May is Mental Health Month, and for Dr. Jason Hershberger, Chair of Psychiatry for One Brooklyn Health, the “B’ in OBH should stand for Behavioral because of the strength of OBH’s Behavioral Health program.
“The reason people use behavioral health instead of mental health or psychiatric care is that we do things that are beyond just everyday psychiatric care or the care for mental illness.
We also care for people with substance problems,” said Hershberger, describing a holistic treatment experience that includes a housing program for folks who have had either substance or alcohol or mental illness-related problems. “We do more than just doctors and patients and psychiatric medication. That’s what we call behavioral health.”
In addition to the center, OBH has mental health and behavioral health footprints in many areas of the hospital, covering all ages. In the child division program at Brookdale, they’ll see children down to age four. “We see people right after birth in the Healthy Steps program helping young families with women who’ve just delivered cope with the stresses of being new moms. So, from my perspective, it’s from zero to 100.”
Their clients come into the program in a variety of ways. “There are folks that realize it in themselves that they have a problem and just call us. People come through an emergency room visit and are evaluated as candidates for the program. “The common one is a concerned loved one who says, ‘Hey, you’ve got to see someone; I’m worried.’ There are all kinds of ways.”
Mobile Crisis Team
One of the ways is with the Mobile Crisis Team, which Dr. Hershberger sees as one of the special things about One Brooklyn Health. “A group of social workers and psychologists and doctors that actually can visit people in the community. There are people in crisis who may not be willing or able to come into the hospital to deal with it. And we actually dispatch a clinical team to go to the person’s house or their home and see them, make an assessment, help them, and link them to real care if they’re lost. Get them into the hospital if that’s what they need. But for the most part, they hook them up with outpatient care.”
Use 988 not 911 for Mental Health Help
Confronting mental health problems to the point where professionals have to be called, until recently the only number used automatically has been 911. That has to be changed.
“One thing that is very important to get out is using 988 instead of 911. If you call 911, you’re going to get the police. 988 is the alternative to 911.
“When you call 988, you’re doing it for a mental health or a behavioral health crisis. And that doesn’t go to the police. It doesn’t go to a police dispatch. It doesn’t go to emergency dispatch. It goes to, in New York City, a program called NYC Well. You dial 988, and you get NYC Well. They have suicide prevention counselors on the phone and mental health counselors that will help people through a bad moment and help connect them to care. And if there’s a need, they’ll send out a Mobile Crisis Team. So, they’ll let me know to send somebody.”
The number is about a year old, and Hershberger says, “It’s wonderful. “Because you call the police, you don’t know what’s going to happen. You’re calling a clinician if you call 988. So, that’s way better.”
White Doctor and Black Mental Health
It would seem the implicit bias in health care would be particularly acute when it comes to mental health, where you’re dealing with a racial component and complexity of unspoken biases on the part of doctor and patient. We asked Dr. Hershberger how he, as a white mental health professional, works with the African American community.
Hershberger said he understood the problem. “Like, who wants to see a white guy in a suit right?” Working with that understanding, he said, “I hire, I recruit, and I train folks that look like the community. One Brooklyn Health is probably one of the most diverse staff that you’ll see in mental health or behavioral health. The majority of the about 50 psychiatrists that work in the department, the vast majority of them are black or brown, that’s the truth of it.”
“We make a special effort to recruit and retain folks that speak Creole, that live in Brooklyn, that are from the community.”
Another aspect of OBH that helps in that recruitment is, “We train medical doctors and psychiatrists to work in Brooklyn. Who we pick to come here is basically who we want to stay here forever. It’s all about smart folks, really dedicated, who have a mission to help.”
The doctor says that because of the density and the stress of being in Brooklyn, there has to be a system dedicated to dealing with it. “When I think about what I try to do for the organization, it’s not just about providing care and recruiting for a system that provides care. It’s about building people up to replace me. And to expand those programs and make them stronger, better, larger, and more welcoming to people.”
Programs like this don’t just spring into being, they come from the top, and Hershberger says CEO LaRay Brown “is the patron saint of behavioral health for Brooklyn.” LaRay as a leader, has really pushed the organization to tackle this mission, to embrace this mission, to own it, and say, this is what we do for Brooklyn. And that’s why I’m here, because of her.”