“We found a 29 percent reduction in hospitalizations compared with the period immediately preceding the change to recovery-focused programs.”
Position: President and CEO
Organization: SERV Behavioral Health System, Inc.
Location: New Jersey
Services: Residential mental health, residential developmental disability (support for co-occurring disorders), day programs, outpatient treatment programs
As a high-school student, Gary Van Nostrand watched friends and family members struggle with mental health and addiction problems and wondered, “How do these things come to be?” Through college and graduate studies in clinical neuropsychology at Tulane University, the University of Florida, and the Mayo Clinic, his curiosity grew into a fascination-and a career. While he published his would-be doctoral thesis, Dual functional asymmetry of the brain in visual perception, Gary never finished his doctorate. Instead, he gained many of the professional skills he would depend on every day on the job, administering multi-county drug and alcohol counseling services in Iowa, then West Virginia, before moving to a similar program at Princeton Medical Center. He even left the field for stints in HR consulting and home healthcare services, though he kept ties through a board chair at SERV Behavioral Health System, Inc. His business acumen made him a natural choice to participate in SERV's CEO search effort in the late 1990s and then, following a leadership crisis, to step in as the organization's CEO in 2002. There were painful changes as the organization's “silos” were dissolved in favor of a team approach and voices, including his, challenged what he describes as SERV's “authoritarian” model for delivering services-especially residential services. “We told residents when to get up, when to go to bed, when to eat, and how to behave. Every residence had a long list of ‘House Rules,’” Gary recalls. “Our professional staff had the attitude that they knew best and residents should do as they were told in order to get ‘better.’” Quickly, however, Gary realized that the culture wasn't working for residents. “I didn't see people developing the way I thought was possible, taking responsibility for their own lives. And I don't think you can be well and not be responsible.” With the support of board members, Gary and his team “did some research into how recovery-focused changes worked” and developed a plan and evaluation methods for a two-year shift to recovery-focused programs, starting in 2005. They got results-including one result that Gary calls “totally unexpected.” “The most interesting finding [of the recovery-focused program] was one we hadn't expected. We found a 29 percent reduction in hospitalizations compared with the period immediately preceding the program. The hospitalization rate was not a focus of our study-more of an after-thought. Clearly, however, something changed.” Gary speculates that the new focus fostered stronger relationships. “One of the major problems [for our consumers] is isolation: ‘Nobody understands me.’ Yet if the individual is connected to an individual or a team of individuals, there's a feeling that ‘they know what's going on with me’ and a trust that the team can be there at tough times.” Among the hundreds of consumers who were, or are, involved in SERV programs that transition them from illness to recovery and isolation into successful educational or employment experiences, these findings offer reassurance, says Gary. “As some people get better, they get jobs, but then face the challenge of keeping them. They don't have the right habits,” he says. “When they're having a bad week, someone can come in and help them by providing an example and offering support. It's the kind of thing that prevents an occasional setback from being a major setback.”
Photo by Michael Mancuso