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Q-and-A with Safe Harbor's retiring CEO By David Bruce david.bruce@timesnews.com

Erie Times-News - 1/21/2017

WEB STORY

Mental health treatments were much different when Jon Evans started his first job in 1974 as a behavioral health crisis worker at then-Hamot Medical Center's emergency department.

Medications for serious mental illnesses such as schizophrenia, major depression and bipolar disorder were not as effective as those now available. Around 200 Erie County residents were committed at any one time to treatment at Warren State Hospital.

"Success at that time was having someone stabilized on medication and achieving compliance," Evans said. "Now we talk about recovering from a mental illness and living a full life."

Evans, 65, left Hamot in 1993 to help create Safe Harbor Behavioral Health, an outpatient mental health treatment center that serves about 4,700 people a year. He is retiring as Safe Harbor's CEO on Jan. 31. Mandy Fauble, the current vice president of clinical operations, will become the new CEO.

Evans recently spoke about his time at Safe Harbor and how mental health care in Erie County has evolved over the past 43 years.

Q What was mental health treatment like in 1974 when you started working at Hamot?

A Erie has always been fairly progressive in treating individuals with mental illnesses but it was very different back then. ... The medications used for schizophrenia, bipolar disorder and major depression didn't work as well as today's medications and they has obnoxious side effects. Patients would stop taking their medications.

Patients with the most severe illnesses would get admitted to the hospital for two to three weeks, sometimes four weeks. If they didn't show improvement, then a hearing would be done at the hospital and the patient could be committed to Warren State Hospital.

Q How did the changes in treatment happen?

A Safe Harbor was founded in 1993 to change how patients were treated. We had (state) funding and new tools, especially medications that were remarkably improved and more effective so that people could live symptom-free.

One of our primary missions early on was to help bring patients from Warren State Hospital back home. We welcomed 188 patients over two years and we are still helping some of those patients today. It wasn't just dealing with their illnesses. These were people who had been well-treated but isolated from society. ... Back in the old days, someone would be discharged from Warren State Hospital and they would be dropped off at a YMCA with no support system. We are there to offer supportive housing and other support.

Q How have Safe Harbor's services evolved over the past 24 years?

A Part of our original funding was to expand the county's crises services. A rudimentary program was in place but much of the emergency mental health services were being done in the local ERs.

We created Crisis Services, which offers emergency services 24/7 by telephone, walk-in or we go to the scene. We now receive 2,000 calls a month and we helped 4,700 people in the last fiscal year.

We also spun off Crisis Residential, where patients in crisis can stay up to five days with a mental-health practitioner (visiting) every day. It's a hospital-like setting, but the patients can wear their own clothes and have their own room during a vulnerable time. It also costs $500 to $800 less a day than being in a hospital.

Q Safe Harbor joined the University of Pittsburgh Medical Center network in June 2015 and is now Safe Harbor Behavioral Health at UPMC Hamot. What is the biggest impact of the affiliation?

A We went through a yearlong process, whittling down 30 interested organizations to two and eventually choosing UPMC. One way this has helped patients is through integrated care, where we have staff available at some Hamot primary care offices. Having a behavioral health specialist in a primary care office can reduce costs, improve outcomes and improve access. ...

Access to care remains the biggest challenge in behavioral health. There is no region in the country, even the middle of Manhattan, that doesn't have a shortage of psychiatrists.

Q What is next for you? Are you truly retired?

A I've been working on a new company for about two years now. InnovaTel Telepsychiatry helps deal with the shortage in psychiatrists by offering access through telemedicine. We are available in five states with 24 psychiatrists. We are headquartered in Erie and creating jobs here in Erie.

David Bruce can be reached at 870-1736 or by email. Follow him on Twitter at twitter.com/ETNbruce.