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2011 - The Year in Review

As 2011 began, those that provide behavioral health care services were stunned by the death of a 25-year-old mental health counselor in Revere, who apparently lost her life at the hands of a resident of a group home where she worked. Nine days later a shelter worker in Lowell was stabbed to death by a 19 year-old homeless man, who had a history of mental illness. While violent acts like these are thankfully rare, and those with serious mental illness are much more likely to be victims of violence than the perpetrators of violence, these incidents have resulted in greater consideration of client and staff safety in our programs.

The Department of Mental Health convened a Task Force on Client and Staff Safety that was charged with developing mechanisms to improve current practices, policies, and processes, and to address community safety. Their thoughtful report raises many critical and sensitive issues and makes a thoughtful list of recommendations. At CCBC, we have expanded our training programs and convened a Safety Committee to review our policies and procedures and to make recommendations.

At the end of September our corporate affiliate, Morton Hospital and Medical Center, was purchased by Steward Health Systems, which operates ten hospitals in eastern Massachusetts. This will bring approximately $100 million of resources to our community over the next several years which will strengthen the local health care system. This change will likely provide CCBC the opportunity to work with other Steward facilities in southeastern Massachusetts, particularly in the area of case management, which has a proven track record of improving health outcomes for those with behavioral health care problems, many of whom have co-morbid health problems.


As we enter 2012, providers of behavioral health services realize that new and difficult challenges lay ahead.

The first challenge we face is the obstacle posed by the severe financial difficulty we have experienced in our world economy over the past three years. In terms of the state budget, we are hopeful that the worst is behind us. However, with the federal debt increasing and tax increases seemingly unlikely, cuts to Medicaid and Medicare loom large in the years ahead. Getting through this period will require perseverance, flexibility, and commitment as we likely deal with budget reductions and new ways of doing business with state and federal government.

The second challenge is the change brought about by health care reform and the place that behavioral health care will occupy in a restructured health care system, especially one that will be considering new focus on reimbursement more closely aligned with outcome. A large, and to my mind, an unanswered question is, will mental health and substance abuse become further marginalized in the health care system or will behavioral health care be recognized for its potential to improve outcome and reduce overall health cost when appropriate care is provided?

A third challenge and related to the above, is how will the health care system, including behavioral health care providers respond to the fact that those with serious mental illness (SMI) currently die an average of 25 years younger than those without SMI. This is nothing short of a disgrace and a major challenge to our nation, our state, and our industry.

This is really a challenge about how health care and behavioral health care can be brought together to coordinate or integrate ways that produce improved health outcomes for those 10% of Americans that suffer with a serious mental illness in any given year.

A fourth challenge is implementation of the reorganization of behavioral healthcare of children in Massachusetts. The Children's Behavioral Health Initiative has been operating over the past year as the Commonwealth's remedy to a judgment in federal court trial that the State did not provide adequate mental health services to children. This initiative is an enormous opportunity and one that we must get right, as the opportunity is not likely to arise again for a generation.

Our fifth and perhaps greatest challenge with respect to those we care for with severe and persistent mental illness, is to make the promise of recovery genuinely available to everyone with SMI. We have known for some time that recovery from SMI's devastating effects is or can be real for many. Our challenge is to make it real for many, many more. I believe this requires that stigma be diminished, that we engage clients more effectively, and that the promise of recovery receives the necessary support.

With your help, I do believe we can respond to these challenges.

Philip Shea, January, 2012