Stuby looks back on 35 years

FINDLAY — In her 35 years at the Hancock County Board of Alcohol, Drug Addiction and Mental Health Services, Precia Stuby has helped shape systems and change misconceptions. Throughout, her goal has been to bring everyone to the table. Stuby, executive director of the ADAMHS board, announced last week she will retire in March. She began her career as a social worker in hospitals and child welfare. An interest in helping shape policy drew her to mental health work. She said that, when people hear about rules or regulations, "it's like it descends from on high. And what I learned is it's people like you and I that make these rules and regulations." In the early 1990s, communities across the United States were developing systems related to mental health. "Before the Mental Health Act of 1988, people with severe and persistent mental illness predominantly lived in state hospitals, and the issue of substance use was not addressed by boards at that time," she explained. The emphasis shifted to helping individuals recover while living in their own communities, but there was no organized system to make this possible. Then-director of the board Phyllis Putnam hired Stuby as deputy director in 1990 to help build a system in Hancock County, as their counterparts were doing throughout Ohio and the nation. Stuby later became executive director in 1997. Stuby's new role included working to develop new services, such as case management. As the state created certification standards for services, Stuby worked with local organizations to ensure they became certified, and helped them set up the infrastructure that, among other things, would allow them to bill Medicaid. Changing attitudes The first hurdle, though, was getting everyone on board. "Even today, there is a lot of misunderstanding, a lot of stigma and a lot of fear associated" with people with severe and persistent mental illness, Stuby said. But 35 years ago, she encountered far more – including seeing some mental health professionals leave the field amid the nationwide shift to care for people in their own communities. "Because they disagreed that individuals could be de-institutionalized," Stuby said. "They were opposed to that…. It was this very controversial thing: 'Can individuals live in the community?'" Stuby said it took time to build relationships and change mindsets. Today, while there is still work to be done, she sees more acceptance throughout society. During the opiate epidemic, people who thought addiction would never touch their lives "began to see coworkers, family members, people in their congregation, people that they never would have thought ever would have been impacted…. All of the sudden, I think, there's this awakening," she said. Trauma, too, is something many people might have thought would never touch their own life, she said. Until 2020. "Well, we all went through COVID. All of us…. All of us have experienced trauma," Stuby said. The last several years have taught us all more about trauma and grief, and the importance of finding a positive way to address them, she said. At the same time, scientists have learned a great deal about the brain, including increasing awareness of the role of family history in addiction. Stuby said it's important to talk about such a family history, just as you would talk about a family history of cancer. Creating a ROSC In 2013, the ADAMHS board began contracting with Michael T. Flaherty, Ph.D., as a consultant. He helped them to create a recovery-oriented system of care, or ROSC. She said research has shown the ROSC approach leads to better outcomes. The idea is that, while people may visit a professional for treatment, "they recover in the community. They live in the community. They work in the community." So, Stuby and her team began working with churches, businesses, schools, the criminal justice system and other community organizations. "It was about, how do we make this a community where people, if they struggle with mental health and addiction, feel the support? People know how to recognize when there's a need," Stuby explained. She likened it to how the community comes together to support a loved one who is diagnosed with cancer. Tell your neighbor about such a diagnosis, she said, and they will immediately respond with empathy, followed by "I'm sorry," followed by "What can I do to help?" People bring meals and shovel your driveway. "Now, if you went home and told your neighbor that you were addicted to heroin? When we really have ROSC, we'll have their intuitive response be empathy, followed by 'I'm sorry,' followed by 'What can I do to help?' Because all those same things that help somebody that has cancer, help somebody that struggles with mental health or addiction," she said. "But, the intuitive empathy? We're getting there. We're not there yet. We still have that idea to flee, like, 'OK, now I need to create distance'. Instead of creating support…. And so it's a work in progress for years to come, but, you know, I think we get a little closer every day." The ROSC transformation drew national attention to Hancock County, and Stuby is regularly asked to speak at conferences about this work. "Hancock County's claim to fame has always been collaboration," on everything from economic development to caring for those who need it, she noted. "And that allows us, I think, to move a little further, faster. I'm fortunate that I've been able to stand on the shoulders of a lot of people before me that believe in that." Looking back on accomplishments ADAMHS Board Chair Jim Darrach first became aware of Stuby's expertise when she presented at a Rotary meeting following the 2007 flood. The mental health toll of that disaster hadn't previously been on Darrach's radar. "She would talk about these things, and it was like, 'Wow,'" he said. "A light went on." In his years serving on the board, he has found Stuby is "always prepared" and the most knowledgeable person in any room. He added that she has surrounded herself with the right people, describing the ADAMHS staff as "all wonderful people that have a passion." "All of the things that Precia has done are foundational," Darrach said. "We have a recovery-oriented system of care. That's here to stay." Stuby said she is proud of having worked to engage the whole community. The truth is, if we all pay attention and reach out to someone who may need it, "We all have that opportunity to save a life," she said. "I'm very proud of helping to be part of a movement to listen and be guided by lived experience," she added. Regardless of the issue, "the wisest individuals are the individuals that experience it themselves, their family members and their loved ones," she said. Melding this wisdom with scientific research is what will produce the best results. Stuby is still determining what retirement will hold. She intends to spend more time with family, including her three grandchildren, and connect with old friends. Beyond that, though, she is excited simply to start a new chapter in her identity.