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Cover Story

Mental Hell at Valley Mental Health Page 3

Cut backs eliminated programs; clients have yet to recover.

By Stephen Dark
Posted // May 19,2010 -

Pathways took on a funereal atmosphere in early January. Some staff who got rehired suffered from survivors’ guilt and received dirty looks from colleagues heading toward unemployment. A client handed Clayton a farewell card. “I’ve got to go,” he told the client and turned away in tears.

Pathways staff at Salmon’s farewell party, days before the unit closed, bit down on angry tongues. “They could have changed this model,” one said. “Instead, they bring down the ax.”

Falvo is unrepentant. She recalls a woman at a Pathways town hall standing up in tears. The woman, Falvo says, said that, “ ‘Pathways is my life.’ At that moment, I knew closing it was the exact right thing to do because treatment should never be your life.”

PATHWAYS.jpgBut for many of Pathways’ severely mentally ill clients, long-term, day-to-night treatment was essential for their care and inevitably led to close relationships with staff. “It hurts,” 30-year-old client Kristie Tribe said at Salmon’s farewell. “I don’t want to say goodbye.”

Her friend, 67-year-old Dee King, a former trucker and now legally blind, had no idea who would be managing her case come Feb. 1 when the treatment center closed. She was more concerned, she said, “about the clients who aren’t as tough as I am surviving the closure.”

Julie, who had spoken up vehemently against the changes at a town-hall meeting, was scared. She couldn’t hug her two daughters, she said, “because my skin is too sensitive.” Her 65-year-old mother, Joyce Johnson, expressed concern. “Now I can’t go to work and feel comfortable she’s safe,” she said.

Salmon gave a brief speech, noting Pathways had sponsored 32,000 groups and classes. A Bosnian client took the microphone and sang a lament. Client Julie told those listening, “The only thing you can count on is change. It’s very hard for people like me to do.” Tribe said she’d written a poem about Salmon but lost it on the bus. “In a way, I owe my life to you.”

On Pathways’ final day, Julie went to say goodbye to Salmon. She grabbed hold of her, and sobbing, cried out, “How am I going to manage? I can’t do this all by myself.”

Holly Chapman Blank, a 49-year-old with bookish glasses, was another Pathways client who feared its end. Pathways “opened a new world for me,” she says. When she started, she was so introverted, “I was worse than a wallflower, I was the wall.” She found “empowerment and responsibility” at Fresh Start, a series of client-run classes and activities that replaced the socialization aspect of Pathways’ services. While higher-functioning Pathways clients have continued to attend Fresh Start and Wellness for Recovery—which provides support classes on schizophrenia and diabetes as well as leadership skills—“a lot of lower functioning clients haven’t come back,” she says. “Pathways meant a lot to them.”

Three months after Pathways’ closure, many former clients remain angry about both the closure and what has replaced it. Sasha, who requested her last name not be used, has yet to be assigned to one of the care-coordinating teams Valley said every client would receive, one of many “bright pretty promises” made at the town-hall meetings she says were never fulfilled. Last fall, 35-year-old Sasha started classes at the University of Utah. The closure of Pathways, where she’d been a client for eight years, made her question going on. “I don’t fit in anywhere,” she says. “Where am I supposed to go for support?”

Fresh Start, she says, “doesn’t help me to shower when I’m too paranoid to get into the bathroom.” When Pathways was open, she could talk to a therapist without an appointment. “Now I’m isolated, I have no one to talk to.”

Tribe is “disgusted” with the changes. At Pathways, “I was doing good, on my meds, going to groups. I never had any friends, then I went to Pathways and I met friends.” Tribe stays in her South Salt Lake apartment with her boyfriend and struggles with paranoid hallucinations. “It’s killing me not doing anything,” she says. “I just sleep all day.”

Prewitt, meanwhile, attends one Wellness two-hour class a week. She can’t bear Fresh Start because her higher-functioning peers, who run the classes, “don’t listen to us,” she says. “They just talk to us.” She stays in her apartment and her drug use escalates her fears of going out, her sister says. Where once Prewitt had Pathways’ socialization to get her out of her home, she now feels, her sister says, “she has nowhere to go.”

The jury is still out, Salt Lake County’s mental health director Whalen says, on whether Valley’s reconfiguration “will be a success.” Out of the four programs slated for closure, only Pathways closed. Out of the 125 intended layoffs, 91 employees left, but Falvo is unable, or unwilling, to say how many were laid off.

Whalen says Falvo told him that the county “can come on in, the lights are on, we can look where we want.” Two staff under Whalen are reviewing clinical and billing records. “I want to make sure we’re getting what we purchase,” he says. Falvo is less than thrilled. “I’m always concerned about additional, repetitive oversight.”

At the end of 2010, Valley Mental Health will bid for the Salt Lake County mental-health contract. Before October 2009, says Pat Fleming, Valley was a “shoo-in” for being the sole source provider for Salt Lake County’s mental-health needs. Post-reconfiguration, he says, the county seems more interested in bringing market forces to bear, “as they can only improve services.” Along with the county looking at what other treatment providers offer, the question of whether the contract should be broken up—or “unbundled”—hangs over Valley’s future.

Falvo says, “I don’t believe personally [that unbundling] is the best way to provide care for people with serious mental illness.”

She acknowledges some staff have “trust issues” with her, and that employees and clients are nervous. “Everybody keeps saying slow down. If we slow down, we will get passed by.”

Krause, meanwhile, continues to battle with Valley Mental Health to find care for her sister. Prewitt was kicked out of one county-funded evening alcohol and drug program she attended for six months because she talked about feeling suicidal. The county referred Prewitt to an intensive Valley program called Mentally Ill Chemically Addicted, only for a furious Krause to discover Valley had just closed it.

Krause and Prewitt attended a meeting with county officials to review Prewitt’s care by Valley. Prewitt spent the meeting with her head in her hands, crying. “But can you help me?” she said. “I need help.” In a subsequent meeting, chief clinical officer Richard Hatch told Prewitt she would be entering Valley programs that in the past Krause had been told her sister was too severely disabled for. While Prewitt is “greatly optimistic,” her sister says, Krause is concerned that Valley is just getting her hopes up.

“I feel helpless,” Krause says. “I never thought I’d have to fight the system that’s supposed to care for my sister. I kick, I claw, I scratch for help, I don’t know what else I can do.”

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Posted // April 10,2011 at 14:35

There should be further investigation into Debra Valvo, Richard Hatch, for misuse of funds and abuse sto patient care, in addition, the board members.


Posted // July 21,2010 at 13:25

Regardless of client complaints and state audits demonstrating poor access for the mentally ill, Salt Lake County has posted an RFP that continues to bundle mental health services, in favor of valley monopoly health. Valley continues to prosper, increasing salaries and exec positions despite its poor reputation and complete lack of staff trust. $100M flowing into vmh and it still takes 5 weeks for an appointment??


Posted // May 28,2010 at 05:50

When does it end. When do state and federally funded organization get held to account for the unethical practices they employ in dealing with the individuals they serve and the staff they employ. How many more complaints and concerns raised for clients, staff, family members and the public does there have to be in order for someone to say stop! Just because the the organization has been successful and around since the dawn of time doesn't mean that that the people in charge are not fallible. We have seen this over and over in organizations and businesses that have been allowed to grow to monolithic proportions. They become arrogant and subjugating. this is what happens when people stay silent. When they allow their own mistreatments to go without remedy. When they are silenced by their fears and their peers.

When we allow this type of treatment to go on, when we let people be treated with such disrespect what does that say about us as a community and as a society?


Posted // August 19,2010 at 19:42 - An OIG officer has been contacting community partners - so apparently some of these complaints have been heard. vmh youth programs will be at 50% capacity from numbers served last year. vmh outpatient units STILL cannot get new clients in for 3-4 weeks and DO NOT provide weekly therapy, leading to increased rates of institutionalization. vmh administrators continue to be highly paid, incompetent, and corrupt.


Posted // May 28,2010 at 15:24 - I guess time will tell.


Posted // May 28,2010 at 10:29 - The county administration's sentiments will be evident in the upcoming RFP. As this article suggests, it's time to end Valley's monopoly on mental health and offer more choices and better access for clients, as they now have in substance abuse treatment.


Posted // May 28,2010 at 02:28

I think it's an absolute shame and very sad the way the Valley Mental Health Administration namely Debra Falvo, has screwed up the mental health system royally and so badly that it's left an indelible scar on people who used to go there and are used to going there for treatment. Treatment, believe it or not, is a way of life for these people. It's all they have (at least some of them anyway), and it happens to be the only station to which they are accustomed. Apparently, Ms. Falvo and co didn't think about the long term or even short term in this case, effects that it would have and has inevitably had on many of it's clients and staff. Just because Fresh Start "seems" to be going okay, things aren't always what they seem. I know this first hand, because I attended Pathways to Recovery for several years. 17 to be exact. It used to be called A.D.T. (for Adult Day Treatment), but even though the name changed, the program was still the same. That is, until now of course when everything suddenly "changed over". A lot of clients have stopped going since everything changed, and it is definitely not the same place. I think it's a shame that some people feel like they have to do away with something that is helping people and changing their lives for the better. Unfortunately, some people just don't care because they're not in a position to care. They're apparently too busy and wrapped up in their own pathetic so called lives to care, so they end up passing the buck, and the clients and staff are the ones who end up bearing the brunt of everything that's wrong with the system and it's like a huge weight or burden is being placed on their shoulders which is much more than they can handle. But why am I not surprised? I know Carol Prewitt and I don't condone her drug use, but when someone feels like they don't have anyone to turn to, of course they're going to self medicate!!!!! Think about it. When someone has a choice, and then their choice is taken away from them and the rug has literally been pulled out from under their feet, what other choice do they have but to isolate and self medicate and feel alienated and closed off from the outside world especially when they don't have anywhere else to go for treatment? It doesn't make sense. Everyone has the right to go someplace where they feel safe and secure regardless of whatever their background is, and nobody should have to be left out in the cold to fend for themselves. Thank you Mr. Dark for your insightful, eye opening article. Problems like this should not be ignored.


Posted // May 27,2010 at 16:09

Just for the record Care Coordinators DO NOT make more than 46,000 a year not even close. I know because I am one so I don't know where someone got these numbers from.


Posted // May 28,2010 at 05:21 - Yeah whatever, guess if you are one (care coordinator) and not making that you're not in the club and therefore replaceable.


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