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SERV is subject of Times of Trenton editorial

An editorial in The Times of Trenton on Dec. 27 acknowledges SERV's use of the Recovery Model, which according to Rutgers psychiatry professor Dr. Paul Lehrer, taps into the body's natural desire for health. To read the full editorial, click.

SERV consumer earns degree, finds job, strikes out on his own

While their son stood at the podium in front of dinner guests at a recent SERV fundraiser, mother and father looked on with pride. Viral was telling his story of recovery from paranoid schizophrenia and drug use to where he is today -- a full-time counselor for people with mental illness and chemical addiction.

Viral, 37, who had utilized SERV Centers of N.J.'s residential and support services since 2005, recently struck out on his own to live and work independently in the community. "This is our hope for all of our consumers," said SERV President and CEO Gary van Nostrand at the event.

Before Viral left SERV in July 2013, he agreed to share his success story in June to reception attendees at the 23rd annual Volley For SERV Tennis Tournament at Cherry Valley Country Club in Skillman. The guests were in awe of Viral's accomplishments as they listened to him talk about how he was able to earn his final credits toward a master's degree from Pace University, thanks to scholarships he received from The SERV Foundation. He also gave credit to SERV counselors who supported him over the years and who encouraged him to apply for the scholarships.

"We are all very proud of Viral and for all he has accomplished," said Tammy Wilson, Director of SERV Centers of N.J.-Central Region.

Viral's story of mental illness began at the age of 20, when he had his first psychotic episode. A frequent user of LSD and a daily pot smoker, Viral attributed his paranoia to the drugs. He also made an inordinate amount of visits to his doctor, believing he had one disease after another. After examinations, the doctor would send him home, suggesting he had hypochondria.

Three years later, after a night of drinking tequila and doing drugs, followed by confusion and paranoia, Viral announced, "I quit." "I never picked up again," he said. "I've been clean for 14 years."

However, the paranoia continued. "I felt people were watching me and I kept looking for evidence. I tore apart my car and house to find cameras," he said.

He voluntarily went to UMDNJ for his first hospitalization for a week. The medication he received helped lessen the paranoia and helped him to build coping skills. "That's when I put on my 'game face,'" he said. "It was a conscious effort to look normal. I had lost many friends because my staring freaked people out."

Two more week-long hospital stays later, doctors in Virginia found the medication that worked best for Viral and it "changed everything," he said.

Now stabilized, Viral returned to New Jersey and his parents, who were getting the emotional support they needed from SAMHAJ, a program of the National Alliance on Mental Illness. The South Asian Mental Health Awareness in Jersey provides support, education and advocacy for South Asians affected by serious mental illness.

Meanwhile, Viral learned of SERV through a friend who was a resident in SERV Centers-Northern Region. Knowing he needed support as he recovered, he participated in a comprehensive assessment at SERV.

During Viral's first three years with SERV Centers-Central Region, he lived with roommates in an apartment in Middlesex County. Longing for a bedroom of his own, he eventually moved into another of SERV's apartments in Middlesex.

Content in his new place, Viral considered going back to Pace University to finish the last two classes he needed for his master's degree in counseling. "I had dropped out of grad school and was very discouraged about school. I thought I would just have some mediocre job."

Viral credits his SERV counselors and Ms. Wilson with providing the encouragement he needed to pursue his educational goals.

"Tammy encouraged me to apply for a scholarship grant from The SERV Foundation," said Viral, who already had a bachelor's degree in criminal justice with minors in psychology and New York City Humanities.

"Viral was the perfect candidate for the SERV Scholarship," said Ms. Wilson. "Because he had defaulted on school loans several years earlier, he could not qualify for any type of financial assistance. The SERV Scholarship provided him the resources to fulfill his dream of completing his graduate degree and, ultimately, to help others in need. This was exactly the need that the SERV Scholarship Fund was designed to fulfill."

After applying for and receiving two grants from the Foundation's Scholarship Fund, Viral completed his graduate studies and later found jobs as a drug counselor and a peer counselor. Now, he is working full time for an agency in Newton as a counselor for people with co-occurring mental illness and chemical addiction. There, he works with consumers on relapse prevention, monitors medication and conducts group therapy sessions. "I have vast life experience and educational experience to offer (in this position)," he said.

In working toward this place in his life, Viral thanks SERV Senior Counselor Praseeda Jayanthan and Residential Counselors Ambrose Ekehlar and Quintella Thomas for their influence. "They helped me with job applications when I needed it, coordinating everything so that I could help myself. They wanted to make sure I was doing well and succeeding in life," he said.

According to Ms. Thomas, Viral's awareness about mental illness and his ever-positive attitude had much to do with his recovery. "He was very knowledgeable about his illness and he paid attention to his symptoms, knowing when he needed a med adjustment. He continued to move forward with is life even though he had a mental illness."

Mr. Ekehlar agrees. "There is something very unique about Viral," he said. "His level of acceptance of his mental illness was very critical to his own success, and with that acceptance came the realization that every so often one does need help."

Viral was proactive in most things, yet would seek help when necessary, said Mr. Ekehlar. "He would talk to several staff members about a problem, request their straightforward opinions, ask more questions, and then make his own decisions based on those conversations. He believed that a problem shared is a problem half-solved."

Because of his successful recovery from mental illness and his achievements at his place of employment, Viral became self-supporting and made the decision to leave SERV and find his own apartment closer to work. "I feel like I don't need services like others may need them, so it's time for me to go," he said. "SERV has been very good to me. I was always able to get a counselor when I needed one. They know how to handle crisis situations very well."

To others on the road to recovery, Viral offers this advice: "Stay on your meds regardless of how you feel, and hang in there; it gets better."

SERV study earns publication in scientific journal

SERV is the subject of a recently published article in the prestigious "Psychological Services" journal of the American Psychological Association. SERV is one of the largest providers of outpatient mental health care in the nation, providing both residential and rehabilitation services to more than 1,200 individuals in five counties in N.J. (Hudson, Mercer, Middlesex, Passaic and Union).

The scientific paper is an empirical evaluation of SERV's 2006-2007 transformation from a traditional mental health services agency oriented to caring for mentally ill people to one guided by the Recovery Model philosophy, which assumes that people with mental illness can recover and that this is best accomplished when they alone decide their life's path. The staff's role is to help them reach their goals, rather than to define goals for them.

The three-year study, in which 627 consumers and 490 staff members participated, found that "recovery-oriented services had a positive impact on rates of overnight hospitalization, residents' ability to function in the community, some professional skills of employees, and the working alliance between direct care providers and residents." It also indicated that "comprehensive and well-structured recovery-oriented care may offer a cost-efficient and effective alternative to the deficit approach to mental health care."

The most important finding, and an unexpected one, according to Dr. Paul Lehrer, a professor of psychiatry at Rutgers-Robert Wood Johnson Medical School in Piscataway, was the decreased number of hospitalizations among SERV consumers, whether for mental health or other reasons. In the period after the Recovery Model was rolled out across the five counties, hospitalizations dropped 30% compared to the period before the rollout.

According to Lehrer, the study began when Gary van Nostrand, SERV's President and CEO, announced at a meeting of the SERV BHS board, of which Lehrer is a member, that SERV was about to adopt the Recovery Model for services. Literature in the mental health field was strongly suggesting that elements of this approach had a high potential for effectiveness. Van Nostrand had decided that existing data warranted a trial at SERV.

Nevertheless, there were as yet no controlled scientific data proving that the model actually worked when it was adopted system-wide by a large mental health agency. What effects would the Recovery Model have in a setting such as SERV's? Would the staff be willing to accept the change? Would the consumers respond well to it?

These questions prompted Lehrer to suggest evaluating it in an organized fashion by collecting data before and after the roll-out of the Recovery Model to "see whether it's as good as it's cracked up to be." However, evaluating a major program innovation is a daunting task, particularly without major external research funding. To accomplish the project, Lehrer involved a psychology graduate student at Rutgers, Igor Malinovsky, who could serve as the point person putting the research together. Van Nostrand was able to find sufficient funds to hire him to perform the task. In the process, Malinovsky thus proceeded to gather his doctoral dissertation data.

When the transformation began, the SERV leadership found that it would not be possible to roll out the Recovery Model in all five counties at once, so introduction began only in Mercer County, followed by a phased sequential introduction, county by county, over an eight-month period. This allowed the use of a "multiple baseline" design for evaluating the program. In this research design, the effects were measured before and after the rollout in each county. In this way the Recovery Model effects would not be confounded with various societal changes that may have occurred over time (e.g., changes in mental health funding, economic stress, etc.).

As adoption of the Recovery Model began across the SERV system, it immediately became evident that the quality of data was very good. "In my judgment, for an organization to do this without major funding is remarkable," Lehrer said. "It shows how committed the organization was to doing this task right. Only a very well-functioning organization can carry out such a laborious and meticulous task, and produce interpretable data. Gary and his whole staff, particularly Tracy Samuelson (Director of Quality and Compliance), saw that research forms were completed and organized as completely as if we had had a $2M grant to do it."

"We undertook this work because Gary wanted to know if this program works, and we wanted to make sure that Gary got his answer," Lehrer said. "The quality assessment was done so well, that it was worthy of scientific publication."

The publication of Malinovsky's manuscript in "Psychological Services" is a prestigious honor, Lehrer said. "This is a peer-reviewed journal, requiring the highest standards of scientific rigor. It took two years of writing, re-writing, analyzing data, and answering questions to meet their standards as well as our own. The journal editors believed that we found some evidence that is solid and worthy enough for the scientific and mental health communities to take note of it."

The paper, titled "An Empirical Evaluation of Recovery Transformation at a Large Community Psychiatric Rehabilitation Organization," was authored by Malinovsky; with Lehrer; Dr.Steven M. Silverstein, Director of Research and Director of the Division of Schizophrenia Research at Rutgers-University Behavioral Health Care (UBHC); Stewart A. Shankman, University of Illinois, Chicago; and van Nostrand, Samuelson and William O'Brien of SERV Behavioral Health System, Inc.

To read the study, click here.

SERV Medical Director honored by NJPA

Dr. Linda Gochfeld, Medical Director at SERV Behavioral Health System for 14 years, recently received the 2013 Platinum Award from the N.J. Psychiatric Association during its "Evening of Excellence." This is NJPA's highest honor.

During an evening reception on Oct. 27 at the Renaissance Woodbridge Hotel in Iselin, Dr. Gochfeld accepted the award from Dr. Bertram Warren.

Betty Linda Allan and Marilyn2Pictured during the “Evening of Excellence” reception of the N.J. Psychiatric Association on Oct. 27 are, from left, Betty Birch, SERV Centers South Region Director; Dr. Linda Gochfeld, Medical Director; Allan Boyer, COO of SERV Centers of NJ; and Marilyn Ticktin, Director of Housing Development.

According to NJPA, "The Platinum Award is given only to one who has demonstrated service to psychiatry over a lengthy period of time, and much above the outstanding contributions many of the recipients of those receiving the Golden Merit Award have achieved." Dr. Gochfeld received the Golden Merit Award from NJPA in 2000.

In its program journal for the "Evening of Excellence," NJPA wrote: "She is known as the person to turn to when our organization needs help with patient services, the many other organizations to which she belongs, or the State of New Jersey, where she has served on many committees and task forces."

Dr. Gochfeld is a cum laude graduate of Barnard College where she received her degree in psychology. She received her MD from Albert Einstein College of Medicine. After finishing an internship at the University of Colorado Medical Center, Dr. Gochfeld completed her psychiatric residency at the Long Island Jewish-Hillside Medical Center. She also was trained in psychoanalysis at the Manhattan Center for Modern Psychoanalysis, Studies: Psychodynamic Therapy. She is certified by the American Board of Psychiatry and Neurology, and a Distinguished Life Fellow of the American Psychiatric Association.

In addition to her work as Medical Director at SERV, Dr. Gochfeld has a private practice in Princeton and is a clinical professor of psychiatry at Rutgers University. She has been active in the N.J. Psychiatric Association since 1978.

"I am very happy and grateful to be working for SERV, where we provide excellent care in an atmosphere of optimism and recovery," said Dr. Gochfeld.

Congratulations, Dr. Gochfeld, on your prestigious award.