28 years ago, as he worked on his doctorate in clinical psychology at Rutgers University, Dr. Peter C. Campanelli wrote of a model service delivery system that could provide service to what were then called “chronic patients.” Seriously mentally ill patients who were constantly rotating through the psychiatric hospitals were the subject of his dissertation.
“What we found, and no great surprise, was that they really didn’t have the skills they needed, and in fact, we could teach them the skills they would need to survive in the community and make sure that they weren’t cycling in and out of hospitals. And for the last 20 years, psychiatric rehabilitation has focused on exactly that,” he explains.
His advisor suggested he form a non-for-profit corporation within his dissertation work. And with the help of an attorney, Campanelli did so in New York state for the purposes of doing research. When the state Office of Mental Health found out he had a “shell of a corporation” and needed an organization to take over a family community residence in Brooklyn that they were about to put in receivership, they asked Campanelli if he would take over. Since he was already working for the state at a mental health treatment services organization, they knew and trusted him. He agreed and the Institute for Community Living (ICL) was born.
Integrating behavioral and physical health services
Fast forward 27 years, and Campanelli has just retired (April 5) from his role as founder, president, and CEO of ICL. As he passes the torch, he shared with Behavioral Healthcare some of his most memorable moments with the organization.
Campanelli has a passion for integrating health and behavioral health services and has been working towards that for the last 12 years at ICL. The organization has received numerous federal grants, has been awarded for its work, and now has a team of professionals who are constantly working on different ways in which health and behavioral health services can be integrated. He says he’s extremely pleased with the way that the organization’s work in this area has evolved.
Integral to the progress of integration was ICL’s designation as a federally qualified healthcare center (FQHC) providing integrated healthcare services to people who are seriously mentally ill and developmentally disabled. He believes this is important because of the research that shows that people who are seriously mentally ill tend to die 25 years earlier than their non-disabled counterparts.
“The reason for that is that they don’t get good clinical continuity of care. They die from some of the same things that we all die from, but they die a lot sooner because they’re not taking care of the problems. This is also costing the government a lot of money because generally these people end up going into acute emergency rooms with acute conditions. They end up hospitalized when they could have been dealt with much more effectively in clinics out in the community,” he says.
He’s also proud of the program that reunites mothers with their children. ICL provides supervised housing to mothers who have a history of homelessness or substance abuse and were separated from their children. ICL works with the NYC Administration for Children’s Services to reunite the mothers with their children, teach them the skills they need to be good parents, and place them into independent, community apartments. This program was started 18 years ago, in part funded by the federal government and by the state Office of Mental Health. Currently, there are more than 120 parents in the program. Although some of them don’t make it through the program, many are able to “salvage their children out of the foster care system and raise them on their own,” says Campanelli.
As for his most memorable moment at ICL, Campanelli describes the scene on the morning of September 11, 2001 as ICL evacuated its headquarters, less than two blocks from where the World Trade Centers were under attack, forced to leave much of the organization’s infrastructure and systems behind. During the massive cleanup effort that followed, the National Guard took up residence in the ICL lobby. In time, ICL staff were able to re-enter the building long enough to relocate essential systems to a temporary headquarters in Brooklyn.
“There were times when I wondered whether the agency would even survive. But the people who work here are very resilient. We set up emergency response teams in firehouses and trauma teams in the Chase Manhattan bank lobby in lower Manhattan. I think that was the most challenging time we’ve ever had,” he recalls.
The field’s future
On where the field is going, Campanelli speaks about New York moving everyone into managed care. “I think that’s going to challenge behavioral healthcare providers to start thinking about what they do and how they do it differently,” he says.
He expects these challenges to not only test ICL, but other behavioral health providers in New York, and will determine whether the local service system will survive.
To adapt, he believes providers need to think about:
· Treatment efficiencies – how to provide good and better care;
· Cost efficiencies—how to do that for less money; and
· Developing and dealing with new payment methodologies