In the second act of his career, Jamison leads mental health services in Bexar County

Instead, she resumed her career in public service in 2017, becoming president and chief executive of the Center for Health Care Services, or CHCS, a local mental health authority that offers a wide range of programs for people. suffering from mental disorders and substance abuse.

She remembers being surprised to be offered the job. At CPS, she focused on energy delivery; at the city, where she became deputy city manager, she worked on economic development projects such as the Alamodome.

“I hadn’t worked in the mental health or medical industry at all. But I saw it as an opportunity to continue to be in public service,” she said. “I just felt like I had more to give.”

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During her five years at CHCS, she led the agency through the COVID-19 pandemic, which has caused a surge in mental health disorders in Bexar County, she said. When some patients struggled to engage with their therapists through phone calls and video sessions, she struggled to find a way to get them in. Sometimes it just helped to let them into the building, where they could video chat with the therapist in another room, she said.

CHCS, a government entity overseen by the State of Texas, offers more than 80 programs, including wellness clinics, services for the homeless at Haven for Hope, an outpatient service that provides an alternative to prison for some non-violent offenders and support groups for veterans. and their family members. He does a lot of work with the city and county of Bexar — including, for the city, offering a “sobering-up unit” where people who are found intoxicated in public and haven’t broken any laws can sober up.

Jamison, who grew up in Louisiana and graduated from the University of the South in that state, had planned to become a lawyer, like her mother, until she met Earl Lewis, a professor at Trinity University, who persuaded her to consider the University of San Antonio’s degree in urban studies. program. An internship at the city of San Antonio led to a job and a 24-year career.

“When I graduated from college, I was ready to do something different,” she said. “I came to San Antonio for college, and 40 years later, I’m still here.”

She recently sat down with the Express-News to discuss the impact of state budget cuts, the shortage of mental health professionals in the United States, and the impact of the pandemic on health. mentality of children and adults. The following has been edited for brevity and clarity.

Q: When you think back to your time in the city, what are you most proud of?

A: I am very proud of bricks and mortar. I worked in public works for a number of years — so street and drainage projects. I know that doesn’t sound very sexy, but working with neighborhoods and understanding how important infrastructure was to them. Many neighborhoods had no sidewalks for their children to walk to school. Many of them couldn’t even receive their mail because they had no way to establish a mailbox. Knowing that you left a better place than you found.

Q: The state cut funding for mental health in 2011. What kind of impact has that had?

A: The area that continues to be severely underfunded and overwhelmed by lack of services is that of people with intellectual or developmental disabilities. There are more than 150,000 people on a waiting list for waiver services in the state of Texas. They haven’t done anything to reduce that waiting list over the years. The current rate that the state allows for services for this population averages $10 or $11 an hour. I don’t know anyone today who pays that price. And the rate is for about five hours of work. So they already assume that the person they hire to work with this very vulnerable population has to do more than one job. That, in and of itself, doesn’t bode well for how you want to care for this very vulnerable population. You don’t even offer a living wage.

Q: You provide mental health services as an alternative to prison for some inmates.

A: Since I guess 2007, the center has been actively involved in Bexar County and diversion. The center has funded someone from the Bexar County Sheriff’s (office) to conduct community mental health crisis calls. This evolved into placing clinicians in the booking center. We have clinicians who are there 24/7. They provide mental health assessments to people who have been examined by law enforcement. That ends up being around 1,500 people per month.

Q: It could be someone disturbing public order, or…

A: They may have broken a window in a storefront, and we’ve conducted that assessment and we’re making a recommendation to the magistrate.

Q: Are they placed in a facility or is it on an outpatient basis?

A: They were released on bail. As a condition of their bond, they must undergo treatment. It is therefore an outpatient treatment. They are monitored by a court liaison officer as well as by our staff.

Q: You said that only 10% of Bexar County residents with mental illness receive services.

A: The National Alliance on Mental Illness has established a benchmark that approximately one in five adults nationwide suffers from mental health issues. If you take that to Bexar County, our population is 2 million; one in five people is about 400,000 people. We see – based on our state funding and other contracts we have with Bexar County, City of San Antonio – about 35,000 or 36,000 patients a year. So you can start to see the disparity in access to care. Now, there are other nonprofit organizations that also treat people with mental health issues or addictions. But I’ll tell you, it’s far from 400,000.

Q: What are the barriers to getting mental health treatment?

A: They are very similar to the obstacles you encounter for medical treatment. How easy is the medical industry to navigate? You go to see your primary care doctor, then you get a referral for someone else, you’re not really sure what’s going on, you have to go somewhere else to get labs. … For many years, physical health has been disconnected from mental health. There are still practicing physicians who are very uncomfortable diagnosing or referring people to mental health services. Many insurances do not cover psychiatrists. When you go to a private psychiatrist for services, the wait is often six to eight months.

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And then the stigma. Individuals and families are a little afraid to talk about it. They don’t know the terminology very well. They don’t know how to diagnose it. We have to overcome all these obstacles. What we try to do at the center is to encourage everyone to provide a safe space for people to talk about their issue. And we try to train people to learn to listen.

Q: Is part of the problem that there aren’t enough psychiatrists?

A: Not enough psychiatrists, not enough trained therapists. Until the Affordable Care Act, there was no parity between mental health treatments and physical health treatments. Labor has not caught up with the need that exists.

Q: Do you see any hope of rectifying this?

A: If I could say there was one positive thing about COVID – and only one – it’s that we’re talking about mental health more freely, because I think it’s more present. We give people the correct terminology. I think from there, individuals might become more interested in pursuing their careers.

Q: What kind of impact have you seen from COVID on community mental health?

A: We see people we’ve never seen before – people whose coping skills have been tested with COVID because they’ve been through isolation, loss of a job, or loss of family members. . They were experiencing anxiety and depression for the very first time, and they really didn’t understand what it was. Children are probably the most affected. Isolation, being at home, being with parents, rather than with teachers and friends at school. Being reintroduced into the school environment has also been traumatic for some children. We have seen an increase in suicide attempts. We have seen an increase in our children’s population – perhaps a 9% increase – in people who have experienced or witnessed domestic violence in their home. We saw maybe a 5% increase in our adult population who had witnessed domestic violence in the home.

Q: Have you seen an increase in substance use disorders since COVID?

A: Yes. The main substance we see in San Antonio, unfortunately, is methamphetamine and heroin. I am told that heroin is very accessible and very cheap.

Q: In the next legislative session, do you see any hope for increased funding for mental health?

A: I know that we are going to ask for an increase in funding for mental health. Talking to the Bexar County delegation, we met them all, they understand all the challenges we face.

We are calling for mandatory training for mental health first aid educators. We are also asking for funds to train student leaders in schools for mental health first aid training. We would like to see stronger relationships between local mental health authorities and school districts. School districts, for many reasons, have been a little difficult to work with. Their regulatory requirements require them to keep students on campus and to keep them focused in class. School districts have not received funding in the past for mental health services, so they were really caught off guard when children returned to school with not enough resources to deal with mental health issues. . We would like to see stronger relationships as we can step in and do crisis assessments, defuse the child, keep them in school, and create a safety plan for the parent. And the child has not lost a day at school.