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The fact that there are people with mental health needs in our community, whose voices are hard to hear, is what motivates Commissioner Brooke Doyle, MEd, in her work with the Massachusetts Department of Mental Health (DMH)鈥攖he largest provider of psychiatric hospital services in the Commonwealth.

鈥淸These individuals鈥橾 voices aren鈥檛 just drowned out, they are being ignored,鈥� said Doyle who views her primary responsibility, beyond running a safe and effective treatment agency, as giving voice to the voiceless鈥攕entiments she shared during a campus visit on Thursday, February 29 aimed at discussing the importance of careers in public sector mental health and why they are worth pursuing.

鈥淭here are tremendous needs in public sector mental health that are going unmet,鈥� said President Nicholas A. Covino, PsyD, in his introductory remarks, using his own early-career experience in the field as incentive to those contemplating theirs. 鈥淭he best place I learned was in a small community clinic in Webster, years ago, with supervisors and patients from the Department of Mental Health,鈥� he said, citing myriad benefits of the work, a topic in which Doyle and her colleague, Benjamin Mathews, LMHC, are well-versed.

鈥淭his job was a calling for me,鈥� said Doyle, an LMHC and long-time champion for mental health parity and access. Her clinical and management experience, coupled with experience in the fields of homelessness and substance use disorder, has proven invaluable to the Department鈥檚 continued work in reducing barriers to service access鈥攅specially among those individuals in need of support.

鈥淲hat keeps me here is realizing there are more people who need our attention who we haven鈥檛 found yet,鈥� said Doyle who has challenged herself to find new and different ways to invite these individuals into the DMH to get the help that鈥檚 available. Perhaps the biggest obstacle to date lies in the lingering stigma surrounding mental illness.

鈥淲e still have to get beyond thinking about mental health as somehow different than health care,鈥� said Doyle, likening the DMH to the 鈥渟pecialty arm鈥� of the behavioral health system鈥攁 flashy term for really disrupted lives and the related engagement challenges. 鈥淲e operate more beds than any other hospital provider out there鈥�and we are also one of the largest providers of [inpatient] substance-use treatment,鈥� said Doyle, pointing to 880 collective beds. A huge volume of community-based work offers a continuum of care, 鈥渟o all of those resources and services that we provide inpatients are in service to help people to get back to living a life that is full and integrated in communities of their choosing鈥攁nd that's a big responsibility,鈥� said Doyle, emphasizing that she and her colleagues work with individuals across their lifespan, which is not true of all State agencies. 

Working with the disenfranchised, including those who have had very minimal voice, has been a motivating force for Mathews, the clinical director at Recovery from Addictions Program in Taunton鈥攖he one and only Section 35 program in the DMH, which treats anyone, 鈥渨ho's been deemed a danger to themselves or others on account of their substance use,鈥� he explained. A majority of the clients Mathews receives are dealing with a major mental health diagnosis, with the average length of stay hovering around 45-50 days.

鈥淏eing in a role where I am always doing work to help others is really what drives me,鈥� said Mathews who sees individuals from all walks of life, a majority of whom are homeless. While the complexity of needs runs the gamut, 鈥渆veryone we see has experienced severe trauma,鈥� said Mathews of a common denominator among individuals with substance use disorder. 

鈥淭here is no criminal component of a civil commitment, and yet [many of] our patients arrive in handcuffs and shackles,鈥� says Mathews, painting a picture of what Doyle calls the engagement hurdle. 

鈥淭here is a big trust factor to get over,鈥� said Doyle of a clinician鈥檚 first job which is to build rapport and reconcile a disruptive arrival in order to create a positive treatment experience. That said, those who come through the DMH doors seeking help historically have the most complex needs and the hardest illnesses to treat. 

鈥淭here is a myth out there, that somehow these individuals are different,鈥� said Doyle before dispelling it: 鈥淭hey're not. What's different is that the standard treatments haven't worked for them.鈥�

Upon the event鈥檚 culmination, Dr. Covino presented a pair of awards. Doyle received the Mental Health Leadership Award, 鈥淚n recognition of [her] commitment to improving the lives of our most vulnerable people; [her] years of directing, supervising, and serving in one of the Commonwealth鈥檚 most complex and necessary organizations; and [her] skill in developing professionals as well as programs and systems of care. You are an inspirational leader who defines what service, professionalism, and advocacy are,鈥� said Covino. 

Mathews was presented with the Community Service Award, 鈥淚n recognition of [his] years of service and support for many of our most vulnerable people. You bring your counsel, support, and care to accompany those on the often long and frustrating journey of recovery from  some of life鈥檚 most threatening conditions. Thank you for your example and for the choice that you make to serve our Commonwealth,鈥� said Covino. 

 鈥淲e don鈥檛 create enough opportunities to promote the benefit and value of doing public sector work,鈥� said Doyle of the increased demand for these jobs right now, all of which make an invaluable impact. Are you a clinician contemplating the future and considering a change? Read on to learn more.

Five Reasons to Pursue a Career in Public Sector Mental Health

1. Collaborate with and learn from a robust network of public sector mental health professionals.

Clinicians new to public sector mental health in Massachusetts might not realize the wealth of resources available here. The Department of Mental Health, the largest provider of psychiatric hospital services in the Commonwealth, employs roughly 3,300 individuals. Each year, these professionals serve more than 29,000 individuals of all ages and backgrounds.

2. Gain experience treating individuals with co-occurring conditions. 

Some of the Commonwealth鈥檚 most vulnerable patients seek treatment from the DMH. Their needs are complex and often include co-occurring conditions, such as substance use disorder and a significant mental health diagnosis. Most have attempted standard treatment in the system which hasn鈥檛 worked. A career in public sector mental health allows clinicians to work directly with these individuals and make a difference in their lives.

3. Work with individuals in a variety of settings.

Public sector mental health facilities are diverse and extend far beyond inpatient psychiatric units. The impressive system includes a variety of different settings, from facility-based care for individuals with mental health diagnoses to community mental health centers, many of which partner with community agencies to achieve the best results possible and get individuals back to living the lives they want to live. 

4. Meet individuals from all walks of life where they are in their treatment journey. 

A career in public sector mental health allows clinicians to develop critical skills adjacent to those required in a clinical setting. Cultural competence, for instance鈥� the ability to understand and respect that values, attitudes, and beliefs differ across cultures鈥攊s invaluable when building rapport and understanding the unique needs of an individual. Considering these differences allows for appropriate interventions, from employing harm reduction techniques to providing overdose prevention. A career in public sector mental health puts these skills to the test. 

5. Give voice to the voiceless. 

Reducing barriers to service access among vulnerable populations might be the most rewarding part of a career in public sector mental health. Beyond reducing the stigma surrounding mental illness, a career in public sector mental health promotes advocacy for those who need it most鈥攚hich begins with normalizing mental health as part of healthcare, so all individuals can be well and get back to living meaningful lives. 

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