July 27, 2023

Voices of Recovery: Episode 18

Ray Lay is on the national Board of Directors, the Board of Directors for NAMI Indiana, and is considered to be in the In Our Own Voice Hall of Fame, having shared his story over 200 times in presentations of NAMI’s In Our Own Voice program. Ray is an honorably discharged veteran who has had experience with substance issues, a period of being unhoused, time in a correctional facility and hospitalization. He draws on all his experiences in helping others, including with the Veterans Administration. Ray talks with Dr. Ken Duckworth, the Chief Medical Officer of NAMI, about how participating in In Our Own Voice both empowers him and empowers others to get treatment.

This conversation was part of Dr. Duckworth’s research for the book, You Are Not Alone: The NAMI Guide to Navigating Mental Health–With Advice from Experts and Wisdom from Real People and Families. Hear more episodes of this and other podcasts at nami.org/podcast.  




Episode Transcript:

[0:00] [background music]

Dr. Ken Duckworth: [0:03] Welcome to "You Are Not Alone, Voices of Recovery." Hi, I'm Dr. Ken Duckworth. I'm a psychiatrist and the chief medical officer for the National Alliance on Mental Illness, or NAMI.

[0:12] I'm the author of NAMI's first book, "You Are Not Alone — The NAMI Guide to Navigating Mental Health, With Advice from Experts and Wisdom from Real People and Families." I talked to over 100 people for this book, and I want to share some conversations that I found might be helpful for you.

[0:31] Ray Lay lives in Indianapolis, and he is well known at NAMI. Ray serves on the National Board of Directors at NAMI and the Board for NAMI Indiana. He's been very active in telling his story in NAMI's In Our Own Voice program.

[0:50] At these sessions, people get up, share personal stories about their mental health journeys. In Our Own Voice can take place at schools, community groups, wherever someone asks NAMI for help.

[1:02] Ray is very proud of his military service. He was honorably discharged from the military and has served as a volunteer peer support specialist in the Veterans Administration for many years. Ray's journey has included inpatient hospitalizations, time in correctional facility and an extended period when he was unhoused.

[1:26] Along the way, he's dealt with what was ultimately diagnosed as schizoaffective disorder, bipolar type, and a substance use disorder related to drugs and alcohol. Ray's story and his recovery are a real inspiration. I asked Ray how he got connected with NAMI.

Ray Lay: [1:44] I found NAMI when my immediate PASS coordinator, In Our Own Voice coordinator asked me to start talking about my journey, and specifically at prisons. I spent approximately seven years of my life in a prison.

Dr. Duckworth: [2:05] I am so sorry, Ray.

Ray: [2:07] That's OK. You didn't do it. No, I did.

Dr. Duckworth: [2:10] I know, but I'm sorry for you because I know from the conventions how lovely you are. You have such great energy, and I'm sorry you did this.

Ray: [2:18] Oh, yes. I still got it. I still got it.

Dr. Duckworth: [2:21] You got it.

Ray: [2:20] Even more.

Dr. Duckworth: [2:21] I remember that very vividly. You went through the prison system, and you're now doing In Our Own Voice in the prison system. Do I have it?

Ray: [2:31] I don't do In Our Own Voices at the prison system. I do them at some correctional facilities, at least I have done them, and mainly for persons experiencing homelessness, recovery. I have utilized it in the parole system because I was also on parole, but mainly, it's through mental health facilities.

Dr. Duckworth: [2:59] Got it.

Ray: [3:02] When she told me that, "Well, we use it for Indiana," NAMI Indiana has a collaboration with the Indiana Department of Correction to help train newly-hired correctional officers on the mental health issues.

Dr. Duckworth: [3:19] Nice.

Ray: [3:21] That was approximately 2012. I have been doing them ever since all over the state of Indiana.

Dr. Duckworth: [3:31] How many times would you say you've done In Our Own Voice, Ray?

Ray: [3:35] I am in the In Our Own Voice Hall of Fame.

Dr. Duckworth: [3:38] [laughs]

Ray: [3:38] I would say probably 200.

Dr. Duckworth: [3:41] 200.

Ray: [3:43] Yes.

Dr. Duckworth: [3:43] You're Henry Aaron.

Ray: [3:46] [laughs]

Dr. Duckworth: [3:47] I don't think anybody's ever done 200.

Ray: [3:50] I'm [indecipherable] . I got a young lady who I present with, she has probably done more.

Dr. Duckworth: [4:00] Really?

Ray: [4:02] Yes.

Dr. Duckworth: [4:04] You're both in the Hall of Fame.

Ray: [4:06] She's in the Hall of Fame, yes.

Dr. Duckworth: [4:08] [laughs]

Ray: [4:09] The Hall of Fame consists of 75 or more.

Dr. Duckworth: [4:14] Did you make that up or is that a real thing?

Ray: [4:17] From what I understand, it's a real thing.

Dr. Duckworth: [4:20] I don't know everything. I learned something on every interview, Ray. I didn't know 75 puts you in the Hall of Fame.

Ray: [4:27] Yes.

Dr. Duckworth: [4:28] This is fantastic, Ray. What is In Our Own Voice? What does doing that presentation mean to you?

Ray: [4:35] It's a medicine that I don't have to take the top off of because the more…

Dr. Duckworth: [4:42] [laughs] I love that.

Ray: [4:43] I'm sorry?

Dr. Duckworth: [4:44] I love that.

Ray: [4:46] Yes, it is. It's true, and especially for me because I mix it up. It's a mix of my CIT presentation, my In Our Own Voice presentation. Just overall, my biography. I mix it up. I use it for newly-hired correction officers and police officers because I also train the Indiana Law Enforcement Academy on mental health issues.

[5:18] I've been doing that seven years. Nine years at the prisons, I have trained at every training facility in the state of Indiana, the only one [inaudible] .

Dr. Duckworth: [5:31] Incredible. Are you born and raised in Indiana?

Ray: [5:36] I was born in Mississippi. I was raised in Gary, Indiana.

Dr. Duckworth: [5:40] Gary, I know where that is.

Ray: [5:43] Home of Michael Jackson.

Dr. Duckworth: [5:45] Michael Jackson and a famous song from "The Music Man."

Ray: [5:50] What Music Man?

Dr. Duckworth: [5:54] It's an old musical. The song is [sings] "Gary, Indiana. Gary, Indiana." Have you heard that?

Ray: [6:01] Yes.

Dr. Duckworth: [6:02] That's where it's from. Michael Jackson and a famous song, it's not terrible.

Ray: [6:10] Karl Malden came from there.

Dr. Duckworth: [6:12] Karl Malden?

Ray: [6:14] Yeah.

Dr. Duckworth: [6:15] He's the man. I love Karl Malden.

Ray: [6:17] Yeah, The Nose.

Dr. Duckworth: [6:18] [laughs]

Ray: [6:22] The Streets of San Francisco."

Dr. Duckworth: [6:25] I love your quote about it's a medicine you don't have to take the top off the bottle. That's beautiful, Ray. I have to include that quote. It's a medicine for you, right?

Ray: [6:35] Yes.

Dr. Duckworth: [6:36] Helping others.

Ray: [6:38] It empowers me. It's not only empowers me by talking about my journey, it empowers others to want to go and get treatment. That's one thing which I feel like my journey has been beneficial, helping others. That's why I have no shame on that.

Dr. Duckworth: [7:14] I'm there. I see it. You're the 117th person who's like, "I got no shame. Let's go."

Ray: [7:19] I have no shame. I'm very honored to be in the position that I'm in. Ken, let me put it to you this way, real simple. I spent over 10 years of my life homeless. I am in my home. It's been over 16 years since I was last hospitalized. I have a dual diagnosis. I'm over 14 years clean and sober.

Dr. Duckworth: [7:54] Fantastic, Ray.

Ray: [7:56] I am the longest-serving peer support specialist at Roudebush VA Medical Center. There are approximately five who have jobs because, at that time, I felt that it might be a trigger. I didn't feel like I was strong enough to try to work a full-time job.

Dr. Duckworth: [8:22] What might be a trick? I'm not following that.

Ray: [8:25] A trigger, the stress.

Dr. Duckworth: [8:27] If you were in the VA system with all these people who were vulnerable, that would be a trigger for you.

Ray: [8:33] It's a possibility. I didn't want to find out. I can walk into there tomorrow morning and get a job.

Dr. Duckworth: [8:47] Yes, of course.

Ray: [8:49] Instead, I maintained as a volunteer status. They call it employee without compensation. I get compensated, but it ain't money.

Dr. Duckworth: [9:06] What's the compensation?

Ray: [9:08] The satisfaction of working with my fellow vets and watching them change their life.

Dr. Duckworth: [9:17] That's the satisfaction.

Ray: [9:19] That's a payment that you can't go in your pocket and give.

Dr. Duckworth: [9:23] That's exactly right, Ray. I love this.

Ray: [9:26] You got to go in your heart and give that.

Dr. Duckworth: [9:28] The reward is in the heart, not in the wallet.

Ray: [9:31] Yes. A lot of them have paid me like that. There's the satisfaction of helping to train others to become peer support specialists. I lie to you not, Ken. There was many, many days I used to say, "Why me? Why I'm hearing these voices? Why?"

[9:54] For many days, I did not accept my condition. I wholeheartedly embrace it now. Keep your friends close but your enemies closer. Schizophrenia is my enemy and my friend.

Dr. Duckworth: [10:10] You've got to keep it really close.

Ray: [10:14] Yes. It's working good. I take it back also to the part where, is the glass half empty or half full, that perspective.

Dr. Duckworth: [10:27] What is it for you?

Ray: [10:32] Both. The reason why I say both, it's half full for the simple reason, I am living with it. It's half empty because I got it.

Dr. Duckworth: [10:42] Right. There we go. That's very elegant, Ray.

Ray: [10:47] If I could give it to you, I'd give it to you.

Dr. Duckworth: [10:51] I understand that. You've gotten into a place of service and purpose which you may not have found through the other part of the glass. This is how you found your path, right?

Ray: [11:05] Yes, you're absolutely right. Plus there's another aspect on that. What you just said, the service and the purpose, they work hand in hand. Through the service, I found my purpose. I believe that that's one of the biggest ways of how I have been able to maintain both my stability and my sobriety.

Dr. Duckworth: [11:34] Yes, the purpose and service.

Ray: [11:38] Yes. My doctor when I first met him, he started saying…He's my current psychiatrist. He gave me a little saying, "Stress less for success."

Dr. Duckworth: [11:56] I like it.

Ray: [11:57] I was two months sober. Right now, I'm over 14…Let's see, this is October. I'm 14 years and five months.

Dr. Duckworth: [12:08] Congratulations.

Ray: [12:09] Thank you.

Dr. Duckworth: [12:11] Stress less for success. I like it.

Ray: [12:13] Stress less for success. I have learned. I haven't had to do a lot of stuff to keep those stress levels down. One of my best ones is exercise. I take my medication, exercise, enjoy my wife. Also, we got a little dog.

Dr. Duckworth: [12:35] A little what?

Ray: [12:36] Dog.

Dr. Duckworth: [12:37] What kind of dog?

Ray: [12:38] Chihuahua.

Dr. Duckworth: [12:40] Can we see her? Is she near you?

Ray: [12:42] I'll get him. It's a him.

Dr. Duckworth: [12:47] Let's see the Chihuahua. Come on.

Ray: [12:51] [laughs]

Dr. Duckworth: [12:51] Adorable.

Ray: [12:55] That's the big boy. I call him the big boy.

Dr. Duckworth: [12:57] Big Boy, is that his name?

Ray: [12:59] No. Bentley like the car.

Dr. Duckworth: [13:03] Bentley.

Ray: [13:03] Yeah. See him?

Dr. Duckworth: [13:09] Love him.

Ray: [13:10] He's a big one. He's my big boy. He's super smart. He flies with us. He does not panic.

Dr. Duckworth: [13:21] He stresses less for success. It's inside the dog too.

Ray: [13:27] Yes.

Dr. Duckworth: [13:28] Let me ask you about Bentley. I've had about four people talk about their dogs. Every person told me a different way their dog supports their recovery. I want to ask, how does Bentley help your recovery?

Ray: [13:46] For one thing, he's funny. He's loyal. With my wife, he lets my wife know when she is going off to the other end. Some kind of way or another, he helps bring her back. I try to make sure that I don't. I try to keep my mood as stable as possible.

[14:14] One thing which helps that tremendously is my exercise. Bentley, we have worked out a way where he lets me know if he needs to use it, and I'll take him out. I do have enough wherewithal when he go, I still clean up behind him. We do have some wild animals around.

Dr. Duckworth: [14:41] You got to be careful.

Ray: [14:43] Yes. One of the major things is…That's probably it plus on a long drive, he loves to rest his head on my arm. We do 12 and 16-hour drives. We drove to New Orleans.

Dr. Duckworth: [15:06] For the convention?

Ray: [15:10] Yes. That's how he did it. I remember one of those saying, "Years ago, I had no shoes, and I complained until I met a man who had no feet." I got nothing to complain about. At least, I'm not a dog. Then, there's the other aspect. The dog ain't got to go to work. He don't pay the mortgage.

Dr. Duckworth: [15:43] Dogs got no worries.

Ray: [15:47] He don't buy no food, but he gets fed.

Dr. Duckworth: [15:50] [laughs] He's got it pretty good. Ray, let's talk about your exercise. How does that help you? What is your routine?

Ray: [16:00] My routine is five miles five days a week walking at a very brisk pace. I usually do it in approximately a hour-and-a-half.

Dr. Duckworth: [16:11] Wow.

Ray: [16:14] It helps me. It gives me the opportunity to think. I get fresh air. I get to stretch my legs. It also helps my medication circulate better. I always drink water before and after. I drink water very often.

Dr. Duckworth: [16:39] Good. Hydration and five miles five days a week. You take two days off?

Ray: [16:47] Yes. My wife, for the longest, she used to say she was scared. The majority of the time, I do it at night, early in the morning after 12:00. My watch, which is also a smartwatch, it gives it time to reset. It keeps my steps. I fulfill three goals every day five days a week, one hour of exercise. I overdo it, 11,500 steps and five miles.

Dr. Duckworth: [17:23] Beautiful.

Ray: [17:27] I'm goal-oriented. For a long time, I did not know what goals were. I was part of a research program at the VA Medical Center. I had a psychologist with me 30 minutes every day for 10 weeks. For lack of a better way to put it, she worked with me. The program was specifically for veterans with schizophrenia. I had accepted my condition at that time.

[18:04] Getting into that program, having that psychologist with me first thing every day, I learned a lot. I just started applying it. Goals was the first one, specific smart goals.

[18:24] I keep it that way, and I'm always trying to think of other ones that will not throw me off track, that can hit or miss with them good.

Dr. Duckworth: [18:35] Good. Was getting on the board a goal of yours?

Ray: [18:39] The NAMI National Board?

Dr. Duckworth: [18:41] Yes. That's…

Ray: [18:42] Yes. I'm also already on the Board with NAMI Indiana.

Dr. Duckworth: [18:48] Of course, yes.

Ray: [18:50] I just got re-elected there, will be my last three years. It'll be nine years altogether.

Dr. Duckworth: [18:57] Wow. This is a great story, Ray. I want to learn more. When did you see your first In Our Own Voice presentation, and is that when you decided that you were going to make this part of your life? What was it about the first presentation that you heard?

Ray: [19:18] I really do not remember seeing my first. My first introduction was training.

Dr. Duckworth: [19:25] Got it.

Ray: [19:28] She asked me about going there, but I was just telling my story. Then she told me about In Our Own Voice. She told me that it would probably make me a better speaker, because, Ken, my hallucinations and voices were so rough, I didn't talk too much.

[19:55] Now I'm not only an In Our Own Voice speaker. I'm actually a national speaker.

Dr. Duckworth: [20:00] Ray, it's fantastic. Let's go back. If you're open to talking about it, when did you join the VA? When did you join the service?

Ray: [20:10] I first went to the VA in 1995.

Dr. Duckworth: [20:15] When did you join the service?

Ray: [20:18] 1977.

Dr. Duckworth: [20:20] How long were you in the service?

Ray: [20:22] One year, nine months, and two days.

Dr. Duckworth: [20:27] May I ask why you left the service?

Ray: [20:31] My schizophrenia was aggravated. I did not know it then. They knew it, but yet the doctor who they took me to, he recommended I get a bad conduct discharge.

Dr. Duckworth: [20:51] Really?

Ray: [20:52] Yes. I had a psychotic break.

Dr. Duckworth: [20:56] In the military. Which branch of the military were you in?

Ray: [21:00] United States Marine Corps.

Dr. Duckworth: [21:01] Marine Corps. Semper fi.

Ray: [21:05] You a Marine?

Dr. Duckworth: [21:06] No, but I admire the Marines.

Ray: [21:10] Yes, I am a Marine. I was a great Marine but I got charged with something that I did not do. I'm well aware now of the diathesis-stress theory of the biopsychosocial model.

Dr. Duckworth: [21:25] Yes.

Ray: [21:28] The diathesis-stress theory of the biopsychosocial model. This is a real mouthful, but it's good to know. This is a theory that mental and physical disorders can occur from two influences, a genetic or biological predisposition, and stressful conditions in a person's life.

[21:49] There really isn't an answer to the question of nature or nurture, but this theory integrates the two. I'm a walking, talking, living, breathing example of it. It happened to me.

Dr. Duckworth: [22:03] How did it happen? What happened?

Ray: [22:05] I was charged with something that I did not do. I was busted in rank, my money was taken, and I was given 30 days of correctional custody. Correctional custody, I called it boot camp times three.

[22:18] Boot camp, we only had one set of drill instructors. In correctional custody, we had three sets of troop handlers. Each one of them was different. They all tried to punish you in different ways. That was when I had this psychotic break. I was being punished for something that I did not do. I called it, it popped me because I don't remember it.

[22:43] My current psychiatrist told me, he said, "That's your evidence of psychosis." Part of the definition of the word psychosis is loss of contact with reality. I lost contact with reality.

Dr. Duckworth: [23:00] You were a young man then.

Ray: [23:03] Yes. When that happened, it was one week prior to my 23rd birthday. That fits within their parameters, 15 years.

Dr. Duckworth: [23:13] Very much, it's right in the middle. It's right in the middle of the bell curve. Right there. Now, were you given an honorable discharge after all?

Ray: [23:22] Yes. My proficiency and conduct marks, that's how you get a discharge from the Marine Corps. Pros and cons. Mine were not through the roof, but they were up at the roof. [laughs]

Dr. Duckworth: [23:34] They were good.

Ray: [23:37] Mine was good.

Dr. Duckworth: [23:38] You got an honorable discharge so you could use the VA system. Was the VA where you got most of your care?

Ray: [23:45] Still do.

Dr. Duckworth: [23:47] What was your experience of the VA system overall?

Ray: [23:50] The VA wants to help, but the only sad part about it is, some of the vets, they be thinking or feeling like the VA can just come and sprinkle recovery on you. You have to work at it. You have to put skin in the game.

Dr. Duckworth: [24:09] Skin in the game, it's so true.

Ray: [24:12] You got to put skin in the game. I am the longest-serving peer support specialist there and one of the longest in the country, if not the longest. I tell all my vets that I have that honor to work with, you have to be ready for this. You got to put skin in the game constantly.

[24:38] You can't say, "I want to quit smoking and puff on a cigarette." No, you got to leave them alone. If you need it, get a patch, get some gum, get some lozenges. I did. That's what I did. December the 12th will be 13 years since I last smoked a cigarette.

Dr. Duckworth: [24:58] Fantastic, Ray. Now Ray, you mentioned you were homeless for some years. What happened there?

Ray: [25:04] Not paying attention to not accepting my condition, not still wanting to drink and drug. That's it.

Dr. Duckworth: [25:20] That's it.

Ray: [25:20] Not accepting my condition, wanting to drink and drug. Even at times I was trying to take my medication and drink and drug at the same time.

Dr. Duckworth: [25:32] Would you say you had lack of awareness of illness or did you just not want to deal with it?

Ray: [25:40] Lack of awareness. Didn't want to deal with it, didn't believe it, but now, I'm not only I'm aware of it. Well, fortunately, I'm well aware of some of the symptoms. The both. I'll put it this way, Ken. I'm aware of the PANSS, the positive and negative symptoms scale.

Dr. Duckworth: [26:12] You know a lot, Ray. You've got a lot of education along the way.

Ray: [26:17] Self-psychoeducation.

Dr. Duckworth: [26:19] That's right. A lot.

Ray: [26:20] That's exactly what has helped me tremendously.

Dr. Duckworth: [26:24] Beautiful.

Ray: [26:24] Now when I hear my voices, and I hear them every day, but I realize I respect them. I look at them as that production of overabundance of endorphins.

[26:43] This is how they are manifesting, but I am not going to be doing what they are suggesting that I do, and/or when they criticize me, I'm going to let that be or just talk to him my way.

Dr. Duckworth: [27:01] You're living this, Ray, you figured all this out. It's amazing.

Ray: [27:06] Also, I had some help, a lot of help. As you say, the VA. I had a psychotherapist, individual psychotherapist. The good part about it is, in my opinion, I never missed an appointment. I keep my appointments or I still ain't missed an appointment in years.

[27:31] When I go into my appointments, I don't just go in there and sit, I participate. I try to lead my appointments.

Dr. Duckworth: [27:40] Ray, it's an incredible story and we're so lucky to have you at NAMI. May I ask you about the time that you were in corrections? Are you open to talking about that? You were homeless.

Ray: [27:55] Yes.

Dr. Duckworth: [27:56] A lot of people with mental health conditions end up in prison.

Ray: [27:59] Yes.

Dr. Duckworth: [27:59] It's a big worry for NAMI. What was that like for you? Do you feel comfortable talking about that?

Ray: [28:06] Yes, I feel comfortable talking about it. I was not the model prisoner. I went in prison in 1980 and I left in '86. I actually went in '79. Anyway, I went to what's supposed to be the worst prison here in the state of Indiana.

[28:33] Approximately six years earlier, I was in a mental institution for three years because of my schizophrenia. I had been in the Marine Corps at that time. I was less than a year out of the Marine Corps. What happened was me, myself, I always felt I wasn't supposed to be in prison.

[29:03] Years later, I found out because the Marine Corps and the Navy did not diagnose and try to treat me, what I went to prison for is the same thing that happened to me while I was on active duty. Because of that, I am now service-connected disabled. I'm 100 percent disabled.

[29:28] I always felt like, "Man, I ain't got no business here." Wait, I'm going to just say it. I felt like I was too smart to be there. Even though it was a lot of people there that knew me because I also was in boarding school when I was younger, which is like the juvenile justice school, the pipeline stuff, school-to-prison pipeline.

[30:09] I did have a nasty attitude. I was in good shape. I'm in good shape right now.

Dr. Duckworth: [30:15] Yes, you are.

Ray: [30:18] I got into it with a lot of the correctional officers. I ain't trying to brag, I did hurt some. I spent some time on segregation and all that good stuff. They realized, "May be best we just leave him alone." They just left me alone.

[30:43] I got a job dumping the garbage cans around the prison. That was what I did until the day that I walked out of prison. There was no treatment.

Dr. Duckworth: [30:59] No treatment at all. All seven years? Nothing.

Ray: [31:02] Yes, correct. No treatment. The closest I had to treatment was for my own self was my exercise. When I did have some of those flare-ups, they would subdue me, handcuff, shackle me, and put me in a cell. That's what they used to do with me.

Dr. Duckworth: [31:25] That was their intervention…

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