Eric Smith, Program Manager
Growing up in an Air Force family, Eric Smith graduated from high school in Germany, where he was inspired by his first psychology teacher. He majored in psychology at Florida State University, then began his career in behavioral studies and treatment for the state of New Jersey. In the mid-1990s, he fell in love with a woman who wanted to live in Colorado, so he moved here, sight unseen, taking a job as a case manager with the Mental Health Center of Denver. Today, he oversees several interdisciplinary teams that include psychiatrists, therapists, nurses and case managers who treat nearly 300 high-intensity cases.
The biggest challenge in working with high-intensity clients is that they are often the newest to treatment and have the greatest needs. Our clients are adults ranging from age 18 to one in her late 70s. When we first see them, they often lack information about mental illness and don’t have much experience with medications. As part of our initial contact with consumers, we triage each individual to figure out what they need first.
For many, the most pressing need is housing. Without secure, stable housing, it can be hard to think about much else. The lack of affordable housing is the biggest challenge we face currently. The Mental Health Center of Denver has a robust housing program, but it is bulging at the seams. New apartments being built around Denver are geared to the higher end of the market, and the average rent in Denver right now is about twice what our people receive from a disability check.
But there are many rewards in this job. Some of the greatest are around the Justice Initiative teams I’ve worked with to divert people from jail, or get them out. Some of our clients are repeat offenders for minor offenses like trespassing. They often don’t show up for court, which can lead to arrest during a future police encounter.
We set up the Court to Community program with the City of Denver to connect individuals that they referred to as “frequent flyers” immediately to services. A hearing judge can tell people they need to break this pattern in order to avoid jail, then hand them off to a case worker who can take them directly to our clinic and get them a psychiatric appointment.
Over eight years, we have reduced jail days for this population by 80 percent. This means they have more time to work on recovery rather than sitting in jail. It also saves taxpayer dollars and promotes the concept of investing in prevention and case management on the front end to save money in the long run. Court to Community has also provided a model for Denver to add a new team devoted to reduce usage and expense in detox and emergency room treatment for a larger number of people who consistently use these services, most of whom have a mental illness.
Moving our team into the Recovery Center in 2012 was a very positive change for both staff and clients. It brought many services—housing, pharmacy, training and treatment—under one roof. It also brought our team closer to other teams for more peer support and greater ability to share resources.
The biggest change I’ve seen in my career has to be the technology. When I first started, we didn’t even have computers in our satellite clinics. It was hard to keep track of who was in treatment. We went to electronic medical records about a decade ago, which has vastly improved the quality of treatment. All of us—managers, pharmacists, case managers, therapists—have instant access to a client’s most recent information. And I believe things will only get better in terms of prescribing accuracy, symptom management and gene typing. Technology will transform treatment from more of an art form to an exact science. I hope to see that in my lifetime.