Changing Lives and Facing Challenges in the New Year

With the start of every new year, we think of ways to improve our lives and to become better people. Sometimes we make lasting changes—we follow through with our diet and exercise plan or we make consistent efforts to improve relationships, work more productively, or conquer a creative project. Other times, we surge into the new year with willpower and motivation but ultimately slide back into old habits. My role as a National Health Corps AmeriCorps member has allowed me to contemplate the tradition of New Year’s resolutions on a deeper level. As a Care Coordinator serving with Starting Point Behavioral Healthcare, my overall goal is to help patients improve their mental and physical health so that they can lead happier, more fulfilling lives.
I spend most of my day in the emergency department (ED) at Baptist Medical Center in Nassau county, where I screen patients for mental health and substance abuse problems as well as for social service needs and insurance. My goal is to identify patients’ health-related needs and to help them to enroll in healthcare programs, to secure social services and insurance, and ultimately to work toward their long-terms life goals. Many patients come through the ED for suicide attempts, substance overdoses, or other conditions that clearly relate to behavioral health. But for some, the signs of a behavioral healthcare need are less obvious: the patient who comes to the ED for nausea but who in fact suffers from severe anxiety, or the patient injured from an accident that you later find was a result of alcohol abuse.

Effective care coordination depends on trust and persistence while also requiring a great deal of creative problem-solving. I build strong relationships with clients and their families and gain perspective on how aspects of their lifestyle and health interact. For example, many of the people I serve lack personal transportation or cannot drive because of medical or legal complications. For clients trying to work, secure food for their families, and attend therapy and psychiatry appointments, this poses an enormous challenge. When patients miss a medical appointment and run out of their medication, they risk relapsing and ending up back the hospital. Part of my responsibility is to connect clients with resources in the community like Nassau public transit, the Council on Aging, Barnabas Health Services (also an NHC Host Site!), local food pantries, and sites that offer crisis services. Familiarizing myself with the Nassau community—and building relationships with the people leading these non-profit agencies—has allowed me to devise solutions for patients who need care that goes far beyond the one-time treatment they receive in the ED.

Even tasks as simple as engaging clients in a behavioral health program prove extremely challenging. I will meet with a client one day, and they will tell me how motivated they are to quit using alcohol or another substance. We will make all the necessary plans for them to enroll in a Starting Point program, and I will end the day feeling hopeful, only to hear from the client the following day that they had a bad night, are feeling more despondent than ever, and won’t be coming in to services this week. I have learned not to let setbacks discourage me. Making a life change—especially one as major as enrolling in behavioral healthcare—may require multiple attempts.

I do not heroically solve clients’ problems in a single visit, but I am motivated by the small successes and feedback that I receive with each interaction. One client told me how much he appreciated my ability to listen thoroughly to his story without responding judgmentally, and this helped me to realize the value of care coordination. A doctor in the hospital—having only a few minutes to assess a patient-- might see just an alcoholic or a drug user, while the care coordinator—who serves both in the medical setting and in the community—has the time and opportunity to see more: a father battling depression, for example, who struggles to support his family and uses alcohol to make it through each day. Part of the stigma around mental illness comes from lack of knowledge, but much of it comes from our failure or inability to take the time to understand individuals without making quick judgments. So now, as I help people make huge and difficult life changes for the new year, I am making a New Year’s resolution of my own: to listen to others and to empathize with the challenges they face.

This blog post was written by NHC FL AmeriCorps member, Anna Dowling.

Anna serves at Starting Point Behavioral Healthcare as a Care Coordinator.