Closing a compassionate career

Kaplan retired after 12 years with San Mateo County’s Health System, a rewarding career preceded by 18 years with Ventura County, where he also served as director of a BHRS.

Dr. David Young was chosen to lead the local department he and Kaplan said strives to promote a healthy and happier life for some of San Mateo County’s most at-risk populations.

While Kaplan spent the majority of his tenure on the administrative end, he cringed at the notion of being called a bureaucrat. He began his nearly 40-year career as a therapist working with youth and, even as he transitioned to a supervisory role, it’s always been the clients who’ve kept him going.

“As I’ve been reflecting on my retirement, the real stories of inspiration have been from the clients and the families. If I ever thought about my job as being hard, I would always think about living with a serious mental illness and how hard that is. My job’s a piece of cake compared to that. It’s how can we make their lives a little easier?” Kaplan said. “It just made the work all the more meaningful.”

There’s a long list of policies and programs Kaplan prides himself on having been a part of. Still, he acknowledges there’s more work to be done — whether it’s continuing to alleviate stigmas around those with mental health issues, implementing changes stemming from the Affordable Care Act, or helping people with substance abuse disorders secure stable housing.

But it was challenges and the prospect of making a difference that always led him forward.

In his earlier days, he enjoyed serving as a therapist to help children, families and adults tackle complex mental health issues. But then he began to recognize how improvements could be made at an administrative level.

“I was really drawn to more of a system change and how the various parts can better work together on behalf of and improve the lives of those individuals,” Kaplan said.

Promoting a coordinated system of care was one of the most effective changes he saw during his time working with at-risk youth and a notion he carried over to other areas of behavioral health. Coordinating care involves imbedding mental health resources and counselors where clients are; whether that’s at schools, juvenile hall or in emergency rooms. For youth in particular, a coordinated system of care involved working with teachers and others to recognize that collectively as public servants, they have a duty to help, he said.

A cross-disciplinary approach was also key and meant spanning training to connect with law enforcement, human services agencies and primary care physicians. Kaplan said creating peer-to-peer counseling opportunities to share learned experiences has also been effective.

It was about reforming treatments to better align with clients’ needs, he explained.

One effort he’s particularly hopeful for is a medication-assistance program that began as a pilot to treat people with chronic alcoholism. It has grown the last few years and involves prescribing Vivitrol, which helps reduce cravings, and pairing patients with intensive case management.

“I’ll tell you, in my retrospective of my career, this is one of the best things that’s ever happened. It’s saving people’s lives,” Kaplan said, before citing statistics that have shown significant decreases in emergency room stays and arrests, while access to primary and specialty care has increased.

Other areas he hopes will continue to expand are treatment models that use early psychosis intervention, individualized plans of care and same-day service for anyone in crisis.

One major shift Kaplan, like others across the county, had to navigate was how the ACA affected substance abuse treatment programs. It’s taken nearly seven years but, for the first time, Medi-Cal funding can be used to pay for the treatment portion of rehab facilities. Kaplan was instrumental in helping San Mateo County become one of the first in the state, if not the country, to navigate the bureaucracy that allows them to pull federal funding for local providers.

“I’m really optimistic on the financial side,” Kaplan said while acknowledging there are still kinks to be ironed out. “It’s going to take some time, it is as much of a transformation of a system as you can have.”

Ushering the changes and programs forward is now in the hands of Young. The new director of BHRS was chosen to replace Kaplan and has years of experience as a psychologist with a master’s degree in health care administration.

Like Kaplan, Young was also drawn to the prospect of effecting greater change through policy. A Bay Area native, he notes his interest in altruism, medicine and child development stem from his parents.

“I really enjoyed being a therapist, but I’d like to have an impact with a larger group,” said Young, whose experience includes work in the nonprofit and private sectors. “At the end of the day, it’s about helping people live a happier and healthier life.”

Aside from lacking clear direction on the future of the ACA at the federal level, the unaffordability of housing for those in recovery is another critical issue BHRS must strive to address, Young and Kaplan said.

And while progress in the behavioral health and recovery field can often take time to manifest, Kaplan has been around long enough to see tangible benefits. So as he reflected on the culmination of a decadeslong career, he encouraged others to consider this meaningful profession.

“You can always meet clients that will tell you something that makes you think ‘this is worth it.’” Kaplan said. “Stories about how their lives have changed. … That keeps you going. There’s a lot of inspiration from that, and how brave and courageous these folks are and the family members too, the struggles that they have and their courage is rewarding.”

samantha@smdailyjournal.com

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