Mental Health History Lesson

View Point Health CEO explains where state services are headed at SWGC event.

Words by Arlinda Smith Broady Photos

by Rico Figliolini lthough mental health issues have come to the attention of the general public in recent years, many still don’t understand the importance of behavioral health services. They may also be unaware of how those services have been delivered in the state, why state-run mental health services exist and where they are going in the future.

To provide clarity and understanding about such an important topic, the Southwest Gwinnett Chamber of Commerce (SWGC) invited View

APoint Health CEO Jennifer Hibbard to speak at its First Friday Breakfast in June.

View Point Health is a public agency created by state law to provide mental health, intellectual / developmental disabilities and addictive diseases services. Services are client-centered, trauma informed and recovery-focused. View Point Health partners with two federally qualified health centers in Gwinnett, DeKalb, Newton and Rockdale counties to offer primary care.

People who grew up in the area may remember the warnings misbehaving kids got from misinformed parents: “If don’t start acting right, you’re gonna go to Milledgeville.”

“As a nation, we began treating individuals with mental health issues by institutionalizing people at Milledgeville or a variety of other state hospitals,” Hibbard said. “This was actually called the state asylum for the insane.”

History of state mental health services

Established in 1842, the building in Milledgeville still stands, but it no longer bears that moniker or serves that purpose. “There are actually parts of the campus still functioning as a hospital. In the 1950s and 1960s, the deinstitutionalization movement happened nationwide …because once you got there, it was really hard to get out,” she explained.

There are currently five state hospitals but it’s difficult to put somebody in one of them. While there are individuals who need that level of care, it’s not nearly as long term as it used to be.

“In 1994, House Bill 100 established the Community Behavioral Health Safety Net, called Community Service schools, and that’s what View Point Health is,” said Hibbard. That means View Point is governmental nonprofit, a public authority established by law.

She clarified that she and the rest of the staff are not state employees, according to the law.

“Our governing body is a volunteer board of but we haven’t reached that cap because we are so severely understaffed,” Hibbard said. “The pandemic has really had an impact on our staffing. I think everybody feels in the last three years that behavioral health issues and mental health issues have become more recognized, not necessarily more prevalent, but more recognized.”

She noted that at the same time, there has been some decrease in the stigma of mental health issues, and individuals are now more comfortable with the idea of seeking help. Together, these factors have opened up a whole new demand in the market.

Companies like Walmart and Amazon are getting into healthcare and it’s taking a toll on the workforce. There’s more demand, but not necessarily more clinicians. In order to stay competitive, View Point hired its first director of marketing in the last year.

“We are not trying to get more clients. We have accountable for that parity. They could charge additional or higher [copayments or you might] not be covered at all.”

Bright future for care

Mental health services are now heading toward converting the community service boards into certified community behavioral health clinics. This is another national movement that has been about 10 years in the making.

Georgia is just now starting the process, Hibbard said. “View Point health has been making sure that we have our operations and systems and policies in line with the CCBHC [Certified Community Behavioral Health Clinics] criteria. Because this is a federal model, for the first time ever there’s a federal definition for how to certify a community behavioral health clinic,” she said. “We’re finally getting there; we’re finally getting to the point where there are regulations and consistency around how to deliver behavioral healthcare to the community.”

Hibbard had invited some of her staff and members of the law enforcement community to help her explain how necessary improved mental health care is to the community.

“It’s very much about keeping people out of the hospital and other institutions like jails or prisons,” she said. “If people have a mental health issue, there needs to be a wide array of supportive services in the community that helps them be successful without having to need those heightened crisis services.” directors that is appointed by our county commissioners, so our board reflects the community who has chosen to elect the commissioners. Then those commissioners choose to appoint our board members. We have to have a certain number of elected officials serve on our board,” she added. “We are the safety net of care for individuals that need mental health and substance abuse services. We primarily serve individuals who are uninsured.”

For example, View Point recently added medication assisted treatment for opioid abuse, another huge epidemic problem in the community. Now it covers all of the required services.

Another requirement is to partner with law enforcement personnel, who are usually the first contact when someone is having an episode. According to data from 2016, 29% of people with mental illness got into care after having contact with law enforcement.

Hibbard estimates that the number has risen drastically. In fact, the nation’s largest mental health facility is the Los Angeles County Men’s Central Jail.

View Point uses the same process to bill the state for services that Medicaid does.

Increased demand for healthcare workers

“We do have a cap as to how much we can bill, more clients than we can handle. We are marketing to get employees and clinicians,” Hibbard said.

Even though the hospitals started shutting down in the 60s, it wasn’t until 1994 that the state created a safety net mental health system. In 2019, the governor established the behavioral health reform and innovation commission just before the COVID pandemic hit. Then, in 2022, another bill passed in Georgia that enforces mental health parity.

“If you’ve got private insurance and you have a $25 copay to see your primary care doctor, you should also have only a $25 copay to see a therapist or psychiatrist,” said Hibbard. “Until 2022, insurance companies in Georgia were not held

“The top three are all prisons — Cook County in Chicago and Rikers Island in New York are [among] our top three mental health hospitals. There’s something wrong with that. It’s not just a Georgia issue,” said Hibbard.

View Point established a co responder unit with the Gwinnett County Police Department as well as some of the individual municipalities that have their own police officers, like Norcross and Lawrenceville.

At the end of the day, Hibbard said she’s glad that there is more awareness about mental health and that the state and the nation are taking an active role in making things right.

“All people, no matter where they are on their mental health journey, are deserving of support, resources, fulfillment and a community that cares,” she said. ##