As the promise of 2021 looms on the horizon, most people are anxious to close the books on what is likely the most unsettling year — from the pandemic to politics to PPP loans — we will ever experience. Strong leadership has never been more essential than it is today. To share their best leadership practices, Az Business magazine sat down with Arizona business leaders to watch in 2021, including Steven Sheets, president and CEO of Southwest Behavioral & Health Services.

Steven Sheets, an innovative leader in behavioral health, was appointed to the position of president and CEO of Southwest Behavioral & Health Services in January 2019.

Transcript of full interview with Steven Sheets

Az Business: How has the pandemic impacted your work at Southwest Behavioral & Health Services?

Steven Sheets: I think that on one hand, we’ve seen some impact that’s been positive. In any pandemic, if we’re not looking out for the positive, we probably are not looking in the right direction. We’re probably still stuck in the crisis. So one of the positive aspects that we’ve seen is an increased demand for service. People that didn’t necessarily think they needed services before are coming in, or virtually through the virtual door, but they’re also needing different types of services.

So in a world where we were face-to-face with people, now they’re okay being virtually connected with people rather than feeling still a little concerned to come into the office. So we’re seeing increased demand. We’re also seeing increased need for security. I can’t speak for all of my peers, but I can say our security and technology costs have gone through the roof.

People that didn’t need a laptop now need a laptop. People that didn’t need a cell phone, need a cell phone. And the people that need that extra layer of added technical security from home, working from home, now need extra layer so we can keep clients’ information secure and also just the information of the agency secure. So it’s been an interesting development.

The first week that Arizona got hit, it seemed like no one needed services. It was like crickets all throughout all of our outpatient clinics. And what we’ve seen is that that was just a little blip. It was just, I think, the shock and awe of what is going on, and then services just continually picked back up. And now that more people are out of work and Medicaid eligible or AHCCCS eligible, people that we’ve never seen or probably wouldn’t have seen because they were stable in their jobs, and now they don’t have a job, now are eligible for services predominantly of what we provide.

And it’s fascinating to watch people go from need to success, because we’re also seeing people leave and no longer need our services in the middle of a pandemic where they get an employment and then they no longer need our help.

Az Business: For people who don’t know, can you talk a little bit about what kind of services you provide as Southwest Behavioral Health?

Steven Sheets: Absolutely. So we have around 12 outpatient clinics, three in Mojave County, one in Flagstaff, one in Prescott Valley, one in Payson, and then the remainder in Phoenix or Phoenix proper, Mesa, Buckeye, Chandler, Phoenix, and North Phoenix. We have four opioid replacement clinics or methadone clinics, one in the Mojave County area, Flagstaff, Prescott Valley, and then one here in Phoenix.

And then we have four inpatient hospital settings. They’re a little bit different. They’re not like a big 300-, 400-bed unit. They’re a 16 bed unit, very specialized for individuals having mental health challenges, three here, and then one in Kingman. And then we’re in, I would want to say, about 160 different schools now. And then we serve a population where we provide housing for another approximately 150 members in the Phoenix area and across the whole landscape that we provide services there.

Az Business: How were you able to manage that challenge at a time when people were having to quarantine and work from home?

Steven Sheets: That’s a challenge, right? So we never shut down any of our clinics. I think that that’s really important, because we wanted to be mindful. We didn’t want to be reactionary. We want to be proactive and planning. So we went into the pandemic with a hybrid approach. People that work from home still came into the office a few days or a couple of days a week, maybe still saw people virtually, but still where there present in case people needed some assistance.

The easiest part about it is, our clients don’t have to get transportation to come to our appointments anymore. They don’t have to get on the bus. They don’t have to get on the light rail. They don’t have to get a taxi cab. We can see them in their comfort of their own home. We can see them in their car, outside of a store, wherever they want to be seen. We can see them.

So that’s been a luxury. The hard part is, it’s not as controlled as an office, so you never know what you’re going to get. And I think some of what we didn’t understand what we would find is, we’re going to be exposed to an environment of our client that we never had a never had the luxury of being in. And it’s actually helped us provide really clear treatment goals for all of our clients that we’re able to get that bird’s eye view, where we talk about our challenges in a controlled environment. But we never actually go to the challenging environment. Now, we’re there. So it’s been really fun to watch that aspect of the ease of access.

The other flip side is, I know in my graduate studies, I was never taught how to do telehealth or what is bedside manner over telehealth? And so we’ve been providing additional tools and resources for staff who are really having a hard time connecting with clients. And that has been fun too, because our staff are becoming a little more well-rounded. They’re becoming okay with the video, almost overemphasizing empathy or care or just some of those really good qualities I think that professional relationship makers would make anyways.

But over video, it’s a lot harder. And so we’ve been able to provide some additional support and training to our staff, which is both impacting our clients and our staff’s satisfaction. It’s impacting clients wanting to come back for the next appointment. Sometimes coming back has been the hardest thing for some clients, but we’re getting more and more comfortable. And the good rule of thumb that I’d like to give my staff is when in doubt, if we’re having technical issues, just pick up that phone. Pick up the phone and just connect with somebody. We’re in such a technical heavy world, Facebook Messenger, Instagram, Twitter, I could probably list them all and list even more.

But what we don’t do really well is pick up the phone and talk to people. Or we don’t get on a video and talk to people very well. And so it’s been really interesting watching clients get okay with that, because clients were okay with face-to-face. We really do face-to-face well. Now it’s video-to-video, and we needed to provide some additional support training. And so I think what we’re seeing is, we’re crossing that line of comfortability. And so the worst thing to do now is just rip it off and say, “You all have to come back to the office.”

The best thing is to say, “If it’s working, if you’re getting better, and if you’re reaching your goals, let’s keep it the same.” The more stability we have in life, the more satisfaction, and the more we feel like we can accomplish our goals. The abrupt issue of the pandemic is the exact reason why we go into challenges. The unexpected happens, and then we have challenges dealing with the unexpected.

Az Business: So post-pandemic, how do you think technology is going to forever change the role of the mental health provider or the behavioral health provider?

Steven Sheets: I think there will always be a need for face-to-face. We are still years away from getting heart surgery where you don’t need anybody in the room other than the patient. And then bringing the patient back, you still have some need for some physical contact. I do think that it will shape the future in easier access to services. Which that lends itself to a lot of other issues, because it’s a additional financial burden on our system. I think that we will probably see some of that.

But I think there will always be a hybrid approach to technology and in-person from here on out. I think that, from my perspective, we were all going in that direction. We were just forced to go into that direction in about 72 hours. And some companies took a little bit longer to go that way than others. It’s just an interesting and fun environment to be innovative in. How can we connect with people virtually? We’ve always thought about it, but then again, we never thought that we’d have to run like that in 72 hours and make a change.

So I think that we will always have the hybrid approach. The challenges will come when you’re really a client and you really shouldn’t be seen over video. There will be clients that are very risky or higher risk than others. And communicating about why one person’s eligible for a certain type of service and one person’s not, I think will be a bigger art than dealing with the technology challenges in the future in general. And so I think based upon how we engage our members and how we engage our clients to be helped will be dramatically changed from here on out.

Az Business: What do you think it is about your leadership style or strengths that helped you with this transition through COVID?

Steven Sheets: So some of the strengths that I was able to use really in order to remain effective to serving our client base were, I had to rely on my team, first of all. I would never be able to take credit for everything we were able to accomplish. I remember coming back actually the beginning of March from Florida and my team said, “No, we need to move virtual right now.” And I said, “No, we’re going to be really thoughtful.”

I would like to say that I bring an innovative approach to my team to say, what if? Let’s think about bigger than that. Let’s think about how instead of needing to order 50 laptops, can’t we just take their desktops, give them a webcam, and put them in their home? Can’t we just think about different ways, giving them a company cell phone and having them connect over Zoom on their cell phone? How can we make this the easiest and most stress-free…

Relatively speaking, there will always be even in this time, even probably more stress, but how can we make this the easiest transition for our clients and for our staff and make them think we didn’t change anything other than their location? And I’ve received emails from staff saying, “You thought this through. You thought through how to make us feel comfortable. And we think you did this probably better than anyone else.” It might be a little biased, but I would hope that we did it better than everybody else.

That’s my goal with my team is to say, how can we transition when we need to transition? And how can we be the leader in it? How can we cause other system partners to be the chain reaction? I’m okay being somebody that reacts to the chain reaction, but I love to be the person that that causes change to happen.

Az Business: Is there anything that you learned during this pandemic that you think is going to make you a better leader in the future?

Steven Sheets: There are plenty of things I learned through this that I hope make me a better leader later on or even today. The first thing, communication. I thought I was pretty good at communication. I realized I need to do better. I realized that staff were concerned in the middle, like in April and May, “Are they going to just force us to come back into the office?”

So we took an approach a little bit later than we probably should have to email our staff letting them know we think you’re effective, we think you’re doing a great job, we’re not changing, and we want to support you. And so we continued relaying in different words that same message all the way up until even… I believe last week was when I sent out my last email of that. And again, we want to just continue to instill there’s changes happening in places we never thought changes were going to continue to happen.

Schools, hours of businesses that will never go back to the same hours that they were before. How can we say we’re in the business of helping people when we’re not going to help our own employees? And so we’ve changed their shift times. We’ve been really flexible. So communication’s been the biggest thing.

The second thing is, how do you show a remote workforce you’re appreciative of them? How do you really show that they’re valued and that we care about them? So we sent them a fun self-care package, every employee, whether they were on contract with us or a full-time or part-time, we sent them a little package to say, “These are some things you can do to care for yourself.” We’ve sent out four free lunches to all of our staff saying, “Thank you. We appreciate you. Here’s a free lunch.”

It’s really almost de-compartmentalizing all of the things we used to do. Potluck, well, how do you do a potluck now in a virtual world? Well, you send everybody a meal, and then you get them on Zoom. And so in some ways we’re advancing the way we connect with people, but in other ways, we’re having to reinvent how we’re connecting with people in new ways. I go on a jog every morning and I go, “Oh, I wonder if we could do this?” And then my team gets behind me and says, “Let’s just try.”

So we’ve been able to really just try new things, and some of them have failed. Some of them have been really successful, and some have been mixed. I don’t think we’re ever going to get everybody to feel like we did everything we could have. But if the majority of people think they at least tried, I think that’s worth it.

Az Business: Moving forward into 2021, a lot of people are saying there’s going to be a lot more need for mental health services, behavioral health services  because of all the stress that everybody’s feeling. What’s your industry outlook for 2021?

Steven Sheets: Before I answer that, Bank of America I believe put their 2022 pandemic plan out. They’re thinking this is going to go all the way to 2022. Which I think is a pretty fascinating thing because everyone’s saying, “I can’t wait until 2020 ends.”

I’m not sure I’m ready for what 2021 is ready to give me. But with that said, I think that as long as we’re able to sustain from a system standpoint, from public mental health, we have to rely on a lot of different funding mechanisms. And so whether there’s a need or whether there’s… Increased demand doesn’t always mean that we’re going to hire more people. But increased demand with the right support system in place from a legislative level and from a governmental level, which we have a very supportive governmental level when it comes to mental health services, means we can increase capacity and serve more people and serve more people effectively.

And so I think the outlook will be increased need, but I think it goes deeper than telehealth. I think it goes deeper than just increased need. I think it goes towards, how are we engaging our members who only come for one appointment and never gets seen again? How are we actually bringing the people in that need to be seen but decide they don’t want to come back? So I think that face-to-face will always have a purpose. And face-to-face could be a re-engagement measure to give us some feedback, to change how we do things, to get some feedback rather than the feedback maybe we get on Yelp or Facebook or LinkedIn, whatever means on social media, and taking that down to a deeper level and saying, “How about I go to you because I never hear from you and say, ‘What could I have done better to keep you?'”

And then I believe that needs to actually go into our strategy planning. How do we actually make movement when we’re given feedback? It’s a two-pronged approach, employees’ purpose and client’s feeling like they’re coming to a place they call home. When they feel like they can come because they trust us, they believe in what we do. And they believe they’re going to get to the end goal that they’re set up to go to. I think we probably hit a win-win-win.

And so the purpose driven by our employees and the purpose driven by our clients feeling that purpose and then [inaudible 00:19:34] it out, it is the only way we’re going to grow, be sustained, and see a brighter future for the whole industry.