Providing Essential Services for the North Country

Any conversation about Behavioral Health Services North, Inc. (BHSN) should begin with Margaret Platt, for whose family the City of Plattsburgh is named. Platt established the original Home for the Friendless in 1874 to care for orphans and abandoned children, and BHSN has been taking care of and expanding its care of individuals, families and organizations ever since. From STOP Domestic Violence to Child and Family Services to ElderCare Services, the organization offers twenty-four programs operating at twenty sites, all of which play a key role in keeping the community and the region strong, vibrant and productive.

Newly appointed president and CEO Mark Lukens is cognizant of the critical role BHSN plays in the Adirondack region. During our interview he began many of his sentences with, “From a regional perspective…”. Snapped up as a BHSN Board Member after he relocated to the North Country from Pennsylvania six years ago, Lukens later became Board Chair and was the obvious choice for Interim CEO when the position was vacated. “I didn’t need a job,” joked Lukens, “but I am passionate about the mission, the purpose of the organization.” Meeting the ongoing needs of the diverse groups it serves is a challenge and a necessity. “Mental health care continues to be an important part of the health care system and the economic impacts of it cannot be ignored,” he said. It is estimated that serious and untreated mental illness costs the United States $193 billion annually. Break that down to the financial impact on Clinton County and it is a cost the region cannot afford.

Lukens is eager to build bridges, collaborate with other providers and make BHSN the strongest regional partner it can be. He hopes to lead the organization’s 177 employees forward with that in mind, and here we shine a light on a few of the critical programs that will assist in meeting that goal.

Personalized Recovery Oriented Services (PROS)
Part of the Adult Services arm of the organization, Personalized Recovery Oriented Services (PROS) has met with great success. PROS operates out of the Center for Wellbeing in Morrisonville, NY. Its mission is to partner with individuals with serious and persistent mental illness, helping them to overcome barriers and achieve goals of their own choosing. Initially the first program of its kind in New York State, there are now over 90 similar programs throughout the state. Program Director Shawn Sabella said, “We currently have about 150 people in the program.” Participants find their way to PROS through assessments and referrals from outside agencies, hospitals, county mental health services, and even their primary care physician.

The “P”, or “Personalized”, focus means the program is tailor-made to an individual’s unique personal goals and needs. For one person, their recovery goal may be to complete their high school equivalency diploma. Someone else might need assistance with parenting, completing probation successfully, obtaining their learner’s permit that will allow them to drive, or learning skills that will help them obtain employment. Through evidence-based practices (those proven to provide results in similar circumstances) the program combines intensive support like multiple hour out-patient counseling sessions, substance abuse treatment, wellness management, and skill building to help individuals work toward their goals. “Forty-seven percent of individuals who are discharged from the program do so with their objectives met,” said Sabella. Program “alumni” come together three to four times a year to share their success stories with individuals in different stages of the program. One recent success story had an individual obtaining their first job in their mid-forties. Two other participants, who were both told they would never complete their high school equivalency did so, proving to themselves and the naysayers that success with mental illness is achievable.

But the path to success is not without challenges. The stigma of mental illness can prevent people from seeking treatment. Although the program is confidential, many people are worried that others will find out. For that reason, PROS formed an anti-stigma coalition, which has worked in partnership with the Champlain Valley National Alliance on Mental Illness (NAMI:CV) for twelve years. The coalition has now grown to include the UVM Health Network, SUNY Plattsburgh and the Clinton County Office for the Aging. The coalition is focused on removing barriers within the community through education about mental illness.

Through Adult Career and Continuing Education Services-Vocational Rehabilitation (ACCESS-VR), also referred to as Supported Employment, individuals with disabilities can achieve employment goals and greater independence. ACCESS-VR cultivates relationships with employers, promoting job development and helping match people to opportunities. At participating employ- ers like CVPH and JCEO, individuals with mental illness can engage in job-shadowing or observation, work with job coaches and also volunteer, helping them gain skills and prepare them for success in subsequent jobs. It is left to individuals to disclose their dis- ability to the employer, but Sabella said the support is strong for an individual to be successful when there is full disclosure.

Through education, PROS hopes to break down the barriers to employment experienced by so many with mental illness. “Depression, anxiety and schizophrenia can hit anyone in any profession, with one in five people diagnosed with a mental health issue in their lifetime. Employers may open their doors to those with mental illness because the issue hits close to home,” said Sabella.

When approaching potential businesses as possible employers, Sabella can demonstrate with confidence the benefits to that employer. “The individual will be better suited to the position because we will know their skills. They are more likely to be successful due to the strong, supportive environment behind them,” he continued. On a community level, it is good business to be disability-friendly. With social media and word of mouth, few employers would want to be on the wrong side of the issue. Federal tax credits, while their requirements can be challenging, are also available to businesses that hire individuals with disabilities.

Employee Assistance Services (EAS)
While PROS supports individuals and their goals, the Employee Assistance Services (EAS) division of BHSN works with employers to take care of their most important asset — their employees. EAS offers early detection and intervention for employees and their families who are experiencing problems that may impact their personal and professional lives. Bonnie Black is the Director of EAS, which currently has 137 businesses in the region under contract, and provides assistance to additional regional, national and federal organizations through referrals. “Contracting with EAS is the least expensive way to keep your organization healthy,” Black emphasized. “We work with everyone from sole proprietors to businesses with upwards of seven or eight hundred employees. It is prepaid insurance at no cost to the employee that they can utilize to keep themselves healthy, which in turn keeps the organization healthy.”

EAS services include face-to-face counseling with a network of qualified clinicians, and it is completely confidential, meaning their employer will not know they are utilizing the services. “There is a term for today’s employees and it is the “working wounded,” explained Black. “These are highly functional individuals who are stymied or stuck at that particular moment. Something is overwhelming them and they need to get that weight off their shoulders. EAS is that ear, that person that listens objectively and doesn’t judge.” With five offices in the tri-county area, employees usually do not have to travel far for services. But with North Country winters known for challenging road conditions, EAS has recently added tele-health sessions. After their first appointment, individuals may communicate via computer with a counselor through a secure, HIPAA-compliant vendor connection. “Tele-health is the wave of the future,” said Black.

Most issues find resolution in a one to four session model. Whatever is happening in an employee’s world is something they can handle because they have the tools to make things better. They may just have forgotten how to use them. “We focus on today’s hurdle, ie., what is this bump in the road right now? We empower people to deal with the stressor with solution-focused brief therapy. People usually have a “light bulb” moment and realize ‘I can do that’!” said Black. EAS also offers training for supervisors on how to appropriately refer a member of their team for counseling, whether it be an informal suggestion or a formal request because the employee cannot currently perform their responsibilities.

Black also works with employers to implement Drug Free Workplace policies and procedures. All federally funded workplaces and those involving safety, health and transportation mandate that the workplace be drug-free, so the employer must have clear procedures for policy violations, methods and regularity of drug testing and second chance procedures. “It is less expensive to work at retaining employees than terminating them and starting all over again,” emphasized Black.

BHSN and the Future
While these and the myriad other BHSN programs focus on keeping the community healthy, Lukens will work to create supports for their success. “Recruiting and retaining qualified staff is one key to success,” he said. “There is high competition for psychiatrists, psychiatric nurse practitioners and MSWs. Demand is high on a national scale and salaries could be 20-30 % higher elsewhere.”

Lukens continued, “Our new reality is all about change. We have to challenge current assumptions and perhaps look a little differently at the way we do things. We want to explore new models that may produce greater efficiency and effectiveness while continuing to improve upon the care experience. This could include approaches such as co-employment, tele-health, mobile units, and partnering with other organizations to take a more holistic and less siloed viewpoint of care. There is a lot of active regional dialog and it is an exciting time to be in the life sciences and healthcare space. We are helping shape the healthcare delivery system of tomorrow and BHSN’s commitment to serve is stronger than it ever has been. I see great things ahead.”