Each quarter we highlight an individual in the field of psychiatry who is a champion for mental health equity—whether through their work in direct care, research, advocacy, or in the community. Our champions will share tangible ways to incorporate a health equity strategy into your practice and take action to increase access to quality of care.

Our Diversity & Health Equity Champion this quarter is Dr. Michele Reid.

Dr. Michele Reid is the Chief Medical Officer for CNS Healthcare, an outpatient mental health provider and Certified Community Behavioral Mental Health Clinic (CCBHC), serving over 7,500 children, adolescents, adults and senior citizens with mental disorders including substance use disorders within the tri-county metropolitan Detroit area.

We sat down with Dr. Reid to learn more about CCBHCs, her work to promote mental health equity, and ways in which American Psychiatric Association members and everyone in the mental health field can be agents of change in promoting mental health equity.

Q: Thank you for joining us Dr. Reid! For individuals who may be unfamiliar, what is the public mental health system and what are Certified Community Behavioral Health Clinics? Why are they important for mental health equity? 

A: Thank you so much for having me here. The public mental health system is designed to work especially in the Medicaid population and individuals who are uninsured or underinsured. We provide a whole host of recovery based and evidence-based practice services, and we're more involved in team-based care and group-based care.

Community Mental Health Centers have been around since the 1960s. Fast forward into 2016, the federal government decided that there were gaps in the public mental health system, so they created the Certified Community Behavioral Health Clinics (CCBHCs). It began with a demonstration grant in 8 states and now there are over 400 CCBHCs across the United States.

CCBHCs, like CNS Healthcare, provide traditional community mental health services. However, they have additional standards and are being held to higher quality standards of care. We must offer suicide services, crisis services, and evidence-based practices.

Prior to becoming a CCBHC, at CNS healthcare, we primarily were a provider of adult mental health services. Becoming a CCBHC allowed us to hire a child and adolescent psychiatrist on staff and we began robustly providing children’s services as well as Medication Assisted Treatment (MAT) for alcohol tobacco and opioid use disorder. So this takes the CCBHC and turns it almost into a Federally Qualified Health Center (FQHC) where we get additional payments for the delivery of a certain set of services. We treat children, adolescents, adults, and older adults with mental health disorders including substance use disorder, and intellectual and developmental disabilities.

Federal law recently changed which will allow a massive expansion of the CCBHC demonstration nationwide. So we are really excited about this! I’m very proud for our clinic to be a member of the National Council of Mental Wellbeing and I’m proud to be a member of the American Psychiatric Association where we have vigorously advocated for the expansion of CCBHCs.

Q: When you joined us for the looking beyond series you discussed some of the barriers that may exist for clinicians who may be interested in working in this field. What would you tell medical students, residents, and early careers psychiatrists who have yet to consider this path?

A: One of the greatest benefits to this work for me is giving back to the community and for me, I feel like community mental health is in my blood. Both of my parents were on boards of community mental health centers, so I heard about community mental health from a very young age.

The two biggest things that impacted me and got me interested when I was a resident were:

1. I was an American Psychiatric Association NIMH fellow so I got an opportunity to come to board meetings and get mentored with the APA. Right now, the Foundation has many pipelines and other programs that reach down to medical students and others.
2. When I was a psychiatric resident, I was on the board of trustees of a community mental health center. We have students now that rotate with us. Getting to do your psychiatric rotation at a CCBHC allows you to see the delivery of services, and I cannot tell you how many people came to our clinic with the intent of being a surgeon or an internist and after rotating in a CCBHC and seeing the team-based care, changed their area of specialty.

So it’s mostly just getting that exposure, so whether it’s volunteering on a board of directors or working with the APA and participating in their medical student summer education programs, or those who are residents to apply for a number of available fellowships.

There are opportunities now that just weren’t there when I came along to get involved with the APA earlier. There’s so many resources out there now on our website, and also the APAF for potential medical students, the general public, schools, and faith-based organizations.

Q: We know you have a lot of experience working with community organizations educating on mental health and reducing stigma. Are there ways for psychiatrists to more broadly to get involved in the community?

A: I think that is a wonderful thing. Being a CCBHC forced us at CNS Healthcare to stretch ourselves in that area because we have to work with law enforcement, faith-based organizations and we have to do community outreach. Yesterday, I was out in the community and I actually got 16,000 steps. We were doing our first annual vax bash where were offering all sorts of vaccines, and a great time was had by all. During the pandemic, as a CCBHC, we made contacts with many community-based organizations.

Also, I’ve been in community mental health for many years and there was no such thing as Facebook, Twitter, Instagram or TikTok when I started in the field. Now through these various federal grants and CCBHC, we are able to leverage all of these mediums to get in touch with a public that we never ever previously reached.

Finally, there are always opportunities around the country, whether you’re someone interested in psychiatry or a medical student, there are NAMI chapters everywhere. Getting involved with your local NAMI chapter is an excellent way to learn more about mental health. There are also a number of free trainings out there in particular working a lot with mental health first aid has been an easy way to get into mental health and to understand better about how to get care for services for people.

Q: What I love that we’ve been learning so far is that at your CCBHC you’re not just having the community come to you, you are really going out into the community and building these relationships and partnerships. Now thinking more broadly on the advocacy and policy level, knowing you are also active in this space, for members who are newer to this space, what can they do on that front to promote mental health equity?

A: The best thing to do is to affiliate with your local district branch of the American Psychiatric Association. The local district branches are working on numerous issues of great importance in the local community and are always looking for volunteers to get active. One of our major accomplishments was making a change in the MI mental health code that required every community mental health clinic to have a medical director.

Our biggest ongoing issue that we continue to work with, is the work that the American Psychiatric Association did to pass the federal parity bill that says that insurances are not able to treat your heart attack any different than we treat your major depressive disorder. There’s still much work to do in the various states to make sure that parity is fully implemented. There’d been a number of studies from the Kaiser foundation and others that have really shown that the federal parity law has not been fully implemented in many states.

Another thing I’ve been very excited about is the 9-8-8 suicide and crisis line so that’s an exciting thing. That system gets trained mental health professionals out there via one, nationwide number to call when you need help. Like 9-1-1, we have if you have a physical health emergency, we now have the 9-8-8. So we are very excited about the APA’s advocacy for that, and the increased funding that’s coming for that to fund more crisis centers and services, and CCBHCs. This is an example of something that was legislative that any psychiatrist can get behind both on their local state level and national level.

In MI, at any given time, we are proudly following 20 different bills in the legislature that impact the provision of psychiatric services. Most recently, people were testifying about telehealth. We’re very concerned both at the APA and locally that some of the rules would be rolled back that would not allow us to have expanded access to telehealth services, including telephone services for individuals who may not have access to a smartphone. Those are examples of local things that have national implications that the average resident, medical, student, or psychiatric fellow or psychiatrist could be involved in at the local level.

APA District Branches usually have legislative committees - we are always looking for volunteers for committees. That’s a good place to plug in and get active legislatively and be educated about what’s going on with the Medicaid budget, the public health budget and other things that impact the practice of medicine.

Q: We want to thank you so much for being here, for speaking to us about your work and how more psychiatrists can get involved to promote mental health equity. Is there anything else you want to share? 

A: What gives me the most hope during this pandemic are the various community organizations that came to our aid. From our funding sources who were able to give us extra funding for recruitment and retention of staff, to Ford Motor Company manufactured face shields for our nurses and doctors to use in the clinic and local organizations. Alpha Kappa Alpha sorority gave us money to buy cellphones for the people served, because they didn’t have a phone that would allow them to do telehealth. Also the United Way of Oakland county stepped up and bridged the gap, and gave us money where we were able to buy almost 2000 phones, tablets, laptops, and also even data minute plans so we could constantly keep in touch with individuals. That’s worked especially well with people who are homeless. The community has really supported us during the pandemic and that was the brightest spot for me during the past couple of years. The way we’ve been accepted in the community and organizations far and wide have come to our aid and assisted us in working with the people we serve here in southeast Michigan.

More on Dr. Michele Reid

In addition to being the Chief Medical Office for CNS Healthcare, a Certified Community Behavioral Health Center, Dr. Michele Reid is a Clinical Assistant Professor in the Wayne State University Department of Psychiatry and Behavioral Neurosciences, the Chairperson of the American College of Psychiatrists, Dean Award Committee and the Area IV Representative to the American Psychiatric Association Assembly for the Michigan Psychiatric Association. Previously, Dr. Reid has served as the Chair of the Committee of Black Psychiatrists, a member of the Council on Minority Mental Health and Health Disparities, and as a representative of the American Psychiatric Association Board of Trustees.

A native Detroiter, Dr. Reid attended Detroit Public Schools (DPS) and received her BA from Fisk University and MD from Meharry Medical College, both Historically Black Colleges and Universities (HBCUs) in Nashville, Tennessee. She completed her internship and psychiatric residency at Wayne State University, Department of Psychiatry and Behavioral Neurosciences at the Detroit Psychiatric Institute and the Detroit Medical Center. She is Board certified in psychiatry and neurology by the American Board of Psychiatry and Neurology.