Five Questions With: Craig Stenning

By Marion Davis
Contributing Writer

Craig S. Stenning, a longtime leader in substance-abuse treatment and mental health, was confirmed by the Rhode Island Senate last Wednesday as director of the R.I. Department of Mental Health, Retardation and Hospitals.

Stenning answered questions about his vision for MHRH and the challenges he faces.

PBN: How big a role do you see government playing in meeting the need for mental health and substance abuse treatment in this state?

STENNING: The state should be and needs to be a rather substantial player, especially in the area of behavioral health, because of the large numbers of people who are uninsured. But going beyond the payment issue, I think the department needs to take a more active role in advocacy with issues such as the stigma attached to these issues, parity, people understanding the connection between behavioral and physical health.

We have done a fairly good job of creating a comprehensive array of services in Rhode Island. It’s a larger array than exists in most states. But for the past five or six years, because of the economic situation, most of our money has been spent on fiscal issues and regulatory issues, and attempting to maintain the delivery system, and we’ve sort of neglected the advocacy role, I think.

PBN: Are there specific things you would like to do in advocacy?

STENNING: I’m struck by the continued misunderstanding of what mental illness, substance abuse and even developmental disabilities are. They each carry with them their own unique stigma, and for many people in the public, until it hits within one’s family, it’s usually a misunderstood issue.

PBN: Is it a matter of people thinking that if you just pulled yourself up by your bootstraps, you’d be sane, or off drugs?

STENNING: I think there’s a portion of that, and there’s a portion of people who see these disorders as much scarier than they really are. I think they are not aware of the progress that we’ve made in treatment, in the areas of behavioral health and developmental disabilities, in maintaining a positive lifestyle. I also think that there’s a tendency to think that these are expensive issues, and when the economy turns negative, as it is right now, the supports for these kinds of services tends to wane.

PBN: Do you see a need to strengthen and expand the mental health safety net in Rhode Island?

STENNING: I think we can always look to strengthen it. There is a fairly good system of care if you are Medicaid-eligible or in some cases, if you are uninsured. It’s almost more difficult if you have private insurance.

PBN: The Eleanor Slater Hospital is a big part of MHRH’s responsibilities. How concerned are you about tightening resources, and having to do more with fewer workers?

STENNING: The work force is a significant issue with this department, as it is with other state departments. We lost a large percentage of workers during the last retirement, one of the largest percentages of any state department, so we are working now to regain a foothold, because we have not only the Eleanor Slater [State] Hospital, but also a system of public group homes for people with developmental disabilities, so we have a rather large work force.

As far as the hospital is concerned, we have taken it a step back. We have a brand-new medical director, we have a brand-new CEO, and of course I’ve just come back to MHRH, so we are taking a careful look at the populations that the hospital currently serves and the services they receive. We’re attempting to do a very comprehensive review of what the hospital’s role should be in the continuum of care, because it’s not a stand-alone hospital – it’s part of a department that has a continuum of care that goes out into the community. And we’re also looking at what the hospital does well, what it could do better, populations that we shouldn’t be serving, and perhaps populations that we don’t serve that we should be serving.

I think we’re going to do a fairly intense review of that, and then make recommendations to the governor and other policymakers about what the real role of this hospital should be in the next 10 years.