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A Bevy Of County Programs Have Improved Lives For Many In Need Of Behavioral Health Services
By Marion E. Breland
This is the story of the Rockland County Executive’s Commission on Community Behavioral Health. It is a true love story.
As with most love stories, it starts out with the promise of a wonderful future — having difficulties, conflict, triumph, fulfillment, and, eventually — an ending of sorts. Not the ideal, nor happiest ending unless we think of it as not an ending at all, but the key to a present-day re-emergence of something unique and profoundly important that sits at the very heart of Rockland County. It is the story of a group of people who did what true love requires; stretching beyond the normal boundaries, beyond the traditional silos, for the love of a county and of its people.
This summer marks the 10th anniversary of the unveiling of County Executive Ed Day’s Commission on Community Behavioral Health Report. The report, and a video covering not only the entire report but also dozens of videos of Rockland consumers, providers, luminaries, and everyday residents who all cared about the behavioral health needs of our people, was released in June 2015, was shared widely online, in large community settings, and was to be the blueprint for behavioral health services (substance use disorder, mental health, intellectual/developmental disabilities) moving forward.
The report was the compilation of a year-long study of Rockland’s behavioral healthcare needs by a group made up largely of volunteers along with a host of County employees and departments (The Action Team) and with the oversight of an Executive Team including a wide array of sector leaders (schools, hospitals, law enforcement, county departments, state and local elected officials). It was a stunning, remarkable collaborative effort that stands as a tribute to everyone who worked on it or participated in it, and to the County Executive who made it possible.
It began in 2013. I used to run into Ed Day regularly during the Rockland County Executive campaign of that year at nearly every fundraising dinner for every possible organization, and as I got to know him, joked with him often that I, as a lifelong Democrat, would never vote for a Republican. It was all good fun, and established a friendly, easy bond between us.
Ed won the election, and in mid-2014 came up to Haverstraw to model at a fashion show that the Haverstraw Collaborative put on for our senior citizens. By that time, it was rumored that the Day administration was planning to consolidate a number of County departments, including the Department of Mental Health, reportedly as a cost-saving measure and for the sake of efficiency. I was horrified. Rockland County had, for many years beginning in the 1950’s, been a model for mental health services, not only locally but nationally. Beginning in the early 1990s, however, with the rise of managed care, the County’s behavioral healthcare services began to evaporate. By 2014, there were only a fraction of the services left, and those that remained were largely re-centralized and much less accessible to those in need, after a long and proud history of decentralization and community-based programming in years past.
I demanded to know if it was true: was Ed Day’s administration really planning to get rid of the Department of Mental Health? Before hearing the answer, I went on to tell him all the reasons that it would be a travesty, especially without even making any effort to determine the County’s needs first.
And to my shock, Ed Day threw open the doors of the County government to us.
By autumn of 2014, the Commission was formed, and our work had begun. The conference room at the Planning Department, where the Action Team’s weekly meetings were held, was our home for nearly a year while the report was developed.
The Commission conducted 1,375 surveys, forty focus groups, and twenty-eight key informant interviews, more than meeting the criteria to be statistically significant in terms of reflecting the community in Rockland. The results were representative of Rockland in terms of gender, race and ethnicity, age group, and town of residence. We analyzed the data, produced 192 specific recommendations for action, and produced not only a written report, but also a video interviewing well over a dozen people, to illustrate Rockland’s human faces behind our recommendations.
Our findings showed that Rockland community members rated behavioral health services 8.5 out of ten in their importance as a priority to Rockland County’s future.
There were five (5) core themes that emerged from the review of the needs assessment data, with recommendations corresponding to the themes: Building Upon Strengths; Increasing Awareness; Removing the Barriers; Closing the Gaps; and Reaffirming the Role of Government. In addition, there were overarching issues that permeated the findings; primarily the need for improved transportation, improved access to insurance, and the dire need for all levels of housing, particularly for those with behavioral healthcare needs, their family members, and for the staff members working in behavioral health programs, who found it difficult if not impossible to afford to live in Rockland County.
The Commission had some early successes in the implementation of its recommendations. We gained mobile mental health services through the Behavioral Health Response Team in 2015 and established an alternative to incarceration program for those with intellectual/ developmental disabilities that became a national model, getting people out of jail cells and connected them with help. We conducted housing forums, began to expand and revitalize the Continuum of Care (overseeing Rockland’s homeless housing dollars), doubling our federal funding in just a few years. We were instrumental in beginning the Partnership for Safe Youth, integrating an array of services for the children and families who had multiple stressors and were the most vulnerable in our county. We also resurrected the Community Services Board and its subcommittees, the County planning process by which community input into our behavioral health needs, programs and services could be increased.
For all we achieved, however, there was a mountain of need that we did not even begin to touch. Realities such as the County’s scary and untenable financial situation at the time made it difficult to tackle some of the larger initiatives, and attracting State dollars without County money to match was impossible, especially given the politics of those days. Many if not most of us who had poured our hearts and souls into the Commission eventually walked away with a sense of disappointment that we did not achieve more. For myself, it was a heartbreak.
Time, however, has given me some perspective. Ten years later, we have in fact been able to achieve much more than I realized and at least are beginning to touch those areas at the heart of our county’s pain that were referenced in the Commission report. Transportation options still must improve, but our buses are free now for anyone who needs them. Where we had no shelter for our homeless, we now at least have a warming center provided through our Department of Social Services operating during the coldest months. Just last year, our County Executive added over a million dollars to the DSS budget for outreach services such as food, showers, laundry, and case management for our homeless and those most at risk. New federal dollars combined with local funding through the Office of Community Development are being used to develop and encourage a wide array of housing options in towns and villages all over Rockland, for our people of every income. The County Executive has declared housing to be a human right, and is committing the resources to demonstrate that commitment, although housing remains “wildly” unaffordable and our County is losing people who simply can no longer afford to be here.
Our Department of Mental Health has survived and is even beginning to thrive under its acting commissioner and her handful of staff. The Department now hosts a behavioral health training center to improve the skills and enhance the creativity of our providers. There has been an explosion of new outpatient clinical services of all sorts, although most are concentrated in a single town in our county while there remain behavioral healthcare “deserts” in other areas. Most of our county’s services are now thankfully offered in multiple languages, with greater sensitivity to the needs of different cultures and underserved/marginalized groups. Yet we live in a time where there is more stress than ever on those groups, on those of us connected to human services, and indeed on most of us.
Ten years later, there is still a mountain of need- some of it the same, and some vastly different. But there are still many who remain wholly committed to making lives better in Rockland County, and whose true love for its people is manifested each day through selfless action and tireless service, whose vision paves the way to a better future for us all. To those who worked hand in hand on the Commission report with the hope and dream of that better future, I write this in your honor, with my deepest respect, and truest love.
Marion Breland is the Director of Youth & Family Services for the Village of Haverstraw
