Community Mental Health and Substance Abuse Partnership

Fort Collins, CO

The Birth of "Joe"

As told by Erin Hall, Program Director

At the time of this story I was relatively new to my job and was providing staff support for a fledgling group of mainly CEO’s from public and private organizations. They had come together with a commitment to make significant changes to our mental health and substance abuse system.

At their previous meeting they gave themselves an assignment. They agreed to write true-to-life case examples to help others understand how their agency or system really worked.

I collected and previewed the stories. A fascinating task! After reading the first few I thought, “Wow! These people are defensive!” Clearly the goal of most of these stories was to say “I am doing my job. If you the hospital and you schools and you substance abuse providers would just do your jobs the world would be a better place!”

At the beginning of the next meeting I handed out copies of the stories and they began reading. One by one a strange sense of recognition appeared on several faces. “I think we wrote about the same guy!” “Is your story about a guy who is yea tall and always wears the jean jacket with the American Flag?” “Wait, are you talking about the man who always talks about his family in New Mexico?”

As it turned out, four of the seven stories were written about the same person. Eight of the 13 people at the table knew this person because they had all served him, at least once.

Gary, the captain of the detention center said, “If this is the guy I am thinking of he is sitting in the detention center today.”

Not able to share his real name we christened him “Joe.”

Kathy, the director of our county health and human services asked, “How much did it cost us to send Joe to jail? How much did each of you spend on Joe?”

With everyone throwing out very rough estimates we came to a grand total of $250,000 over the course of two years.

What went wrong? How could eight agencies serve the same person, without knowing where else he had already been? Without knowing what had been tried, what was working or not working for him? How could each agency have tried so hard to help Joe and have him end up in jail?

The epiphany that occurred for our group that day was a realization that the problem isn’t the hospital, it isn’t the schools, it isn’t the mental health provider or the DA’s office; it is the fragmented, uncoordinated system that we are all trying to work within. We don’t need change at the agency level; we need massive change at the system level.

That was in 2000 and since that time, this Partnership has created a new information, referral and assistance service, has trained nearly 2000 gatekeepers to help connect people to mental health and substance abuse services and we plan to roll out a new emergency assessment center and a new integrated mental health/primary care project and are working on seven other prioritized systems.

As we work on other strategies we often refer to Joe. We even have a life size image of Joe on foam core that lives in our office. I never learned what actually happened to Joe after he was released from jail. Our Partnership has rewritten Joe’s story to demonstrate how his life would be different with all of the new changes to our system. Joe gives our group a common theme. Joe gives our group a shared story and a reason to keep working together.