Episode Transcript
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It's Tennessee Matters on the Tennessee RadioNetwork. Welcome to Tennessee Matters. I'm
John Clark and the Tennessee Radio Network. Tatis's statewide association of alcohol and drug
treatment, prevention and recovery service professionalsand others interested in adduction issues. TATIS
keeps alcoholism, drug abuse, andother addiction issues to the forefront, and
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public policy decisions are made and throughthe collective voice of members. My guest
on today's program is Mary Lyndon Salter. She's the executive director of TATIS.
TATIS, at its core, isan association of addiction service providers, so
that's the group that were lily cametogether and started TATIS as an organization.
But in their interest in trying topromote access to addiction services, it became
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clear that there were certain pieces missing. So one of the early grants that
the Department of Mental Health and Substitutesgave to TATIS was to run a statewide
clearinghouse of information about addiction, recovery, mental health, etc. So that
is a free service. Anybody inthe state of Tennessee can ask us for
anything on any issue related to addiction, family services, aging, mental health,
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etc. And it's all free literaturethat we send all over the state
at no cost to anybody. Soschools, the Quanis Club, whoever,
you know, we send them everything. But soon after that they funded us
to run a statewide toll free hotline, and that is a Tennessee hotline that's
available twenty four seven and it providesaccess to addiction treatment referrals, and addiction
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being defined very broadly. It canbe an eating disorders addiction. It can
be a gambling addiction, it canbe a pornography addiction. That can be
an alcoholism or a drug abuse issue. But that toll free number is refers
people to both private insurance, tencareor even state funded programs for the n
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injured. So that's those are twoof the big reasons why we're kind of
involved in a little bit of everything. Yeah, it's it's addiction is so
broad, so broad in it it'salcoholism, gambling, depression, eating disorders.
It just goes on and on andon. Yeah. Well, what
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we've come to find out about thebrain is the same chemicals that get released
when you, we know, consumea substance are the ones that get released
when you're dopamine you know, getsengaged for any pleasurable activity. So yeah,
we have come to think more broadlyabout what addiction is. Is that
how you look at it, whatthe brain feels it. You know this,
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this makes it happy, this makesit happy, this makes it sad.
Is that what you focus on morethan the addiction itself? Well,
for us, I think it's reallyone and the same. You know,
there's a there's some subtle differences,like managing pain is something that your survival
center brain wants to do to beable to keep you out of trouble.
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So yes, there are certain thingsto get reinforced when you take a chemical
or you consume alcohol, But yoursurvival center brain that just responds very instinctually,
you know, without thinking necessarily.Those are the things that get engaged
when you're when you are trying tomanage pain. So you're I think that's
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one of the difficult things about substanceabuse disorders that people need more information about
because when you're when you're functioning onsuch an instinction an instinctive survival center focus.
You know, if you think youdie, if you're in survival or
center mode, if you had tolike stop and say, oh, there's
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a tiger, I should run overthere. By the time you've thought that
through, the tiger's eating you right, right, So your brain is programming
that you don't think when you engagesurvival center, and so people want to
believe that you that people in activeaddiction could kind of be reasoned with about
what their addiction is, and theycan't. Necessarily they're functioning on a survival
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focus. Well, that's interesting.So if I instead of so if for
depression, if I've anxious about depressionor whatever, i just take antidepressants and
then I've become I may be addictedto but it's more better than being help
hurt in other ways. That isthat's sort of am I getting it a
little bit? Well, you cancertainly become dependent on any depressants, but
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you don't become like physically addicted ina in a sense that you crave them,
right, You you crave perhaps thefeeling of happiness. I'm wanting to
be better, and crave is probablynot even the accurate word for that.
But you your your body, yourbrain wants to do things to regulate your
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emotions and to give you a senseof, you know, of not being
in an anxious or upset state.So, yeah, here things that reinforce
that your body wants to do againand again, and then you just get
to a point where you're doing ittoo much, that you're doing it too
much, and then it becomes adependency or something that you can't stop right
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without you know, help. Andwhen it's something you can't stop yourself,
that's when we come to determine anaddiction. Yeah, it's alcoholism that was
most prevalent among all of them people. It is still the most prevalent,
although people hear a lot more aboutopoid addiction, but it's still the most
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common reason that people get admitted totreatment. Is alcohol use is that because
of its availability, it's so reallyavailable, you can just take it.
You'd have to get to the prescriptioners ay, think perfect, it's readily
available, more socially acceptable. Ithink people, yeah, have have access
for a lot of reasons, butopioids, I think near the level of
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consumption just because it was so accessiblefor a certain period of time. I
think doctors are better about prescribing practicesnow, but we certainly had a wealth
of prescribing that contributed to that.Boy, access was key with the opioid
epidemic. Yeah, that's true,and you just you saw it all of
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a suddenly prescribe. We'll give youa percose it for that or whatever for
that. And now they're just scalingback some and it's like you don't really
think about it, but it wasthere. It was definitely there. And
and we've come to focus on otherpain management techniques and other prescribing practices that
will help mitigate, you know,addiction. So I think people want it
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fast, that want maam, hurryup, take the spell and it'll be
over in a hurry, you know, and that makes it you know,
Well, you mentioned taking antidepressants,and you know, I think there's obviously
a reason why people are prescribed toantidepressants. But that's not like the cure
I'm using. But I think,you know, what people need to understand
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is that, you know, antidepressants work, but they work with therapy
best. It's not like you cantake a pill and just make the depression
go away. There's there's things thatgo hand in hand when people take medication
for even for addiction management, medicationassisted treatment like an orphine or vivitril or
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other substances. It's always prescribed wheneverpossible with therapy. These changes to the
brain don't happen just by taking apill. You have to practice retraining the
brain and giving it a different setof responses to what can be a survival
center or you know, just painmanagement issue for people. Yeah, that's
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true. That's true. Yeah,some of the you know, look at
eating disorders and you don't think,well, eating disorders, how really,
I just eat and I go at, won't But I guess they they that's
a that's a condition like this thathappens soon. That's for a little bit
more a little bit different reasons thana substance abuse. You no addiction,
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but many of the chemicals like dopamineand other endorphins and things are released when
people eat, and and it becomessomething that is that people act on,
you know, and for eating disorders. Yeah, and you and I guess
you well, I guess it's likeeverything else, right, You're just you're
eating to get rid of the pain, and that's what it's doing you.
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You are it's I don't know ifyou've heard of the adverse childhood experiences studies,
Okay, well, they're commonly referredto in the treatment community as aces
adverse childhood experiences and if I findif my memory is right. The original
position who did the research on itwas working with folks around losing weight,
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right, and he discovered the warand war he looked into that patient population
that they had all had common childhoodadverse experiences in their lifetime. So he
went with Kaiser Permanente apparently and gota nationwide research study that found a high
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correlation between adverse childhood experiences and laterin life mental health, addiction, heart
disease, diabetes and all these things. And when you think about it,
the thing that people used to regulate, you know, emotions and feelings are
often things around food and substances andthings like that. So you know,
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your ability to self soothe can befood related or it can be substance abuse
related. And those turns into thoserates of diabetes and heart disease and whatever
along with what people think of behavioralhealth issues. Yes, interesting, you
know you I've talked to somebody onthe show before recently about diabetes, and
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you know that's a big issue usuallybecause they're not everybody. In most cases
it just happens, but they're bigand they've because they've eaten so much,
and I guess maybe they hit eatingdisorders. Some people did well. They
may also have adverse tribal experiences whichare contributing to that. So in combining
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physical health and behavioral health services forpeople you know who have those common childhood
experiences, it's one of the waysthat we found makes for better interventions,
right. Yes, I noticed onit too. Something to deal with is
domestic violence. That just kind ofdebtails off of this, But that too
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is for getting for for for fordoing it and then for accepting it.
That's I don't know, that's there'sall sorts of resources for that too.
There are sort of reasons for that. There's reasons that we that are some
of the mental substance abuse issues anddomestic violence are often correlated because of the
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use of substances is often part ofa domestic and violence episode. Not always,
but you know, there are thereare definite commonalities. But you know,
we provide resources on the Tennessee RedLine for people who call with pretty
much any issue. And we dothat because frankly, people don't always know
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who to call when they're having anissue, so we want to kind of
provide a no wrong door coach.Yes, we're funded to do addiction treatment
referrals, but you know, ifyou call and you're experiencing some suicidal thinking,
we're going to be able to helpyou and refer you where you need
to be. If it's domestic violence, same thing, if it's gambling addiction,
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same thing. So we always tryto be a resource, and but
typically the callers, so we get, are more about a substance abuse than
gambling addiction. Oh substance okay,So so what it's it's one eight hundred
eight eight nine ninety seven eight nine. By the way, if you're if
you're suffering through this right now andneeded right now, I'll call that number
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absolutely and we'll we'll hapfully help youwith referrals that anybody in crisis and a
behavior health crisis should call. Ninetyeight eight. That is a nationwide toll
free access number for anyone any inbehavioral health crisis. Okay, so just
those three numbers. Eight Oh really? Oh okay, good, that's even
that's even quicker it is. Andif you need treatment referrals, you know,
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they'll definitely send you to our redlineor they can provide referrals as well.
But you know, we all worktogether. Yeah, and that's that's
what anything that we're talking about todaytoo. Anyway, if you're in experiencing
that kind of a crisis, nineand eight can help you. Yes to
that where you say resources with domesticviolence, it could be caused alcoholism.
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That could cause that. It couldbe because things like it could it could
cause that. I wouldn't say cause, it would say contribute contribute to.
Okay, Yeah, yeah, Ithink there's there's reasons why when your inhibitions
are lowered because of alcohol use.You know, all kinds of things can
unfortunately occur, and so there isa strong correlation, but not causing.
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And drug dependency could could certainly bepart of that too. Yes, and
it often contributes to you know,childhood neglect and issues for example, or
maybe even eating disorders, all kindsof things that are contribute to but at
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the same time not causation. Right. You know, when people have experiences
like the adverse childhood experiences that Italked about, you know, they often
are, like I said, selfsoothing. So many things contribute to soothing
ourselves, whether it's eating, drinking, isolation, any of those things will
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contribute to the medical and behavioral healthdisorders. Yeah, some of the other
things you had, suicide prevention forexample, that's that's that's pretty unfortunately,
that's it's becoming it is to getsuicide and it's not right. And so
what about suicide, Well, wedefinitely work hand at hand with the mental
health community and that one of theprograms that TAT is suspended to help manage
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and provide is the Tennessee Suicide PreventionNetwork And we have nine people and various
parts of the state that all workin local communities across the state to provide
suicide prevention awareness education, make peopleaware of resources available for treatment and things
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like that. But they work withschools, they work with local hospitals,
just trying to make sure that teachersand everyone are aware of some of the
signs and some of the issues tolook for. They do trainings. There's
a training here that's called question Persuaderefer and it's just so that people who
are not necessarily mental health clinicians orpractitioners, but like a teacher, you
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know, a business owner whoever canunderstand, you know, the kinds of
things that they should ask and tryto help people have access to treatment or
prevention resources when needed. So andin a case of suicide, when should
you as if someone who's listening tothe person who's when should you take action?
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Well, I don't think there's anypoint that you couldn't take action if
somebody's experiencing that kind of thinking,whether they're whether you think they're going to
act on or not, they're definitelyin need of some support and resources.
So I would say always act onit, and then you know you're hopefully
preventing, but at the same time, you want to make sure that you're
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interceding if needed. Yeah, andthat would also one of the reasons for
that. One of the reasons forthat would be PTSD is that's that's something
now that you know, I've hadtalked about and that's something that's really real
now too. It's PTSD. Yes, post traumatic stress disorder is something that
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we see stemming from adverse childhood experiences, you know, like sexual abuse,
trauma, even medical treatment, chronicmedical treatment can cause trauma for people as
well as some of the people thinkof as like wartime experiences, a plane
crash. I mean, all kindsof experiences can cause PTSD. All they
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are treatable, you know, andcertainly we would want people to understand the
signs and symptoms of that. Butmany of the signs and symptoms of PTSD,
the anxiety, the depression, thesubstance abuse, you know, go
hand in hand with the services thatwe provide. Ye, right, they
all intertwine. It seems like notall of them, but some of that.
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So many of them do, oh, definitely, And I think it's
it's important to understand that for peoplewith a mental health diagnosis, I'm probably
I'm doing this off the top ofmy head. I'm not going to get
this exactly right. But for peoplewith a mental health diagnosis, I think
it's between forty to forty five percentof those people also have some kind of
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a substance use disorder. But forpeople with a substance abuse disorder, it's
over half of them typically have amental health disorder as well. Yeah,
so there's a strong combination of thosetypes of behavioral health issues as well.
Yeah. Yeah, and with PTSD, dealing with that, you do you
think you think people who are inlaw enforcement or sells things in military,
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but it's really it's so many otherpeople. Now, it's so many people,
right, Well, we've all livedthrough COVID and the isolation and the
stress that went along with COVID,I think is contributing to people's awareness that
they're they're having increased anxiety and increaseddepression, and it's become a commonality.
So being able to reach out andto get support, you know, as
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becoming more of a recognized support that'sneeded in our society. But I think
we have unfortunately of lack of orworkforce shortage right now, not only in
Tennessee but across the United States.So we're working really hard to try to
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you know, bring people into behavioralhealth professions and provide that that kind of
support and services. But we recognizeuniversally nationwide that those support and services and
early support and services prevention is reallywhat's needed. So prevention programs in the
schools with our young people is somethingthat I think we're going to get more
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and more used to. You know, early mental health awareness and education will
help prevent some of those long termissues. How was how was your sponsored
COVID? Did you get more callsto the hotline? We did, really
we did a lot more calls.It's we also had an interesting correlation because
here in Tennessee the sports bedding waslegalized right about just before COVID starts,
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and so sports bedding really took offand people were isolated and at home,
and sports bedding I think was anoutlet for many people. So we saw
a huge increase in the number ofgambling related calls on the redline, and
those sports bidding calls continue to trendvery high. But if the overall calls
are now coming down a bit.I could see during well just about all
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of these alcoholism, drug, addiction, eating disorder there's so many calls because
people are just sitting at home bythemselves during COVID, and that causes intend
to call. The isolation and thestress was definitely a huge factor. But
you know, the one of thecommon phrases about addiction is that the opposite
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of addiction is connection. And wereally think that's true for a lot of
the behavior health disorders. You know, being able to connect, to participate
in your community, to find connectionwith people, places, and things.
It's an important part of our wellnessas human beings. That's very true.
Yeah, just getting out and doingsomething, come with us, come with
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us, come out here and doingsomething that that could prevent a lot I
guess. Yes, physical activity doesa lot, and it releases endorphins for
all the right reasons. Yeah,yeah, it really does. You mentioned
gambling. What about the gamming addictionsthat you have, Now that's part of
a part of your issue. Well, we definitely are seeing a continued incremental
rise in gambling addiction calls on thered Line. We have definitely increased our
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gambling addiction resources here in Tennessee.The Department of Mental Health and Substance Abuse
has contracted with an increasing network ofproviders to be able to provide support for
that. So I do think we'rerecognizing it and we're treating it. We're
providing support. But yes, onlinesports betting is something that's readily accessible.
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When you had to go to acasino to place a bet, there were
some some automatic barriers. I mean, you can get in unless you're twenty
one. You've got to have somemeans to get there. It's often a
drive. But online sports betting reducesall of those barriers. So it's just
just been a phenomenal phenomenon here inTennessee and elsewhere that I don't know that
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people were predicted. Yeah, that'swhy I was going to ask that is
was it sports betting and sports bettingat home with COVID at home at home
at home and bam, you're ininteresting trouble. Yeah. Yeah, And
there's a lot of things about theonline gaming much less sports betting that you
know, the the gamers the sportsbetting apps are they know how to you
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know, connect with your sensory awarenessin order to make it as enticing as
possible. So yeah, I meaneven even out of state, you still
in Tennessee. If you're out ofstate, you can really online for example,
I guess, I guess online cannotreally really releases that for some of
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them and everything. It releases alot of inhibitions when you can do it
privately and things like that. Butit also I think has increased in our
awareness of the fact that a lotof kids under twenty one are online gaming,
whereas they might not have been ableto have access otherwise. So yeah,
what about conditions that you have hhaving an age for example or something
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like that, what about those conditionsthey have a hole that's a whole another
type of middleilists as you have.Then if you get that, it could
I don't know, it just drivesyour depression or how does it. There's
certainly depression and even anxiety affiliated witha lot of long term chronic illness,
and that can be a cancer,it can be you know, all kinds
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of other diseases like that. Oneof the one of the things that we
do work with is is some ofthose out region support groups to try to
make sure that people have support forLuke Garrig's disease, musculturisticy, a lot
of those chronic health conditions asthma asa chronic health condition, diabetes as a
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chronic health condition. So making surethat people have access to those uh services
would be key. Yeah, I'veI've I've had a condition and it was
it could it could have depressed,but it didn't. But I've seen so
many people are heard about so manypeople with a stroke who continued to they
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just gave up. And so thatyou know that that presents a whole that
that's a whole other middle right there. Well, I think I believe his
name is John Fetterman, the UScongressman who recently had a stroke and then
suffered a period of depression afterwards.There are consequences of having that kind of
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a brain event that can cause depression. So it's actually fairly likely after a
stroke to suffer from depression. SoI'm hopeful that his open discussion of his
condition helped people be aware that that'sa great example. That was that was
a really terrible example. He Imean, he was in a debate and
you could you could tell he wasstruggling, and then he went into depression
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and he's I hope he's back outnow, and I hope he's doing good.
Yeah, that's I think. Isaw him on social media over the
weekend. He shaved his head andhe oh, okay, he was looking
like he had fun with him.There's so many of these, so many
reasons that people could call your hotline. This is amazing. Well, like
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I said, there's a no wrongdoor approach. I mean, we don't
claim to be the experts and everything, but I can get you to the
right place. That's what I'm saying. You can you will get the person
to the right place. Yeah,because you've got alcoholism, depression, mental
health, all types. Yeah.And one of the key reasons for our
hotline is he used. Is Ishould say of our hotline is so many
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people who called because they don't haveresources, So we help connect people to
state funded programs where if you're uninsuredor under insured, those programs can provide
treatment. Right and again the numberto call. The number to call is
eight hundred eight eight nine nine seveneight nine, Okay, or you can
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call nine eight eight just called nineeight eight is the best number. Twenty
seven seven toll free nationwide. Ninetyeight eight is the number to call.
Is there a website you want themgoing to look at two for you to
find out more about your work?Well, there is a nine eight eight
website, but there's definitely a TATUSwebsite taadas dot org where you can see
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our programs and learn more about ourfree literature, the Redline, and some
of the other services we provide.So I didn't highlight all of them,
but Tennessee Suicide Prevention Network is somethingthat's under our umbrella. We definitely don't
have an advocacy grant as well,so we work with the Tennessee legislature around
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policy issues to help provide access tofood, to treatment, and for prevention
services for people in the state ofTennessee. Well, let's hope that somebody
here's us today and needs help andthey called one eight hundred eight eight nine
nine seven eight nine and call andget get help or call nine eight ninety
eight eight. Definitely, and hopethey do. And I hope it's hope
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we've done some good today. Yeah, that would be great. And obviously
the if people have questions or concernsabout the nature of any of these conditions,
you know, the Tennessee Statewide Clearinghousecan provide information. So how need
to do that? You mentioned earlierthat you need do you need health professionals?
Health professionals you know who need informationcan certainly call us and TATIS is
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one of several entities around the statethat are working on healthcare short workforce shortages
in the state of Tennessee. We're, you know, concerned about making sure
that we have adequate professionals to providetreatment where it's being asked for. So
we I think, and again don'tquote me because I think I'm doing this
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off the cuff, but all ninetyfive counties in the state of Tennessee have
a healthcare shortage of some kind,so we we need healthcare workers. And
it's a I've always enjoyed it asa profession. I know it's not for
everybody, but it is something thatgives you a lot of satisfaction, a
lot of a lot of I don'tknow. I think the support and and
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uh and the things that you're thatprofessionally I think are important in choosing our
career. Yeah. Is there aplace to go for TATIS to find out
if you if you well? Onour TATIS website, we definitely have some
job postings, but we work withvarious entities to try to work on healthcare
shortage issues. The Tennessee actually,Rural Healthcare Association of Tennessee is an entity
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that we work with because they providegrants for people in rural areas to have
internships and preceptorships and such in orderto enter the professions. So that's a
good example of a partnership that wedo provide in order to try to promote
the workforce. That's Mary Lyndon Salter. She's executive director of TATIS, Tennessee
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Association of Alcohol, Drug and OtherAddiction Services. If you have questions of
comments about today's program, you canemail me John Clark at iHeartMedia dot com.
Thanks for listening. I'll talk toyou next week right here on your
local radio station on Tennessee Matters