Envisioning better mental health care

Last week, more than 100 behavioral health advocates gathered at the Hotel Roanoke to envision a more humane system of care for people with mental illnesses.

It was a chance to check all reality checks at the door for a few days, even if it was hard to forget that those ever-present funding problems would still be there after the forum ended.

The focus of the event was recovery-oriented care, a concept that has gained greater acceptance over the past decade. Just as patients with a physical illness tend to get better faster if they are knowledgeable and involved in their treatment, the same is true for those with mental illnesses. But the confusing web of services, gaps in care and societal stigma add to the challenges of making that participation a reality in behavioral health.

“We must change our way of thinking that we know best,” said John Pezzoli, assistant commissioner with the Virginia Department of Behavioral Health and Developmental Services, which sponsored the forum with help from a $50,000 federal grant.

A major focus of the forum was peer support specialists, individuals who have experienced a mental illness and use that background to help others.

A handful of them are already at work in our region.

Blue Ridge Behavioral Healthcare employs four, Catawba Hospital has one and the nonprofit On Our Own of Roanoke Valley has a staff of nine peer support specialists.

“They share experience, strength and hope,” said Gail Burruss, director of adult clinical services at Blue Ridge. “It’s another step away from that historic paternalism.”

Yad Jabbarpour, chief of staff at Catawba, said the peer specialist at the hospital works side-by-side with clinicians.

“The peer support specialist can ask things where we can’t go,” he said.

For example, someone being discharged from the hospital and trying to decide whether to move in with a boyfriend who uses drugs or with her parents may not seek or want advice from a psychiatrist, but she might listen to someone who has faced a similar situation.

“We don’t tell people what to do,” said Robin Hubert, executive director of On Our Own. “We help them see their choices. The value of peer support comes from living through it, that concept of been there, done that.”

The 20-year-old nonprofit logs 560 visits per month on average. It offers seven-day-a-week walk-in service, essentially free, to those who want to learn more about their illness, need help navigating the confusing array of mental health programs available or just need someone to listen.

A common theme throughout the forum was the need for more peer support specialists and the need for better pay for existing ones. But there also was a recognition that doing so will be difficult when even basic services remain lacking in parts of the state. Those reality checks kept intruding.

Peer support, as part of broader recovery­-oriented reforms, could help to transform Virginia’s behavioral health network into a more effective system of care.

But it is not a replacement for crisis assistance, which is lacking in rural regions like far Southwest and even in parts of Northern Virginia, where demand outpaces capacity. It’s also not a replacement for supported housing, inpatient hospital treatment and intensive community services that help keep people out of hospitals.

All of those services remain vastly inadequate in swaths of the commonwealth.

It’s just another reminder of how difficult it is for Virginia to make progress on mental health reforms when it’s still struggling to string together the bare minimum necessary for a safety net.

It was nice, though, to spend a few hours with a group of people who really care and to share in their hopes for a kinder, healthier world.

I’m glad to know many of them are working hard to achieve that goal, despite the challenges, right here in our community.

Nuckols is editorial page editor of The Roanoke Times.

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