Mark Kline, Psy.D., Executive Director of The Human Relations Service (HRS) in Wellesley, has been busy writing reports for the boards of health in Wellesley, Wayland, and Weston upon his retirement from the job. Earlier this week at the Wellesley Board of Health meeting he shared the highlights and lowlights of the mental health situation locally during the pandemic, with a look ahead at continuing challenges (we last discussed these issues with Kline about a year ago).
“The problems with mental health care are what I call systemic and institutional,” said Kline, who has been with HRS for 32 years. “They go well beyond problems in the outpatient mental health service delivery system…I am confronted on a weekly basis with horrifying cases of kids who have spent weeks in emergency rooms…”
The list of problems goes on, from acute care to intensive outpatient care, to a lack of beds and day treatment programs.
“This past year the number of kids I heard of being discharged from hospitals who were referred to virtual day treatment programs was just beyond the ken of my imagination,” he said. “How you would take a kid that had been suicidal, send them home and spend the day on zoom and think anything good could come of it, I have no idea.”
HRS provides outpatient services, and has been doing so virtually during the pandemic, with hopes of returning mainly to in-person by fall. The outfit produced more direct service hours this past year vs. the year before, but Kline said “it’s been an incredibly trying year.” The virtual services work okay for most clients, and telehealth services will provide benefits going forward, he said, though such services are not so great for kids.
HRS’s biggest challenge is developing a funding mechanism to increase staff needed to serve rising demand. Clinicians are graduating with licenses these days, hanging up shingles right away, and attracting clients. They can make a good living doing this, and don’t need to take insurance. This means they can take clients who can pay cash, while those who rely on insurance need to look elsewhere.
HRS can’t currently afford to compete with such practices.
“We can’t afford to operate under that framework anymore…” said Kline, who plans to go into private practice. “We have to figure out some way to dramatically improve how we compensate clinicians. To me, it starts with [paying a bigger chunk of] health benefits.”
That might mean paying more like 80% of health benefits than 25% for part-time employees, he said.
Kline even raised the idea of HRS might need to run at an operating deficit in the short-term to be able to afford hiring more clinicians.
One hope for attracting more clinicians is that as pandemic protocols fade, the collegiality, community-orientation and mentorship you can find in a setting like HRS might win over some. He complimented the mental health specialists who work for the town and public schools that HRS staff coordinates with on local cases.
Board of Health Vice Chair Marcia Testa-Simonson said there is also a push ramping up now to get state dollars to support local health organizations, particularly in the area of mental health.
An executive search agency has been hired to replace Kline, hopefully by fall.
Kline’s briefing starts about 30 minutes into Wellesley Media recording