Behind the Scenes

30 06 2010

It’s definitely been awhile since I last posted, so to the followers of this blog, I’m sorry!!!

My lack of posts, however, definitely doesn’t mean that nothing has happened in the past few weeks; on the contrary, it’s been quite the whirlwind 🙂 Let’s see…since my last post, I’ve gotten better at enrolling patients in the office, and thankfully, I’m no longer as flustered (and yes, I can now do simple subtraction in my head). I’ve also gotten more adept at screening patients for the program on the phone and for the past few weeks, that has comprised the majority of my job at Project Access.

I’ve also attended a couple meetings, the first of which convened several of Durham County’s leaders in the charity health care field. Project Access, the Duke University Health System, the Durham Center, the North Carolina Council for Women/Domestic Violence, the Partnership for a Healthy Durham, El Centro Hispano, the North Carolina Area Health Education Center, and the Durham System of Care were the organizations represented at this meeting. The organizations convened for this meeting to discuss the feasibility of a Pro Bono Mental Health Project for Durham County aimed at providing free mental health counseling to Durham County residents faced with depression and anxiety disorders, in addition to abusive/troubled relationships and conditions caused by coping or the diagnosis of a disease. And while many private psychologists, counselors, and therapists in Durham County offer free or reduced-fee services to those who cannot afford them, Durham County does not have a unified system of care that systematically or “officially” treats these patients; that is, there is no record of the amount of donated care mental health specialists give, nor is there an official “way” to deliver crucial mental health services to those who need them most but cannot afford them.

During the meeting, the group discussed various models that Durham County could emulate, such as the Pro Bono Counseling Network of Orange County’s Mental Health Association and Maryland’s Pro Bono Counseling Project. Both of these organizations serve low-income, uninsured residents, and thus serve the same population as Project Access does. In that vein, the group decided that expanding Project Access’s network of clinics to include mental health practitioners would be the most feasible option (in terms of cost and time).

This would require that PADC establish relationships with counseling facilities and determine which aspects of mental healthcare would be feasible to address (given cost and liability concerns). Several questions remain to be answered: will PADC only serve patients who are experiencing anxiety and stress disorders resulting from their sicknesses? Or will they treat any type of anxiety or stress disorder? The group decided, however, that chronic mental illnesses and substance abuse disorders were beyond the scope of what a pro bono service could provide; they also concluded that at this stage of the planning process, each member should research 1) which populations should be the target populations for the project, 2) which disorders would be feasible to treat, and 3) which clinics/pro bono mental health networks we should partner with to deliver the services. Sally spoke with me after the meeting and we have started drafting questions to ask of the Maryland Pro Bono Counseling Project and have begun looking into the data that we need to analyze so that we can determine an appropriate target population to serve. The next meeting will be held in August and each member will present their findings.

From working with PADC, I’m quickly finding that doctors are very much only one part of the machine that is the health care system. It takes a HUGE effort by administrators, policymakers, and program coordinators to come up with the groundwork for a program, not to mention the commitment it takes to continually refine the programs that do progress beyond the planning stages. This is not to say that doctors do not play large roles in health care (they certainly do; it would be pointless to argue which “side” contributed more to health care), simply that many key players in the industry are overlooked. And, of course, the implementation of any health care program needs the input of practicing doctors and other health practitioners. I guess if I come away with anything from this experience, it’s that health care is very much a multi-faceted effort; this seems obvious to me now (and I feel like it should have seemed obvious to me before), but only from observing and taking part in some of the work have I truly realized how important the administrators, policymakers, and program coordinators are  in this equation.

– Kelly Hu

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