Civic Dispatch: The Route to Becoming a Neighbor

Jean O’Connor-Snyder intern Katy Hurd delves into the role of Capstone Rural Health Center as a staple for Walker County in both healthcare and community connections.

Defining “community” can be difficult. It can be as simple as “a group of people living together” but also as complex as a group of people defined by mutual social ties and common goals within a larger system who live in the same area. During my time in Jasper, I have seen that Capstone Rural Health Center, as a key health provider in Walker County, consistently prioritizes developing strong bonds in the communities that they serve. And their connections with their patients create a system unlike anything I have ever seen in healthcare.

This summer, through a partnership between the University of Alabama’s New College, the Walker Area Community Foundation, and the David Mathews Center for Civic Life, I’ve served as a Jean O’Connor-Snyder Internship Program (JOIP) intern in Walker County, Alabama. JOIP focuses on developing leaders in civic engagement through immersion programs around the state. My placement has been with Capstone Rural Health Center to learn about their behavioral health services and addiction treatment.

Capstone Rural Health Center has operated in Parrish, AL since 2001 with the goal of offering quality healthcare to surrounding rural areas. Starting in 2007, the clinic became a Federally Qualified Health Center (FQHC) through the Department of Health and Human Services, which gave them the ability to use a sliding fee scale for patients and receive governmental funding. These abilities are dependent on the clinic providing comprehensive services (such as primary care, dental care, mental healthcare, etc.) to underserved populations.

As ground-zero of Alabama’s opioid crisis, Walker County is a unique area to serve in. Treatment of substance abuse can go hand-in-hand with the treatment of mental health, comorbidity that Capstone works to address. The US Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that about 20% of individuals living in rural areas have a mental illness, but even citing statistics like these tends to breed fear and resentment, rather than convincing residents to talk about or seek treatment for mental illness. Capstone’s model of focusing on community health and creating trusted providers makes them unique in their field.

In conversations with Rachel Wilson, a new counselor at Capstone who holds a Master’s and an Educational Specialist degree in Clinical Mental Health Counseling, I learned more about how the Center operates both inside the exam room and out in the community at large. Capstone masterfully walks a fine line between acting as mental health providers and community partners. The role of a mental health provider, according to Rachel, is to be a non-judgmental empathetic observer. Essentially, this comes down to supporting patients in confronting their own challenges and making decisions of their own judgment in a safe environment.

On the other hand, the role of a community partner is to fulfill needs identified by the community. This often involves instruction and guidance from the community itself. If the intention is to remain an impartial observer solely guided by the patient, the difficulty of reconciling these roles becomes obvious. During our conversations, Rachel was always aware of this line, saying that “Particularly in the initial conversations [with Walker County partners] I do the same thing that I think I am called to do in counseling, which is be non-judgmental…I’m not going to argue, it’s about ‘how do we treat human beings’.” At the end of the day, Rachel believes that both a community partner and a mental healthcare provider act in the same role: to help and heal the people they serve. Despite the differences in methods between these positions, Capstone’s ultimate goal is person-centered. When what serves a patient also serves a community, these roles become easy to reconcile.

For providers like Rachel, an aspect of walking this fine line centers on building trust – both in the community and with the people who live there. In Rachel’s case, this process must be approached slower and with more care than others might since she is not originally from Walker County. When developing bonds in a community new to her, she acknowledges the importance of patience and a positive outlook, saying that “I am very aware that I am new to this area, and I am trying hard to start with ‘help me understand’, with gaining awareness, and with gaining insight into this culture and this community without trying to come in and ‘fix’ stuff.” This is more than just talk. Rachel’s kindness and care for Walker County residents clearly shone through as we spoke. Acknowledging these starting points is an important step towards cultivating relationships with residents. Rachel demonstrates a clear commitment to connecting to the community. She shows this by her willingness to learn from and by respecting differences she encounters. She knows forcing change might alienate those in need.

Rachel’s route to developing cultural and community understanding, as well as building trust, is tried-and-true – simple conversations. So far, she has reached out to and spoken with local faith and community leaders, and she hopes to meet with more as she continues to establish herself as a community provider. Overall, her point is straightforward – in her own words, “The biggest thing is it’s about listening. It’s about communicating not just in words, but in actions ‘I’m here to listen and I want to understand you’.” At the core of mental healthcare and establishing community relationships, I hope every provider follows the route Rachel takes.

Katy Hurd is a  junior at The University of Alabama with the University Fellows Experience studying Psychology and Addiction & Recovery and hoping to pursue public interest law at the intersection of health and policy.

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