by Mary Pat Angelini
I recently announced my retirement as CEO of Preferred Behavioral Health Group and my transition to a new position in advocating for public affairs, with a focus on healthcare policy. Working in the field of behavioral health care for more than four decades, it is gratifying to see this field develop so dramatically; Most importantly, we have greatly reduced stigma and greatly improved the quality of care provided to clients. However, there is a lot of work to be done, particularly in helping our young people who are facing record levels of depression, anxiety and addiction in a post-COVID world.
When I first started my career as a social worker in the 1980s, mental health issues weren’t talked about regularly, because they carried such heavy stigma. As a result, seeking help from individuals was a major obstacle. I am happy to report that this has changed for the better, with many regular campaigns to combat stigma in schools and the community – ranging from issues such as suicide prevention, self-harm awareness, and eating disorders to postpartum depression. We now have regular, frank conversations about mental health that haven’t happened in 20 – or even 10 – years.
In the 1980s, inpatient treatment was prevalent for psychiatric and addiction issues, and many psychiatric hospitals in the state conducted large patient censuses. Boarding houses were the standard for communal placements. Over the years, group home settings have proven to be a better alternative, with case management services that are supportive and customized to each individual. Day therapy programs have become an accepted and preferred form of treatment and rehabilitation, and these services continue to exist today along with a variety of case management programs that provide care in the community. As a former legislator serving as a prominent member of the Health and Seniors Services Commission, I am proud to sponsor legislation to improve conditions for state psychiatric hospitals.
Addiction treatment looked a lot different, too. In the 1980s, addiction programs were divided into those counselors who treated people with alcohol problems and those who treated people with drug problems. Funding sources have been divided into these two categories as well. Today, substance abuse treatment programs are managed comprehensively by licensed addiction counselors, social workers, family therapists, psychiatrists, nurse practitioners, and nurse practitioners who collaborate and develop customized treatment programs. As a result, evidence-based programs and high-quality treatments lead to better long-term outcomes. The expansion and acceptance of drug-assisted therapy has become a game-changer for many.
Another important milestone in behavioral health care was the passage of the Americans with Disabilities Act in 1990, which included mental illness and addiction as a covered disability. Thanks to state and federal mental health parity laws, insurance companies are now obligated to pay for mental health treatment at the same level as Medicare. These two laws have made a huge difference in making mental health treatment affordable and accessible.
Unfortunately, many drug abuse prevention programs have fallen by the wayside in the past 20 years. In the 1980s, programs such as Nancy Reagan’s highly successful “Say No” to drugs were ridiculed for their overly simplistic message. However, this message has been incorporated across the country into television, radio, and print media. We need to get back to focusing on prevention in our schools. The last coordinated national effort to do so was wiped out over a decade ago. At a time when teenage deaths from overdose are at a historic high, we owe it to our children to provide meaningful preventive services in our schools.
Finally, as our young people face a mental health crisis, our students need and deserve immediate access to high-quality support in their schools. We need to expand school programs that give children direct access to mental health experts and prevention specialists, without creating unnecessary barriers to care.
As I reflect on decades of work in behavioral health care, I am pleased with how far we have progressed in improving the quality of services for all New Jersey residents. There is more work to be done, but I know we can get it done together – using an integrated approach focused on individuals, families and communities.
Mary Pat Angelini is the outgoing CEO of Preferred Behavioral Health Group (PBHG), a nonprofit behavioral health care organization located in central New Jersey. From 2008 to 2016, she represented the 11th legislative district in the state assembly, where she served as convention vice president.