A couple years ago my son, Merton Hershberger, began working at a community mental health agency as a peer support counselor. He recently described to me the physical benefits as well as the financial benefits already seen in this pilot program.
From the late 1950’s to the early 1970’s, across the country, governments were setting up community mental health agencies (CMHs). While for some it was an improvement over asylums, for others, it simply meant a change in residence. It did not end the fact of their diagnosis with schizophrenia, bipolar disorder (manic-depression), chronic depression, anxiety or some other host of problems.
In fact, recent studies have shown that people who receive services through CMHs die, on average, 25 years younger than the rest of the population. There are several factors: people with serious mental health challenges are more likely to be obese, smoke and abuse alcohol, aside from a higher rate of suicide. Poor mental health tends to lead to a lack of ability to focus on other areas of health.
As this fact came to the surface and the startling barriers to recovery were faced, beginning in 2009, federal grants to facilitate integrated health in these CMHs were given.
Washtenaw County in Michigan is the home of a forensic psychiatric hospital, three inpatient psychiatric hospitals and a Community Mental Health Agency, along with a couple of schools for social work and graduate psychology and psychiatry programs. It is a great place to get sick if you have a mental illness.
However, people with a mental illnesses tend to die younger and that is not so great as was underscored with the recent news that another agency client died. My job is to help reverse those trends, and we are seeing SOME progress.
Michigan is a national leader in equipping those with a history of mental illness to give back by opening the door of employment for those who are further along the road to recovery to share their lives and stories and hope with others.
For several years, the CMH in Washtenaw County has had an Integrated Health program which sought to address chronic health conditions such as diabetes, cardiovascular disease, obesity and respiratory disease (often caused by smoking), as well as prevention and now substance abuse. While there are other issues that have been addressed, these are what helped lay the foundation of a bridge from mental illness to creating a medical home and giving broader access to mental health services.
We are finding that as we engage with clients on a personal basis, whether our role is as a nurse, dietitian, nurse practitioner or peer, people are recovering.
Sometimes people are hard to reach or will not return phone calls, but those who respond to our interaction are more likely to get better as they walk with us on the road to recovery.
I have seen people become more active physically in taking walks, working and biking. I have seen people make reductions in their smoking habits and choose healthier diets and lose weight.
I have even seen one fellow get to the point where he no longer needed diabetic medication. Another is frequenting the hospital far less and visiting the doctor and making safer, healthier decisions that have led to weight loss and greater involvement in the community. Another has become a deacon in his church and said he feels better now than ever before.
Clients are being hospitalized less frequently and, consequently, they are using fewer government dollars. So while it did require some initial government aid, in the end, it is costing less. The investment in health is paying off.
There is no magic formula. We cannot mass produce this. While we teach classes, this is not where the most change happens. Statistically, when we give personal attention to those who are most vulnerable, they get better.
Whether we as peers are taking folks to food banks to get enough food or walking with them through the park, or just hearing them recount their series of medical dilemmas and going to appointments to advocate for them, people are realizing that they count. Their lives and their choices matter. Those we serve are coming to value themselves and their role in the community.
We are also connecting people to new resources and information so that they can improve their own health and wellness. We are helping them access their own medical records so that they can take even more personal ownership of their health.
Some peers focus on helping people get free of addictions. There is also a registered dietitian who works with clients to create meal plans and to guide in managing diabetes and weight. A nurse practitioner sees clients without insurance for non-emergent concerns. Nurse case managers educate and assist clients with a wide range of appointments and medical concerns.
The team provides an extra set of eyes and ears for the case managers. When they are unaware of what is going on, we let them know.
The purpose of the team reminds me of another team assembled by a wise leader. He sent them out two by two to heal the sick and remove the spirits which would afflict. He also said, “Do unto others as you would have them do unto you.” In walking with them, He showed the way. Indeed, He is the Way, and He walks among us still.
(Writing with her son, Merton, Joan Hershberger is a reporter at the News-Times. E-mail her at jhershberger@eldoradonews.com.)