Andrew Wainwright, Chief Development Officer and Founder of AiRCare Health, discusses the importance of family support, reflects on the last two decades and looks towards the future of behavioral health.
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Nate Randall: My guest today is the Founder and Chief Development Officer of AiRCare, as well as the author of It's Not Okay To Be A Cannibal: How to Keep Addiction From Eating Your Family Alive. Andrew, welcome to Illuminate HR.
Andrew Wainwright: Nate, it's good to be here. Thanks for taking the time and having me.
Nate Randall: Yeah, absolutely. I'm interested because you founded AiRCare back in 2002. You guys are based in Minnesota. I'd like to get into a little bit of the why and the how, but let's start with what is AiRCare? What do you guys do?
Andrew Wainwright: Sure, happy to. Great question. We've been in the space since 2002, and navigating and pivoting as we've gone along with the changes both inside and outside of the behavioral healthcare world. There's lots of history there, but where we are today is we're in a place where we serve individuals and families, and the goal is to move those in behavioral health with issues and struggles to some level of remission or management. What that means is we want to make people better.
Andrew Wainwright: What we've found over the years is that we want to make more people better. So, that's led us to effectively provisioning benefits to the large employer market. For us, that's the easiest way to access the largest number of people. In its simplest form, I think we always wanted to change the world in our own little way. We always wanted to make it a little bit better, be of use and service in some capacity that we were able to. Once you're doing this long enough, then the question becomes, how do we do that for the most amount of people? So, how do we bring the most amount of good to the most amount of people?
Andrew Wainwright: So today, for us, that means inserting ourselves into benefits that large self-funded employers, because it gives us access to hundreds of thousands, effectively millions of covered lives of moms, and dads, and brothers and sisters, employees, folks on the health plan- all who may be struggling, mostly unacknowledged with some level of behavioral health issue.
Nate Randall: Yeah, 17 years start up. I can't even imagine the ups and downs of that.
Andrew Wainwright: You start off doing a job and working hard, and you like it, and the world changes. The economy gets bigger, the economy gets smaller. There's more less needed of the services. But, if you don't feel like changing careers or moving on to do something different, you really feel like it's your calling, it's the right place, and it's where you're supposed to be. You stick with it. So, we grew. We got big. When the economy changed in 2008/2009, we got small. We got bigger again. We got smaller again. And I think we're on the road hopefully to getting bigger again.
Andrew Wainwright: The best news maybe for us by getting bigger, is it means we're able to help more people. The good news for me, I suppose, is that for 17 years I've got to do something that I love. I like coming to work every day. But yeah, it's interesting. I think if we all read Fortune Magazine, or Inc., or any of the stuff we see when we're getting on the airplane, it looks like people are starting companies left and right, and it's easy to make a million, billion dollars. That hasn't been my experience, but I have gotten to meet a lot of wonderful folks along the way.
Andrew Wainwright: My longterm history is that my folks thought that I was going to grow up and be a professor, and that I would be working at a university teaching an English class. That would have been a great life. The fact that I'm running a small business and employing people, I think is still a mystery to them.
Nate Randall: If you'd be willing, I'd love to hear a little of your story. I know you're a trained interventionist, and I also know that we both made it through the Grunge Era, although not unscathed. You've really dedicated your life to this cause on the long haul. Why do you do what you do?
Andrew Wainwright: I think the answer to why I do what I do is- and I told this joke at a luncheon just the other day- is that I'm not sure that anybody else would have me. I think it comes to a point where maybe your character defects stand in the way of you being operational or useful in a traditional sense, and you find a way to make them useful in an unconventional sense that still adds value to you and the people around you. I think that's a little bit of my story.
Andrew Wainwright: My original backstory is I was born and raised in Washington, DC. I'm 49 years old, so that puts me born back in 1969. So, raised up in Washington, DC during the 70s and the 80s. It's a unique environment to get raised in. It comes with both good and bad. From there, I went off to college and in the larger sense, I was really great at being at college. I really enjoyed the experience, and I was good at the idea of being at college. I was not so great at assimilating to traditional roles in life post-college, or matriculating into adulthood, as some folks might say.
Andrew Wainwright: The alcohol use, the drug use that began in college picked up a lot of speed as I made my way back home to Washington, DC, and eventually put me in the hospital at the age of 25. When I was 25, I was grateful to have a family that cared enough to give me the gift to know, and to make decisions on my behalf. They pulled me out of the Washington, DC hospital and they sent me to Minnesota for drug and alcohol treatment. So my life really gets divided into the before and after.
Andrew Wainwright: What happened before was a guy was on one path living on the east coast, and the after was a different lifestyle choice that began with getting sober in 1996 in St. Paul, Minnesota. The lifeline for me picks up from there and moves forward as I've navigated from 1996 to 2019, and I'm grateful to have 23 years of sobriety, and I'm grateful for all of the events that led to this life's path for me.
Nate Randall: Yeah, it's really interesting the way you talk about it, because I think we've discussed before we've got similar yet different paths. When I talk about where I grew up in Anchorage, Alaska, I use a lot of the same words like, "A unique place to grow up," and I also have a sense of the before and after person. For anybody who's been through substance abuse issues, and made it through to the other side, it really does look like you're looking back on a shadow of yourself, or almost a different person. At least, that's the sense that I've gotten over the years.
Andrew Wainwright: I agree 100%. People always ask when they sort of look from the outside in of what that experience is like. I think the words I used a moment ago, "lifestyle choice" really do apply. I think if you decide you're going to be let's say a Harley Davidson guy, there's a lot of lifestyle that goes along with riding that particular type of motorcycle. Or, if you're going to be a surf bum and travel the globe with your surfboard, I think all of those are lifestyle choices that affect all of your decisions in the way you approach love, life, happiness, wealth.
Andrew Wainwright: For me, getting sober was most certainly that. It was a lifestyle choice that has impacted all of the decisions I have made after that in unbelievable and unimaginably fabulous ways.
Nate Randall: I want to jump into something you said there. You talked about the importance of family, and I know a lot of your work has revolved around the important of family. I know Aircare, it's a big deal to have family included in the solution. In addition, your book is a really great resource for families who are dealing with a loved one's addiction. Talk to me about the importance of family when going through things like mental health, substance abuse or behavioral health issues.
Andrew Wainwright: I think family in general- all families- whether that's husbands or wives, parents, kids, anybody that's in the sort of immediate orbit of someone struggling with substance abuse disorder or issues, is at an extreme disadvantage because they show up from a place of love and grace, and honesty, and they want to deal with this problem with integrity. They want to be of use and make help available. They're effectively going to war against and doing battle with this disease that is just nefarious, that will use any and all means to keep itself alive.
Andrew Wainwright: It's an unfair fight, in my mind, when fair, considerate parents and family members try and help individuals that are struggling, and then they get beat back time and time again. They can't understand how they can be losing in this fight. We recognize that- or I at least recognize that- early on. I did a lot of work in the provider section of substance abuse disorder, and then began working with clinicians and individuals who are in the intervention space and the consulting space.
Andrew Wainwright: It was there where we began to work with families one on one, that I learned the real lessons about how enabling families can be, how in mesh they can be, and how difficult it is for them to provision help to the people that they very much want to help, and how much that it requires effectively an outside resource to come in and apply some [inaudible 00:10:43] pressure in particular ways to leverage a deal that works for everybody.
Andrew Wainwright: It's complicated, but the reality is that families are at a tremendous disadvantage, because they come from a place of love, and they're battling against just a pernicious, nefarious illness when we're talking about substance abuse disorder.
Nate Randall: Yeah, and I've definitely experienced that in many different ways. I've seen families come to the table with all of that love just to be beaten away like you're talking about. I've also seen that when the family member: the parent, the spouse, the brothers and sisters, whatever it is, take the approach of dealing with themselves along the journey even if the person who they're trying to help isn't willing to be a part of it, that can be incredibly beneficial and it, at minimum, stop enabling some of the behaviors that you might unintentionally be doing by giving your love.
Andrew Wainwright: Yeah, the example we used to always use was that of a rollercoaster. If you think about the car on the rollercoaster, and it's got six seats- so there's mom and dad, and the brother and the sister, and only one of the individuals- we'll call him the brother- is smoking pot, and drinking beer, and causing a ruckus and making everybody else in the family crazy, but they're all together on this rollercoaster. And the rollercoaster goes up and down, right? It goes up. It goes screaming down. Everyone's sick to their stomach, and they can't really take it anymore.
Andrew Wainwright: But yet, the whole family stays on this ride with the person that's causing all the craziness. The very first blush for us was always to see if we couldn't talk the rest of the family to get out of that car and get back onto flat ground. If that one individual- in this example, the brother- wants to continue on this crazy ride and go up and down, and make himself sick all the time, effectively he gets to do that, right? That's an independent decision that he gets to make, and it's a not a great one, but he gets to do that.
Andrew Wainwright: If we can get the other five people out of the car, then for us that's a win. We always think of the utilitarian principle, "The greatest good for the greater number of people." Moms and dads that always get upset or cry, because they say, "You're willing to sacrifice our boy," or, "You're willing to let him go." I said, "I'm absolutely willing to let him go if it means that I can save the five of you." That's a hard principle for families to get ahold of.
Andrew Wainwright: But the inverse of that it is that you sacrifice six people for one person's sickness, and that's not really a great deal. That's not one I was always a fan of making.
Nate Randall: Switching gears a little bit, you've seen quite the evolution of behavioral health over the last almost two decades. Especially in the employer space now, there seems to be a growing recognition that mental health can't be ignored. What gives you hope in this space for the future?
Andrew Wainwright: Well, let's talk about the first part first. You asked about what changes have come about, especially in the employer space, as it relates to behavioral health. A number of things have prompted change. There's been a lot of good legislation in the last decade that came out of Washington, DC. The Parody Act was a big deal, the PPACA forced a lot of good change. So, we're seeing the focus on utilization of healthcare as a priority. Even from where I sit, the rising cost is a useful instrument to focus attention on where the system is bleeding and where it's not getting the attention it needs, which brings behavioral health into clear focus.
Andrew Wainwright: So all of those things, I think are great in terms of moving behavioral health to the forefront. When things come into the bright light, then that means people start working on solutions for them. I'm happy with the progress, whether it comes from good or bad reasons, that's happened over the last 20 years. On the other side of that however, some of the progress is a little bit... It looks good without a lot of depth. So, I think you see a lot of stigma campaign is a popular thing, and a larger employer may say, "We're really excited about rolling out this new anti-stigma campaign."
Andrew Wainwright: So, an anti-stigma campaign is going to say we really need to relate to folks that have substance abuse disorder, and understand what's going on and recognize them as equals, which I think is useful. I don't think it's proactive. I don't think it's into action. But I do think it covers a little bit of liability, and I think it's a step in the right direction. But, I don't think it covers the whole solution.
Andrew Wainwright: So, I still see a lot of employers falling back on, "We have a wonderful [inaudible 00:15:31]. They've got great engagement. We're running an anti-stigma campaign. We really feel like we've checked the box." But if you're asking me, I don't think that checks the box. I think there are lots of wonderful solutions that could be put into use today that are effective, that are outbound and that truly drive engagement and remission.
Andrew Wainwright: That's where we are. We spend our time, that's what we focus on. I was just trying to prompt folks to say, "There's always more that we could do," and I think it's our responsibility to do it. If we know that solutions exist and we have access to them, I think it is our responsibility to put them to use.
Nate Randall: Yeah, absolutely. For the future, what does it look like? Is it bright? Are we heading in the right direction?
Andrew Wainwright: I think it is bright. I would say even three to four years ago, people would fight us on what percentage of their employees struggled with behavioral health. They would routinely say, "It's 5-6% of folks that have run a behavioral health code," or they have a traditional behavioral health issue. We would define behavioral health in that context as folks with serious mental illness, or diagnosed depression or anxiety, and then you're always talking to the folks that are suicidal.
Andrew Wainwright: I think those all deserve attention, and I think those are real areas to focus on. But my experience with behavioral health, and I think this is where the awareness is changing- recently, let's say even the last 18 months- those folks that are really sick do deserve attention and lots of it. They deserve all the help that's available. But the rest of the folks... The 75% of everybody who's never run a behavioral health code, and isn't Schizophrenic, and doesn't necessarily need to be on meds, all of us- or that contingent- that portion of folks, the have a girlfriend or a boyfriend they just broke up with. They have a dog that died. They have a dad they need to put into elder care. They have financial issues. They have stuff. They have things that keep them up at night.
Andrew Wainwright: So, my hope- and I think is what we're seeing- is that not to take any focus away from those that are truly ill and need serious longterm help and solutions, but to also focus on the majority, the plurality of the employees that have behavioral health issues that aren't going to draw the attention of the top 10%, but are really the biggest portion of folks that struggle. Because when you have those kinds of stuff going on, you're not at your desk. You're not at your best. You're not showing up your family. I think they deserve equal, if not more, attention than the small minority.
Nate Randall: Yeah. I love that. I don't know if you saw it, probably not. I'm a huge hockey fan, so I do things like watch the NHL Awards Ceremony. If you haven't seen it, it's really worth a watch. Find the clip for a guy named Robin [Lenner 00:18:34], who's a professional hockey goalie. This year, at the beginning of training camp, he came out and went to help from his general manager and the organization for having mental health and substance abuse issues. He went through the programming the NHL has, which is really amazing.
Nate Randall: He did one of the toughest things I think you can do, in accepting an award last night for Perseverance, and got up there on stage in front of his teammates, peers, colleagues, everybody in the world, and talked about his own mental illness and had a statement where he said, "You know, I'm mentally ill, but that doesn't mean I'm mentally weak." He also happened to- after successfully going through this program- have one of the best years in his career.
Nate Randall: It kind of highlights to me that even though people can struggle through, and even at that elite level, he was able to struggle through for quite a number of years and be a great professional. Once he got all this stuff out of the way, he really was able to thrive and be his best sort of happy self. So, tying that back to what you just said, I think there is a huge thing in my mind that's missing where we're letting people walk around slightly unhappy, because we're just unwilling to recognize the stress and the anxiety that many, many, many people- maybe the majority- go through day in and day out.
Andrew Wainwright: I agree 100%. I think it can all effectively be boiled down to fear, some level of fear that says either, "I'm not going to get what I want, or something that I have is going to be taken away." Fear comes in a thousand forms. In the previous examples, it means that "My girlfriend doesn't love me. Nobody will ever love me. My dog doesn't love me." There's lots of ways to have fear take over our lives. When we talk about what keeps you up at night, that's some form of fear.
Andrew Wainwright: "I'm not going to pass the test tomorrow. I'm not going to do well at work. Something tragic or terrible will happen." That may not be I get by a car, just maybe something small. But it keeps us up at night, and that means you're not sleeping, which means you're unhealthy. I'm with you 100%. I think that the ultimate goal... So we get effectively 27,000 days on planet earth, and if we could write a formula for all of us, I think it's how do we make that for anybody? The majority of those 27,000 be happy, be filled with joy.
Andrew Wainwright: Why wouldn't we want that for everybody? I think it is the little nibbling fears that eat away at our days and our nights that take away the majority of those days. The big stuff is certainly big stuff, and it needs to be dealt with in its own way, but I agree 100%, it's the small fears that keep us all awake, that we don't always talk about or share with others, that eat away at the majority of the joy that could be ours.
Nate Randall: Well this has been great. Thank you so much for your time, Andrew. I really appreciate it.
Andrew Wainwright: Nate, it's been wonderful to be with you. Thanks for having me today.