The Massachusetts Health and Human Services secretary was in Pittsfield on Wednesday to hear from healthcare providers about the community’s needs. As WAMC reports, they had a lot to tell him.
From a lack of public transportation and affordable housing to an abundance of addiction and mental illness, it's not easy offering behavioral health services in Berkshire County. Practitioners say it's even more difficult when you’re short-staffed.
“We don't have enough clinicians to do the work, and so we're trying to recruit folks to live out here and to work out here," Lindsay Ciepiela told WAMC. "It's common everywhere in the country, this shortage of behavioral health professionals, but especially in the Berkshires we just don't have as many bodies to fill the roles, so it's all these vacancies.”
Ciepiela is the division director of acute services and community services at the Brien Center, the region’s main hub for behavioral health and addiction support.
“Most people don't actually need to be seen in the emergency room for their behavioral health care," she explained. "If they're at immediate risk of harm, they should be there. But treatment doesn't happen in the emergency room- It's just stabilization. So, if you start in the community, you're seeing people's environment, you're seeing their supports, you're reducing their waits in the ER, and you're really starting treatment. You're figuring out, who can I get linked with, and then you're staying with them over sometimes weeks until they get hooked up with providers to keep them stable and keep them out of the hospital.”
With an aging population often set in tiny communities tucked into remote hills and thick woods, the Brien Center faces a distinct set of challenges for the Berkshires.
“Primarily, our problem is isolation and loneliness," said Ciepiela. "So many of our calls at crisis are people at night who are actually lonely, and so figuring out transportation, particularly in the evening part of the day. So many places are open eight to four, nine to five, and people are not going to bed at 5 o'clock at night.”
The county’s challenges also extend to its youngest.
“We do not have a placement for kids who are having a behavioral health need that might need a respite," Ciepiela said. "They might need two or three days, a place to stay, maybe stabilize on medication. They are very expensive to stand up, and we need that service line out here. We have to figure out how to do that in a sustainable way to get our kids out of the emergency room and keep them in the community.”
Health and Human Services Secretary Dr. Kiame Mahaniah’s tour of the Brien Center’s facilities in downtown Pittsfield allowed Ciepiela and other local leaders like Mayor Peter Marchetti to report on the community’s pressing needs.
“I think the lack of housing that we have, both for mental health issues and for substance use issues, are a really big piece, and so, additional dollars to build housing for both substance use and mental health,” he told WAMC.
Pittsfield opened a daytime community resource center for homeless residents named The First earlier this year. Marchetti says the next step in preventing overdose deaths is to carve out a similar space for the night.
“If they have a substance use issue and you leave them alone and they do whatever they do, then they're alone and they could be a casualty- Where, if they have a community space, [they're] living," the mayor said. "And that's what I get out of The First all the time, is it's all about community building, it's about trying to find a level of comfort amongst themselves where they fit in.”
For his part, Mahaniah told WAMC his time at the Brien Center was both inspiring and concerning, specifically praising its model for substance use disorder treatment.
“It's a remarkable institution, and I think people in Pittsfield should feel proud that there is an institution like Brien here," he said. "I would say that it's also very clear that the needs that are in the community likely outstrip their ability to provide those.”
The secretary described the administration of Governor Maura Healey as having an all-government approach to issues like health that promotes working between offices to create holistic responses to the kinds of issues Berkshire County experiences. That includes working together on health-related factors like transportation and housing to the question of battling loneliness and the dangers it poses.
“The fact that we fund our Councils of Agings and our ASAPs means that there is a place for older citizens to be able to get together," said Mahaniah. "How do we fund our schools so that they have enough resources to create extracurricular activities that allow the students to be able to gather around certain interests? And then I think something that has come up during my visit here today is what kind of funding stream would you need in order to create third spaces where people can gather. So, I think that's one thing I'm really taking back from my visit here, is how creative can we be in terms of helping municipalities fund types of activities that people experience as third spaces.”
