Ed Diehl clearly recalls the moment when he knew it was time for his addiction treatment organization to stop being complicit in what he and others saw as managed care's dissolution of meaningful residential lengths of stay. Having seen its 30-day residential model disintegrate into a barely one-week window of opportunity to reach troubled clients with intensive treatment in the 1990s, Seabrook House in southern New Jersey was used to not being able to give desperate family members the level of support they wanted. But one family's situation stood out.
Ed Diehl Seabrook staff had recommended inpatient treatment for a teenage boy who was using heroin daily. The family's insurance company denied the admission and authorized intensive outpatient (IOP) treatment for the youth—three sessions in the first week and only one session a week thereafter. Desperate to make sure that he could keep his son safe, the boy's father resorted to locking his child in his room and climbing atop the roof of the house to secure the bedroom window.
Seabrook House has been providing addiction treatment in southern New Jersey for more than 30 years. “We really were meant to be here—I’m virtually certain of it,” says Ed Diehl. “I can’t think of a place that has undergone so much change, adversity, and victory over trouble.”
Diehl remembers thinking at the time, “How are we helping when we're dealing with an adversary who either thinks or doesn't care whether a 17-year-old boy with a craving for heroin can somehow anchor his recovery with just one week of IOP?”
A transformation was at hand for a treatment organization that had established a strong national reputation in providing addiction treatment services in southern New Jersey since 1974. Ironically, this was occurring at a time when the entire nation was experiencing a transforming event. Seabrook's management team had called a special meeting of the board of directors just two days before the September 11, 2001, terrorist attacks.
This meeting would launch a process that Diehl likens to the “moral inventory” that occurs for the individual in the Fourth Step of Alcoholics Anonymous's 12 Steps. Within the next couple years, Seabrook would terminate a handful of managed care contracts that contained what Diehl terms “ridiculous” provisions. It would close four outpatient facilities, including one housed on its main campus, in order to invest the majority of its resources into the quality of its residential program.
The overall effect of these changes gave Seabrook the flexibility to finance a portion of some patients' care when insurance and self-pay resources together still fell short of covering an optimal length of stay.
Diehl says financial stability was difficult to come by after these changes were initiated, but he gives ultimate credit to a management team that stood by the organization's mission and never stopped coming up with creative solutions for clients. “My management team gutted it out,” Diehl says. “We believe in treatment.”
In fact, that's who he sees remaining in the addiction field after managed care left its indelible mark in the '90s—a committed group of true believers. “There is a strain of our field that is its backbone: people who are spiritually and emotionally invested in the recovery movement,” he says.
Diehl's place in that movement was ensured through his own recovery more than 30 years ago.
Diehl's father, Jerry, had entered recovery in the late 1960s. In 1974, Jerry cofounded Seabrook House with Diehl's mother, Peg, and later that year sent a friend who had been sober for two years to visit Diehl, who by then had been an active user of alcohol, marijuana, and stimulants for seven years. Soon Diehl was attending at least one AA meeting a day for several weeks with his new acquaintance, and the man and his girlfriend ended up staying at Diehl's place.
“We played pinochle and drank bad instant coffee,” Diehl recalls. “These people moved into my home, so it would have been hard to slip away to get high.” Through this process, “The recovery bug bit me hard. I never used again.”
Jerry Diehl, who died in 1989, had been involved in Democratic Party politics in Pennsylvania for many years, and that life appealed to his son as well. Even in his active addiction, Ed Diehl imagined that “one day I'd be riding down Pennsylvania Avenue.” But when he began to consider entering the addiction treatment field instead, he didn't want to fall back on having his father get him a job. In 1976 he accepted an $8,300 a year job at a detox facility in a dilapidated section of Atlantic City, New Jersey.