When you’re the CEO of a 100-year-old organization, it might be all too easy to rest on laurels, coast on the well worn paths of the past or ride the current of general momentum. But in behavioral healthcare, such idle attitudes can cause an abrupt end to the business and shatter its mission. In the rapidly changing atmosphere of mental health and addiction treatment, a chief executive has to be as evolutionary as the system itself.
In 1971, Philip Eaton was a new college graduate with a degree in social work, starting his first job treating adolescents at the Rosecrance Memorial Homes for Children. Now 45 years later, he’s the company’s president and CEO as well as its longest tenured employee. Marking its 100th anniversary this year, the not-for-profit Rosecrance organization is a $70 million business that has more than 800 employees and 40 locations in three states.
“When I joined Rosecrance, we had 24 kids, a staff of 14 and an annual budget of $300,000,” Eaton tells Behavioral Healthcare. “I had no idea what I was getting into. Finding myself a parental figure at 22 years old for kids who were 16 or 18 was like ‘oh my god.’ All of the sudden, the realities of dysfunctional families and things that I read about were right there.”
Clearly, things have changed since then for Eaton, for Rosecrance and for the entire industry.
Awareness of behavioral health issues has grown, as have the services and supports to treat them.
“One of the biggest changes has been the public attitude about behavioral health,” Eaton says. “Decades ago, it was viewed as a burden in a community. Homeless people, alcoholics and people with serious mental illness were viewed as a burden, and communities were trying to figure out what to do.”
For example, 45 years ago, a legislator concerned about homeless people sleeping on park benches might react by removing the park benches long before considering any legislative moves to address the underlying issue. But today, lawmakers have a greater understanding of vulnerable populations and the services needed to assist them.
As more families, neighbors and co-workers begin to see substance use disorder (SUD) and mental health touch their lives first-hand, Eaton says, they can relate to those who need treatment with a more enlightened form of understanding. Improved approaches today now emphasize the preference for a community-based infrastructure of support and a recovery-oriented model, reflecting such changing attitudes.
“People with serious mental illness or substance use disorder decades ago would be relegated to care ‘someplace else’ because they were seen as flawed people,” he says.
Individual stories seem to be driving much of the evolution. For example, each of the current presidential candidates, on both sides of the aisle, has discussed behavioral health openly on the campaign trail. Hillary Clinton offered a $10 billion addiction policy early on in the race, and Ted Cruz has often spoke about his half sister who died of overdose.
“This is many steps beyond the Just Say No program of the 1980s from First Lady Nancy Reagan,” Eaton says. “This is up close and personal in terms of the candidates’ understanding of the seriousness of these issues for families and communities.”
And the awareness has made a tremendous difference in policy perspectives. Eaton believes the inclusion of behavioral health services as one of the essential health benefits prescribed by the Affordable Care Act as well as the ultimate progress of parity laws in recent years were all the direct result of societal attitude shifts. He says communities are responding with programs and services because they are motivated to be solution-oriented.
The healthcare industry at large is more prepared as behavioral health disorders are increasingly seen as chronic conditions that require ongoing care.
“We’ve seen progress with physician training,” Eaton says. “Medical schools have come to us to ask if their doctors can do rotations at our facilities. That didn’t happen 20 years ago. Back then, they probably got 20 minutes of training and a handout. And that wasn’t really that long ago.”
Today, primary care physicians who often help to identify behavioral health issues are better equipped not just to ask diagnostic questions about substance use or depression but also to offer resources and referrals to specialized treatment. It’s a significant difference, Eaton says.
And there’s no doubt these new trajectories can be favorable for business growth. The attitude shift was even evident in one of the zoning battles Rosecrance experienced recently as the organization sought to expand its portfolio in Illinois.
The company planned to open a new outpatient clinic with a 30-bed recovery residence on the north side of Chicago, located five blocks from Wrigley Field. Even though several opponents had challenged approvals for the residential space right up until the last possible day, the zoning board granted Rosecrance a special use permit to begin operations in May. The board also resolved that people in recovery are considered a protected class entitled to fair housing.
“The zoning board unanimously approved it, and it was probably one of the most favorable write-ups [prepared] on a controversial subject,” Eaton says. “It was really a good, solid ruling in our favor.”