By: Kathie Mitchell
Nancy Wieman can be described as a calming force in the middle of a windstorm. Whether it’s figuring out a budget, troubleshooting problems as they arise daily, or turning the mental health system on its head, she does it with a kind of grace that inspires those around her to dust off their shoes and step up to the plate.
In a career that spans 45 years, Nancy has gone from a vocational worker at Norristown State Hospital to Montgomery County’s Deputy Administrator of Mental Health. What she did along the way in her thoughtful, pragmatic style was learn from the people she served and always – yes, always – she made a plan.
The forever strategizer, her planful way helped her run a one-person county mental health office, change a system from medical to recovery and even plan how not to get wet in a recent high profile ALS Ice Bucket Challenge. Does anyone know if donning a garbage bag is permitted?
Being prepared, anticipating change and thinking strategically were key elements that can be attributed to her success – or any success, Nancy said.
“What is certain is there’s always going to be change,” Nancy said in a recent interview. “If you can be out in front, it’s strategic to help shape it.”
So as Nancy faces her next phase of life – retirement – surprisingly she says she has no plans. But reflecting over her long career, she said the highlights include meeting people who inspired and taught her important lessons along the way. Lately, she’s been hearing from people who have thanked her for helping them and realizing that for many of these moments, she hadn’t even known that she’d made a difference.
“That’s very touching,” Nancy said. “I don’t know what to say. I will grieve this loss in my life.”
What she does know is that she will miss her work which began in the late 60s as a young vocational counselor at the state hospital which at the time housed 5,000 people. When she realized she wanted to stay in the field and become an administrator, she moved to utilization review which gave her the freedom to move from unit to unit reviewing patient charts. She gained firsthand experience of the inner workings of the state hospital, observing the staff and the treatment that was being delivered.
After working 18 years at the state hospital, Nancy decided to transition to the community and became the Deputy Administrator of Mental Health. For a short time, she was the only person in the office. Nancy decided she needed to learn firsthand about the individuals receiving services in the community and the providers who delivered the services.
“It was an enormous opportunity to build goodwill,” Nancy said. “I visited all the programs. I went out to shelters with case managers. I did that my whole career. I wanted to see where people lived and what it’s like to be a worker.”
One of the most dramatic impacts on Nancy’s view of mental health and her social work philosophy was when she realized that her job wasn’t to help people who couldn’t take care of themselves. When she realized people can and do recover from mental illness, it changed everything.
“My idea of help changed over time,” Nancy said. “What I had presumed about people really wasn’t the truth. I grew with it over time. My hope is that anyone can do that. You have to be open and honest with people and you grow.”
Nancy was willing to take steps and certain risks to try new things. It was the late 80s, state hospital downsizing began and Community Hospital Integration Projects Program (CHIPP) monies were available from the state. These monies helped counties develop housing and supports for individuals coming out of the hospital as well as build and expand the current infrastructure. In 1997, the county implemented HealthChoices where it began to manage the public mental health dollars and move forward with its vision for the community. Over these years, the county was able to increase its staff as the community programs and opportunities grew.
Nancy pointed to 2003 as the year that major change took place in the county’s mental health system when the recovery approach officially replaced the medical model with the adoption of the county’s Partnership of Recovery – Journey of Hope initiative.
“There had always been a different approach (different tools to help people) until it was a personal journey,” Nancy said. “The journey was about the individual and the tools were there to help. It made sense to me.”
Another life-changing event that Nancy said gave her new insight and empathy was being diagnosed with breast cancer in 1993.
“I learned firsthand what it means to live with a serious illness, how to manage it and the anxiety that comes with diagnosis and treatment,” Nancy said. “Something deep inside you changes. At least with me it did.”
In addition, Nancy experienced peer support in her own life for the first time. While in the hospital, Nancy received a call from Jane Ballard, a volunteer with Reach for Recovery who is also a breast cancer survivor. Jane reached out to Nancy and supported her during her recovery and a lifelong friendship began. Nancy herself became a Reach for Recovery volunteer.
“When we began to discuss peer support in the mental health system, I didn’t even have to think about it,” Nancy said. “I knew it worked.”
Nancy also has embraced the idea of a trauma informed delivery care system as recent research has revealed that the majority of individuals with serious mental illness have suffered trauma in their lives. Finding out “what happened to you” was a different framework and changed the whole dynamics, Nancy said.
And change is still happening. Community mental health funds are shrinking. There is a lot of belt tightening and cuts have been made to some programs to make way for new ones. Nancy helped spearhead the creation of a Behavioral Health Court that diverts individuals with mental illness from jail into community treatment. There is also a Justice Related Services Department that combines staff from the county, Montgomery County Correctional Facility, Probation and Parole, MCES, the county Public Defender’s Office and Community Advocates to work on finding appropriate supports for individuals coming out of jail.
Mental health funds have been consolidated into a Human Services Block Grant and are now the responsibility of the county commissioners. While some opponents have expressed concern about managing community mental health dollars at the local level, Nancy said the redesign of human services may be another opportunity for growth.
“I don’t think we should be afraid of it,” Nancy said. “You do not want it to happen to you. You want to be there fashioning it.”