already shift in style happening, but those happen all the time. what is the real traditional kind of laboratory? >> some good examples are behind us here. this is a vanity. it has the countertop and the basin. it has the areas for storage. this is something that people would like. another popular trend -- i do not know if the camera can catch it, but below here, so people would roll up their towels. >> this also allows you to have one more step toward aging in place and accessibility. if you ever need to roll a wheelchair in, you have an opportunity here. >> absolutely. >> this does not have an overflow. is that required? >> overflows are not technically required. >> what i mean is one of the little holes like this where the city will run out so it will not spill out onto the floor.

>> they are practical and important to have, but they are not a code requirement. if you have children or something, you might want to have an overflow. if you are comfortable having one without, then you would have that choice. >> i was particularly intrigued by this sink. i know the manufacturers were up this year. this is made out of some extremely heavy duty class. here is bob, who is the rep from oceana who manufactures this thing. this is not the type of sync that would set on top. it recesses. what is this made of? >> it is actually made of glass. it is a company in pittsburgh, and it is an extremely durable class. they actually do the globe in chicago for a recovery like standards. >> and outdoor material in chicago has to withstand the heat of chicago and the cold --

the heat of summer and cold >> of winter > exactly. this piece comes in about 12 different colors. it has a backing to it, to. you cannot see through it, but it gets a lot of light back through it, so you could actually back like it if you want. >> we really like all these different styles. some of these that sit on top have advantages as well as disadvantages -- cleaning -- but they are stylish. but this has real advantage. when you lay it down, flesh, dram, and it has the faucet holes in here. it has the race area here so water will not run back off of it. >> let's go take a look at shower fittings and fixtures and the shower systems year. they are fascinating and very, very modern looking. all sorts of great stuff. do people like these in their homes? >> yes, i think this is a great example of how people do not

want their parents shower anymore. this is the new generation of shower systems, and they have and what occurred, -- accouterments. they just give a wide volume of water distribution. >> is that a problem with water flow? >> these technically meet those standards. the shower head distributes it, so it just kind of gives an appearance of more volume. these are body sprays that will take your body. this is a hand-held, and this is a good example where you could put a bar here. you could leave it in place as the traditional shower, or you could take it, and you could do it, and this is also great for cleaning and washing your dog and things like that. >> right, so you cannot get your hair wet while your taking a shower. i suppose this has the same kind of back float servants and --

backflow prevention built in. >> right, and it shows the variety of finishes here. the chrome. this looks like brushed stainless steel. what you do not see is brass, and press has really become -- is in favor these days. kroll is probably the most popular. it is similar to in kitchen appliances, stainless steel. is good. it goes with all color schemes. >> there was a recent change to san francisco's codes that said you could not have more than one sitting turned on at any more than one time. so you cannot have multiple salaries and more for water savings. >> right. a lot of people like showers for two, and now, you are saying one valve for one shower. >> i think you could probably sit flow rates could be adjusted, and you could probably make it happen, but it is beginning to be very tightly

regulated. tell us, when people come in to buy, what is it that they like? what are they actually buying? >> a lot of it has to do with style. first is for the lab faucet's. you have the widespread, the two handles, hot and cold. very modern design. >> people like modern. >> people like modern, but we are in san francisco, so we get a wide range. then the one hand, very popular, ada-approved. saves water. very easy to use >> > one of the standards for commercial, not residential, is that you have to be able to operate equipment with a single operation without tight grasping or pinching. so this actually allows that to happen. you can operate without having to grab and pitch and twist

something. this is very user-friendly. it is also reduced flow, and you do not have to have two faucet's running. >> only have to cut one hole in your credit. . granite. this is really traditional, very popular fish. >> nice. and this is, -- chrome, and brushed nicke. >> as far south as there, and showers are popular right now. rain heads are popular, but you want something that is functional for what you use, so hand showers are great. >> is this one of the ones that has a sheet of water? >> it does. waterfalls of this type come down to a point when you turn them on. this particular one, because we have reworked the inside of it

in a fairly complex plumbing system in there, it will actually come out as a sheet of water like a true waterfall. >> but it still meets the flow requirements? >> it does. many of the process we are shipping today will be these standard at 1.5. >> i think 1.5 is the california appliance efficiency standard. >> that's right. that is what we are shipping out. >> terrific. what do you call this kind of head? >> there are just the regular overhead tight showerheads. they can be mounted, or they could come out at different lengths. >> so you could screw this on to enormous shower? >> as long as they can rotate. some of them are fixed flat. >> that is terrific. thank you for joining us today

for "building san francisco" and we hope to see you on the third wednesday of every month. sometimes we do leches with guests in our studio. please join us, and you can get more information that sfgov.org. it is a wonderful day, and i'm going to go get a burrito.

[music] hello i'm ivette torres and welcome to another edition of the road to recovery . today we'll be talking about recovery support and the necessary coordination, collaboration, and recovery management of services. joining us in our panel today are

dr. keith humphreys, professor of psychiatry and behavioral sciences, stanford school of medicine, department of psychiatry, stanford, california. beverly haberle, project director, pennsylvania recovery organization, achieving community together, southeast pennsylvania. joe powell, executive director, association of persons affected by addiction, dallas, texas. dr. thomasina borkman, professor of sociology emerita, george mason university, fairfax, virginia. keith, let's start out by letting the audience know what is the need for treatment in terms of substance use and mental disorders in this country? a lot of people aren't aware of how prevalent these conditions are, but amazingly there are 45 million american

adults who meet the criteria for a mental health problem. and 23 million who meet it for substance use, alcohol or drugs. and most of those who also smoke and the overlap between those groups is about 10 million people who struggle with both of those problems. so that means at any given time one in four people in this country could conceivably benefit from treatment for mental health or substance use disorder. and actually, we're using the term now, behavioral health, do you want to explain a little what behavioral health encompasses? behavioral health is a bridging term, i mean, what is happening around the country is there's much more desire to integrate services, integrate thinking about these different types of disorders. and behavioral health is sort of a way we describe them as a whole because there are certain things that are quite similar about them, having a chronic course, having a part that's about our own behavior environment, things of that sort. so that's the phrase that's being used much more at the federal level and also around the country. and bev, i suspect that many of these folks

have co-occurring conditions. do you want to help us understand a little bit what co-occurring conditions are all about? absolutely. you know, many people will have two separate conditions occurring at the same time and so they may have depression along with substance use disorder. and so parallel services need to occur in order for them to be able to sustain long-term recovery. and joe, speaking of co-occurring issues, how many people are actually treated, you know, for co-occurring and for substance use and for mental illnesses? well, that's a good question ivette, i mean, there are many, of course, there are millions of course, of people that are being treated for both co-occurring disorders and that is all over the country. i think that in treatment they have been parallel and they have been separated, so now is the time for treatment to happen for both. yes. does everyone, thomasina, that wants to get treatment,

are they able to find it? is there enough treatment around the country if all these millions of people wanted to be treated for their condition? i mean, there certainly is a lot of self-help groups that are open, and they're almost cost free. i think the question also is of all the millions of people though many of them are not ready for treatment. so it's just because they need treatment doesn't mean that they're ready and willing to go to treatment. i think that's a really big issue for both mental illness and substance use. i think an important part of that, thomasina, is that sometimes the quality of the services hasn't been there. so sometimes people would like to seek help, but, for example, the treatment program is only open when they're at work or there's no parking, there's no childcare and so part of what our responsibility is,

is to make those services more attractive and more accessible to the population because, as you know, only about one in 10 people with an addiction will get treatment each year and only about 1 in 3 with a mental health problem get treatment each year. right, right. and just to add to that, when you were saying it was 45 million people, of course, that was suffering from substance use. it seems that it's 19.7 is what i heard the statistic is as far as people with a co-occurring, so it's almost half of the folks that have a co-occurring disorder.

people need that it's so important to make sure that

services available because you're right, everybody can't go during the day when they need to go to work or they need to do other things, but there needs to be a whole menu of ways for people to get the services that they need. and joe, you had, you yourself are in recovery and are one of our pride and joy in terms of individuals who go around the country talking about your recovery. do you want to tell the audience, really in terms of your own situation, how you came into recovery and what was your pathway? thanks for asking me, but yeah, i'm definitely in long-term recovery and, of course, it's only because of long-term recovery i'm able to be a father today and a husband and a person also that is the executive director for the association of persons affected by addiction. for years of course-i was 36 years old when i first went into

the rooms of a place that reached out for me and it was a 12-step program that actually helped me and welcomed me. but before that i had struggled severely with both addiction, alcoholism, and substance use. and also having a family, out of seven brothers and one sister, five have serious mental illness and all eight of us struggled with addiction and alcoholism. and my mother didn't drink, only my dad did. but for my recovery, of course, once i got in it, it just so happened that the one person that reached out and helped me through these last 23 years has been with me for awhile to help me with my recovery. my recovery has taken off with new meaning and quality of life to where, yeah, i can do what i do today, it's only because of my long-term recovery. but i'm also able to give back for me all that i have been given freely, and so i'm excited about samhsa and

being able to be a part of this leadership as far as recovery and moving recovery throughout the community. today, of course, being executive director for apaa, association of persons affected by addiction, which is a recovery organization, we're actually able to not only locally but also working with the state and the federal to actually move as being a part of the recovery movement, but it was only because of my personal recovery where it all started. and you're also working with some of the folks in the recovery movement in the mental health community. talk a little bit about that. very important, and, you know, i didn't see this at first and, of course, also being a licensed chemical dependency counselor to do the work on myself as well as to see about the co-occurring mental illness part and the mental health part of my own family. but the way it worked in my recovery is that being a counselor and working with people with co-occurring and also looking at my own family, now i'm at the level to where we're doing work with the managed care company, we're able to do also as far as

the recovery-oriented system of care to integrate both sides of the system, the mental health side and the addiction. so not only do i work with the addiction side but also with nami, mental health association, etc. and we'll be talking a little bit more about the system's framework in some of the other panels, but thomasina i want to get back to the whole issue of really what are the costs to society for individuals that need treatment and don't get the help? i mean, it's huge. a large part of our homeless population either have mental illness or substance abuse or both, a huge part. and that is a very tragic thing. their health problems are greater. the financial costs are greater. the health problems of particularly like the people

with co-occurring disorders, they live a shorter length of time; they have other kinds of chronic conditions. okay. on and on, the family, i mean, we could go on and on about the family consequences, the broken families that can be healed together by recovery. right. and keith, there's also some workplace issues, tremendous workplace issues, correct? oh absolutely. i mean it's one of the most common reasons for absenteeism on the job is substance use or mental health problems-injuries on the job, accidents on the jobs, workplace violence. i mean, these problems are sewn through every part of american life and that's the really daunting aspect of this problem but the upside is recovery. just as joe was saying so well, you look at how much he's giving back is because addiction is so destructive by definition, then recovery is a chance for us to get double benefits and repair that damage and benefit the entire society, not just the person with the problem.

and bev, in terms of that whole issue in the workplace in particular, i know that there are policies in place that companies can adopt, correct? yes, drug-free workplace policies, employee assistance programs where people can access help at the earliest possible moment so they're then supported, integrated back into the workplace. i also wanted to mention the impact on the criminal justice system, and i think what's so exciting is that when people really have opportunities to access recovery and move into long-term recovery, their involvement with the criminal justice system just goes down so much, and people who haven't had a way out now have a pathway to be able to restore their life and move away from their life of being involved with the criminal justice system. and i'm glad you talked about pathways, because

when we come back we're going to be talking about the whole changes in the healthcare system and how they're going to affect substance use disorder and mental health services. we'll be right back. [music] well, the recovery support initiative is really a recognition that a vast majority of americans have some experience of mental illness or addiction. either themselves or in their families. and we tend to think of this as a quiet or hidden problem and it's really not. people are seeking help through their primary care physicians, they're seeking help through specialty organizations, and they're seeking help through mutual aid approaches. so when we think about who's in recovery or what does that mean we really have to go back to it has to do with

people with mental health and substance use problems who have identified themselves as needing that help to move into recovery and it's a very personal path. samhsa is-one of our priorities is recovery, and so our goal is to promote recovery though mobilizing all of the relevant agencies to involve the consumer and people in recovery in that effort, to make sure that families are educated and that treatment services are available and that we are working with child welfare, criminal justice, as well as primary care so that people have access to services. we want a recovery-oriented environment and that also includes housing, employment, as well as the health care that i mentioned. it's very important to connect recovery and recovery support services to the dimensions of a person's life

which would include a home, having a purpose, living in a community and, in fact, having relationships and something to occupy them in a normal meaningful way. so recovery and recovery support services is a construct that samhsa proposes and uses in order to think about the individual living in a community with the appropriate kinds of supports and services that they need in order to make their life a quality one. they tell me i was there, but i don't remember. i don't know where i really was. i do not know what i had for breakfast. i do not know who won the game. i don't recognize this man. if you or someone you know is struggling with a drug or alcohol problem, there is a solution. recovery. call 1-800-662-help for information and for hope. through treatment, my life's a whole lot brighter now. brought to you by the department of health and human services. [music]

the cool thing is that i'm at the level now of the recovery movement, that i'm at the federal level with samhsa and the white house, you know what i mean, and seeing how the top, how really still today, when we say that stuff rolls down hill. so the cool thing is that thirteen years ago, when csat and dr. clark said, you know, hey we're going to do a peer-to-peer recovery community support, and then i was part of that in '97-'98, and thirteen years later where we are today. so we've come a long way from thirteen years ago of just advocating for recovery, prevention, and treatment. but i think again five years from now, we're going to come a long way, because now, everybody's on board. i mean, this year is like really turning point and historical

point, because we got not only the federal, but we also have the state, i'm involved at the state level and the local level. and everybody's doing the same work right now, transformation of behavioral health leadership integration and definitely recovery community supports. keith, let's talk a little bit before we get into the health care dialogue, let's talk about how has recovery evolved throughout the years? there's been a very positive change in the united states, which i'll just give a personal story. early in my career when i would give a talk about alcoholics anonymous i would get angry emails from people saying, "that's a bad organization, i got better in treatment." and then i'd give a talk about methadone and people saying, "oh, methadone's terrible, you should tell people to do this in that way." it was like a bunch of little battling sects. and what's changed that's really exciting is that there's this collective sense of we need to honor all pathways to recovery. and i think csat actually deserves a lot of credit for

that with the national summit on recovery. when people stood up there with people who had recovered "the wrong way" and said, "this is not my pathway, but i honor and accept that." that's when the recovery movement started to become a force because if you don't divide yourself then you have the ability to influence lots of other people and that's very important because this is a health problem and nobody ever says about cancer, "you know, oh, you got better on tomaxafin instead of chemotherapy, how sad." they say, it's great. you've recovered from cancer. and that's what we should say. everybody who recovers from these disorders, we should hug them, celebrate them, be very, very happy. and we do during recovery mont. that's right. yes. may i say something about the origin of recovery? the origin really is from alcoholics anonymous, the term. they use the term "recovery." and i think it's really important, as we're going to talk later, about recovery being self-directed, that it came out of a self-help mutual aid movement.

it did not start with professionals and that's kind of the key pin of recovery is, i think, due to the historical basis in the 12-step movement. thank you. and bev, you know you were at the meeting in 2005, i believe, when we first gathered all the folks in recovery, i was there as well. and what was magic about that? i think that as keith said, the fact that people were all there talking about the different ways that they were able to access recovery, but also in one room having the opportunity just to talk about it. i think that there has not been that opportunity to bring people from all different sectors of the community together to really talk about recovery and try to define recovery and recovery principles and what are the values and all of those things.

so it was a maybe a leveling of the playing field to be able to honor all of those different perceptions and ideas. and i also-i think that what keith said about the recognition and celebration, i think, many of us for many years hid our recovery and i think the opportunity to be able to talk about it is really a blessing for many people because not only does it provide hope it also is healing. it's not something to be ashamed of. and joe, talk to us a little about those principles for recovery. yeah, great, i think that, you know, it's so interesting how the principles have came a long way. i mean, like going back to what you were saying, thomasina, as far as alcoholics anonymous but even today when we talk about pathways to recovery, that's one of the principles that we honor all pathways to recovery. and to see how samhsa has really taken the lead, i mean i go back 13 years ago to the first peer-to-peer recovery