumers, and interested community members, we have the challenging and exciting task of making sure our new friends have the opportunity to learn about the myriad of services we offer, and those who have been with us for a long time have compelling reasons to stay engaged through our social platforms.

Enter… The Big Lens Video Contest! 


The Big Lens Video Contest is for you (18+): our employees and families, friends, consumers, community stakeholders, anyone interested in film and Aspire, all those up for a little competition, and anyone who just wants a chance at a $2,500 grand prize!

Yes, a $2,500 grand prize! 

Here’s how to participate:

Create a video that tells a positive story about Aspire. It could be about the work that we do, the services we provide, a personal story of impact, etc. You can try and cover the whole spectrum of Aspire or focus on any aspect you choose. But remember, the videos have to be between 90-120 seconds.

The deadline for video submissions is March 31st, 2017. Videos that meet the criteria will be posted on Youtube, and the video with the most views at the end of the viewing period will receive the grand prize of $2,500!

We hope that with YOUR creativity and talents we will be able to take a step back and see Aspire from a new perspective,  through a bigger lens.

If you are interested in participating in “The Big Lens” video contest, check out the video along with the full rules and entry form linked below. If this isn’t for you, would you help us out by sharing it with someone who may be? We’d really appreciate it!

“The Big Lens” video contest rules and entry form


Posted in Integrated Healthcare, Marketing, Social Media, Uncategorized, Workplace Culture | Tagged , , , , , , | 1 Comment

“As Seen On TV”

When I think of outlandish claims, the phrase “As seen on TV” instantly comes to mind. Whether it’s indestructible hoses, pajama jeans, sauna pants or anything else “As seen on TV”, they claim to be the latest and greatest items you couldn’t live without. The loud and flashy commercials, unsettlingly happy actors, and promises of incredible value lure you in. In your mind you’re thinking, “I know it can’t be as good as promised…can it?” We’ve all fallen prey to these sales pitches at some point in our lives, only to be disappointed when reality fails to live up to expectations.

As I reflected on my first 120 days, I jotted down a list of words I felt described my time with Aspire, along with a list of meaningful events. What I discovered was quite intriguing. The words I was choosing aligned perfectly with the Aspire Values that Executive Vice President and Chief Operating Officer Barb Scott has been writing about over the last several months.

In my first 120 days, I have seen an organization that believes passionately in the potential of its PEOPLE, both its employees and the individuals we serve. I have seen this through the stories of folks being promoted through the organization, through the interest others have shown in my personal development, encouragement, and the belief that recovery is possible for our clients. 

In my first 120 days, I have seen my coworkers display countless acts of INTEGRITY through hard work, honesty, vulnerability, and dedication. The culture here has been to do things well, and to do it the right way, with character and integrity.

In my first 120 days, I have experienced so much LAUGHTER! The friendly banter, seeing my coworkers dressed up for May Day, hilarious pranks, and a relaxed atmosphere has made laughter abundant.

In my first 120 days, I have been immersed in LEARNING. Aspire has so many moving parts and is impacting lives through so many different ways. As a grant writer, I have the privilege of learning about all of these moving pieces and have the joy of sharing their successes with others. This isn’t just a first 120 day experience. Through Director of Training, Clinical Supervision & Outcomes Mike Gray’s training sessions, professional conferences, webinars, and collaborative teams, Aspire employees are always learning.

In my first 120 days, I have felt the weight of ACCOUNTABILITY. Those we serve deserve our best. At Aspire, we are all responsible for the success of our organization. It is a fast paced environment with lots of challenges to overcome. We are all yoked together in this work. Personal accountability is important, but just as important is the teamwork I have seen that helps everyone be successful.  

In my first 120 days, I have seen an organization that values RELATIONSHIPS. Birthday cards, celebratory parties, pitch-ins for sick and hurting employees, and lunches with coworkers are just a few of the ways I have seen Aspire employees live out the Value of Relationships and serve one another in love.

When I came to Aspire 120 days ago, I had heard some “As seen on TV” quality claims. What I have discovered in my short time here is that we truly are “Together…making health and well-being a reality!” The values Aspire upholds as essential to our organization have tangible manifestations in the workplace and actively inform and direct they way we conduct our work. Aspire has been everything I had hoped for and more; there is no “buyer’s remorse”!
When I chose to come to Aspire I was looking for a place that was making a difference in the community and where I could make have a meaningful impact. At Aspire I have found both.

About the Author: Kevin Sheward, MBA, is a grant writer with Aspire Indiana. Learn more about Aspire Indiana on Facebook or at its website.


Posted in Employment, Health, Integrated Healthcare, Uncategorized, Workplace Culture | Tagged , , , , , , , , | 6 Comments