Smith County Behavioral Health Leadership Team Spearheading Local Systems Change

DALLAS (May 11, 2016) – “Texas is unique in that it is the only large state that does not have an organized infrastructure for comprehensively coordinating resources to manage behavioral health services to populations at the local or regional level. Historically, there has been an assumption that behavioral health was a state responsibility, even though local communities don’t usually look to Austin to solve their problems. When community leaders discover they have an alternative for local control to develop local solutions, it’s empowering. That gets people excited,” says Ken Minkoff, MD, Director of Systems Integration at the Meadows Mental Health Policy Institute.

Minkoff cited the Smith County Behavioral Health Leadership Team as an excellent example of an engaged community putting the local systems change process to work to identify and address behavioral health needs in East Texas. The Smith County Behavioral Health Leadership Team was formally chartered in June 2015, but its original momentum is rooted in the experience of the Doug McSwane family of Tyler, Texas.

When the McSwanes’ son, Patrick, was diagnosed with schizophrenia in 2005, their awareness of treatment options in East Texas was extremely limited. There was no visible community collaboration where issues of mental illness were identified as a priority for conversation and attention. The family managed the disease as best they could, but in 2012, Patrick lost his battle with schizophrenia. Doug McSwane gave purpose to the family’s loss by working with Fonda Latham, LCSW, ACSW, Executive Director, Samaritan Counseling Center to organize the first “Peace of Mind” conference in 2014 aimed at reducing the stigma surrounding mental illness and spreading a message of hope.

Response to the Tyler conference was much greater than anyone anticipated with about 800 people attending the event. The energy surrounding community mental health care services highlighted a bigger issue than stigma alone. The next day, McSwane contacted an acquaintance, Bob Garrett, President and CEO of Fair Oil Company in Tyler, who serves on the board of the Meadows Mental Health Policy Institute (MMHPI), for advice. Bob Garrett helped McSwane get connected to MMHPI for assistance in building a local collaboration that had the capacity to create meaningful change.

“We became involved with helping to facilitate meetings with key local leadership and providing hands-on assistance and guidance to the community volunteers as they began the work to organize into a behavioral health leadership team,” says Christie Cline, MD, MBA, Director of System Quality Improvement.

With assistance from Drs. Minkoff and Cline, McSwane and Latham co-chaired a planning committee and community meetings were held to assess needs and recruit an inclusive behavioral leadership team representing behavioral services, the local Mental Health Authority, psychiatric inpatient units, substance abuse providers, public health, social services, education, justice, city and county government, the faith community, nonprofit services, area businesses, and individual volunteers with lived experience in their own lives or in their families. The committee divided into sub-groups to accomplish the initial steps to charter the Behavioral Health Leadership Team. They were able to expedite some activities using the Institute team’s experience and access to best practice examples of organization structure, charter documents, and processes used by like communities.

The Smith County Behavioral Health Leadership Team moved quickly to adopt its mission, values and bylaws, identify priorities, develop an initial set of deliverables, and form work groups. Its goal is to pull together resources to improve the access and delivery of behavioral health services in Smith County. Two initial priority objectives are in the area of improving the continuum of behavioral health crisis services – with a particular focus on diversion from jail and emergency rooms – and improving coordination of prevention and early intervention efforts across the community. Work groups have been chartered to address each of those issues, along with a Medical Practice Workgroup representing a collaboration between ER physicians and local psychiatry leaders.

The City Council of Tyler approved a resolution to support and recognize the work of the Smith County Behavioral Health Leadership Team, and the County Commission is in the process of doing so. In addition, Episcopal Health Foundation has recognized the value of the Behavioral Health Leadership Team’s work and has granted funding for project management staff to assist the community volunteer effort in achieving its vision. The project manager formally began her efforts in March 2016, and represents additional capacity to help the efforts of the Smith County Behavioral Health Leadership Team to be more coordinated, to have greater capacity to develop a more comprehensive strategic plan, and to track measurable targets and objectives of progress.

The Meadows Mental Health Policy Institute is a nonpartisan organization that supports the implementation of policies and programs to help Texans obtain effective, efficient mental health care when and where they need.

For more information about the Institute, please visit