By Sherry Larson

People’s Defender

When we invite someone to sit at the table, it should be an offering of much more than a seat. We need to extend an ear and respect and welcome ideas. One might say we are “one another-ing.”

Adams County Common Pleas Judge Brett Spencer invited Danielle Poe, Director of Behavioral Health for the Adams County Health Department, to sit at the table a little over two years ago and discuss some of the crucial issues facing Adams County. They came from different viewpoints and work experiences. But they were able to make space for one another and listen. As Poe stated so beautifully, “We were able to shift our lens.”

Poe continued, “We were trying as public health to expand access to services.” She explained they were slowly building on mental health services and addiction services in Adams County and reducing the stigma of those issues. Judge Spencer reached out. Poe said, “We looked at each other’s points of view and our work field.” They examined the impact they both saw in the community and were determined to devise a plan.

Most agencies have a “lane” they follow and a reference point for their views. Poe questioned, “At what point do we set that aside and try to shift our lens and see through the other person’s lens so we can understand one another?” She and Judge Spencer knew impactful conversations led to empathy and fostered unity. Their meetings were fruitful, primarily when they used the Community Health Assessment data facilitated by Dr. William Hablitzel. The data was clear – Adams County faced significant substance abuse problems and mental health struggles. A crucial issue was the lack of mental health care in the community, where poverty and trauma touch the lives of children and adults.

“So, if that’s the root, then that’s where we needed to start. Judge Spencer and I talked about options,” stated Poe. And then, he handed her a post-it note and told her to write down some ideas. They shared a few varying thoughts, but one item matched, the concept of partnering with a university in a residency program. This model could offer cost-effective services. Hmm – what could they do with little money or resources? Poe said she and Judge Spencer laughed, “This is what we do.” That’s when the table grew much longer and added several more chairs.

Dr. Hablitzel took a seat at the table and contributed his expertise and connections at the University of Cincinnati. He reached out and relayed the vision and community data. The statistics for Adams County were staggering, especially among children. The University responded by affirming that it was an excellent opportunity for a partnership. A Zoom meeting later confirmed that the University was onboard. Dr. Christopher Marett, MD, MPH, would make a virtual step into Adams County, offering his passion and expertise in the mission. Poe said, “Through the screen, you could feel his eagerness. He would say, ‘we can do this.’”

In the throes of COVID, the team formulated a plan for telehealth services. They started with an adult program piloting at the Common Pleas Court. The goal was to have more than a doctor on a screen but also personal care coordinators who were “boots on the ground.” These folks connected with families. A vital part of the process is that people maintain a connection with their community. Poe explained, “Care coordinators invest in the lives of individuals enrolled in the mental health programming. So you are going to have access to a doctor, psychiatrist, or psychologist who can help you and are essentially getting connected to a mentor.” The coordinators perform a holistic approach to determining the other needs in a person’s life. Poe explained, “If someone is walking along beside me and my life, they’re able to start identifying things that maybe I didn’t even see were a problem.”

The pilot was a success. People from all walks of life were reaching out and requesting services. This program, with its’ wraparound care, made a difference. And the team was ready to branch out to help the youth. Pull up a chair Superintendent Richard Seas of ACOVSD – there’s room at the table. The ACOVSD Board said “yes,” and contracted with the Health Department to sustain the program.

There is now nationwide recognition of the University of Cincinnati (UC) Program model that started here in Adams County. Poe describes the model with public health at the hub branching out into the criminal justice system, the schools, Children’s Services, and churches – “it’s like tree branches.” She said, “There’s a connection. We have care coordination plugged into all these child and adult serving organizations.” She elaborated, “This model says that we’ve created a safety net because we’re all connected through public health being the hub – we’re the center filter, and that’s why all the employees are employed through us. That’s part of the model so that we can monitor what’s happening, and we know there’s a safety net created in our community among all these organizations.”

Judge Spencer added, “There is an old but wise saying, ‘You can’t talk about the elephant unless you’ve been to the circus.’ I believe that the suggestion of utilizing medical school residents to assist, under the supervision of the University of Cincinnati’s experienced psychiatrists and psychologists, was the lynchpin that caused UC Medical School to hook its wagon into our first in the nation project. The idea of utilizing residents under the constant supervision of UC’s medical staff has been seamless due largely to the program’s highly talented and hand-selected residents. We are proud to be associated with UC’s medical school in providing mental health services to any child or adult in Adams county who need the availability of services.”

Poe was asked to visit Washington, D.C., where she presented this model to the Human Resource Services Administration, the federal agency over human resources in the nation. Unprepared for the outpouring of positive response, Poe said, “People’s minds were blown, which blew my mind as if this had never been done before.” People loved the concept of no silos. Poe expanded, “We can have 20 different treatment providers, a criminal justice system, and children’s services, but if we’re working in silos, we have no impact. In this case, we’re all walking side by side doing this together.”

The people at the national conference were shocked that the Health Department could get the criminal justice system as a partner. Poe explained that it all started with relationships and people willing to put their thoughts and opinions aside and – wait for it – look at the world through a different lens. She said, “If we could all do that, then think what an impact we can have. You must have a community mindset and healthy relationships. The conference attendees could not believe that the Adams County Common Pleas Court Judge was a part of the program.” They said, “You mean he’s allowing it to happen?” Poe said, “No, we’re saying he’s a part of it and a part of the planning. He gets excited. He’s in the details.” That’s when Poe realized this program model was more extraordinary than they had imagined.

Since that conference, Poe has been invited to present at four other federal national conferences on the UC model. She and Chelsea Blevins, Adams County’s Chief Probation Officer, will deliver to the National Conference for Attorneys. The attorneys want to know how to recreate this model in helping advocate for someone.

Poe might have to pinch herself because these are overwhelmingly wonderful accomplishments. She wonders, “How is this happening?” and immediately answers, “It’s God and community. Simply shifting our lens to say I care enough about the place that I live and the people that are here that I’m going to hold hands with, even people that maybe see differently than I.”

The table extends to an entire nation, and it started with a bit of lens shifting in Adams County, Ohio.