The ghosts of Democrats past and present were in the airand on stageas nearly 2,000 mental health leaders considered their future at the 38th annual meeting of the National Council for Community Behavioral Healthcare in Boston this week.
This group of more than 1,400 member organizations represents county, state and privately owned mental health centers that, in turn, employ about a quarter of a million people nationwide. Led by President and Chief Executive Officer Linda Rosenberg since 2004, the National Council has gained momentum in the last few years, increasing in its size and meeting attendance. Three years ago, for example, the group hosted about 1,200 attendees at its meeting in San Francisco, according to Rosenberg, who served previously as senior deputy commissioner for mental health in New York.
We have to become a real voice, Rosenberg said. To do this, she suggests that National Council members reach out to their elected representatives; encourage those elected officials to visit mental health centers; and work on the campaigns of politicians who are sympathetic to mental-health issues. Establishing a political action committee might also be in the group's future.
Rosenberg took some time to talk with me in between the very well-attended morning and afternoon plenary sessions. The high turnout was undoubtedly due to the days speakers: political strategist and Hillary Clinton supporter James Carville, and former Massachusetts first lady Kitty Dukakis, who was joined by her husband, former Gov. Michael Dukakis, the 1988 Democratic nominee for president, who now teaches political science at Northeastern University and UCLA.
Carville, the morning speaker, seemed to delight the standing-room-only audience with his now-famous Loos-ee-ana drawl (which he hasnt lost, despite living in Alexandria, Va., with his wife Mary Matalin and their two daughtershe probably has to get it just right as his family prepares to move to New Orleans this June), irreverent one-liners and relaxed style. Carville was so relaxed, in fact, that he proceeded to dig out what must have been breakfast remnants with a toothpick that he replaced in its holder, all the while listening to a question from an audience member.
He talked about the election, of course, and said it doesnt make sense for people to think Sen. Clinton should pull out of the race when shes still winning primaries.
As Ive said, if Sen. Clinton gave Sen. Obama one of her cajones, theyd both have two, Carville said as attendees erupted in laughter.
Some of his other jokes seemed tired (The big news from the DNC is they hired someone to dig up something on McCains past, he said. It was an archaeologist. And: Fred Thompson is the only candidate that tested positive for Ambien.), but a few were fresh, as when he said Thompson was so in favor of the No Child Left Behind act that he married one.
Carvilles best insight was his comment on choosing a vice presidential running mate successfully. That happens, he said, when the campaign manager of your opponent reaches for the trash can to vomit. For John McCain, that person would be Colin Powell, Carville said.
But I think my favorite Carville moment came at the end of his remarks when he said Democrats would actually have to beg people not to vote for them in order to lose this race.
Give us a chance! he said. Well do it!
The meeting had a wide selection of sessions on topics that included developing financing strategies, complying with Medicaid, measuring recovery, helping therapists become capable managers, and learning how other countries provide mental health services.
While leaders at last months meeting of the National Association of Psychiatric Health Systems focused heavily on legislative action, this group seemed intent on learning from their peers. That was the case for Cindy Sill, executive director of Tri-County MHMR Services in Conroe, Texas.
It's always good to hear what's going on in other parts of the country, Sill said. That was a general comment from other attendees as well, including Jim McCreath, president and CEO of Hall-Brooke Behavioral Health Services, an 86-bed facility in Westport, Conn. (Hall-Brooke also has two clinics and a special education school.) For McCreath, that meant attending a session on seriously emotionally disturbed children, and also learning about ways to identify schizophrenia earlier. This was definitely a working conference, and I noticed that in everything from the boxed lunches during the Town Hall meeting and sessions to attendees exchanging stories as they sat Indian-style on the floor when chairs were not available.
In the afternoon of the first day, former Gov. Dukakis received applause and cheers when he apologized for not beating the old man in 1988 and said the current President Bushs administration is the worst the country has ever seen. But his brief remarks were made only after his wife of nearly 45 years talked about her battle with depression and her recent success with electroconvulsive therapy, or ECT treatments. Dukakiswho later signed her 2006 book, Shock: The Healing Power of Electroconvulsive Therapysaid it has been the only effective treatment she has had for depression, which she faces every nine or 10 months and has been a part of her life for nearly two decades.
A topic of interest that seems to have considerable possibilities for improving behavioral healthcare is the idea of integrating mental healthcare and primary-care services at mental health centers. Still in its early stages, the integration model would also work in reverse, in that primary-care centers could screen for mental health needs, said Chuck Ingoglia, vice president of public policy and practice improvement for the National Council. Primary care and mental healthcare were sisters separated at birthlets get the family back together, Ingoglia told me at the members' reception at the close of the meeting's first day. The National Council is testing this theory (through screening procedures, mostly) in seven communities across the country, with four more to come.
The highlight of the meeting was the conferences keynote speaker, Jim Collins, author of the best-selling books, Built to Last (which he co-authored with Jerry Porras in 1994) and, in 2001, Good to Great. This was his first appearance before a healthcare audience. Collins is now applying his research about turning good companies into great ones to the not-for-profit sector. His current client roster includes Johns Hopkins University, the U.S. Marine Corps and the Girl Scouts of America.
Collins was emphatic that audience members not leave thinking that they should operate their organizations like companies, but rather develop certain disciplines, in both thought and action, that will lead to superior performance in life and at work. That list includes remembering that the right peoplenot just peopleare an organizations greatest asset, and creating a stop doing list after a to-do list. That last point was repeated in personal and cell-phone conversations among attendees as soon as Collins finished his hour-long remarks.
Work is infinite, he said. Time is finite.