Podcast: Who Gets Help for Mental Health?

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Wellspring President and Co-founder, Tova Kreps interviews Wellspring therapist, Lindsey, and Wellspring Development Assistant, Alejandra on how stigmas keep people from getting help.

Wellspring President and Co-founder, Tova Kreps interviews Wellspring therapist, Lindsey, and Wellspring Development Assistant, Alejandra on how stigmas keep people from getting help. 

ON THE SHOW

Host: Tova Kreps, LCSW
wellspringmiami.org//Facebook // Linked-In
Co- Host: Lindsey Steffen, LMHC
wellspringmiami.org//Facebook // Linked-In

Guest: Alejandra Buitrago
wellspringmiami.org

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TRANSCRIPT

Introduction:

Welcome to Wellspring on the Air where professional Christian counselors share practical life and Bible insights. Why? Because hearts and minds matter. We're glad you joined our show today to hear from our host Tova Kreps, president of Wellspring Counseling in Miami. Tova is a licensed therapist with many years of experience as a Christian counselor. Tova teaches, writes, and consults and Life FM is pleased to have Wellspring Counseling, restoring hearts and minds in our community.

Tova Kreps: Welcome to Wellspring on the Air. I'm Tova co-founder and president of Wellspring Counseling. Today with me on our show, we have two people. I have Lindsey Steffen. Hi Lindsey.

Lindsey Steffen: Hi there. Great to be here today.

Tova: You're often a cohost, so I don't feel like I need to introduce you, but if you're just listening for the first time today to our show, Lindsey is one of our therapists at Wellspring and tell us about yourself.

Lindsey: Yeah, I'm one of the trauma counselors at Wellspring, work with all ages and work at one of our partners sites with the kids at Urban Promise. So very happy to be here today.

Tova: Awesome and we also have somebody new on the show. I brought someone from our office over. Her name is Alejandra Buitrago

(Laughter)

Alejandra: You said that right.

Tova: I said that right. Awesome! All right, Alejandra, welcome to the show.

Alejandra: Thank you for having me.

Tova: What would you like to tell us about yourself today?

Alejandra: Well, I am working for Wellspring as a development assistant and I'm 100% behind them on everything that they do and I'm just so excited to be here.

Tova: and you're also in graduate school for

Alejandra: mental health counseling.

Tova: There we go. All right, so she does have some things to contribute to the show today, but let's talk about the show we are doing yet another show on the stigma of mental illness and how we just kind of blame the victim in our culture, how we have shame attached to it and we want to shatter that stigma and so what we want to talk about today is how having a stigma against mental health keeps people from getting help. And we want to talk about who gets help for mental health and who avoids it because of stigma. This is why we need the stigma to go away because people don't get help and they need to get help. So we're going to go through that and talk about who does come and get help and who stays away because of shame and stigma. So first of all, let's talk about who gets help. So what do you think Lindsey, who gets help? Who comes to our offices?

Lindsey: Well, a lot of times people in crisis, you know, people come and it's just like maybe they've tried everything or they just notice “I'm in the same pattern and it's been 20 years” So often they're very low, very discouraged and that's kind of one population that comes in. They just need something.

Tova: Let's just talk about that because I think, you know, when life is painful enough, we'll go anywhere. We'll try any solution somebody gives us if the pain is that bad.

Lindsey: Yeah.

Tova: and so really, I think the first most typical client we have is the desperate client.

Lindsey: Yeah.

Tova: They're, they're there because they can't, they'll do anything to make the pain stop: in their marriages; with their kids, otherwise. So

Lindsey: they're kind of at their wits end. They just need, yeah, “please, please give me something that will change my situation.”

Tova: I think the second group of people who come in are people who actually already believe have gotten past any mental health stigmas and they actually believe that mental health is a tool for them to live a better life. And that's the group we're wanting to grow. Right.

Lindsey: Yes! I love that. I actually, I can say as a counselor, I've had all my friends pretty much go to counseling now and they're like, “Lindsey, I don't know what to say.” I say, “just go and tell the therapist that you want to grow in your self-awareness” so you're going – they’re not going necessarily in crisis sometimes, but just to go and know yourself more, know your patterns, and just live a fuller life. Thrive.

Tova: There's a beautiful thing about therapy and that is having somebody who's not a part of your  family system, who's not going to throw it back at you, who's objective, who does. You don't have to take turns with it. You don't have to listen to their life. They just listen to yours. It's hard to find a society today. And so

Lindsey: Without a bias, I think that's the best part. You know, cause your family does, they know you from before. They know you now. So, they can't help but see you in a certain lens.

Tova: and if we're good therapists, we don't give a lot of advice right, we actually help you come up with your solutions. And so, family doesn't do that very well.

(laughter)

Lindsey: No, they love to give advice.

Tova: so, so yeah, so people who want a better life. So we have people who don't come in even with problems. I have people who come in and came in for, for an annual checkup and the same way you go to your doctor for an annual checkup. Like, how am I doing? Am I reaching my goals? What do I want to work on? Maybe they want to have better performance. I mean, we've worked with athletes who are competing at high levels and they wanna have the best performance possible and to do that, they have to get the best thinking possible in their head, their fears, things like that. So, business leaders who want to do a better job, that thriving and wellness work. We have people who come in like that, right.

Lindsey: To be great leaders. I think they just are saying, “I don't even know what my blind spots are, but help me figure them out.” “I want to, you know, be even fuller as a person, more thriving and

Alejandra: it's so interesting that you said that because you, I would think it's only those that need help are desperate that seek mental health. But that is so good to hear that people just, you know, it's like an annual checkup.

Tova: We have this thing that people with “problems” need mental health treatment as opposed to seeing it the way we see physical fitness. So, if you think in the world of physical fitness, you know, yeah, when you have broken a limb and then you have to go to rehab and then have, you know, OT training or PT work, that's you working in the physical realm on a problem, you've got to get your ability to walk back. Well, that's the way we think of mental illness. We think that's who goes to therapy. I see mental health the same way I see physical health. So in the physical room, yeah, you gotta go to rehab when you've injured yourself, but you also have this whole middle realm of just eating well and nutrition and exercise and all of that and we have the same thing in the mental health realm. Just do I meet my goals? am I having good relationships? Am I able to to self-regulate is what we call it? which is keep your emotions in check and not be over-reactive. That's kind of that middle realm. And then on the high end of the spectrum are the mental health athletes and who are those? Those are the people who are able to handle their emotions really well, like they can handle major stressful situations. I honestly, I think my husband is like this, he tolerates so much stress because he's actually developed an endurance for it and a capacity for it.

You know, so people who can keep themselves regulated, who can make good behavioral choices on a regular basis. So that self-discipline, that capacity, who can maintain love and grace towards others even when they're not kind to them. That's the mental health athlete.

Lindsey: Yeah, well you can tell they practice maintenance. That's what I always tell my clients. We want to get you into a maintenance phase where you are just checking in sort of as needed or once a month, every couple months just to make sure everything's on track and I do that myself just to be transparent. You know, at times I'm going because there is something really going on, a deeper issue. But if not, I just, as a trauma counselor, it's a stressful job, so I check in with my therapist at least every month or two just to say, “Hey, let's clear out anything that's there so I can keep performing at a high level”

Tova: And I want to say that to our listeners right now. So, we really encourage most of our therapist to get therapy. It's important that we remember what it's like to be on the other side or to be on the couch or however you want to put it and because it gives us great empathy for our clients and their bravery to come in and be vulnerable and let people in on their lives. But we practice what we preach. We believe in the wellness theory. And this makes me a better person. Why would I not choose to be the best person I can be and honor God with not just my body, but my mind and my emotions? All right, so let's think about who else comes. This is kind of similar, but I think the people who come are the people who believe that therapy works, and this again is a growing group of people that we want to grow.

So, if you think of getting surgery, you know you, you let a doctor talk you into letting them put a knife into your skin, right? It was kind of a crazy thing, but we believe that we will be better afterwards. We know will be worse for a little while. We know that we'll have a week of misery or whatever it is, but that afterwards we're going to be better than we were before. And so people who come to therapy are often those that believe that there is a science behind therapy. It's not just talking, is it just talking?

Lindsey: No, it's, we're offering a lot of techniques and different skills that just the average person wouldn't know and so I think just like you go to PT and you learn exercises to kind of maintain or get, well, we do the same thing in therapy.

Tova: We actually use evidence based. uh

Lindsey: Um, yeah, it's all in research

Tova: techniques, right? We figure out what has the best, uh, research behind it and the best proof and we know that CBT works. We know that EMDR works. We know a variety of these tools that we use work and we use the ones that fit our clients, so, there's actually science to it.

Lindsey: Yeah, it is. It's all scientific. It's all a lot of its medical that we do. So, it's just, it's really the science of the brain and the mind not different than the body.

Tova: So, I think that's who comes to therapy, people who are desperate, people who believe that it works and people who want, you know, wellness and their best self and we want to shake the stigma that keeps people from coming in. So let's talk about who is least likely to get help. And I want to tell you all his listeners, this comes from some pretty big research by the psychological medicine and if you want that website, I can give it to you.

What is the impact of mental health related stigma on help seeking? And so this was a large review of a lot of research that basically said, how does the stigma keep people from coming in? And so the first group, you won't be surprised at this, but the first group that falls into that, that doesn't seek help even if they have mental health illnesses or is less likely, let me put it that way. Right. Are those who have sort of a machismo, that's the best way to describe it. That's the way they describe it in the research. The machismo belief system, which is really that, particularly men but not even just men, but that if you're strong then you don't talk about your feelings, that talking about your feelings is weak and therefore, and it shows a weakness and so this is men, this is first responders and this is particularly the military and you know it's really important that the military and the first responders have themselves together and aren't going to fall apart in a crisis. We need them to not, but they can be so trained that they're never allowed to let down.

Lindsey: Or even just knowing some people who have come back from, you know, their deployment, they all know, I've heard this from them directly, we know what to say to the psychologist to get through and so they know, you know, they do feel like, “no, I don't need that help but then I do” I even have friends or you know, people who are close, who they definitely have PTSD and high anxiety and you know, you see that develop into alcoholism and other things because they're not getting the help they need because there is the stigma, like we're talking about that “you're a man, you were deployed, you should be able to come back and be a man in your family again” and they need help.

Tova: and that being a man is to not have weakness.

Lindsey: Exactly.

Tova: You know, and scripture shows us quite a contrast to this. So if you, so my favorite one in scripture along these lines is Joseph. Now Joseph is the one character in the Bible that didn't have any flaws that we know of, like a Christ figure and say, and he went through terrible things, right? So his brothers sell them as a slave. He works as a slave. You know, he's then betrayed even there and lied against and thrown into prison and he, if you talk about handling things well, he handled it well. He was a good slave. He was a good prisoner. He was a good servant. You know, he literally bucked up and did it well and yeah, you see later in his life when the pain of his being betrayed by his family came in and his brothers show up that and he finally reveals himself, he cried so loudly that the entire court heard him.

You know, so this is the strong, now the Pharaoh second in command leader and he's wailing like a baby. without any apologies. And I think that's just a good picture for us. This is the head, the leader, the strong guy who did everything right, but he felt the emotions are normal and so I guess I want to say the feeling fear when you're in danger is normal. Feeling sadness when you've had a great loss is normal. Its actually how we're designed to process these things, right?

Lindsey: It's healthy. It actually, it makes you stronger. I tell my clients, I hear all the time, I don't want to cry or I don't want to cry in front of you. I say, “okay, and you can or you don't have to. It's up to you.” But it's a strength because all that means is that you're feeling and to feel is very brave. I think it's way braver than shutting off and just pretending that there's nothing there because we're humans and we are emotional beings. So to acknowledge that, I tell my clients, I think you're the bravest people for sitting here and doing this hard work cause you are, you're, you're going to dark places in the hopes of then getting to lighter places.

Tova: And that goes to just the whole idea of shattering this mental health stigma. Because though the fastest way to get over bad things that happen is to feel the feelings that went with them proportionate and appropriate to them. So as long as we're stuffing those, those negative events stay in our being, in our body, in their mind, and they distract us but the more we process it, the fastest way is to feel it, the fastest way is to cry it through. And that's the, and when we believe that, then we'll go through those steps to get over things because we want to be strong. We don't want to be handicapped by these things invading us.

All right? We've made a good dent in this in this show we've been talking about who gets help for mental health and the first group that tends to avoid it are those that have that belief that to be strong is to not talk about your feelings. All right. If you miss the beginning of the show, then find us on your favorite podcast. Wellspring on the Air or on our website, wellspringmiami.org we have blogs there and you can find any of these shows. This show is called “Who Gets Help for Mental Health” and if you missed the beginning you can find that. Otherwise we're going to take a quick break and we will be right back.

Commercial Break:

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Tova: Well, welcome back. This is Tova and Alejandra and Lindsay on Wellspring on the Air and we're talking about the stigmas of mental health and how having stigmas against those with mental illness keep people from getting help that they need. And we talked about people who do come for therapy, those who are desperate and those who believe that a little work can make a difference in their lives. And then we've talked about the first group that- is likely to avoid it- are those that have a belief system that to talk about your feelings makes you weak like that machismo men, first responders and particularly the military as a population.

So, I want to talk about a second group, and this is kind of an interesting one. I was surprised as came up in the research and that is health professionals.

Lindsey: Yes.

Tova: What do you think about that? Health professionals are some of the least likely to get help?

Lindsey: Yeah. It's not surprising at all. I actually, I had my, uh, primary care, she told me, she said, Oh cause she was just doing some normal assessments and did the depression assessment, all that. And she says, Oh, she made a joke. She said, “Oh, you're a mental health counselor. You'll definitely under-report you all do.” (inaudible) it was kind of alluding to, you know, you feel like if you are in the mental health or you know, the medical community that you're the professional, you must be put together and strong and kind of have it together. You shouldn't have those type of problems, which is not true. Where human, absolutely, we have the same stuff going on.

Tova: Interestingly, the, uh, health professionals have the high as a professional, the highest suicide rate of any other profession.

Lindsey: cause I think we're stuffers if we don't (laughs) get help

Tova: and I , you know, dentists particularly and doctors of the health professionals, and I think, and the doctors have a very high suicide rate and I do think that there's been kind of a myth over the, you know, generations that doctors are kind of godlike, you know, and that, and so they have very high expectations of them. Like the military during your residency programs. It's just, you never stop you, you know, because people's lives are in your hand. And so, you can't, it's like being a pilot, you know, you can't break down, you can't stop. Although it's interesting. Pilots, we now know, we believe people's lives are in their hands. And so we only let them work so many hours in a row. But that's not true for doctors. Doctors need a union somehow. They need somebody to help them say, yes, know that's too many hours. Don't go into surgery. You know, they, but we, I were lots of medical people in my family and they'll, you know, work 120 hour weeks. It's just, it's not healthy.

Lindsey: It's not, and it's such a high stress job. You literally, at times of people's lives in your hands, life or death decisions and so if you're exhausted three days in without any sleep, of course you're not at your best. So,

Tova: and they have great fear over malpractice and of doing something wrong and so that it's just, it's hard. So, all that to say, but let's talk about why we think they avoid getting help and I think the one of the biggest issues is confidentiality. It's like a fear that someone in this community is going to know. They're going to have see my electronic medical records. They're not going to keep that secret and you know, that's a hard thing.

Lindsey: Yeah. Cause I think a lot of my clients who even maybe they're younger and they're going into the medical field, they're very worried. Maybe a diagnosis I put on their chart or something. They think “Will this affect me one day. Will this affect me getting into this program or this med school?” So I think, yeah, I was sharing with Tova, I go to a counselor myself, you know, we practice what we preach, but it's kind of, it's odd. You're in the same therapeutic community together and so there is a little bit of vulnerability there. Feeling like, okay, I'm sharing all my stuff with a fellow professional and so it does, I think it takes some extra bravery.

Tova: Okay, so, and I'm going to fess up here because I was not brave enough to do this. So I actually do have had a therapist in our community, but this last year I decided I just needed a good checkup. I needed some time inside, flew all the way to Phoenix!

(Laughter)

Lindsey: two States away

Tova: to spend four to spend five days in a row and doing some personal work just to be in a good wellness place. But I did go to Phoenix really partly because of that reason. I just needed to be out of our community. I'm president of Wellspring, you know, like who do I go to? And I'm so, I'm just fessing up on that. But I did go, I just want credit. I want points for that.

(laughter)

Lindsey: So you got the help you needed and maybe if that felt safer than, I think there's nothing wrong with that, but it just shows that there is a difficulty sometimes feeling like you can trust within your community.

Tova: I also think in the health professionals, they lean toward the medical model and the medical model is diagnoses for illness and so when we think about mental health and you only think of it as the illness side and a diagnosis of not functioning, they don't want to go to therapy because it means they have an illness versus not a medical model, but when I was talking about earlier, with that spectrum model of physical health is on a spectrum of everything to the great athlete, to the person whose ill and dying and mental health is the same thing. You know, it's a spectrum and so I think the health professionals have a harder time getting out of that diagnosis mode. The problem oriented. Yeah.

Lindsey: I think in this kind of, this, I don't want to be off topic, but it also makes me think of our ministry workers, you know pastors

Tova: pastors.

Lindsey: Yeah. I think I get a lot of pastors or pastors families who that, I mean they will avoid it for a long time and maybe they're struggling with big issues because again, they're supposed to have that put together

Tova: all together

Lindsey:  god like you know, quality, which is not, it's not true at all. Those are the people who are bearing other's burdens and so I think more than anyone, they need to go and have a safe place to unload that and really, you know, be cared for themselves.

Tova: and that's for sure. Well let's go to the next group, which is actually a lot of groups, but the research says that people the least likely to get mental health help are in different subgroups and some of those subgroups have to do with ethnicity. So, I'm going to list them for you and it says: Asians, Arabs, African Americans, and almost all the other minority ethnic groups have, are less likely to seek that and let's, let's talk about that. That's, that's really a cultural thing. So, Alejandra you’re here with us today and you represent a subgroup of the Latino. Can we, can you make you represent that entire group today?

(laughter)

Tova: Talk to us about it.

Alejandra: Definitely. There's even a saying in Spanish that says like, the dirty dishes are washed at home. You don't go outside your house to talk about your issues. You have to protect your family, you have to protect your reputation and you know it, it's detrimental in the long run.

Tova: So, one of those aspects is family loyalty, keeping secrets, keeping things within the family. So why would you talk to anybody outside the family about your dirty laundry, if you will? So I think that's one huge aspect of it. I also think they're just cultures that don't talk about feelings at all in within their culture. So, I have a friend who's Chinese and she was telling me about that, that, you know, as I've spent time with her, she's always like, “Oh, we wouldn't talk about that with my family. Oh, we don't talk.” You just literally don't do it.

Lindsey: Yes. I also had a friend from China and same thing she said, “no, like we don't really say I love you or express anything of affection” and, and I can't speak for every Asian family, but this was, yeah, her, her experience and so, but she was very emotional and she loved, I guess as an American friend, she loved to just, you know, express things and talk about that. So, I think that desire's there because all these groups, they're human, of course they are emotional beings, but there's just such a stigma or such a pressure to not go outside the family system.

Tova: or to talk about those feelings. And I, the African American is a group. We really have a lot fewer counselors. We, we've been working with a group up in North Miami as mostly an African American culture. Met with a bunch of pastors there and they're like, well how do we get them in?  How do we get them to talk about this? And I think that's where education makes - makes a difference. So maybe they aren't going to come for therapy, but that's why at Wellspring we do counseling. But we also do education because just educating people of what's normal. What happens when you have PTSD? what happens, you know, with depression? how do you handle families where there's been a suicide? just all that mental health education just kind of gives permission for people to, to feel and to talk and to get help and to get well.

Lindsey: Right. I just did that recently. I went to a church, a pastor friend, he, its a Latino church and he said, please come. We have so many mental health issues, but people don't know how to talk about it. And I'm a pastor. This isn't my realm. So we had me come and speak and it was amazing just educating on mental health. People were so responsive, they were hungry for it and actually many people came up after wanting, you know, referral information, wanting to seek help. So that's something I love about Wellspring is just educating the community. So then they know, “Hey, what I'm dealing with, there's actually solutions to this or there's a place I can go and get help.” Kind of breaking that stigma.

Tova: So, Alejandra, what do you think would help in the Latino culture? Would help a family or help individuals in a family to overcome that family rule of don't go outside the family on, don't talk about these things?

Alejandra: I think it just takes one person, one person in that family to seek help and to go outside of that system and talk about it and it will actually spread to their family. I've seen it in my family. I like Lindsay, you know, recommend to all my friends, you know, get counseling, talk to somebody. But I think that um, after that one person does it and sees, you know, how much they were carrying that they didn't need to be carrying, how much responsibility was theirs and not theirs and, and gets the help, I think it, it will have an effect, a positive effect on their family again.

Lindsey: I think and, once they see the change in that person, you know, maybe it rocks the boat at first

Alejandra: It does (laughs)

Lindsey: but then they see, you know, like this person, wow they're very different. So, whatever they did, it worked. I think a lot of parents see this with their kids. That's my experience working. Some kids they see, wow, my kid is different, their behavioral issues are changing. You know, you have to get the parent on board to change some things at home. But then I see parents then seek counseling at times because they're like, “wow, this works” this isn't just, you know, this is actually science. This is something with um, strong, you know, evidence-based backing.

Alejandra: and I think also like, you know, parents gave us what they could and you know, seeking that healing and, and seeking help helps, you know, to forgive and to have compassion for them and to have like the, the real relationships that you want. Yeah. But they gave us what they could and you know, and now we get to break that generational curse.

Tova: Well we do. And I come from another subculture that is not on this list and that is the missionary mentality born in the mission field and that very stoic, cultural, the Bible is enough and talk about bootstraps. It's bootstraps in the Bible and that's how you get over it. And I came from a family where we didn't talk about those things either because you just had to have faith and you had to just get over it and you had to pray about it and it would be fine. And, and I had to be the one in my family who kind of broke those myths and talked about things and

Lindsey: Look at you know

(laughter)

Tova: Look at me now. Although, I know.

(laughter) I hope my mother never hears the show but I remember her saying to me, I said something about going to counseling together. We could work on some stuff. And she said “over my dead body”

(laughter)

Tova: and I still laugh about that. She's very supportive of me in Wellspring and it's been great. But I mean that was like, Oh no, if that's not happening.

Lindsey: Yeah, I think it feels threatening though. You know, it's like, “why do you need to go to counseling? What did I do wrong?”

Tova: “We don't have that bad of problems” and so, you know, so I, there are lots of cultures that have trouble with this and as we come to wrap up, I just want to say, you know, Jesus wept, right? and you may not have been popular in his culture either to weep. I don't know what that stigma was for him, but he, he let himself feel, he let himself need his friends to pray for him. He asked for help when he was in distress. And we know in scripture, in 2 Corinthians 1:3-4  it says, “blessed be the God and father of our Lord Jesus Christ, the father of mercies and God of all comfort who comforts us in our afflictions so that we may be able to comfort those who are in any affliction with the comfort with which we ourselves are comforted by God.”

God comforts us. We comfort each other. The body is meant to take care of each other, not just our physical illnesses, but our emotional and our mental illnesses too. We're meant to take care of each other and to go to each other with those things and we need to be wise about where we go and make sure it's a good safe place.

But all right, so we're going to wrap the show, but any last words there? Lindsay

Lindsey: This is great. I just, yeah, I think of, uh, just as humans, like we're meant to live in community. We're meant to give and take from other humans. So, I think just knowing a counselor, someone who’s there literally for you to take from in a good way, they're there. They have their people who care for them, they do their own work, but you know, we're here to really pour into people. So, I think it's a resource that's available. We just, we're hoping this show really helps break some stigmas that people are okay coming in and knowing that it's not wrong. It's actually such a healthy thing and it'll affect you and everyone else in your life in a positive way.

Tova: Yeah. So this show was called “Who Gets Help for Mental Health” because they overcome a stigma and we were hoping that everyone will overcome the stigma and not just see it as something for broken people, but something for anyone and everyone  to get well and to be the best we can be. So, thank you, Alejandra and Lindsey for being on the show with us. It's time to wrap up. This is Tova with Wellspring on the Air because hearts and minds matter.

End : Wellspring on the Air as a production of Wellspring Counseling, a nonprofit professional counseling center with multiple locations in Miami Dade County. Wellspring therapists are licensed by the state of Florida and Christian in their worldviews. They have wide ranges of clinical expertise including marriage, family, anxiety, depression, and trauma. Their diverse group of therapists includes several who speaks Spanish or Portuguese. If you would like to know more about Wellspring services of counseling and education, go to their website at wellspringmiami.org or give them a call at 786-573-7010 or email them at ontheair@wellspringmiami.org again, you can find a way to contact them at wellspringmiami.org.